The importance of discourse when discussing microplastic pollution with oyster stakeholders in Massachusetts, USA

Oysters have socioeconomic and environmental importance globally and are currently threatened by microplastic pollution. Whether solutions (e.g., laws, policies, or best management practices) are needed to protect oysters from microplastic pollution is still in question given the complexity of the issue and the multitude of stakeholders involved. Minimal research has been done to examine the public's view of the microplastic problem and, separately, few economic studies have examined non-monetary values for oysters. Here, we employed a discourse-based method (deliberative multicriteria evaluation methodology) to engage with oyster-relevant stakeholders in Massachusetts, USA, to evaluate how the stakeholders discussed and interacted with each other on the topic of 'microplastics polluting oyster habitats' using hypothetical scenarios. Our qualitative analysis indicated that participants discussed human welfare and non-human welfare aspects of oysters when considering what is threatened by microplastic pollution in oyster habitats. In all the workshops, an important theme emerged which is the role of oysters in supporting services (e.g., the concept that microplastic filtration or ingestion by oysters might impact the oysters' role as eco-engineers). Decision-making is not a linear process, especially when complex pollutants (e.g., microplastics) are involved. Here, we learned that both environmental and social data are needed for the oyster stakeholders to make decisions, and discussion among stakeholders can highlight gaps in scientific knowledge. The results were then used to inform the development of a decision-making process for evaluating complex environmental issues, like microplastic pollution.

"It is this very knowledge that makes us doctors": an applied thematic analysis of how medical students perceive the relevance of biomedical science knowledge to clinical medicine

BACKGROUND

Intensive study of the biomedical sciences remains a core component of undergraduate medical education with medical students often completing up to 2 years of biomedical science training prior to entering clerkships. While it is generally accepted that biomedical science knowledge is essential for clinical practice because it forms the basis of clinical reasoning and decision-making, whether medical students perceive an expanded role for their biomedical science knowledge remains to be examined.

METHODS

We conducted a qualitative research study to explore how medical students in the first clerkship year perceived the relevance of biomedical science knowledge to clinical medicine during this pivotal time as they begin their transition from students to physicians. To identify previously unidentified perspectives and insights, we asked students to write brief essays in response to the prompt: How is biomedical science knowledge relevant to clinical medicine? Ten codes and four themes were interpreted through an applied thematic analysis of students' essays.

RESULTS

Analysis of students' essays revealed novel perspectives previously unidentified by survey studies and focus groups. Specifically, students perceived their biomedical science knowledge as contributory to the development of adaptive expertise and professional identity formation, both viewed as essential developmental milestones for medical students.

CONCLUSIONS

The results of this study have important implications for ongoing curricular reform efforts to improve the structure, content, delivery, and assessment of the undergraduate medical curriculum. Identifying the explicit and tacit elements of the formal, informal, and hidden curriculum that enable biomedical science knowledge to contribute to the development of adaptive expertise and professional identity formation will enable the purposeful design of innovations to support the acquisition of these critical educational outcomes.