Despite collaboration among different professions being recognized as fundamentally important to contemporary and future healthcare practice, the concept is woefully undertheorized. This has implications for how health professions educators might best introduce students to interprofessional collaboration and support their transition into interprofessional, collaborative workplaces. To address this, we engage in a conceptual analysis of published collaborative, interprofessional practices and conceptual understandings in theatre, as a highly collaborative art form and industry, to advance thinking in the health professions, specifically to inform interprofessional education. Our analysis advances a conceptualization of collaboration that takes place within a work culture of creativity and community, that includes four modes of collaboration, or the ways theatre practitioners collaborate, by: (1) paying attention to and traversing roles and hierarchies; (2) engaging in reciprocal listening and challenging of others; (3) developing trust and communication, and; (4) navigating uncertainty, risk and failure. We conclude by inviting those working in the health professions to consider what might be gleaned from our conceptualization, where the embodied and human-centred aspects of working together are attended to alongside structural and organizational aspects.

This study examined the relationship between motivation, performance accomplishment, and persistence as a mediator among medical students. Quantitative and qualitative data were collected through a two-stage sequential design to investigate the hypothesised model. A sample of 645 medical undergraduates participated in the quantitative stage, responding to an electronically structured questionnaire. Confirmatory factor analysis and structural equation modelling were utilised to analyse the data and assess the fit of the conceptual model. In the qualitative stage, semi-structured interviews were conducted with a purposeful sample of twelve medical students, and thematic analysis was employed to explore the qualitative findings. The results indicated a well-fitting model, with significant positive relationships observed among motivation, persistence, and performance accomplishment. Notably, including persistence as a mediator reinforced the relationship between motivation and performance achievement. The qualitative data supported and further emphasised the importance of persistence in the medical student population. The findings have practical implications for medical students, educators, and universities, highlighting the significance of promoting and enhancing learners' persistence. Suggestions for future research include developing additional statistical models, conducting experimental studies, and undertaking longitudinal investigations. By expanding the understanding of the relationships between motivation, persistence, and performance accomplishment, future studies can contribute to developing effective interventions and strategies to support medical students in their educational journey.

As trainees resist social harm and injustice in medicine, they must navigate the tension between pushing too hard and risking their reputation, or not enough and risking no change at all. We explore the discernment process by examining what trainees attend to moments before and while they are resisting to understand how they manage this tension. We interviewed 18 medical trainees who shared stories of resisting social harm and injustice in their training environments. Interviews were analyzed using open and focused coding using Vinthagen and Johansson's work, which conceptualizes resistance as a dynamic process that includes an individual's subjectivity within a larger system, the context in which they find themselves, and the interactions they have with others. We framed these acts as an individuals' attempt to undermine power, while also being entangled with that power and needing it for their efforts. When deciding on how and whether to resist, trainees underwent a cost-benefit analysis weighing the potential risk against their chances at change. They considered how their acts may influence their relationship with others, whether resisting would damage personal and programmatic reputations, and the embodied and social cues of other stakeholders involved. Trainees undergo a dynamic assessment process in which they analyze large amounts of information to keep themselves safe from potential retaliation. It is by attending to these various factors in their environment that trainees are able to keep their acts professional, and continue to do this challenging work in medical education.

Studying texts constitutes a significant part of student learning in health professions education. Key to learning from text is the ability to effectively monitor one's own cognitive performance and take appropriate regulatory steps for improvement. Inferential cues generated during a learning experience typically guide this monitoring process. It has been shown that interventions to assist learners in using comprehension cues improve their monitoring accuracy. One such intervention is having learners to complete a diagram. Little is known, however, about how learners use cues to shape their monitoring judgments. In addition, previous research has not examined the difference in cue use between categories of learners, such as good and poor monitors. This study explored the types and patterns of cues used by participants after being subjected to a diagram completion task prior to their prediction of performance (PoP). Participants' thought processes were studied by means of a think-aloud method during diagram completion and the subsequent PoP. Results suggest that relying on comprehension-specific cues may lead to a better PoP. Poor monitors relied on multiple cue types and failed to use available cues appropriately. They gave more incorrect responses and made commission errors in the diagram, which likely led to their overconfidence. Good monitors, on the other hand, utilized cues that are predictive of learning from the diagram completion task and seemed to have relied on comprehension cues for their PoP. However, they tended to be cautious in their judgement, which probably made them underestimate themselves. These observations contribute to the current understanding of the use and effectiveness of diagram completion as a cue-prompt intervention and provide direction for future research in enhancing monitoring accuracy.

