Hot Topics: Neuroeducation: Realistic or Idealistic?

In this week’s top topic blog, Dr Fiona Holmes explores the challenges and realms of our minds in her blog on neuroeducation.

Education is not the learning of facts, but the training of the mind to think.” – Albert Einstein

I’ve spent most of my career so far as a neuroscientist, but more recently my role and research interests have an education focus. So, in this blog I’m combining both and discussing neuroeducation: the application of neuroscientific evidence to pedagogy to understand and enhance learning.

Since learning happens in the brain, the link between neuroscience research and educational research should be a no-brainer – right? Well, it’s rather complex and controversial and so far, neuroeducation research has not yet revealed a magic strategy to make geniuses of us all – but it’s relatively early days!

The idea of brain-based learning

Caine and Caine (1990)1 proposed the following 12 basic principles, extrapolated from the neuroscience-derived ideas at the time:

  1. The brain processes multiple things in parallel therefore teaching should orchestrate all the dimensions of parallel processing by teaching in complex multi-sensory environments;
  2. Learning engages the entire physiology so teaching must incorporate stress management, nutrition, and exercise;
  3. The search for meaning is innate so teaching should incorporate a stable and rich environment to facilitate this;
  4. The search for meaning occurs through patterning so teaching should incorporate thematic teaching, curriculum integration, and life-relevant approaches to learning;
  5. Emotions are critical to patterning so ensure a supportive emotional environment and co-operative learning;
  6. The brain simultaneously perceives and creates parts (details) and wholes (global concepts) so learning is cumulative and developmental;
  7. Learning involves both focused attention and peripheral perception therefore utilise the entire sensory context of the learning through appropriate visual and emotional stimuli;
  8. Learning involves conscious (remembering) and unconscious (priming) processes so incorporate active learning and reflection in teaching;
  9. There are at least two types of memory: spatial memory system (strongest) and rote learning memory, so avoid just fact memorisation;
  10. The brain understands and remembers best when facts and skills are embedded in contextual (spatial) memory therefore use a multisensory experiential learning approach;
  11. Learning is enhanced by challenge and inhibited by threat so maintain an environment of relaxed alertness;
  12. Each brain is unique and uniquely adaptable therefore use multifaceted teaching to address diversity.

But are these principles really novel and does a neuroscience-focused approach to evidencing, understanding and advancing these ideas provide strategies to improve educational practice?

A key aim for neuroeducation is to work out what happens in the brain when it learns and then how to best stimulate this in an educational environment. It has been shown that neuroeducation research may help inform, refine, select, and support aspects of pedagogy, alongside other methods.

There have been numerous studies over the last 20 years or so which support a neuroeducational strategy, including the identification of brain areas involved in reading – and the proposed neurobiological basis of dyslexia; the neural circuitry of numerosity; the neural substrates of attention, emotion and social cognition, relevant for further understanding of e.g. attention deficit hyperactivity disorder and autistic spectrum disorder.

It has potential for neuroprognosis (i.e. predicting educational intervention outcomes); assessing the effect of educational, genetic and/or environmentally induced changes on neurophysiology and cognition; engagement, motivation, and risk to potentiate learning. Furthermore, neuroeducation could influence curriculum design and educational reform.

Neuromyths

However, such principles and popular brain science may over-simplify and over-interpret complex and incomplete neuroscience research and may contribute to the establishment and perpetuation of neuromyths – misconceptions generated by a limited or misunderstanding of data from brain research, albeit based on a kernel of truth, e.g. the learning styles myth2,3.

Despite its widespread acceptance, research fails to support the idea that teaching which aims to fit an apparent learning style enhances learning. So, is ‘a little knowledge a dangerous thing’? There is concern that significant resources may be invested in policies, training, research, and practice based on half-truths. This has emphasised the importance of bidirectional education, mutual cultural understanding and shared experience of each other’s environments between neuroscientists and teachers and students.

Useful advances in the field can come from reciprocal training in relevant knowledge, concepts, and research methods, ensuring robust, relevant and practically applicable research findings through co-constructing research projects; and using neuroscience to distinguish between educational theories rather than drive them. An appreciation of each other’s knowledge and perspectives through co-education and collaboration will facilitate increasingly beneficial outcomes for education and help to bust neuromyths.

