Clinical Learning Environment Research Articles

Obstetrics clinical learning needs: Priorities of undergraduate medical students

Background. The obstetrics clinical learning environment is complex and often not conducive to learning. Understanding the priority clinical learning needs of students with experience in this setting is essential for designing effective educational interventions to optimise clinical learning. Objective. To describe the priority obstetrics-related clinical learning needs of undergraduate medical students informed by their experience of the clinical learning environment. Methods. A multigroup nominal group technique (NGT) was applied to a purposively sampled group of medical students who had experienced obstetrics-related clinical placements in facilities at various levels of care, from primary to tertiary. Individual group priorities were further integrated into themes. Results. Seven priorities emerged: (i) perinatal procedural skills, (ii) teaching approaches to obstetrics, (iii) pregnancy-related screening and complications, (iv) postnatal support for women, (v) interprofessional and gender roles, (vi) orientation to patient care and the clinical environment, and (vii) psychological preparation of students. Conclusion. Educational interventions to optimise the obstetrics clinical learning environment must consider students’ priorities. These priorities extend beyond procedural skills and include collaborative practice and psychological preparation.

Advancing interprofessional workplace learning: Successful implementation of the ‘WILD Series©’ hybrid professional development model

BackgroundThe 2021 NCICLE Pathways to Excellence framework highlights the need for professional development opportunities promoting interprofessional learning to optimize healthcare provider and learner teaming in the clinical learning environment. Despite this priority, research shows some clinicians are not developing their collaborative practice skills. PurposeThis article describes the hybrid Workplace Interprofessional Learning and Development (WILD) Series, which was developed to promote interprofessional preceptor development through workplace learning. MethodThe WILD Series© includes four unique six-week offerings, each dedicated to one Interprofessional Education Collaborative (IPEC) competency area. Each six-week session includes five weeks of one topical, actionable independent email engagement and concludes with a structured, facilitated synchronous debriefing session. DiscussionThe WILD Series© is the first IPE program designed for independently practicing clinicians and preceptors that includes synchronous and asynchronous components. Initial feedback was positive regarding the series format, content, and outcomes. ConclusionThe WILD Series© demonstrates that workplace learning can be an effective strategy for addressing gaps in interprofessional preceptor development.

Perceptions of Makerere University Undergraduate Radiography Students on Clinical Rotations in Mulago National Referral Hospital

Introduction: Clinical rotations are an integral component of the radiography programs worldwide as it is a practice-based profession and the effectiveness of clinical training is responsible for the competency level demonstrated by radiography students after qualification. Clinical rotations provide opportunities for radiography students to apply theory into practice. The effectiveness of the rotations is greatly affected by the setting of the clinical area. Makerere university undergraduate radiography students experience various circumstances that facilitate or inhibit their clinical learning process in Mulago National Referral Hospital (MNRH). Aim: The study aimed at exploring the perceptions of Makerere University undergraduate radiography students on clinical rotations in Mulago National Referral Hospital. Methodology: A cross-sectional exploratory, qualitative study was done. 19 third- and fourth-year Makerere University undergraduate students offering Bachelor of medical radiography were sampled purposively. Data was collected using semi-structured face to face interviews and analysed thematically. Results: Three major themes emerged from the data: (1) learning experience, (2) effectiveness of clinical rotations in MNRH and (3) challenges faced. Most factors related to the themes above positively impacted the students’ perceptions on clinical rotations in MNRH radiology department with more positives and the rotations meeting expectations of the majority, though with some challenges like limited clinical supervision by university lecturers and inadequate time for practicing some modalities. Conclusion: Clinical rotations can be effective and beneficial when a supportive learning environment is provided. This study reveals mixed student perceptions regarding clinical rotations in radiology department of MNRH, with predominant positive perceptions. Addressing identified challenges can significantly improve the clinical learning environment and thus the effectiveness of clinical rotations.Top of FormBottom of Form

Innovations report: A grading committee for a required fourth-year emergency medicine clerkship.

