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Objective At present, current didactic teaching delivery method help nursing students apply theory to clinical situations in an inefficient way. The flipped classroom (FC), a novel teaching mode emphasizing self-study and critical thinking, has generated interest in nursing education in China. However, there are a gap in the literature and no consistent outcomes of current studies which compared FC and lecture-based learning (LBL), and no systematic review has comprehensively compared theoretical scores as an affected outcome in FC versus LBL modes. Methods In this review, we analyze flipped-learning nursing students’ scores, and aim to assess the efficacy and provide a deeper understanding of the FC in nursing education. Following the inclusion criteria, articles were obtained by searching PubMed, Embase and Chinese data, including the China National Knowledge Infrastructure, Wanfang Data, and VIP database until 3 January 2020. Data were extracted from eligible articles and quality was assessed. A meta-analysis was then performed using a random effects model with a standardized mean value (SMD) and a 95% confidence interval (CI).32 studies were included after reviewing 2,439 citations. All studies were randomized controlled trials (RCTs). The FC theoretical knowledge scores in FC were significantly positively affected compared to those of the traditional classroom (SMD = 1.33, 95% CI: 1.02–1.64; P < 0.001). In addition, 23 studies reported skill scores, indicating significant difference between the FC mode and LBL mode (SMD = 1.58, 95%CI: 1.23–1.93; P < 0.001). Conclusions The results of this meta-analysis suggest that compared to the LBL teaching method, the FC mode dose significantly improve Chinese nursing students’ theoretical scores. However, the problems of heterogeneity and publication bias in this study need to be remedied high-quality future studies. © 2020 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Opportunities to provide clinical immersion experiences to bioengineering undergraduate students have expanded over the last several years. These programs allow students to observe the clinical environment in order to better understand workflow processes, the context in which medical equipment is used, and identify unmet needs firsthand. While each program focuses on identifying unmet needs, these experiences vary in content and implementation. Here we discuss features of clinical immersion programs, share details of our program after six years, and present data regarding post-graduation employment of our participants. Students who participated in the University of Illinois at Chicago Clinical Immersion Program are not more likely to pursue careers in industry as compared to non-participants, nor do they demonstrate an ability to find a job more quickly than non-participants. However, participants who did enter into industry self-reported that the program was impactful to both their career interests and ability to find their first employment position. © 2020, The Author(s).

Objective: To synthesise quantitative data on the effects of rural background and experience in rural areas during medical training on the likelihood of general practitioners practising and remaining in rural areas. Study design: Systematic review and meta-analysis of the effects of rural pipeline factors (rural background; rural clinical and education experience during undergraduate and postgraduate/vocational training) on likelihood of later general practice in rural areas. Data sources: MEDLINE (Ovid), EMBASE, Informit Health Collection, and ERIC electronic database records published to September 2018; bibliographies of retrieved articles; grey literature. Data synthesis: Of 6709 publications identified by our search, 27 observational studies were eligible for inclusion in our systematic review; when appropriate, data were pooled in random effects models for meta-analysis. Study quality, assessed with the Newcastle–Ottawa scale, was very good or good for 24 studies, satisfactory for two, and unsatisfactory for one. Meta-analysis indicated that GPs practising in rural communities was significantly associated with having a rural background (odds ratio [OR], 2.71; 95% CI, 2.12–3.46; ten studies) and with rural clinical experience during undergraduate (OR, 1.75; 95% CI, 1.48–2.08; five studies) and postgraduate training (OR, 4.57; 95% CI, 2.80–7.46; eight studies). Conclusion: GPs with rural backgrounds or rural experience during undergraduate or postgraduate medical training are more likely to practise in rural areas. The effects of multiple rural pipeline factors may be cumulative, and the duration of an experience influences the likelihood of a GP commencing and remaining in rural general practice. These findings could inform government-led initiatives to support an adequate rural GP workforce. Protocol registration: PROSPERO, CRD42017074943 (updated 1 February 2018). © 2020 AMPCo Pty Ltd

