Narrative medicine as a medical education tool: A systematic review

Aim: Narrative medicine has been promoted as an innovative and effective means of stimulating medical students' professional development by teaching them to approach their patients' experiences of illness with more understanding and compassion. This systematic literature review aims to answer the following question: what evidence of effect is available in the literature about models for teaching narrative medicine? Methods: We conducted a narrative review of 36 articles and used the Best Evidence in Medical Education (BEME) Global Scale and Kirkpatrick Scale for strength and importance of evidence to categorize reported assessment strategies and to evaluate the effectiveness of their narrative medicine programs. Results: We found evidence that narrative medicine is an effective pedagogic tool with a clear and replicable structure and methodology. We also determined that a positive impact could be measured when pertaining to participation and modification of attitudes, knowledge, and skills. However, unequivocal evidence of the effect of narrative medicine on students' behavior or ongoing interaction with colleagues and patients is still lacking. Conclusion: While many recent publications describe the goals and virtues of a narrative-based approach, more research is needed to determine whether or not there is an ideological consensus undergirding this approach. In addition, it is still unclear whether the long-term impact of narrative medicine classroom interventions are felt by patients, or whether such interventions positively impact patient care.

Twelve tips for the introduction of emotional intelligence in medical education

Emotional intelligence (EI) is the ability to recognize, understand, and manage emotions in yourself and in others. EI has long been recognized as a critical component for individual and organizational success within the business realm, and there is emerging evidence that enhancing EI is equally important in the medical setting. EI can improve interpersonal communications, enable constructive conflict resolution, and promote a culture of professionalism. As healthcare becomes increasingly team-based, proficiency in EI will be required to build consensus among multidisciplinary stakeholders, and effect change in attitudes and behaviors that result in improved patient safety and clinical outcomes. Based on the existing literature and the authors' experiences, these 12 tips provide practical suggestions on how to introduce EI into a medical curriculum. These tips have broad applicability, and can be implemented in courses on topics such as professionalism, leadership development, empathy, patient safety, or wellness.

Spirituality in medical education: a concept analysis

Spirituality in medical education is an abstract multifaceted concept, related to the healthcare system. As a significant dimension of health, the importance and promotion of this concept has received considerable attention all over the world. However, it is still an abstract concept and its use in different contexts leads to different perceptions, thereby causing challenges. In this regard, the study aimed to clarify the existing ambiguities of the concept of spirituality in medical education. Walker and Avant (Strategies for theory construction in nursing, Prentice Hall, Boston, 2011) concept analysis eight-step approach was used. After an extensive review of online national and international databases from 2000 to 2015, 180 articles and 3 books in English and Persian were retrieved for the purposes of the study. Analysis revealed that the defining attributes of spirituality in medical education are: teaching with all heart and soul, Life inspiring, ontological multidimensional connectedness, religious-secular spectrum, and socio-cultural intricacies. Moreover, innate wisdom, skillful treatment, transcendent education, and environmental requirements were antecedents to this concept, with the health of body and soul, intrapersonal development and elevation, and responsive treatment and education being its consequences. The defining attributes provided in this study can assist physicians, instructors, and professors to develop and implement evidence-based, health based and comprehensive education plans according to the guidelines of professional ethics and qualification of using spirituality in practice. The clarification of the noted concept facilitates further development of medical knowledge, research, and research instruments.

Clinical reasoning as a threshold skill

Background: Threshold skills are defined as new ways of thinking about and performing in a discipline. They represent transformed ways of thinking and doing that are pivotal to learners' progress. Our aim was to establish whether clinical reasoning exhibited features of a threshold skill. Methods: Twenty-five final-year medical students were interviewed with a five-question protocol about how they were learning clinical reasoning. Students' responses were analyzed using a deductive method to identify features of threshold skills. Results: Students' descriptions of learning clinical reasoning exhibited five features: transformation, troublesomeness, integration, association with practice, and issues with transferability. Conclusions: Viewing clinical reasoning as a threshold skill is a novel interpretation of its nature and has implications for learning, teaching, and research. Students can be reassured that, although initially troublesome, with practice, they will not only learn the skill but also how to use it more effectively. Teachers can help students to understand that clinical reasoning is difficult to learn and will require time and repeated practice under supervision to develop.

