Clinical Education for the Health Professions

Clinical Education for the Health Professions Debra Nestel • Gabriel Reedy • Lisa McKenna • Suzanne Gough Editors Clinical Education for the Health Professions Theory and Practice With 128 Figures and 94 Tables Editors Debra Nestel Monash University School of Clinical Sciences Clayton, VIC, Australia Gabriel Reedy King’s College London London, UK University of Melbourne Department of Surgery (Austin) Melbourne, VIC, Australia Lisa McKenna La Trobe University School of Nursing and Midwifery Melbourne, VIC, Australia Suzanne Gough Bond University Faculty of Health Sciences and Medicine Gold Coast, QLD, Australia ISBN 978-981-15-3343-3 ISBN 978-981-15-3344-0 (eBook) https://doi.org/10.1007/978-981-15-3344-0 © Springer Nature Singapore Pte Ltd. 2023 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd. The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore Preface The education and training of health professionals is fundamental to the success of health services. Philosophies, approaches, and practices vary internationally. We frame clinical education as any activities that prepare health professionals to learn and work effectively in clinical settings. We believe this major reference work, Clinical Education for the Health Professions, represents, supports, and advances scholarship and practice in this field. It assembles accessible and evidence-based content, on what is known about many facets of clinical education. Clinical Education for the Health Professions is divided into eight parts. We start with the contemporary context of health professions education; shift focus to theoretical underpinnings, curriculum considerations, and approaches to supporting learning in clinical settings; a specific focus to assessment approaches; and then to evidence-based educational methods and content. Governance and other formal processes associated with the maturation of education programs are also considered, including the increasing professionalization of clinical education. Finally, we look to the future drawing upon much of what has surfaced in the past and present. The development of multi-authored international work can be complex. We outline the development process in the introduction. We are grateful for the generosity of contributors – researchers, educators, and clinicians – who have given their time, especially coinciding with the COVID-19 pandemic. Melbourne, Australia London, UK Melbourne, Australia Gold Coast, Australia July 2023 Debra Nestel Gabriel Reedy Lisa McKenna Suzanne Gough Editors v Acknowledgments We are grateful to all the contributors to this major reference work. We thank Ms. Shameem Aysha S. of Springer Nature for coordinating the editorial process. vii Contents Volume 1 Part I The Contemporary Context of Health Professions Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 Medical Education: Trends and Context Jennene Greenhill .................... 3 2 Surgical Education: Context and Trends . . . . . . . . . . . . . . . . . . . . David J. Coker 29 3 General Practice Education: Context and Trends . . . . . . . . . . . . . Susan M. Wearne and James B. Brown 49 4 Anesthesia Education: Trends and Context . . . . . . . . . . . . . . . . . . S. D. Marshall and M. C. Turner 69 5 Clinical Education in Nursing: Current Practices and Trends Marilyn H. Oermann and Teresa Shellenbarger ... 87 6 Nursing Education in Low and Lower-Middle Income Countries: Context and Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . Christine Sommers and Carielle Joy Rio 107 7 Obstetric and Midwifery Education: Context and Trends . . . . . . . Arunaz Kumar and Linda Sweet 121 8 Allied Health Education: Current and Future Trends . . . . . . . . . . Michelle Bissett, Neil Tuttle, and Elizabeth Cardell 135 9 Dental Education: Context and Trends Flora A. Smyth Zahra and Sang E. Park ..................... 153 Interprofessional Education (IPE): Trends and Context . . . . . . . . Lyn Gum and Jenn Salfi 167 10 ix x 11 12 13 Contents Global Surgery and Its Trends and Context: The Case of Timor-Leste . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sean Stevens 181 Surgical Training: Impact of Decentralization and Guidelines for Improvement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Christine M. Cuthbertson 201 Mental Health Education: Contemporary Context and Future Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Christopher Kowalski and Chris Attoe 217 14 Dental Education: A Brief History . . . . . . . . . . . . . . . . . . . . . . . . . Andrew I. Spielman 251 15 Surgical Education and Training: Historical Perspectives . . . . . . . John P. Collins 267 16 Nursing and Midwifery Education: Historical Perspectives . . . . . . Lisa McKenna, Jenny Davis, and Eloise Williams 285 17 Health Sciences and Medicine Education in Lockdown: Lessons Learned During the COVID-19 Global Pandemic . . . . . . . . . . . . . Suzanne Gough, Robin Orr, Allan Stirling, Athanasios Raikos, Ben Schram, and Wayne Hing Part II Philosophical and Theoretical Underpinning of Health Professions Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Cognitive Neuroscience Foundations of Surgical and Procedural Expertise: Focus on Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pamela Andreatta 303 333 335 19 Mastery Learning in Health Professions Education . . . . . . . . . . . . Raymond Yap 347 20 Threshold Concepts and Troublesome Knowledge . . . . . . . . . . . . . Sarah E. M. Meek, Hilary Neve, and Andy Wearn 361 21 Social Semiotics: Theorizing Meaning Making Jeff Bezemer ............... 