Neuroeducation-informed practice

It will come as no big surprise that we should be designing teaching that engages mental activities that enhance the acquisition, processing, storing and use of knowledge in a diversity of learners, as well as promoting meta-cognition – thinking about thinking. So… we must be aware of cognitive diversity and use a variety of teaching methods to accommodate and engage all our students. Lets think about afew ideas and examples:

Active experiences linked to positive emotions are critical for learning: Provide student-centred, active and adaptive learning-by-doing memorable experiences such as problem-based, project-based and co-operative in a supportive environment. Simulation and gamification places students in an environment where they can experience how to be, how to do, and has been shown to increase concentration and reduce tension.  Get students to use the learning at different times in different contexts. Include repetition, retrieval, and association tasks to enhance efficient memory systems.

Memory acquisition relies on attention: Engage and motivate students by starting a session with something provocative and relevant to contextualise the teaching and learning process. It could be an anecdote, an image or question that affects and connects with the lives and interests of your students. This will enable reflective discussion and critical analysis to help them acquire knowledge through their own conclusions.

Encourage students to be active in their own learning journey: This can be achieved through reflection, problem-solving and critical thinking as well as providing them with specific, meaningful, actionable, and timely feedback.

Implement mental and/or physical activities at the beginning of a session: A puzzle or meditation can aid concentration and therefore assimilation of knowledge. Include games, fun, social interaction, and reward to foster interest and pleasure, ensuring the learning objective is clear so that the students will be able to appropriate and transform the acquired knowledge.

Educational Neurotechnology: Brain scan to lesson plan

Exciting advances in the technologies to study the neurophysiology of learning in an education environment are continually developing. This will be the topic of my next blog.

Further reading:

  1. Caine R and Caine G (1990). Understanding a brain-based approach to learning and teaching. Education Leader 48(2): 66-71.
  2. Howard-Jones P A (2014). Neuroscience and education: myths and messages. Nat Rev Neuro 15: 817-24.
  3. Newton P M et al (2021). The learning style neuromyth is still thriving in medical education. Frontiers in Human Neuroscience 15: 1-5.

Hot Topics: The ELMER project

This week’s blog is from Dr David Hettle, hot off the recent announcement of winning the ASME/GMC Excellent Medical Education Award (postgraduate category). David tells us a bit more about the planned research project with colleagues across the country, exploring the experiences of doctors undertaking an entry-level medical education roles (ELMERs).

Lisa Jayne Collage
Image from ASME Awards page

Lisa-Jayne Edwards (University of Warwick), Claire Stocker (Aston University), Julie Browne (Cardiff University), Cara Bezzina (University of Glasgow), David Hettle (University of Bristol)

Introduction

More and more doctors take time out of clinical training, with many choosing to undertake teaching posts during years out, especially ‘F3 years’: time out of training after your initial standardised two years post-graduation1, the ‘Foundation Programme’. These teaching posts have a variety of names including Clinical Teaching Fellows (as they are locally in Bristol), Teaching Fellows, and Education Fellows.

With the increasing need for educators, these posts host a crucial place for doctors developing interest, skills and expertise in medical education as they progress in clinical and educational training. Therefore, there is need to understand the landscape of educational practice which these positions deliver and support the development of these current educators and future educational leaders.

Previous work reviewed the current landscape of entry-level education posts across the UK, finding over 400 positions per year in the UK in 20232, up from 77 in 20083. Though the numbers of these posts have increased, due to the variety of different titles used and the often transience of the doctors in these positions, research into posts is challenging. Importantly this means research into the quality of these posts remains under-studied.

Why does this matter?

This research holds great opportunity to really find out how early-career educators can be supported. Currently, there seems to be wide variation in the quality of posts, with some offering financial support for educational accreditation, others designated time to teach and develop skills in specific aspects of education.

On the flip side, they are others without any additional time, support or links to educational teams offered, yet still carrying responsibility for others’ learning. This work hopes to facilitate more information and some degree of quality control for early-career educational roles as occurs with other medical specialties, for example through their colleges and specialty societies.

The ELMER study

Building on our work undertaken alongside the Academy of Medical Educators (AoME), this new project through the Association for the Study of Medical Education (ASME) seeks to explore the perspectives of current early-career education post-holders. We will investigate how different role qualities and opportunities impact their experience within medical education and, as a result, doctors’ inclination to pursue future teaching and training responsibilities once they move on from these posts (often back into clinical training).