A Review of Strategies for Designing, Administering, and Using Student Ratings of Instruction

Objective. To review and recommend strategies for utilizing student ratings of instruction (course and instructor) including considerations regarding design, administration, and use and interpretation of results. Findings. Improving course delivery and pedagogy using student ratings of instruction requires programs to design evaluation instruments that are aligned with the following good, scholarly teaching criteria: offer 10-20 rating scale questions and at least one written response question, ensure that students understand what the questions are asking, use a standardized form for evaluating all faculty members, allow for additional tailored questions to be added to the form, and employ a four- or five-point rating scale with a "not applicable" option. When administering evaluations, programs should limit the number of faculty members evaluated to those teaching greater than or equal to five clock hours of lecture or schedule evaluations based on academic rank; use an online course evaluation tool; randomly select students to participate; offer the evaluation at the end of the term (and/or midpoint for team taught classes); offer the evaluation during scheduled class time; and allow for voluntary, anonymous student participation. Finally, programs should create an assessment plan that outlines the results' release timeline, a list of who will receive result summaries, and how the results will be used. Programs should also encourage faculty reflection, offer mentoring in results interpretation, coach faculty members to summarize and quantify comments and longitudinally track results using tables, and create an accountability action plan to address deficiencies. Summary. In order to better ensure that student ratings of instruction are used to improve teaching, colleges and schools should adopt intentional design, structured administration processes, and transparent reporting of results.

Assessment of the College of Intensive Care Medicine's capacity to train: a survey of trainees and directors

BACKGROUND

In Australia and New Zealand, the numbers of intensive care medicine trainees have increased significantly over the past 15 years. This has implications for supervision, clinical and procedural experience, and availability of rotations. The College of Intensive Care Medicine of Australia and New Zealand (CICM) decided to estimate the current training resources using several domains.

METHODS

An online survey was sent to all CICM trainees (n = 528) and all directors of intensive care units (ICUs) (n = 106), using the SurveyMonkey tool.

RESULTS

The overall response rate for the survey was 44% (trainees, 38%; directors, 72%). Most trainees had a 1:1 day-night roster system. Experience among trainees with common ICU procedures appeared limited. Fifty-six per cent of trainees reported spending more than 20% of their time attending medical emergency team calls. Difficulty accessing anaesthesia, medicine, paediatric and rural terms were reported by 35%, 26% 46% and 40% of trainees, respectively. Thirty-seven percent of trainees reported having to wait at least 1 year and 10% waited up to 2 years over and above their required training time to secure an anaesthesia term. Owing to gaps in experience in certain modules, one-third of final-year trainees felt underprepared to take on a role as a specialist, an observation shared by 15% of directors.

CONCLUSION

This report has provided an assessment of the available resources within Australia and New Zealand for training doctors in intensive care medicine, and has identified significant limitations and concerns among trainees and ICU directors regarding the capacity to train. The findings call for a review of the training program, including a determination of optimal numbers of training positions.

A Consensus Guideline to Support Resident-as-Teacher Programs and Enhance the Culture of Teaching and Learning

BACKGROUND

Methods for assessing residents as teachers are limited, and it can be difficult to discern optimal curricula for training residents as educators. A guideline may be a tool to assess resident-as-teacher programs and to help enhance a culture of teaching and learning.

OBJECTIVE

We developed a consensus guideline to assess academic medical centers' resident-as-teacher programs and teaching environments.

METHODS

Faculty representing 8 specialties from 5 teaching hospitals created a guideline for resident-as-teacher programs through an iterative expert consensus development process. To assess local resident-as-teacher practices, the guideline was administered as an online survey to program directors from 47 residency programs at 5 hospitals. The survey included 26 items addressing curricula, educational climate, financial support, assessment, professional development, and promotion.

