Medical education: Overview

Abstract
Introduction: The negative effects of microaggressions on patient care, provider well-being, and medical education are well-documented. Critically evaluated programs addressing microaggressions remain largely absent in the literature.

Methods: We developed the 90-minute Speak Up! Simulation Workshop for GME trainees (residents, fellows), physician attendings, other health care professionals (e.g., nurses, nurse practitioners, child life specialists) based on Kolb's Experiential Learning Cycle. We utilized deidentified cases reported at our institution, emphasizing psychological safety and upstanding. Based on Kirkpatrick's Evaluation Model, we distributed pre- and postworkshop surveys to assess perceptions of psychological safety, confidence in recognizing microaggressions, comfort in upstanding, and likelihood of addressing future discrimination incidents. Five-point Likert scales and Bowker's symmetry tests were used.

Results: Eighty anonymous postworkshop surveys were collected from GME trainees (N = 151) at 14 sessions. Of the respondents, 63 (79% [95% CI 70% to 88%]) reported feeling psychologically safe. When the 80 respondents compared their comfort in addressing microaggressions before and after the workshop, a significant shift was seen in the likelihood of speaking up when witnessing a microaggression (χ2[df5] = 42, p < .01), with scores from 42 respondents (52%) increasing by at least 1 point. Significant shifts in confidence in identifying microaggressions also occurred (χ2[df5] = 43, p < .01), with 43 respondents (54%) showing increased confidence.

Discussion: Evaluation of our curriculum demonstrated improved understanding of microaggressions and enhanced self-efficacy in upstanding. This simulation workshop provides psychologically safe opportunities to explore the impact of microaggressions and empowers participants to respond effectively in professional settings.

Abstract
Clinical reasoning is foundational to effective medical practice, yet explicit instruction in this skill remains insufficient. Traditional bedside teaching, though invaluable, often fails to make reasoning processes transparent, leading to gaps in diagnostic acumen. This article introduces the cause-and-effect clinical method (CECM)-a structured five-step framework designed to make clinical reasoning teachable and visible. Grounded in cognitive science, the method trains learners to think backwards from symptoms to causes and forward to consequences. Through its integration into bedside teaching, case discussions and assessments, the method promises to enhance diagnostic accuracy and prepare learners for the complexities of patient care.

Abstract
Background: The necessity for self-regulated, lifelong learners in the rapidly evolving field of medicine underscores the importance of effective study skills. Efforts to support students with these skills have had positive outcomes but are often limited in scope and accessibility, with a tendency to target groups facing immediate challenges.

Objective: This study aimed to explore the student perspective on study skills support at University College London Medical School through a student-staff partnership, with the goal of guiding future improvements.

Methods: A mixed methods approach was adopted using an anonymous questionnaire and focus groups. After analyzing questionnaire responses using descriptive statistics to refine focus group questions, focus groups were conducted to delve deeper into identified issues. Transcripts were analyzed thematically using inductive coding.

Results: In total, 116 students completed the questionnaire in full and 6 students participated in 2 focus groups. The questionnaire revealed that 68% (68/100) of respondents felt that they never received study skills support at University College London Medical School. Preferred methods of support included small group sessions (56/100, 56%) and topics like examination preparation (83/100, 83%) and study skills specific to medicine (72/100, 72%). Focus group themes were the lack of current study skills support, delivery of study skills support, specific study skills for medical school, personalized approach to support needed, and accessing support. Findings informed the co-creation of study skills resources.

Conclusions: Overall, the findings highlight the need for strategically incorporating study skills support at medical school, emphasizing early and consistent promotion and tailored delivery methods.