To encompass all similar roles, our research team has chosen to use the term ‘Entry-Level Medical Education Role’ or ELMER as an individual’s first formal role in medical education.

We will use these doctors’ experience in their ELMERs to identify factors which promote formal teaching and increased educational activity and development. We have positioned the study in a pragmatic paradigm, focusing on the interaction between individuals (i.e. ELMER post-holders) and their environment, emphasising experiential research, and actionable knowledge. The study will use a mixed methods approach using a survey, followed by interviews, inviting any current ELMER post-holders to take part. Qualitative data will be analysed using reflexive thematic analysis, developing and telling the story of current ELMER post-holders.

Alongside the prior review of ELMER posts across the UK, the primary objective of this integral work is to offer insights that can inform policy decisions on how ELMER roles can support doctors in training to become future trainers, assessors, and leaders in medical education.

Why is this work so important to me?

As someone who has been a CTF in the past, but having finished that formal role wondered ‘where next?’, this work adds to the evidence for the development of a more formalised medical education career pathway, supporting educators of the future, alongside their clinical training. The current lack of such a pathway risks losing excellent educators after their ELMER posts, a risk which the field of medical education should not leave to chance.

Watch out for details of how to be involved soon if you are an early-career educator, ‘ELMER’ – we’d love to hear your experience! Drop me an email at david.hettle@bristol.ac.uk if you want to hear any more before then.

References

  1. Church HR, Agius SJ. ‘The F3 phenomenon: Early-career training breaks in medical training. A scoping review’, Med Educ 2021; 55(9): 1033-46.
  2. Hettle D, Edwards LJ, McCormack R, et al. (2023, Dec 4-5). A UK-wide review of Entry-Level Medical Education Roles (ELMERs) [Poster presentation]. Developing Excellence in Medical Education, Manchester, UK.  https://www.demec.org.uk/category/demec-2023/
  3. Wilson S, Denison AR, McKenzie H. A survey of clinical teaching fellowships in UK medical schools. Med Educ 2008; 42(2): 170-5.

Hot Topics in Medical Education Research: Interdisciplinary Medical Education – Learning Better Together

In the second hot topics blog of 2024, Fiona Holmes considers the benefits and challenges of interdisciplinary learning. The inspiration for this came from teaching Clinical Perfusion Science students (clinical scientists who operate the heart-lung bypass during cardiac surgery) who come from different disciplinary backgrounds (bioscience/bioengineering and nursing/ODP), and who learn together and from each other and work as part of a complex multidisciplinary team.

What is IDL?

The World Health Organisation defines interdisciplinary learning (IDL) as ‘students from two or more professions learning about, from and with each other to enable effective collaboration and improve health outcomes’ and has stated that ‘interprofessional education and collaborative practice can play a significant role in mitigating many of the challenges faced by health systems around the world’.

What are the benefits of IDL?

Shared knowledge. Healthcare students face careers in increasingly complex healthcare systems where mutual understanding and integration of complementary expertise, communication, collaboration and decision making is key to comprehensive patient care and best outcomes. Medical issues and clinical situations often require a holistic understanding that goes beyond a single discipline; generalists and specialists need to work together. Practioners can’t know everything about everything!

Widened horizons. IDL can help students appreciate the interconnectedness of various factors important for patient care such as physiological, psychological, and social. IDL can expose students to different knowledge and perspectives such that they can analyse complex cases from different angles and integrate knowledge leading to more effective problem-solving in clinical settings. It can increase the ability to recognise bias, think critically and tolerate ambiguity.

Effective teamwork. IDL develops effective communication, collaboration and teamwork among healthcare professionals, important for delivering comprehensive and coordinated patient care. This can better prepare students for work in diverse healthcare settings and equip them with broader skills, enabling them to be more versatile and adaptable in their careers and enhancing their professional development.

Improved student experience. IDL can improve the student experience; by and large studies have shown that students express higher levels of engagement and satisfaction when exposed to IDL, which can contribute to improved learning outcomes.

How can IDL be implemented?