RESULTS

Forty-nine percent of residency programs surveyed completed the questionnaire, representing 65% of specialties (17 of 26). Respondents reported that residents were required to participate in a teaching orientation in 78% of programs (18 of 23) and were evaluated on teaching in 91% (21 of 23). There were special educational programs and teaching awards in 91% of programs (21 of 23), respectively. All programs included evaluations of faculty teaching, which were linked to faculty annual reviews in 52% of programs (12 of 23), but to faculty promotion or salary in only 22% of programs (5 of 23).

CONCLUSIONS

We developed a resident-as-teacher consensus guideline that could provide a road map for program directors and institutions to think broadly about how they educate residents and fellows as teachers.

Reflection in medical education: intellectual humility, discovery, and know-how

Reflection has been proclaimed as a means to help physicians deal with medicine's inherent complexity and remedy many of the shortcomings of medical education. Yet, there is little agreement on the nature of reflection nor on how it should be taught and practiced. Emerging neuroscientific concepts suggest that human thought processes are largely nonconscious, in part inaccessible to introspection. Our knowledge of the world is fraught with uncertainty, ignorance and indeterminacy, and influenced by emotion, biases and illusions, including the illusion of not having illusions. Neuroscience also documents that lifelong learning processes may hone nonconscious cognition to high levels of sophistication, allowing rapid and precise perceptions, judgments and actions in complex situations. We argue that knowledge of mechanisms underlying human thought may be useful in designing educational programs to foster desired attributes such as curiosity, critical self-awareness and intuitive acumen in medical professionals. The juxtaposition of neuroscientific insights with ideas from Kant on reflective judgement, van Manen on tact, and Aristotle on phronésis, supports a concept of reflection that manifests as wise practice. We suggest that reflection in medical education should be (a) an imperative for educators seeking to guide learners to manage the complexity and "messiness" of medical practice, and (b) a role-modelling mode of medical practice characterized by self-correcting behaviors that culminate in good and right professional actions. An example illustrates reflective practice in the teaching and learning of physicianship.

The Efficacy of Frontline Near-Peer Teaching in a Modern Medical Curriculum

Within medical education a reduction in curriculum time for subjects, such as anatomy puts pressure on educators to ensure the same learning outcomes are conveyed in less time. This has the potential to impact negatively on student experience. Near-peer teaching (NPT) is often praised as an effective revision tool, but its use as a frontline teaching resource remains unreported. The study explores the potential for NPT to promote delivery of learning outcomes and maximize student experience within a neuroanatomy module for second year medical students. The study occurred in three educational settings, (1) frontline NPT of cranial nerves, (2) revision session NPT of cranial nerves, and (3) NPT alongside faculty staff in laboratory-based neuroanatomy practical exercises. For the first and second components, knowledge was measured using a pre- and post-session test and student perception was ascertained with a questionnaire. For the third component, student perception was assessed with an end-of-module survey. The results show that overall, NPT was well received by learners. A significant knowledge gain was seen between the pre- and post-session test of the frontline NPT session. The study presents evidence in favor of using NPTs to supplement the delivery of learning outcomes in a time and resource constrained curriculum. In particular, for the effective delivery of frontline material. Anat Sci Educ 0: 1-9. © 2018 American Association of Anatomists.

The education avenue of the clinical learning environment: A pragmatic approach

Aim: This perspective is part of a series of articles that are outcomes of a consensus conference, that seek to offer a comprehensive examination of the clinical learning environment (CLE), using different academic disciplines and areas of focus termed "avenues." The education dimensions of the CLE are discussed in detail in this perspective, along with critical linkages to the other avenues. Methods: Using iterative presentations, discussion and small group work, in October 2018, the consensus conference participants explored the education, psychological, sociocultural, diversity and inclusion, digital and architectural aspects of the CLE. Results: The education avenue of the CLE includes elements of teaching and learning such as the curriculum, clinical experiences, the assessment system, educational program governance, trainee selection, faculty development, and program evaluation and improvement. Within the educational domain, we focus on organizational and personal/social aspects of the CLE, including (1) curriculum design and deployment, including placement of trainees in clinical settings, organizational culture, practices and policies, and accreditation and regulatory requirements from the organizational domain (2) the education system, including assessment, program evaluation and organization and governance; and (3) elements from the personal and social domains, including peer-to-peer, trainee-faculty, and trainee-patient relationships that influence how and what postgraduate trainees learn, trainee selection, informal and hidden curricula, and trainees' perceptions of their learning environment. Conclusions: We provide suggestions for further research and recommendations for addressing challenges and facilitating improvement in the educational aspects of the CLE, along with actionable practice points.