Objective. To examine the Qatar University Doctor of Pharmacy (PharmD) program for evidence of incorporation of communities of practice (CoP) learning theory. Methods. A developed CoP framework was used as a theoretical instrument to analyze the evidence of CoP theory in QU PharmD program, utilizing a case study research approach. Results. The research suggests that the evidence of the CoP framework in the PharmD program falls into three categories. The first category represents elements of CoP that were fully evident, such as knowledge recontextualization, social and professional acceptance, and effective assessment measures. The second category represents elements that were partially evident, such as the formation of a co-development team, informal learning, mentoring strategies, and preceptors’ orientation to assessment. The third category represents elements that were not evident, such as collaboration between faculty and preceptors and ensuring the reliability and validity of assessment tools. In cases where elements of CoP were implemented, this was an implicit rather than explicit application of CoP theory. Therefore, it was theorized that the disconnect between CoP learning theory and educational practices is at the “implicit disconnect” level. Conclusion. This research indicates that the CoP framework facilitated the identification of areas for future quality improvement and suggests that the theoretical CoP framework could be used by other programs to identify areas for improvements. We theorize that a full and explicit implementation of learning theory into educational practices is crucial, which calls for the collaboration of academic, practice, accreditation, and governmental sectors in pharmacy educational reform initiatives. © 2020 American Association of Colleges of Pharmacy.

Balint allows colleagues to explore emotions generated from doctor-patient interactions, complexities sometimes overlooked within traditional curricula. With an increasing burnout rate, evidence-based strategies to support trainee general practitioners (GPs) are needed and we investigated if Balint could be one way to improve this. There are no recent studies looking at Balint in UK GP training. Our aim was to establish GP trainees’ understanding of the purpose of Balint and perceived advantages and disadvantages. Qualitative methodology was used to conduct semi-structured interviews with trainees and alumni participating in Balint within a suburban London Vocational Training Scheme. Emergent coding was performed and a phenomenological approach taken to thematic analysis. Eleven participants took part in the study. Balint provided a supportive, confidential outlet to help normalise trainees’ feelings after challenging doctor-patient interactions. Multiple viewpoints, the chance to vent and a sense of comradery was unanimously enjoyed. Participants could see potential benefits for delivery of care, patient safety and remaining up-to-date. There was debate over inclusion of clinical management, and variation in preferred facilitation styles. Disparity in Balint contribution was attributed to differing personalities and confidence levels. With the growing demands of general practice, a flexible approach to Balint facilitation could add value in training by providing a peer platform to help address the hidden curriculum. © 2020 Informa UK Limited, trading as Taylor & Francis Group.

Background: New teaching strategies must be developed not only to enhance nurse's competence but also to allow nurses to respond to the complex health care needs of today's society. The purpose of this study was to explore the learning outcomes of a flipped classroom teaching approach in an adult-health nursing course for students in a two-year Bachelor of Science in Nursing program. Methods: The study had a quasi-experimental design. An 18-week flipped classroom teaching approach was applied in an adult-health nursing course. In total, 485 nursing students enrolled in the study, with 287 in the experimental group and 198 in the control group. The Self-Evaluated Core Competencies Scale, Metacognitive Inventory for Nursing Students, Self-Directed Learning Readiness Scale, and self-designed learning satisfaction questionnaire were used to evaluate the students' learning outcomes. Results: The experimental group showed a statistically significant increase in the overall scores for self-evaluated core competencies, the "self-modification"subscale of the Metacognitive Inventory for Nursing Students, and in overall self-directed learning readiness; further, they also showed high levels of course satisfaction. Conclusions: A flipped classroom teaching approach had a positive impact on student's learning motivation and contributed to better learning outcomes in an adult-health nursing course. The flipped classroom combined with hybrid teaching methods is a suitable and effective learning strategy for a registered nurse (RN) to Bachelor of Science in Nursing (BSN) program to tackle today's complex revolution in nursing curricula, and may enhance nursing students' abilities to address numerous challenges. © 2020 The Author(s).

Objective: Educational track choices have far-reaching consequences because they are associated with long-term life success. Theoretical approaches and previous empirical research have nearly exclusively identified family background and achievement as determinants of these choices. Although students’ educational track choices might fit their personality, individual differences in personality have not been explored. We investigated the effects of two personality aspects—RIASEC interests and Big Five traits—on hierarchically ranked track choices (vocational vs. general educational track), alongside family background and achievement. Method: We used two German data sets (TOSCA 10 study: N = 473; TOSCA study: N = 4,218) focusing on choices between the general educational track (leading to higher educational attainment) and the vocational track (leading to work life) at two different stages in educational careers. We ran several multiple (logistic) regressions. Results: The results showed that certain aspects of students’ personality matter for educational track choices. Accordingly, across both studies, students with high Investigative or Enterprising interests more often chose the general educational track, whereas students with high Social or Conventional interests more often chose the vocational track—after the Big Five personality traits, achievement, and family background were controlled for. The Big Five traits showed no or only small significant associations with educational track choices. Conclusion: These findings underscore the importance of considering individual differences when investigating important life outcomes such as track choices. © 2020 The Authors. Journal of Personality published by Wiley Periodicals LLC.