Assessment of medical students in the clinical learning environment is fraught with challenges. Seemingly small variations in clinical clerkship evaluation can significantly impact a student's future. As such, the integrity of the grade selection process must be heavily scrutinized. Group decision making in the form of a clerkship grading committee may be part of a solution to address this complex problem. We conducted a retrospective observational study to describe grading committee decisions for a required fourth-year EM clerkship from August 2021 to April 2022. Literature on best practices for group decision making and assessment were reviewed. This informed the development and implementation of the committee process. Each committee meeting was video recorded and coded for discussion time per student, times the committee grade differed from historical-grade cutoffs with reasoning, and the frequency a committee member voiced a first-hand account of student performance. Data from nine meetings was reviewed (86 students). The mean discussion time per student was 2 min 13 s (range 11 s to 9 min 22 s). The final committee decision differed from historical-grade cutoffs for nine students (10%), six were adjusted above and three below. In 64% (55/86) of student reviews a committee member voiced a first-hand experience of working with the student. Positive grade adjustments were made due to outlier evaluations and negative adjustments were made for professionalism concerns. Grading committees are a means to conduct a comprehensive review of student performance and offer shared ownership of the grade decision among committee members. More study is needed to directly determine their potential benefit and role in clerkship grading.

Fostering the clinician as teacher: A realist review.

Clinician-teachers, physicians with educational responsibilities in either classroom or clinical setting, are assumed to add value by virtue of their dual role. The clinical responsibilities are often prioritised over the educational tasks. How and under which circumstances clinician-teachers are able to perform their educational role and create added value for different stakeholders is currently unclear. To identify for whom, how and under which circumstances educational activities executed by CTs by virtue of their dual role add value to others. CTs activities linking the system of education and clinical practice beyond direct patient interactions and purposefully executed. A realist review was conducted. Databases were searched in two stages: a narrow conventional search, followed by a comprehensive artificial intelligence-aided search. Studies concerning clinician-teachers' dual role were included. Realist analysis was applied to identify in which contexts resource mechanisms triggered reasoning mechanisms, which led to specific outcomes for different stakeholders. Sixty-six studies were included. In contexts where clinician-teachers' dual role was formally recognised and valued, clinician-teachers benefitted from the credibility and legitimacy bestowed on them, making the transfer of domain-specific knowledge more impactful. In contexts where sociocultural differences between both systems existed, CTs were able to mediate and adjust recommendations aligned with stakeholders' perceived relevance. Also, contexts organised to support both roles made resource mechanisms more impactful. Clinician-teachers added value to students' clinical competency and learning environment, and to educational organisations' curricular innovation. In their clinical workspace, clinician-teachers added value by enhancing colleague physicians' teaching expertise, implementing educational innovations and recruiting students for scarce specialisms. Clinician-teachers add value to students, colleague physicians and the clinical and educational contexts at large. Domain-specific knowledge of both systems was important to gain credibility and achieve added value. Openness, formal recognition and allocated time for both roles in educational and clinical contexts towards the dual role are important to strengthen the impact of the dual role.

Framework for managing inappropriate behavior in clinical dental learning environments.

Workplace violence (WPV), such as physical violence, harassment, intimidation, or other threatening behavior, commonly occurs within healthcare settings including dentistry. The objective of this study was to analyze the behavioral and environmental factors contributing to WPV, determine its prevalence within one dental institution, and develop a WPV prevention and management protocol that is dental specific. To identify factors that impact WPV occurrence, the PRECEDE-PROCEED planning model was employed. A pilot cross-sectional survey was then conducted among faculty, staff, and dental learners (students/residents) to evaluate the prevalence of WPV incidents experienced and witnessed over the past year. The survey also assessed the locations where incidents took place, their type, and the strategies employed to manage them. A comprehensive protocol aimed at preventing and managing WPV in dental settings was subsequently developed. Multiple factors influence the occurrence of WPV. The prevalence of experienced and witnessed WPV incidents was 22% and 24% among faculty/staff and 7% and 5% among learners, respectively. Verbal aggression was the most common type of WPV. Most respondents lacked awareness of the available reporting mechanisms for WPV. A WPV prevention and management protocol was developed, consisting of five steps: intervene, report, document, access support services, and resolve (IRDAR). Administrators must have a comprehensive understanding of the prevalence of violence in their workplace and the underlying factors that contribute to it in order to take appropriate action. IRDAR is a clearly defined and easily implemented protocol designed for preventing and managing WPV in dental learning environments.