Experiences with using e-learning tools in orthopedics in an uncontrolled field study application

BACKGROUND

E-learning is widely used in undergraduate medical education and often in blended learning settings for students learning at home. This study should assess the educative value of e-learning tools in orthopedics and traumatology when used under "field" conditions, in comparison with a controlled laboratory-like setting.

MATERIALS AND METHODS

Medical students were invited for their voluntary online participation in an uncontrolled study (UCS). They were randomly exposed to digital book chapters or podcasts on four different orthopedic diseases, and then filled in pre-/post-tests and evaluations. Test results indicating insufficient study participation were not included in the subsequent analysis. Results in a gain of knowledge and student's satisfaction were compared to existing data of a randomized controlled trial with the same tools in a laboratory environment (RCT).

RESULTS

Among 84 included UCS students and 130 RCT students, podcast learners showed a significantly higher gain of knowledge compared to text learners independent of the learning setting (UCS p<0.011; RCT p<0.001). There were no significant differences in the gain of knowledge for the two different learning tools when comparing each the UCS and RCT settings. Evaluations showed positive ratings for both tools, while podcasts were on the average rated higher than texts were. Significantly more UCS participants (n=46) compared to the RCT (n=34) showed signs of disengagement with the study (p<0.05).

DISCUSSION

The findings suggest that it is possible to achieve a similar gain of knowledge with e-learning tools in uncontrolled settings and in RCTs. The role of e-learning materials in voluntary and formative learning settings is of value and should be explored in future studies.

LEVEL OF EVIDENCE

III, case-control study.

Task planning for sports learning by physical education teachers in the pre-service phase

Planning the learning task is one of the principal actions that a teacher should engage in, and it is important to know how teachers in the pre-service phase plan learning and communication tasks and the feedback that they use in the classroom. The aim of the present study was twofold: i) to characterize the learning tasks designed by the pre-service physical education teachers; and ii) to identify the relationships between the variables that define the learning tasks and the phases into which a session is structured in Physical Education Teacher Education (PETE) in the pre-service phase. The sample comprised 695 learning tasks designed by fourteen pre-service phase teachers. The independent variable was the lesson structure and the dependent variables were the learning means, the game situation, the game phase, the space where the students practice, the use of the ball in the task, and the kind of feedback provided in the learning tasks. The high predominance of exercises, unspecific games, and no opponent situations, coupled with the low percentage of reflexive feedback, indicates that the pre-service teachers give prevalence to technical over tactical learning. In addition, pre-service teachers show preferences for some of the task characteristics for each part of the lesson structure. Teachers in PETE pre-service phase tasks tend to follow a more traditional methodology, despite having received information about the different methods of sports teaching in their initial training. The current findings seems to indicate a resistance to changing a traditional model for other models centered on game comprehension.

Peer instruction improves comprehension and transfer of physiological concepts: a randomized comparison with self-explanation

Comprehension of physiology is essential for development of clinical reasoning. However, medical students often struggle to understand physiological concepts. Interactive learning through Peer instruction (PI) is known to stimulate students' comprehension, but its relative efficacy and working mechanisms remain to be elucidated. In this study, we investigated if and how PI could optimize comprehension of physiological concepts and transfer relative to Self-explanation (SE) which is considered a lower-order type of overt learning. First-year medical students (n = 317) were randomly assigned to either PI or SE in a pre-post test design, followed by a set of near and far transfer questions. In both PI and SE groups post-test scores were significantly improved (p < 0.0001) with PI outperforming SE (+ 35% vs. + 23%, p = 0.006). Interestingly, a substantial number of students with initial incorrect answers even had enhanced scores after discussion with an incorrect peer. Both methods showed higher transfer scores than control (p = 0.006), with a tendency for higher near transfer scores for PI. These findings support PI as a valuable method to enhance comprehension of physiological concepts. Moreover, by comparing the effects of interactive PI with constructive SE we have established new insights that complement educational theories on overt learning activities.