IDL can be incorporated into medical education in a number of ways, but to be effective it needs to be purposefully integrated into the curriculum and explicit in learning sessions (you can’t just throw students together and expect the learning to happen spontaneously). IDL lends itself to learning opportunities that can be designed to be authentic real-life situations such as:

  • Case-based learning (CBL) – students work together on case studies that require input from various professions to help them understand each other’s roles and contributions to patient care;
  • Simulated scenarios / role playing – students from different professions (or playing the role of different professions) collaborate to address the simulated patient’s needs, honing their teamwork and communication skills in a safe environment as well as understand the perspectives and responsibilities of each profession;
  • Interprofessional clinical experiences – students from various professions complete clinical placements together to expose them to the interprofessional dynamics of healthcare delivery in reality;
  • Team-based learning (e.g. clinical rounds) – students discuss patient cases and treatment plans collaboratively (builds upon CBL);
  • Interprofessional workshops/projects – bring students from various disciplines together to collaborate and develop solutions for healthcare challenges;
  • Reflective practices – such as team debriefing sessions and individual reflective journals to contemplate experiences, challenges, insights and opportunities for improvement, with a focus on the IDL.

What are the challenges of IDL?

Resource implications. Implementing IDL can pose logistical and resourcing (appropriately skilled staff – ideally interprofessional team teaching, time, costs) challenges; it can be difficult to coordinate curricula and schedules to bring different healthcare students together at appropriate time in their educational journey.

Timing. The jury is out as to when is the best time to implement IDL and for how long (e.g., periodic exposure or continuous immersion). Ideally team dynamics need time to develop, so communication becomes more open and collaborative, with trust and appreciation of diversity of knowledge.

Experience levels. While the point of IDL is to bring together diverse students for learning, there may be issues associated with this such as: Learner-level matching (do they have sufficient background knowledge and experience to work together effectively?); differences in learning preferences may be more exaggerated due to prior teaching and learning experiences; epistemics (the disciplinary ideas about what knowledge is and how to use and produce knowledge) and specific manner of communication are part of the culture of particular disciplines that may hinder IDL.

Perceptions and Biases. Perceptual barriers in competence perceptions may lead to a lack of self-confidence or respect for co-learners and personal characteristics such as curiosity, respect, and openness, patience, diligence, and self-regulation have been suggested to be important characteristics for enabling cognitive advancement in IDL.

Measures of impact. Evaluating the effectiveness of IDL can be challenging. Traditional assessment methods may not adequately capture the depth and breadth of knowledge, behaviour and attitudes or ‘interdisciplinary thinking and doing’ – i.e., the capacity to integrate knowledge and ways of thinking and doing across areas of expertise to produce a better outcome than could be achieved otherwise.

Future Research

While the general consensus is that IDL should be an integral part of the curriculum for healthcare students, the importance of IDL is largely based on theory and there remains a lack of large, multi-centre long-term studies. Therefore, currently it is unclear what strategies are best for long-term behaviour change and positive patient outcomes.

Some additional further reading:

Attitudes towards Interprofessional education in the medical curriculum: a systematic review of the literature | BMC Medical Education | Full Text (biomedcentral.com)

Experiential Learning of Interdisciplinary Care Skills in Surgery Assessed From Student Reflections – ScienceDirect

Interprofessional team-based learning (TBL): how do students engage? | BMC Medical Education | Full Text (biomedcentral.com)

Interdisciplinary education affects student learning: a focus group study | BMC Medical Education | Full Text (biomedcentral.com)

BMERG Blog

BMERG publishes a new blog every Friday on a range of topics of interest to both medical and other educators involved in higher and postgraduate education, including publishing, building community, conference and event reports, professional development opportunities, hot topics in #MedEd and more.

You can search for keywords below, choose from the categories list in the left side bar or check out the latest blogs linked below

Latest Blog Posts


  • BMERG Blog

    BMERG publishes a new blog every Friday on a range of topics of interest to both medical and other educators involved in higher and postgraduate education, including publishing, building community, conference and event reports, professional development opportunities, hot topics in #MedEd and more. You can search for keywords below, choose from the categories list in…


  • Building Community: BMERG Journal Club Review, Medical Education Research Labs

    The BMERG blog series on building community continues to grow, with a review of our recent journal club publication. Our BMERG Journal Club lead Dr Claire Hudson reflects on the discussion from our May journal club on the establishment of medical education research labs. Paper reviewed: Gisondi, Michael A. et al. The Purpose, Design, and…


  • BMERG News: Reflection on winning an ASME education award

    In this blog, Dr Grace Pearson reflects on her recent TASME Mentorship Prize from the Association for the Study of Medical Education. She describes how this award has supported her work in collaboration with the University of Zimbabwe Medical School. I was absolutely delighted to receive the 2024 TASME Mentorship Prize, which I’ve put towards…


  • Conference Report: TICC 2024: The Inaugural CTF Conference, 5th April, Bristol

    The latest blog is a conference report celebrating the work of clinical teaching fellows across our region. Ed Luff reflects on this event and shares exciting plans for TICC 2025. On Friday the 5th of April, the University of Bristol, in collaboration with BMERG, hosted TICC 2024: The Inaugural CTF Conference. TICC 2024 provided an…


Hot Topics in Medical Education Research: Virtual Reality – what’s the reality?