Psychometric properties of the Arabic version of PHEEM applied on a sample of medical residents in Syria

BackgroundThe clinical learning environment (CLE) plays a crucial role in shaping the learning experiences and professional development of medical professionals. Understanding and optimising this environment is essential for improving doctors’ knowledge acquisition, clinical skills, and overall well-being. The development of the Postgraduate Hospital Educational Environment Measure (PHEEM) and its translation to numerous languages has been a milestone in clinical education. Even though PHEEM was recently translated into Arabic, its psychometric properties in this form remain unevaluated. Therefore, this study aims to conduct a comprehensive psychometric analysis of the Arabic version of the PHEEM questionnaire.MethodsThis is a cross-sectional questionnaire survey validation study. The defined population were medical residents in Damascus, Syria. A paper-based survey as well as an online-based one were conducted using several non-probability sampling methods namely, convenience, river and, snowball sampling between June 15, 2023, and June 21, 2023. Both exploratory (EFA) and confirmatory (CFA) factor analyses were conducted. Several psychometric criteria were applied including scree plot, eigenvalue > 1.5 and the ‘proportion of variance accounted for’ criterion.ResultsA total of 543 participants completed the questionnaire (56.9% female). Kaiser-Meyer-Olkin measure for sample adequacy was high (0.937) and the P-value for Bartlett’s test was < 0.001. EFA revealed five meaningful factors which were labelled: perception of teachers, learner’s engagement and social participation, external regulation, work culture, and living conditions. These factors had the following eigenvalues: 12.6, 2.18, 2.03, 1.86, and 1.41 respectively, with a total explained variance of 43.45%. Cronbach’s Alpha was 0.938. CFA confirmed the model structure of EFA (SRMR = 0.067 and RMSEA = 0.066). The Average Variance Explained (AVE) value of any given factor was > 0.7.DiscussionThe Arabic PHEEM inventory demonstrated satisfactory psychometric properties. The extracted domains are of theoretical relevance to the psychosocial-material conceptual framework for learning environment. Nonetheless, this validation was performed in the Syrian context; therefore, future studies in other Arabic countries are recommended to support the applicability of Arabic PHEEM in the wide Arab World.

Linking nursing students' professional identity, clinical learning environment, financial incentives, and career opportunities with migration intent: Structural equation modeling.

To investigate how nursing students' professional identity, clinical learning environment, financial incentives, and career opportunities influence their intention to migrate. There is a preponderance of studies about nurse migration and its impact on the global nursing workforce. However, a critical gap remains about nursing students' intentions to migrate, particularly among developing countries like the Philippines. Using a cross-sectional design, third- and fourth-year nursing students (n=316) from the largest comprehensive university in Manila were conveniently recruited. Data were collected from November to December 2023 using five validated self-report scales. Descriptive (e.g., mean, standard deviation) and inferential statistics (e.g., Spearman rho, covariance-based structural equation modeling) were used to analyze data. The emerging model demonstrated acceptable model fit indices. Nursing students' professional identity (β=0.18, p=0.043) and financial incentives (β=0.10, p=0.046) significantly and positively influence the intention to migrate. The satisfaction with future career opportunities (β=-0.12, p=0.038) and clinical learning environment perception (β=-0.15, p=0.048) negatively influence the intention to migrate. These four predictors accounted for 4.60% of the total variance of intention to migrate. Nursing students' professional identity and financial incentives directly impact intent to migrate, whereas future career opportunities satisfaction and clinical learning environment inversely affect intent to migrate. This study underscores the imperative for nursing colleges and faculty to promote positive professional identity and provide a conducive clinical learning environment to develop sustainable nurses' migration policies.

Nurses, midwives and students' reports of effective dedicated education units in five European countries: A qualitative study.

To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment. A multi-country, phenomenological, qualitative study. Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives. Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment. A close educational-service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment. It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population. Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes. Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement.

“This should be a compulsory placement for all nursing students”: An evaluation of pre-registration nursing students’ perceptions of learning on a mental health clinical placement