Patient-centred education: How do learners' perceptions change as they experience clinical training?

The use of patient educators is one of many teaching strategies meant to foster principles of patient-centred care. We previously found that early patient educator exposure helped to shape the understanding of patient-centredness in pre-clerkship learners. We now expand on this work to evaluate whether there is persistence of initial perceptions and to explore general reflections on longer-term impacts of early patient educator exposures once learners are immersed in the clinical phase of their training. In this follow-up study, we conducted group interviews with a sample of learners who wrote reflections as part of their pre-clerkship patient educator experience. We explored how perspectives on patient educators changed over time, and determined which themes identified during pre-clerkship remained relevant to clinical trainees. Audio recordings were transcribed and analyzed thematically using a hybrid inductive and deductive analysis to construct a thematic framework derived through a method of constant comparison. We identified three new themes: "value of early clinical experience", "change in learners' perspectives", and "valuing and applying CanMEDS roles other than Medical Expert". Themes from pre-clerkship that remained relevant included: "patients' perspective humanizes disease", "patients' experiences with navigating the healthcare system", "learners' perceptions of the learning strategy", and "inaccuracies and inconsistencies in the learning experience." Many themes identified in pre-clerkship learners remain relevant in early clinical trainees. Further, insights from pre-clerkship experiences with patient educators evolve as learners experience clerkship with definite shifts in emphasis and new perspectives. This work illuminates the utility of patient educators for those considering this strategy for supporting the development of patient-centredness in undergraduate medical education.

Transition to active learning in rural Nepal: an adaptable and scalable curriculum development model

BACKGROUND

Traditional medical education in much of the world has historically relied on passive learning. Although active learning has been in the medical education literature for decades, its incorporation into practice has been inconsistent. We describe and analyze the implementation of a multidisciplinary continuing medical education curriculum in a rural Nepali district hospital, for which a core objective was an organizational shift towards active learning.

METHODS

The intervention occurred in a district hospital in remote Nepal, staffed primarily by mid-level providers. Before the intervention, education sessions included traditional didactics. We conducted a mixed-methods needs assessment to determine the content and educational strategies for a revised curriculum. Our goal was to develop an effective, relevant, and acceptable curriculum, which could facilitate active learning. As part of the intervention, physicians acted as both learners and teachers by creating and delivering lectures. Presenters used lecture templates to prioritize clarity, relevance, and audience engagement, including discussion questions and clinical cases. Two 6-month curricular cycles were completed during the study period. Daily lecture evaluations assessed ease of understanding, relevance, clinical practice change, and participation. Periodic lecture audits recorded learner talk-time, the proportion of lecture time during which learners were talking, as a surrogate for active learning. Feedback from evaluation and audit results was provided to presenters, and pre- and post-curriculum knowledge assessment exams were conducted.

RESULTS

Lecture audits showed a significant increase in learner talk-time, from 14% at baseline to 30% between months 3-6, maintained at 31% through months 6-12. Lecture evaluations demonstrated satisfaction with the curriculum. Pre- and post-curriculum knowledge assessment scores improved from 50 to 64% (difference 13.3% ± 4.5%, p = 0.006). As an outcome for the measure of organizational change, the curriculum was replicated at an additional clinical site.

CONCLUSION

We demonstrate that active learning can be facilitated by implementing a new educational strategy. Lecture audits proved useful for internal program improvement. The components of the intervention which are transferable to other rural settings include the use of learners as teachers, lecture templates, and provision of immediate feedback. This curricular model could be adapted to similar settings in Nepal, and globally.