Given the high prevalence of multiple-choice examinations with formula scoring in medical training, several studies have tried to identify other factors in addition to the degree of knowledge of students which influence their response patterns. This study aims to measure the effect of students' attitude towards risk and ambiguity on their number of correct, wrong, and blank answers. In October 2018, 233 3rd year medical students from the Faculty of Medicine of the University of Porto, in Porto, Portugal, completed a questionnaire which assessed the student's attitudes towards risk and ambiguity, and aversion to ambiguity in medicine. Simple and multiple regression models and the respective regression coefficients were used to measure the association between the students' attitudes, and their answers in two examinations that they had taken in June 2018. Having an intermediate level of ambiguity aversion in medicine (as opposed to a very high or low level) was associated with a significant increase in the number of correct answers and decrease in the number of blank answers in the first examination. In the second examination, high levels of ambiguity aversion in medicine were associated with a decrease in the number of wrong answers. Attitude towards risk, tolerance for ambiguity, and gender did not show significant association with the number of correct, wrong, and blank answers for either examination. Students' ambiguity aversion in medicine is correlated with their performance in multiple-choice examinations with negative marking. Therefore, it is suggested the planning and implementation of counselling sessions with medical students regarding the possible impact of ambiguity aversion on their performance in multiple-choice questions with negative marking.

Even though past research suggests that visual learning may benefit from conceptual knowledge, current interventions for medical image evaluation often focus on procedural knowledge, mainly by teaching classification algorithms. We compared the efficacy of pure procedural knowledge (three-point checklist for evaluating skin lesions) versus combined procedural plus conceptual knowledge (histological explanations for each of the three points). All students then trained their classification skills with a visual learning resource that included images of two types of pigmented skin lesions: benign nevi and malignant melanomas. Both treatments produced significant and long-lasting effects on diagnostic accuracy in transfer tasks. However, only students in the combined procedural plus conceptual knowledge condition significantly improved their diagnostic performance in classifying lesions they had seen before in the pre- and post-tests. Findings suggest that the provision of additional conceptual knowledge supported error correction mechanisms.

Research has demonstrated erosion of empathy in students during medical education. Particularly, U.S. studies have demonstrated empathy declines during clinical training in the third and fourth year of traditional medical programs. Yet, studies conducted outside the U.S. have not confirmed this trend. Timing and extent of patient interactions have been identified as empathy-protective factors. The need to examine empathy within different learning contexts has been noted, as has the need for longitudinal and time-series research designs to analyze trajectories. Between fall 2010 and spring 2019, we assessed empathy longitudinally among six student cohorts (N = 493) at a U.S. medical school, where patient interaction occurs early and throughout an integrated curriculum. Empathy levels of students in each cohort were assessed at five time points utilizing the Jefferson Scale of Physician Empathy-Student version. We hypothesized empathy levels will not degrade by program end, and trajectories will not show patterns of decline in Years Three and Four. Analysis of Variance (ANOVA) and Linear Mixed Model (LMM) analyses were used to analyze differences at baseline and changes in empathy trajectories. ANOVA analyses revealed statistically significant differences at baseline by class cohort (F(5, 487) = [23.28], p < 0.001). LMM analyses indicated empathy was either significantly higher or not different at the end of the program (F(19, 1676) = [13.97], p < 0.001). Empathy trajectories varied among cohorts; yet, none resulted in an overall empathy decline by the end of the program. Findings demonstrate empathy in U.S. medical students can be unchanged or higher by the end of medical education. Outcomes are consistent with reports of non-declining medical student empathy outside the U.S. and support the notion of context-specificity. Results further support recent research, suggesting decreases in empathy during training can stabilize or increase by program end. These findings have important implications for future empathy research context and design considerations, as well as program planning.

Recently, a new digital clinical reasoning test (DCRT) was developed to evaluate students’ clinical-reasoning skills. Although an assessment tool may be soundly constructed, it may still prove inadequate in practice by failing to function as intended. Therefore, more insight is needed into the effects of the DCRT in practice. Individual semi-structured interviews and template analysis were used to collect and process qualitative data. The template, based on the interview guide, contained six themes: (1) DCRT itself, (2) test debriefing, (3) reflection, (4) practice/workplace, (5) DCRT versus practice and (6) ‘other’. Thirteen students were interviewed. The DCRT encourages students to engage more in formal education, self-study and workplace learning during their clerkships, particularly for those who received insufficient results. Although the faculty emphasizes the different purposes of the DCRT (assessment of/as/for learning), most students perceive the DCRT as an assessment of learning. This affects their motivation and the role they assign to it in their learning process. Although students appreciate the debriefing and reflection report for improvement, they struggle to fill the identified knowledge gaps due to the timing of receiving their results. Some students are supported by the DCRT in exhibiting lifelong learning behavior. This study has identified several ways in which the DCRT influences students’ learning practices in a way that can benefit their clinical-reasoning skills. Additionally, it stresses the importance of ensuring the alignment of theoretical principles with real-world practice, both in the development and utilization of assessment tools and their content. Further research is needed to investigate the long-term impact of the DCRT on young physicians’ working practice.