The next hot topic under review from BMERG’s Fiona Holmes is Virtual Reality. In her blog she explores the different types of VR and shares and how her team is trialling the technique to enhance education practice and experience for student learners.

Photo by Bermix Studio on Unsplash

Virtual reality (VR) is not new, but it’s new to me, and I was curious to learn more about VR simulation in the context of medical education: What exactly is it? What has it been used for successfully? What are its limitations?

So, what is VR?

VR is an artificial reality with which a user/student can interact. The main difference between the types of VR is the extent of ‘immersability’ and interaction within the VR.

Fully immersive VR

This is the ultimate VR experience within a virtual environment, disconnected from real life.

It involves wearing a VR head mounted display (HMD) and may also involve other equipment such as haptic (real feel) data gloves, voice recognition and sound software. It puts the healthcare learner completely inside the experience complete with a virtual surgical team, equipment, and patient. Like being in a real-life computer game.

Fully immersive VR has been used particularly effectively in surgical training programmes to practice procedures (decreases injury, increases speed and improves overall outcomes) and manage cases and has been shown to enhance experiential learning and acquisition of cognitive, psychomotor, and affective skills.

Immersive VR can incorporate virtual worlds that can involve multiple participants in different locations. They have been used for training in the management of stressful emergency or major incident situations and can hone attention, decision making, critical thinking, clinical reasoning, multi-tasking and communication skills. However, so far, fully immersive VR hasn’t been used widely in medical education mainly due to the high upfront costs.

Semi-immersive VR

This doesn’t fully enclose the user/student in the virtual environment although interaction can involve using headsets or motion controllers connected to a computer which displays e.g., medical simulations. Augmented reality fits into this category and involves overlaying images onto the real world and it has been used to visualise anatomy and practice surgical procedures on physical models.

Non-immersive VR

Some suggest this isn’t really VR, and although it is a lower tech, provides a more accessible (cost and ease of use) method of providing an interactive environment for clinical educational experiences. Simulations of medical procedures or clinical scenarios (which can be standardised to current protocols) on a computer can be interacted with using a keyboard or mouse. Some applications incorporate gamification which can enhance engagement.

How we are going to trial VR in our programme

I co-ordinate the Clinical Perfusion Science programme at Bristol, where our students are training to be perfusionists, the professionals who operate the heart-lung bypass machine during cardiac surgery. Alongside teaching and learning of relevant theory they hone their practical clinical skills on the job, based in hospitals throughout the United Kingdom and Ireland, becoming independent practitioners over a period of about 2 years.

While in Bristol they do some low-fidelity practicals, and some simulations (situations that replicate real-life clinical perfusion scenarios using a high-fidelity ‘beating heart’ manikin and cardiopulmonary bypass pump followed by feedback and debriefing). There is no doubt that simulation is an essential and effective part of clinical education and it’s always our students’ favourite part of their study blocks. They really value the freedom to practice with their peers and ask questions in a safe environment, but there simply isn’t enough time, space, or resources to fit in as much as we or they would like.

While VR cannot substitute for in person simulations and certainly not the real clinical experience of a multidisciplinary potentially high stress environment of a cardiac surgery operating theatre, we want another way to bring in more clinically relevant and practical teaching to their education. Ideally it would allow standardised and repeatable, with everyone able to have a go multiple times, safe, controlled, flexible, scalable learning at a distance. Clinical experiences could be shared between our students in hospitals across the world.

Due to the accessibility and ease of use of non-immersive VR, we have chosen to trial this type of VR to meet some of our training objectives using the VirCPB system, a gamified online cardiopulmonary bypass training program. VirCPB is relatively easy to set up, affordable, and it doesn’t require the students to have anything more than a laptop to access a virtual cardiac theatre via a link.

