From clinician to educator: A scoping review of professional identity and the influence of impostor phenomenon

Introduction: As healthcare educators undergo a career transition from providing care to providing education, their professional identity can also transition accompanied by significant threat. Given their qualifications are usually clinical in nature, healthcare educators’ knowledge and skills in education and other relevant theories are often minimal, making them vulnerable to feeling fraudulent in the healthcare educator role. This threat and vulnerability is described as the impostor phenomenon. The aim of this study was to examine and map the concepts of professional identity and the influence of impostor phenomenon in healthcare educators. Methods: The authors conducted a scoping review of health professions literature. Six databases were searched, identifying 121 relevant articles, eight meeting our inclusion criteria. Two researchers independently extracted data, collating and summarising the results. Results: Clinicians who become healthcare educators experience identity ambiguity. Gaps exist in the incidence and influence of impostor phenomenon in healthcare educators. Creating communities of practice, where opportunities exist for formal and informal interactions with both peers and experts, has a positive impact on professional identity construction. Faculty development activities that incorporate the beliefs, values and attributes of the professional role of a healthcare educator can be effective in establishing a new professional identity. Conclusion: This review describes the professional identity ambiguity experienced by clinicians as they take on the role of healthcare educator and solutions to ensure a sustainable healthcare education workforce.

Measuring online self-regulated learning among early-career medical doctors in a Massive Open Online Course on COVID-19

Introduction: As significant autonomy is given in a Massive Open Online Course (MOOC), online self-regulated learning (SRL) ability is crucial in such courses. We aim to measure the online SRL abilities of early-career medical doctors enrolled in a MOOC. Methods: We performed a cross-sectional study using the Self-Regulated Online Learning Questionnaire-revised version (SOL-Qr). We conducted a three-stage cross-cultural validation of the SOL-Qr, followed by Confirmatory Factor Analysis (CFA). The online SRL ability of 5,432 medical doctors enrolled in a MOOC was measured using the validated SOL-Qr. Results: The CFA of the cross-translated SOL-Qr confirmed its comparability to the original version, with excellent validity & reliability. Participants showed high levels of online SRL during their early careers. Despite high online SRL scores, MOOC completion rate was low. Male participants showed slightly better time management ability than female participants. Participants working in the primary epicentrum for COVID-19 in the country showed lower online SRL scores, while participants who graduated from higher accreditation levels showed better time management ability. Conclusion: The SOL-Qr and its subscales are suitable and valid for measuring the online SRL abilities of medical doctors in a MOOC during their early-career period. Time management ability was associated with previous experience during the medical education period, while other online SRL subscales were mostly associated with workload. However, as the scores did not correlate with the time spent for learning in MOOC, the corresponding learning effort or time spent may be beyond just the commitment to the described MOOC.

Use of simulation-based learning in Japanese undergraduate nursing education: National survey results

Introduction: Simulation-based learning (SBL) is a practical and efficient learning method that involves the replacement of a portion of clinical education with quality simulation experiences. It has been utilised in various countries, such as the United States, Canada, and South Korea. However, based on current regulations in Japan, clinical education cannot be replaced with simulation experience. For future curriculum integration, it is necessary to clarify the current use of SBL and tackle systematic educational strategies of SBL. Therefore, this national survey aimed to clarify the prevalence and practices of SBL in undergraduate nursing education programs in Japan. Methods: This article presents the results of our national survey in Japan. It presents the questionnaire based on the International Nursing Association for Clinical Simulation and Learning Standards of Best Practice and demonstrates the use of simulation-based learning in Japanese undergraduate nursing programs. Results: Overall, the schools using simulation-based education (SBE) comprised 346 schools (82.4%) of the sample. Those equipped with high-fidelity simulators were 146 schools (27.6%); the rest owned medium-fidelity simulators. Almost all undergraduate nursing education systems were equipped with simulators, however, the frequency of use was low. SBL was incorporated into the curriculum at many undergraduate nursing education institutions, and awareness of the INACSL Standard of Best Practice: SimulationSM was extremely low. Conclusion: This study shows that SBL is not properly utilised in undergraduate nursing programs, even though many schools are equipped with simulators. Thus, further study on barriers to simulator use is needed.