AimTo conduct a longitudinal exploration of pre-registration nursing students’ perceptions of their learning on an immersive mental health clinical placement grounded in learning from people with a lived experience of mental illness (otherwise known as consumers). BackgroundEnriching mental health clinical learning environments are crucial for positive mental health nursing outcomes. Though non-traditional clinical placement (i.e. non-hospital-based) models effectively increase student learning in a range of domains, little is known about the specific features of contemporary non-traditional placement settings that may be supporting student learning over time. DesignA survey design in the form of a standardised evaluation tool with additional qualitative response questions was used to examine nursing students’ perceptions of learning whilst on a non-traditional clinical placement over a 5-year period. Non-traditional placement settings are alternative placement options to traditional inpatient/community mental health settings. The TREND Statement Checklist was adhered to. MethodsSecond- and third-year students studying a Bachelor of Nursing (N = 753) from eight Australian Universities completed a Student Placement Feedback Survey between 2019 and 2023. Data were collected via an evaluation survey including 7-items (rated on a 5-point agreement scale) and three free-response questions. Quantitative and qualitative responses were analysed over all observations and compared between the five years of student evaluations. ResultsAcross five years, the immersive mental health placement was consistently rated by students as a highly valuable learning experience. Utilizing a Multivariate Analysis-of-variance (MANOVA) for the quantitative component revealed that student ‘learning from lived experience’ remained uniformly high and steady throughout 2020–2023. This was despite disrupted learning that ceased face-to-face tuition caused by the COVID-19 pandemic. An increase in ‘student enthusiasm for nursing’ was identified after the return to face-to-face learning. Qualitative analysis identified a greater need for preparedness prior to attending the placement and wellbeing support amongst students. ConclusionsOver the five years, pre-registration nursing students report clinical skill improvement and enhanced knowledge following the immersive mental health placement alongside an increased desire for further skill development. Learning from people’s lived experience of mental illness and specialised facilitators was valuable for student learning outcomes. Increased support is needed for student mental health vulnerabilities and wellbeing ahead of clinical placements. Further research is recommended on the aspects of non-traditional clinical placements that may be protective for student learning.

Impact of Clinical Learning Environment and Incivility on Professional Self-Concept in Dental Hygiene Students

Impact of Clinical Learning Environment and Incivility on Professional Self-Concept in Dental Hygiene Students

Clinical learning experiences of healthcare professional students in a student-led clinical learning environment (SLCLE) – A mixed methods evaluation

AimTo evaluate healthcare professional (HCP) students clinical learning experiences’ whilst undertaking placements in a student-led clinical learning environment (SLCLE) and any changes in self-reported ratings of confidence. BackgroundThe English NHS Long Term Workforce Plan (2023) highlights the need to expand domestic education of HCPs to meet workforce shortages. The demand for quality clinical placements to support the preparation of HCP students remains a challenge globally. A creative solution has been the development of student-led learning clinical environments in healthcare settings. SLCLEs provide high-quality learning experience, increase clinical placement capacity whilst maintaining patient care standards. A multisite NHS Trust adopted this model as evidence suggests HCP students will be better prepared on qualification to adopt registered practitioner professional responsibilities. This model has been integrated across three hospital sites within a large teaching hospital, providing care for a diverse population and designed to accommodate students from a range of HCP disciplines and higher educational institutions. DesignA mixed methods convergent design. MethodsAn online survey was administered to SLCLE allocated nursing and allied health profession (AHP) undergraduate and graduate-entry first, second and third-year students (n=132). Face to face focus groups/individual interviews were undertaken with a purposive sample of student participants (n=80) to evaluate their experiences of clinical learning in SLCLEs. Survey data were analysed using descriptive statistics and paired t-tests, interviews using framework method. ResultsUndergraduate and graduate-entry students from four UK universities completed the survey (n=132), 103 students (78 %) responded. Most were year 2 students (n=43/42 %), pursuing nursing programmes (n=82/80 %). Most considered the SLCLE met their expectations (n=76/74 %), reported increased confidence post-placement (n=84/82 %), felt supported by staff (n=80/78 %), peers (n=93/90 %) and clinical educators (n=93/90 %). Self-reported confidence scores post-SLCLE were significantly higher than pre-SLCLE. On-line pre-placement information was infrequently accessed yet identified as an omission. Four themes were identified: (i) preconceptions and initial anxiety; (ii) empowerment, growth and a unique learning experience; (iii) collaborative inter-professional learning and support; and (iv) insights and anticipations. ConclusionsThe SLCLE allocation enhanced students’ confidence and knowledge. Support from clinical educators, ward staff and doctors was perceived as invaluable for creating a positive learning culture. Peer support and opportunities to lead care delivery contributed to students’ professional development. The format and method for providing pre-placement information needs review as do strategies for avoiding delays in completing assessment documentation. Overall, the SLCLE experience offers much potential as a nurturing and effective learning environment for HCP students.

Clinical learning evaluation among undergraduate physical therapy students during rotations in teaching hospitals of Sialkot and Lahore.