Teaching History of Pharmacy in U.S. Pharmacy Schools

Objective. To determine how the standards for teaching pharmacy history were met by U.S. pharmacy schools, whether schools wanted to expand their commitment to pharmacy history, what pedagogical assistance, if any, was desired, and whether elective courses were offered. Methods. There were 133 school deans who were asked to identify the responsible faculty for teaching pharmacy history. A 10-question online survey instrument was designed and emailed to these faculty or the dean if no faculty were identified. Follow-up emails were sent at 2-week intervals. If they were non-responsive after three attempts, then telephone solicitation was attempted. Results. There were 100 schools (75%) that responded. Fifty-three percent were public and 47% were private; with 50% having class sizes of 100 or less, 41% with 101-250, and 9% having over 250. Eighty-six percent of respondents meet the ACPE requirement within a required course. Seventy-two percent devote only one to five hours of instruction to meet the requirement. Sixty-eight percent use no supporting literature, and among those who do, there was no common textbook. Interestingly, 21% wanted more teaching time, and 91% desired pedagogical assistance, varying from a packaged course (26%) to a syllabus with assignments and assessment banks (23%). Conclusion. Since no time or material guidelines were established to fulfill the ACPE pharmacy history educational requirements, these results provide a starting point to judge what is adequate and/or preferred. With the development of teaching guidelines and adoptable teaching materials, the pedagogical solution to this ACPE standard may become more complete and consistent.

The graduation shift of German universities of applied sciences

In research into higher education, the evaluation of completion and dropout rates has generated a steady stream of interest for decades. While most studies only calculate quotes using student and graduate numbers for both phenomena, we propose to additionally consider the budget available to universities. We transfer the idea of the excellence shift indicator [1] from the research to the teaching area, in particular to the completion rate of educational entities. The graduation shift shows the institutions’ ability to produce graduates as measured against their basic academic teaching efficiency. It is an important advantage of the graduation shift that it avoids the well-known heterogeneity problem in efficiency measurements. Our study is based on German universities of applied science. Given their politically determined focus on education, this dataset is well-suited for introducing and evaluating the graduation shift. Using a comprehensive dataset covering the years 2008 to 2013, we show that the graduation shift produces results, which correlate closely with the results of the well-known graduation rate and standard Data Envelopment Analysis (DEA). Compared to the graduation rate, the graduation shift is preferable because it allows to take the budget of institutions into account. Compared to the DEA, the computation of the graduation shift is easy, the results are robust, and non-economists can understand them results. Thus, we recommend the graduation shift as an alternative method of efficiency measurement in the teaching area.

Student-Led Cardiopulmonary Resuscitation Education to Lay Providers Results in Successful Knowledge Acquisition and Skill Performance

AIMS

To assess outcomes associated with student-led lay-responder cardiopulmonary resuscitation (CPR) education to community members.

METHODS

Healthcare students (87% pharmacy) were trained as American Heart Association (AHA)-certified CPR instructors and delivered CPR certification programs for the community through the AHA's Heartsaver® CPR Automated External Defibrillator (AED) certification course from August 2016 to January 2017. Knowledge acquisition was evaluated using 5 pre/ post-course questions adapted from the AHA Basic Life Support (BLS) certification course to be consistent with the AHA Heartsaver® CPR AED course learning objectives. Skill performance was evaluated using the AHA's standardized form for adult, child, and infant CPR assessment.

RESULTS

The majority of community member participants (n=105) were female (71%), African American (71%), 45-64 years of age (46%), employed (71%), college educated (50%), and had previous CPR training (63%). Participants demonstrated 100% success rate in correctly performing CPR skills. The mean percentage of correct responses increased from 36% for the pre-course questions to 85% for the post-course questions (p<0.001).

CONCLUSION

Healthcare students successfully provided CPR education to community members who then correctly demonstrated adult, child, and infant CPR skills. Data suggest that student-led CPR training has a positive impact on knowledge acquisition in community members.

