Clinical teachers' perceptions of role modeling: a qualitative study

A narrative analysis of clerkship reflections: Medical student identity development in a changing world

BACKGROUND

Medical students' written reflections on their clinical experiences can be a useful tool for processing complex aspects of development as physicians. To create educational programs that scaffold adaptive professional identity development, it is essential to understand how medical students develop as professionals and process the dynamic sociocultural experiences of the current moment.

OBJECTIVE

To explore the developing professional consciousness of medical students through clerkship reflections.

DESIGN

Narrative analysis of written reflections are produced by clerkship students, who were asked to tell a story that resonated with the physician's relationship with patient, self and colleagues. Two independent readers applied inductive labels to generate a homogenous codebook, which was used to generate themes that were then used to construct a conceptual model.

KEY RESULTS

Four themes were identified in the data that describe relationships between medical students' developing professional identities and the norms of their future professional and personal communities. These included: medical students as outsiders, conflict between the student identifying with the patient versus the healthcare team, medical students' own value judgements and, finally, the changing societal mores as they relate to social and racial injustice. The conceptual model for this experience depicts the medical student as pulled between patients and the social context on one side and the professional context of the medical centre on the other. Students long to move towards identification with the healthcare team, but reject the extremes of medical culture that they view on conflict with social and racial justice.

CONCLUSIONS

Medical students in clinical training identify strongly with both patients and the medical team. Rather than viewing professional identity development as a longitudinal journey from one extreme to another, students have the power to call attention to entrenched problems within medical culture and increase empathy for patients by retaining their strong identification with the important issues of this time.

Development and validation of a core competence instrument for clinical nursing teachers: A mixed-methods study

BACKGROUND

Competence-based education (CBE) highlights the important position of clinical nursing teachers and stipulates additional requirements for them. However, research on the core competence of clinical nursing teachers remains lacking, which has hindered their development and the cultivation of nursing students.

OBJECTIVES

Developing and verifying a core competence instrument to evaluate clinical nursing teachers' competence in clinical settings and provide empirical guidance for their development.

DESIGN

A mixed-methods study including qualitative and quantitative methods.

SETTINGS

Primarily, 9 universities and hospitals throughout China.

PARTICIPANTS

Fourteen nursing experts and 2 students participated in the qualitative study, and 626 nursing professionals ultimately participated in the quantitative study.

METHODS

The instrument was developed based on behavioral event interviews and expert consultation as well as exploratory factor analysis using a cross-sectional survey, following which the instrument was verified by confirmatory factor analysis.

RESULTS

A 4-factor core competence instrument for clinical nursing teachers was developed and verified; the four factors included education and teaching competence, clinical nursing competence, management competence and professional awareness and attitude, and the instrument included 25 items in total. The instrument has an explanatory degree of 90.58 %, and it exhibits good reliability and validity as well as a good fit to the data.

CONCLUSIONS

This instrument can provide theoretical guidance for the development of clinical nursing teachers and can be widely used as an effective tool in practice. Nursing administrators and educators should implement policies and programs to help clinical nursing teachers improve their competencies with regard to these four aspects, which can play an important role in the development of nurse education.

Role Modeling of Professional Behavior in Nursing Education During the COVID-19 Pandemic: A Mixed Method Study

This study aimed to examine professional behavior as role models in nursing education during the COVID-19 pandemic perceived by nursing students. This study applied a mixed-method design using a sequential explanatory approach. A total of 120 nursing students participated in the self-reported questionnaire, and 10 were involved in semistructured individual interviews. The Professional Nurse Educator Role-Model questionnaire developed by the authors was used to collect quantitative data, and four open-ended questions modified from a previous study as the guideline in qualitative data collection. Quantitative data were analyzed using descriptive quantitative analysis. Open-ended questions were analyzed using thematic analysis. Quantitatively, students reported that excellent professional behaviors as role models were prevalent in nursing education (Mean 3.61 out of 4). Four themes from qualitative findings were revealed to complement the quantitative data, including teaching by example, altruism, efficiently performing, and effective communication. In conclusion, nurses as educators and clinicians could be students' professional role models, particularly in clinical settings during the COVID-19 pandemic. It is essential for nurse educators and clinicians to actively create a culture of professional nursing care for self and others during the pandemic to be present in wholeness and provide holistic care.