To evaluate the clinical learning environment among undergraduate physical therapy students. The descriptive, cross-sectional study was conducted from Januar y 23 to May 25, 2023, after approval from the ethics revie w committe e of Imran Id rees Ins titute of Rehabilitation Sciences, Sial kot, Pak istan, an d comprised undergraduate physical therapy students of either gender aged 19-26 years in their 3rd to 5th academic year studying in different institutions in Lahore and Sialkot. Data was collected using the clinical learning evaluation questionnaire. Data was analysed using SPSS 22. Of the 295 students, 269(91.2%) were females and 26(8.8%) were males. The overall mean age was 22.03±1.14 years. There were 210(71.2%) stude nts enrol led in the semester system , w hile 85(28.8%) we re part of the an nual system. The overall mean score was 71.05±10.20. Super vision (76.02±11.80) and motivation (80.21±11.71) were the most satisfying part of clinical learning identified by the students. The clinical learning environment demonstrated high satisfac tion levels in supervision and motivation domains, while im provements were nee ded in the areas of cas es, authenticity and organisation of doctor-patient encounters.

Some is not everything? Designing an instrument that measures the clinical learning environment holistically

This article describes the development as well as face and content validation of an instrument for measuring the clinical learning environment of professional healthcare students. A methodological research design was used to develop the instrument and a Delphi technique was used to determine face and content validity. The research was conducted systematically in two phases to construct the instrument, and to establish face and content validity. Phase 1 comprised a general literature overview to identify existing instruments. The retrieved instruments were thematically analysed into the four themes of atmosphere, teamwork, workload and learning opportunities, and then the first version instrument was drafted. In Phase 2, the first version instrument was evaluated for face and content validity. Thirty-six healthcare professional experts responded in the consensus Delphi study, and consensus was reached after three rounds. A consensus Delphi study confirmed the face and content validity of 62 items. The second version of the new instrument was determined. A new holistic clinical learning environment measuring instrument, based on existing instruments, was developed to promote quality student placements.

Do Resident Unions Improve Graduate Medical Education Training? Benefits and Potential Pitfalls.

The last 10 years have seen an increase in union representation for residents and fellows across the United States. It is estimated that 15% of residents and fellows are represented by unions. With increasing numbers of U.S. residents and fellows in graduate medical education (GME) programs being represented by unions, the authors contend that it is worthwhile to consider the benefits and potential drawbacks of resident unions and how GME and health system leaders can best work to ensure that the educational needs of residents continue to be emphasized in an era of resident unionization. Union bargaining can be a method to secure salary increases and other benefits for residents. Unionization can also provide a mechanism for more rapidly addressing worker protection issues and allows residents to advocate on behalf of patients. Residents participating as union leaders may develop important leadership and negotiation skills as well as gain beneficial knowledge about health system structure, financing, and priorities. However, with all the possible benefits that may come with resident unionization, there are also potential pitfalls. The collective bargaining process may create an adversarial relationship between program and institution leaders and trainees. Additionally, while residents are considered employees and able to collectively bargain, the National Labor Relations Board has also acknowledged that residents are "students learning their chosen medical craft." Program and institution leaders have an obligation to prioritize resident education and adhere to accreditation requirements even when these requirements conflict with union demands. Furthermore, because of the obligation to protect the public, program leaders should maintain control of resident academic due process issues. Program and institutional leaders must continue to prioritize resident education. Furthermore, GME leaders have a joint responsibility to create clinical learning environments that are conducive to quality patient care and promote resident learning and well-being.

The second victim phenomenon: A qualitative study among bachelor’s degree nursing students within the clinical learning environment

AimThis study explores and describes the second victim phenomenon in nursing students in association with the characteristics of the clinical learning environment and the clinical supervision process. DesignQualitative design using conventional content analysis and summative content analysis approaches. MethodsFrom September 2022 to July 2023, in-depth semi-structured individual interviews were conducted with a purposive sample of 10 undergraduate nursing students. ResultsSix main themes were developed: ‘defining the physical and psychological responses after the most significant patient safety incident’, ‘analyzing the characteristics of patient safety incidents’, ‘creating a safe learning environment to provide the best care for patients’, ‘developing mentorship capabilities and qualities for an ideal follow up of students as a second victim’, ‘providing resources and integrating support structures to second victim nursing students during their clinical learning’, and ‘considering the cooperation and coordination between the health institution and the higher education institutions.’ ConclusionNursing students become second victims during their clinical placement. The clinical learning environment and mentoring characteristics influence the second victim experience.