Global Health Research Mentoring Competencies for Individuals and Institutions in Low- and Middle-Income Countries

Mentoring is beneficial to mentors, mentees, and their institutions, especially in low- and middle-income countries (LMICs), that are faced with complex disease burdens, skills shortages, and resource constraints. Mentoring in global health research can be enhanced by defining key competencies, to enable the skill set required for effective mentoring, determine training needs for local research mentors, and facilitate institutional capacity building to support mentors. The latter includes advocating for resources, institutional development of mentoring guidelines, and financial and administrative support for mentoring. Nine core global health research mentoring competencies were identified: maintaining effective communication; aligning expectations with reasonable goals and objectives; assessing and providing skills and knowledge for success; addressing diversity; fostering independence; promoting professional development; promoting professional integrity and ethical conduct; overcoming resource limitations; and fostering institutional change. The competencies described in this article will assist mentors to sharpen their cognitive skills, acquire or generate new knowledge, and enhance professional and personal growth and job satisfaction. Similarly, the proposed competencies will enhance the knowledge and skills of mentees, who can continue and extend the work of their mentors, and advance knowledge for the benefit of the health of populations in LMICs.

The Evolution of Mentorship Capacity Development in Low- and Middle-Income Countries: Case Studies from Peru, Kenya, India, and Mozambique

Following the Fogarty International Center-supported "Mentoring the Mentors" workshops in South America, Africa, and Asia, approaches and guidelines for mentorship at institutions within these low- and middle-income country (LMIC) contexts, appropriate for the respective regional resources and culture, were implemented. Through the presentation of case studies from these three geographic regions, this article illustrates the institutional mentorship infrastructure before the workshop and the identified gaps used to implement strategies to build mentorship capacity at the Universidad Peruana Cayetano Heredia (Peru), Kenya Medical Research Institute (Kenya), Saint John's Research Institute (India), and Eduardo Mondlane University (Mozambique). These case studies illustrate three findings: first, that mentorship programs in LMICs have made uneven progress, and institutions with existing programs have exhibited greater advancement to their mentoring capacity than institutions without formal programs before the workshops. Second, mentoring needs assessments help garner the support of institutional leadership and create local ownership. Third, developing a culture of mentorship that includes group mentoring activities at LMIC institutions can help overcome the shortage of trained mentors. Regardless of the stage of mentoring programs, LMIC institutions can work toward developing sustainable, culturally effective mentorship models that further the partnership of early career scientists and global health.

Doing philosophy effectively II: A replication and elaboration of student learning in classroom teaching

An important aim of teaching philosophy in Dutch secondary schools is to learn about philosophy (that is, the great philosophers) by doing philosophy. In an earlier study published in PLoS ONE, we focused on the relationship between student learning activities and teacher behavior by analyzing eight lessons. Correspondence analysis revealed that doing philosophy was more effective in some lessons than in others. We replicated this finding in the current study, using 10 new lessons, and elaborated on the relationship between the likely causes for doing philosophy effectively. The data suggest that conducting a dialogue in the form of a philosophical discussion is sufficient for achieving an effective lesson, whereas the teachers’ guidance being shared with the students is a necessary but not sufficient condition for achieving an effective lesson.

Teaching sociology to undergraduate medical students

Understanding the social basis of health and medicine and the contexts of clinical care are essential components of good medical practice. This includes the ways in which social factors such as class, ethnicity, and gender influence health outcomes and how people experience health, illness, and health care. In our Guide we describe what sociology is and what it brings to medicine, beginning with the nature of the "sociological imagination." Sociological theory and methods are reviewed to explain and illustrate the role of sociology in the context of undergraduate medical education. Reference is made to the 2016 report, A Core Curriculum for Sociology in UK Undergraduate Medical Education by Collett et al. Teaching and student learning are discussed in terms of organization and delivery, with an emphasis on practice. Sections are also included on assessment, evaluation, opportunities, and challenges and the value of a "community of practice" for sociology teachers in medical education.