We will use it as a formative learning tool, an adjunct to our in-person simulation sessions. Practice makes perfect and students can engage multiple times, flexibly, autonomously as well as collaboratively. It will be combined with feedback and debriefing to develop technical and non-technical skills. We and the students can monitor their performance and improvement. We hope it will provide a standardised and objective way to potentially assess competency.

We are going to start with a product trial to evaluate the benefits of VR in a study led by Jody Stafford, Honorary Lecturer, Bristol Medical School. We believe that students will benefit from this experience and hope we can incorporate it into our programme more permanently – watch this space!

Read more:

If this blog has sparked your interest, here are a couple of examples of papers about VR techniques in medicine:

Current and Future Applications of Virtual, Augmented, and Mixed Reality in Cardiothoracic Surgery – The Annals of Thoracic Surgery (annalsthoracicsurgery.org)

Virtual Reality: The Future of Invasive Procedure Training? – Journal of Cardiothoracic and Vascular Anesthesia (jcvaonline.com)

Using Virtual Reality Simulation Environments to Assess Competence for Emergency Medicine Learners – McGrath – 2018 – Academic Emergency Medicine – Wiley Online Library


Hot Topics: Medical Education Research – Why, How, Why and What

In the next of our hot topic blogs, Dr Fiona Holmes from our BMERG committee talks about what actually defines a ‘Hot topic’ in Medical Education, and the importance of thinking about why and how we find out about what’s new and upcoming in our discipline.

 

Photo by Guido Jansen on Unsplash

While I was thinking about what to discuss, I realised that what I think is a hot topic might be just lukewarm to other people. We are all driven by different interests, experiences, and priorities.

In the hope of finding relevant and interesting subjects I started by looking into why a topic is hot, how they are identified and why this is important (which links back to why a topic is hot). This led me to what main areas of medical education are currently widely considered to be hot, and we look forward to exploring some of these in more depth in future hot topic blogs.

Why are topics considered ‘hot’?

Hot topics are influenced by various social and cultural contexts and needs, and may be hot because they are:

  • Relevant
  • Controversial
  • Timely
  • Impactful
  • Novel

Within medical education, and by extension pedagogical research in this field, there are a wide range of factors that have been identified to contribute to hotness:

  • Advancements in knowledge and technology: It has been estimated that new medical information doubles every 73 days. What and how to teach and the evaluation of learning needs to keep pace with these developments. How to prepare students to deal with such rapid developments and to be life-long learners is also a priority. Advances in technology for teaching and learning as well as the practice of medicine are transforming healthcare and its education. Adapting education to these technological changes will ensure future healthcare professionals are prepared to utilise these tools effectively.

  • Patient-centred care: With ever-changing healthcare needs and demographics, education research is needed to address the teaching of emerging health concerns, population health management, and the needs of diverse patient populations. This is twinned with a need for more consideration of patients’ values, preferences, and needs when making healthcare decisions therefore effective education in communication skills, empathy, cultural competence, and shared decision-making.

  • Interprofessional collaboration: Effective co-training of different healthcare professionals to foster teamwork skills to prepare students for collaborative healthcare environments.

  • Accreditation, regulation, stakeholder input: Accreditation bodies and regulatory agencies may revise guidelines to promote quality, safety, and innovation in medical education, prompting educational institutions to adapt their curricula accordingly. Such changes can drive research in this area. Likewise, public expectations, patient advocacy, and input from stakeholders (e.g., healthcare providers, patients, policymakers) play a role in shaping medical education and its research. These can influence curriculum content, teaching methods, and the overall educational experience.

  • Global health and environmental challenges: Global health issues, such as pandemics, emerging infectious diseases, health disparities, as well as environmental contexts highlight the need for a globally competent healthcare workforce. Medical education is addressing these challenges by incorporating global health content, cross-cultural training, and exposure to international healthcare systems.

Then of course there is medical education research itself and the innovation and design that comes with sharing evidence-based practice. This contributes to the evolution of medical education by identifying effective teaching methods, assessment tools, and strategies for continued professional development and aiming to ensure that innovation is beneficial.

How do hot topics get identified and become ‘hot’?

You may initially think that hot topics are simply those that are most prevalent in the current medical education journals, and this may well be true. Most things move in cycles and there are often trends for the types of issues that we see and trends in the solutions implemented. But, when you think about it, how do we find out what is prevalent or ‘trending’ at any given time?