The role of competency based medical education in addressing health inequities and cultivating inclusive learning environments

Pediatric health inequities are pervasive and reflect the confluence of social and structural determinants of health including racism in all its forms. Current approaches in graduate medical education that prepare trainees to address health inequities and improve population health are inadequate. Competency based medical education (CBME) can advance equity-oriented efforts to improve patient outcomes, optimize the learning environment and encourage lifelong learning. We briefly describe the impact of racism and discrimination on the clinical learning environment. We then highlight how to apply the 5 core principles of CBME to equip learners across the continuum to address health inequities. We provide specific examples including 1) how CBME can inform teaching, assessment and professional development activities to promote equitable pediatric health outcomes via enturstable professional activities, 2) competency-focused instruction that address racism and inequities, 3) multimodal learning approaches to facilitate the acquisition of the desired competencies to address health inequities, 4) sequenced learning approaches across the continuum of practicing pediatricians, and 5) tools and resources for programmatic assessment of trainee and program performance in addressing pediatric health inequities.

Translation, cultural adaptation and linguistic validation of the postgraduate hospital educational environment measure into Arabic

BackgroundAssessment of the clinical learning environment (CLE) is an essential step that teaching hospitals routinely undertake to ensure the environment is conducive, learning-oriented and supportive of junior doctors’ education. The Postgraduate Hospital Educational Environment Measure (PHEEM) is an internationally recognized tool for assessing the CLE with evidence of high reliability and validity. Translation of PHEEM into other languages such as Spanish, Japanese and Persian enabled wider adoption of the instrument in the world. However, in Syria and other Arabic countries, a validated Arabic translation of PHEEM is still not available, making it difficult to adopt it and use it in Arabic contexts. This study aims to translate and culturally adapt the PHEEM from English into Arabic.MethodsThis study followed the structured translation and validation process guideline proposed by Sousa & Rojjanasrirat 2010. First, the PHEEM went through forward translation by three translators, then reconciled with the aid of a fourth translator. Afterwards, two professional bicultural and bilingual translators conducted back translation into English and compared it with the original version. This formed the Pre-final Version (PFV) which was then pretested for clarity on a sample of medical residents in Damascus, Syria. Following appropriate modifications, the PFV was sent to a panel of experts for a comprehensive review of language clarity and to assess content validity.ResultsA total of thirty-five medical residents were recruited. Ten items with language clarity issues were identified and modified according to the elicited suggestions. Thereafter, the modified PFV was presented to ten subject experts who identified three items in need of revision. The item-content Validity Index (CVI) was over 0.78 for all of the 40 items; the calculated scale-CVI was 0.945.DiscussionThis study provided the first linguistically valid Arabic translation of the widely used PHEEM inventory. The next step is to conduct a full psychometric analysis of the Arabic PHEEM to provide further evidence of validity and reliability.

Recommendations for Faculty Development in Addressing Implicit Bias in Clinical Encounters and Clinical Learning Environments.

Recommendations for Faculty Development in Addressing Implicit Bias in Clinical Encounters and Clinical Learning Environments.

Sociotechnical imaginaries in academic medicine strategic planning: a document analysis

Purpose Along with other industries, healthcare is becoming increasingly digitized. Our study explores how the field of academic medicine is preparing for this digital future. Method Active strategic plans available in English were collected from faculties of medicine in Canada (n = 14), departments in medical schools (n = 17), academic health science centres (n = 23) and associated research institutes (n = 5). In total, 59 strategic plans were subjected to a practice-oriented form of document analysis, informed by the concept of sociotechnical imaginaries. Results On the one hand, digital health is discursively treated as a continuation of the academic medicine vision, with expansions of physician competencies and of research institutes contributions. These imaginaries do not necessarily disrupt the field of academic medicine as currently configured. On the other hand, there is a vision of digital health pursuing a robust sociotechnical future with transformative implications for how care is conducted, what forms of knowledge are prioritized, how patients and patienthood will be understood, and how data work will be distributed. This imaginary may destabilize existing distributions of knowledge and power. Conclusions Looking through the lens of sociotechnical imaginaries, this study illuminates strategic plans as framing desirable futures, directing attention towards specific ways of understanding problems of healthcare, and mobilizing the resources to knit together social and technical systems in ways that bring these visions to fruition. There are bound to be tensions as these sociotechnical imaginaries are translated into material realities. Many of those tensions and their attempted resolutions will have direct implications for the expectations of health professional graduates, the nature of clinical learning environments, and future relationships with patients. Sociology of digital health and science and technology studies can provide useful insights to guide leaders in academic medicine shaping these digital futures.