General dental practitioners’ perceptions on Team-based learning pedagogy for continuing dental education

Introduction: Team-based learning (TBL) pedagogy is a structured, flipped classroom approach to promote active learning. In April 2019, we designed a TBL workshop to introduce the New Classification of Periodontal Diseases 2017 to a group of general dental practitioners (GDPs). We aimed to investigate GDPs feedback on learning this new classification using TBL pedagogy. Methods: Two articles related to the 2017 classification were sent to 22 GDPs 2 weeks prior to a 3-hour workshop. During the face-to-face session, they were randomly assigned to five groups. They participated in individual and group readiness assurance tests. Subsequently, the GDPs had inter- and intragroup facilitated discussions on three simulated clinical cases. They then provided feedback using a pen-to-paper survey. Based on a 5-point Likert scale (1-strongly disagree to 5-strongly agree), they indicated their level of agreement on items related to the workshop and their learning experience. Results: Majority (94.7%, 18 out of 19 GDPs) agreed the session improved their understanding of the new classification and they preferred this TBL pedagogy compared to a conventional lecture. All learners agreed they can apply the knowledge to their work and there was a high degree of participation and involvement during the session. They found the group discussion and the simulated clinical cases useful. Conclusion: A TBL workshop is suitable for clinical teaching of the New Classification of Periodontal Diseases 2017 for GDPs. Its structure promotes interaction among learners with the opportunity to provide feedback and reflection during the group discussions. This model might be a good pedagogy for continuing dental education.

Patients’ attitude and factors influencing the acceptance of medical students’ participation in pelvic examination

Introduction: Pelvic examination of patients in the department of obstetrics and gynaecology (Ob-Gyn) is an important skill for medical students. Because it involves a physical assessment of the patients' genitalia, patients may refuse medical students to participate in the examination, affecting the medical students' clinical skills. Methods: This cross-sectional study was conducted at Naresuan University Hospital to determine the factors that influence the acceptance of medical student participation in the pelvic examinations. A total of 198 out-patients from the Ob-Gyn department were included. A Likert scale questionnaire was designed which featured topics on patients’ attitudes and circumstances related to medical student involvement in gynaecological procedures. Results: The majority of outpatients (71.7%) accepted the participation of medical students in pelvic examinations. Patients with prior experiences in physical and pelvic examination by medical students had a significant impact on the patients' acceptance (P-value<0.001). The patients’ impressions had an influence on the decision to accept students in pelvic exam participation. Approximately 40% of patients were concerned about the breach of confidentiality. However, most patients strongly agreed that allowing medical students to perform pelvic examination would benefit their medical education. Conclusion: Most of the participants permitted medical students to participate in pelvic examinations and preferred that the medical instructor be the one to request permission. The patients’ impressions of medical students were crucial factors that significantly influence their decision whether to allow or deny them to participate in the procedure. Disclosure of confidentiality was found to be matters of concern to most patients.

Enhancing the student experience through sustainable Communities of Practice

Introduction: The switch to online off-campus teaching for universities worldwide due to COVID-19 will transform into more sustainable and predictable delivery models where virtual and local student contact will continue to be combined. Institutions must do more to replace the full student experience and benefits of learners and educators being together. Methods: Our centre has been delivering distance blended and online learning for more than 40 years and has over 4000 alumni across five continents. Our students and alumni come from varied healthcare disciplines and are at different stages of their career as educators and practitioners. Whilst studying on the programme students work together flexibly in randomly arranged peer groups designed to allow the establishment of Communities of Practice (CoP) through the use of online Discussion Boards. Results: We found Discussion Boards encouraged reflection on learning, sharing of ideas with peers and tutors, reduce anxiety, support progression, and enable benchmarking. This led to a highly effective student sense of belonging to each other, our educators, and the wider University, with many highlighting an excellent student experience and maintaining a thriving CoP within the alumni body. Conclusion: Despite being based on one large postgraduate programme in medical education, our CoP approach is relevant to any undergraduate programme, particularly those that lead to professional qualification. With our mix of nationalities, we can ‘model the way’ for enabling strong CoP’s to share ideas about best practice with a strong student and alumni network which can be shared across the international healthcare community.

Challenges and experiences to develop a Japanese language course for international medical students in Japan: Maximising acquisition of Japanese language by applying adult learning theories

Introduction: The International University of Health and Welfare (IUHW) School of Medicine was founded in 2017 with the intention of providing medical content in English a historical first in Japan. Twenty international medical students have been accepted annually, with the majority possessing less than beginner level Japanese language proficiency at the time of enrolment. However, proficiency in Japanese, especially in the context of medicine is required for academic success and program completion. To address this, the IUHW School of Medicine has developed a course in medical Japanese with the objective of facilitating international students’ acquisition of medical Japanese and reinforcing such acquisition through various listening, speaking, reading, and writing activities. This study aims to describe the Japanese language education program for international students at the IUHW School of Medicine, with particular focus on the development of the curriculum and course content. Methods: The course is designed based on the following educational strategies and their applications: (a) Synchronisation of both medical and Japanese contents; (b) Collaborative learning; (c) Japanese output of medical content learned in English; (d) Practical output through making/giving a presentation and discussion with medical experts; (e) Detailed language feedback from language experts; (f) Reinforcing the vocabulary knowledge by writing; and (g) Building up vocabulary and expressions with relevant contents. Results: Our observations suggest that our international students have been able to continue their medical education in Japanese smoothly. Conclusion: The content-based instructional design that includes second language acquisition strategies may also be applicable to other Asian languages such as Korean and Chinese.