A systematic scoping review of reflective writing in medical education

BACKGROUND

Reflective writing (RW) allows physicians to step back, review their thoughts, goals and actions and recognise how their perspectives, motives and emotions impact their conduct. RW also helps physicians consolidate their learning and boosts their professional and personal development. In the absence of a consistent approach and amidst growing threats to RW's place in medical training, a review of theories of RW in medical education and a review to map regnant practices, programs and assessment methods are proposed.

METHODS

A Systematic Evidence-Based Approach guided Systematic Scoping Review (SSR in SEBA) was adopted to guide and structure the two concurrent reviews. Independent searches were carried out on publications featured between 1st January 2000 and 30th June 2022 in PubMed, Embase, PsychINFO, CINAHL, ERIC, ASSIA, Scopus, Google Scholar, OpenGrey, GreyLit and ProQuest. The Split Approach saw the included articles analysed separately using thematic and content analysis. Like pieces of a jigsaw puzzle, the Jigsaw Perspective combined the themes and categories identified from both reviews. The Funnelling Process saw the themes/categories created compared with the tabulated summaries. The final domains which emerged structured the discussion that followed.

RESULTS

A total of 33,076 abstracts were reviewed, 1826 full-text articles were appraised and 199 articles were included and analysed. The domains identified were theories and models, current methods, benefits and shortcomings, and recommendations.

CONCLUSIONS

This SSR in SEBA suggests that a structured approach to RW shapes the physician's belief system, guides their practice and nurtures their professional identity formation. In advancing a theoretical concept of RW, this SSR in SEBA proffers new insight into the process of RW, and the need for longitudinal, personalised feedback and support.

The Influence of Various Role Models on Children’s Pro-environmental Behaviours

Although most schoolchildren can dispose of their own litter, they are typically not sensitive to environmental issues in the school’s public areas. How do we improve children’s sensitivity to public environments and cultivate pro-environmental behaviours? Based on Bandura’s social learning theory, this study explored the effects of various role models (teachers and peers) on the pro-environmental behaviours of children aged 7–13. A field study was conducted in which examples of postprandial garbage disposal behaviours were provided using role models and the subsequent behaviours of the children were observed. We located the experiment in a real educational context and manipulated the type of role model (teacher or peer) and the behaviour being modelled (positive behaviours involving picking up litter or negative behaviours involving littering). The results showed that different role models had different effects on the subjects’ pro-environmental behaviours. Only positive demonstration by teachers significantly improved the subjects’ pro-environmental behaviours, that is, teachers’ picking up of garbage in front of children significantly improved the children’s attention to the environment and their adoption of pro-environmental behaviours. Positive demonstration by peers, negative demonstration by teachers and negative demonstration by peers had no impact on the children’s pro-environmental behaviours. The results demonstrate that teachers must be mindful of their role as role models in the educational environment and facilitate students’ development of pro-environmental behaviours.

An analysis of student essays on medical leadership and its educational implications in South Korea

To examine medical students’ perceptions of leadership and explore their implications for medical leadership education. We conducted a qualitative analysis of the essays submitted by students in the medical leadership course from 2015 to 2019. We categorised the essays by the characteristics of the selected model leaders (N = 563) and types of leadership (N = 605). A statistically significant proportion of students selected leaders who were of the same gender as themselves (P < 0.001), graduate track students chose leaders in science (P = 0.005), while; military track students chose leaders in the military (P < 0.001). Although the highest proportion of students chose politicians as their model leaders (22.7%), this number decreased over time (P < 0.001), and a wider range of occupational groups were represented between 2015 and 2019. Charismatic leadership was the most frequently selected (31.9%), and over time there was a statistically significant (P = 0.004) increase in the selection of transformational leadership. Students tended to choose individuals whose acts of leadership could be seen and applied. Medical leadership education should account for students’ changing perceptions and present a feasible leadership model, introducing specific examples to illustrate these leadership skills.