Background: Improved medical care access for rural populations continues to be a major concern. There remains little published evidence about postgraduate rural pathways of junior doctors, which may have strong implications for a long-term skilled rural workforce. This exploratory study describes and compares preferences for, and uptake of, rural internships by new domestic and international graduates of Victorian medical schools during a period of rural internship position expansion. Methods: We used administrative data of all new Victorian medical graduates' location preference and accepted location of internship positions for 2013-16. Associations between preferred internship location and accepted internship position were explored including by rurality and year. Moreover, data were stratified between 'domestic graduates' (Australian and New Zealand citizens or permanent residents) and 'international graduates' (temporary residents who graduated from an Australian university). Results: Across 2013-16, there were 4562 applicants who filled 3130 internship positions (46% oversubscribed). Domestic graduates filled most (69.7%, 457/656) rural internship positions, but significantly less than metropolitan positions (92.2%, p < 0.001). Only 20.1% (551/2737) included a rural location in their top five preferences, less than for international graduates (34.4%, p < 0.001). A greater proportion of rural compared with metropolitan interns accepted a position not in their top five preferences (36.1% versus 7.4%, p < 0.001). The proportion nominating a rural location in their preference list increased across 2013-2016. Conclusions: The preferences for, and uptake of, rural internship positions by domestic graduates is sub-optimal for growing a rural workforce from local graduates. Current actions that have increased the number of rural positions are unlikely to be sufficient as a stand-alone intervention, thus regional areas must rely on international graduates. Strategies are needed to increase the attractiveness of rural internships for domestic students so that more graduates from rural undergraduate medical training are retained rurally. Further research could explore whether the uptake of rural internships is facilitated by aligning these positions with protected opportunities to continue vocational training in regionally-based or metropolitan fellowships. Increased understanding is needed of the factors impacting work location decisions of junior doctors, particularly those with some rural career intent. © 2020 The Author(s).

High resident job performance is essential for effective medical professionalism. To date, few studies have investigated the potential predictors of job performance among residents in standardized residency training (SRT) program in China. Therefore, a nationwide survey among Chinese residents in SRT program was conducted to evaluate the impact of job satisfaction and psychological resilience on job performance. A total of 1146 residents from 9 hospitals were recruited in this study. Demographic and work-related information, job satisfaction, psychological resilience and job performance were collected through questionnaires. Hierarchical regression analyses indicated that, “work pressure”, “doctor-patient conflict”, “intrinsic job satisfaction” and “psychological resilience” were significant predictors of job performance for residents in SRT programs and explained 61.3% of variance, while the three dimensions of psychological resilience (tenacity, strength and optimism) accounted for 27.2% of variance. The area under curve (AUC) of the receiver operating characteristic (ROC) curve showed that resilience had the highest predictive accuracy than another three subscales. This study indicated that intrinsic job satisfaction and psychological resilience had a significant influence on job performance. Strategies and measures to improve residents’ intrinsic job satisfaction and psychological resilience may be efficacious ways to enhance their job performance. © 2020 Informa UK Limited, trading as Taylor & Francis Group.

Health professions education is that part of the education system which applies educational philosophy, theory, principles and practice in a complex relationship with busy clinical services, where education is not the primary role. While the goals are clear—to produce the health workforce that society needs to improve health outcomes—both education and healthcare systems continue to evolve concurrently amidst changes in knowledge, skills, population demographics and social contracts. In observing a significant anniversary of this journal, which sits at the junction of education and healthcare systems, it is appropriate to reflect on how the relationship is evolving. Health professions educators must listen to the voices of regulators, employers, students and patients when adapting to new service delivery models that emerge in response to pressures for change. The recent COVID-19 pandemic is one example of disruptive change, but other factors, such as population pressures and climate change, can also drive innovations that result in lasting change. Emerging technology may act as either a servant of change or a disruptor. There is a pressing need for interdisciplinary research that develops a theory and evidence base to strengthen sustainability of change. © 2020, Springer Nature B.V.