There are number of ways to identify recurring themes, emerging topics and changes in research focus and involve both quantitative and qualitative research methods, and there is some overlap in the methods used. Examples include:

  • Literature review:  The systematic search, selection, and evaluation of relevant studies.
  • Bibliometric analysis: Analysis of publication and citation patterns over time to provide insight into the volume of research, popular topics, influential authors, and collaborations within the field.
  • Content analysis: Systematically categorise and analyse the content of research articles, conference proceedings to identify patterns and trends in research articles, social media discussions and online forums.
  • Surveys/questionnaires: Analysis of perceptions and attitudes of educational practices and emerging trends.
  • Interviews/focus groups: In-depth exploration of topics and contextual information.

Let’s look at an example:

Ji et al (2018) used social network analysis to identify changing trends in medical education and interpreted their findings to suggest 5 eras of medical education:

Figure. Ji et al Eras of medical education research

They determined that “during the 53-year period studied, medical education research has been subdivided and has expanded, improved, and changed along with shifts in society’s needs.” By analysing the trends they determined that medical education is forming a sense of the ‘voluntary order’ within the field and establishing legitimacy and originality. (Ji et al (2018) Research topics and trends in medical education by social network analysis | BMC Medical Education | Full Text (biomedcentral.com)).

So, why do we need to know about hot topics?

Hot topic research is important to ensure that medical education remains dynamic, responsive, and aligned with the evolving demands of the healthcare field and the needs of the learner. It supports the continuous improvement of medical education, leading to better-prepared healthcare professionals and ultimately improved patient outcomes.

Identifying hot topics helps time-limited researchers and educators stay informed about the latest trends, innovations, and challenges in medical knowledge, education and assessment practices to enhance teaching and learning methods, and to focus efforts on areas that require attention. This can then inform curriculum development and promote evidence-based practices.

Sharing hot topic research also helps to foster collaboration and networking among those with shared interests, leading to the exchange of ideas and development of research networks. As this grows, this helps institutions and funders prioritise and allocate resources by identifying areas of high research interest and impact. This is particularly important in identifying areas of medical education that are under-researched or require further attention.

What is hot right now?

Here are 8 of the hottest topics currently shaping medical education research in 2023:

  • Technology in education: Virtual (VR) and augmented reality (AR). Digital tools to engage with, filter and disseminate information that are interactive, efficient, and individualised.

  • Experiential and simulation-based learning: Through VR and AR, standardised patients, manikins, clinical scenarios to allow students to practice complex procedures and decision-making in a safe and controlled environment, improving their skills, confidence and safety.

  • Interdisciplinary education and team-based learning: Students from various healthcare disciplines learn about, from and with each other collaboratively. Case-based discussions and interprofessional simulations and debriefing, allow students to develop the skills needed to function in teams. It improves patient outcomes and enhances healthcare delivery and professional satisfaction by encouraging mutual respect, understanding, and effective communication.

  • Diversity, equity, and inclusion: Recruitment and retention of students from diverse backgrounds so that the healthcare profession better represents the patient population. Educating students in culturally appropriate care practices and social determinants of health. Learning environments to promote respect for diverse perspectives and equality of opportunities.

  • Competency-based education: Teaching and assessing ability to perform specific tasks and skills rather than relying solely on traditional exams to ensure proficiency in essential competencies required for clinical practice.

  • Biopsychosocial education: Effective teaching and learning to provide a more holistic, ethical and comprehensive approach to patient case.

  • Wellness and resilience: Self-care, stress management, and mental health support approaches such as mindfulness and peer support networks. Curriculum reform, including flexible scheduling, reducing workload and modifying assessment practices to create a healthier learning environment and promote a culture of empathy and compassion in healthcare.

  • Data-driven and evidence-based medicine: Education in critical appraisal of biomedical literature, interpret research findings, and apply evidence-based practices in clinical decision-making.

  • Photo by Bermix Studio on Unsplash

    So, I hope it is interesting to consider why we should know the hot topics for research and identify topics that are warming up so that we can strive towards thoroughness in medical education research. We look forward to sharing more hot topics through the BMERG blog.

    “Medical education is not just a program for building knowledge and skills in its recipients… it is also an experience which creates attitudes and expectations.” Abraham Flexner

    You can also check out Grace’s recent hot topic blog on Reflexive Thematic Analysis here


    Do you have a hot topic that you would like to write about for BMERG? Get in touch at brms-bmerg@bristol.ac.uk