385 22 Communities of Practice and Medical Education . . . . . . . . . . . . . . Claire Condron and Walter Eppich 403 23 Activity Theory in Health Professions Education Research and Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Richard L. Conn, Gerard J. Gormley, Sarah O’Hare, and Anu Kajamaa 24 Reflective Practice in Health Professions Education . . . . . . . . . . . Jennifer M. Weller-Newton and Michele Drummond-Young 417 441 Contents 25 xi Transformative Learning in Clinical Education: Using Theory to Inform Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Anna Jones 463 26 Self-Regulated Learning: Focus on Theory Susan Irvine and Ian J. Irvine .................. 481 27 Critical Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nancy McNaughton and Maria Athina (Tina) Martimianakis 499 28 Focus on Theory: Emotions and Learning . . . . . . . . . . . . . . . . . . . Aubrey L. Samost-Williams and Rebecca D. Minehart 521 29 Ecological Systems Theory in Clinical Learning Yang Yann Foo and Raymond Goy .............. 537 30 Philosophy for Healthcare Professions Education: A Tool for Thinking and Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kirsten Dalrymple and Roberto di Napoli 555 Part III Curriculum Considerations in Health Professions Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573 31 Health Profession Curriculum and Public Engagement . . . . . . . . . Maree O’Keefe and Helena Ward 575 32 Teaching and Learning Ethics in Healthcare . . . . . . . . . . . . . . . . . Selena Knight and Andrew Papanikitas 587 33 Simulation as Clinical Replacement: Contemporary Approaches in Healthcare Professional Education . . . . . . . . . . . . . . . . . . . . . . . Suzie Kardong-Edgren, Sandra Swoboda, and Nancy Sullivan 607 34 Teaching Simple and Complex Psychomotor Skills . . . . . . . . . . . . Delwyn Nicholls 35 Developing Professional Identity in Health Professional Students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Kathleen Leedham-Green, Alec Knight, and Rick Iedema 645 Hidden, Informal, and Formal Curricula in Health Professions Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lisa McKenna 667 36 625 37 Arts and Humanities in Health Professional Education . . . . . . . . . Pam Harvey, Neville Chiavaroli, and Giskin Day 681 38 Debriefing Practices in Simulation-Based Education . . . . . . . . . . . Peter Dieckmann, Rana Sharara-Chami, and Hege Langli Ersdal 699 xii 39 40 Contents Written Feedback in Health Sciences Education: “What You Write May Be Perceived as Banal” . . . . . . . . . . . . . . . . . . . . . . . . Brian Jolly 717 Technology Considerations in Health Professions and Clinical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Christian Moro, Zane Stromberga, and James Birt 743 41 Role of Social Media in Health Professions Education . . . . . . . . . . Victoria Brazil, Jessica Stokes-Parish, and Jesse Spurr 42 E-learning: Development of a Fully Online 4th Year Psychology Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F. J. Garivaldis, S. P. McKenzie, and M. Mundy 43 44 Teaching Diversity in Healthcare Education: Conceptual Clarity and the Need for an Intersectional Transdisciplinary Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Helen Bintley and Riya E. George Planetary Health: Educating the Current and Future Health Workforce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Michelle McLean, Lynne Madden, Janie Maxwell, Patricia Nanya Schwerdtle, Janet Richardson, Judith Singleton, Kristen MacKenzie-Shalders, Georgia Behrens, Nick Cooling, Richard Matthews, and Graeme Horton 765 777 795 815 Volume 2 Part IV 45 46 47 48 Supporting Learning in Clinical Settings . . . . . . . . . . . . . . . . 845 Learning and Teaching in Clinical Settings: Expert Commentary from an Interprofessional Perspective . . . . . . . . . . . . . . . . . . . . . . Debra Kiegaldie 847 Learning and Teaching at the Bedside: Expert Commentary from a Nursing Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Michelle A. Kelly and Jan Forber 869 Learning and Teaching in Clinical Settings: Expert Commentary from a Midwifery Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Linda Sweet and Deborah Davis 891 Learning and Teaching in the Operating Room: A Surgical Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . V. Chao, C. Ong, Debra Kiegaldie, and Debra Nestel 909 Contents 49 xiii Learning and Teaching in the Operating Theatre: Expert Commentary from the Nursing Perspective . . . . . . . . . . . . . . . . . . Rachel Cardwell, Emmalee Weston, and Jenny Davis 933 50 Learning and Teaching in Pediatrics . . . . . . . . . . . . . . . . . . . . . . . Ramesh Mark Nataraja, Simon C. Blackburn, and Robert Roseby 955 51 Optimizing the Role of Clinical Educators in Health Professional Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Simone Gibson and Claire Palermo 985 ................... 999 52 Well-Being in Health Profession Training Andrew Grant 53 Embedding a Simulation-Based Education Program in a Teaching Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1017 Rebecca A. Szabo and Kirsty Forrest 54 Targeting Organizational Needs Through the Development of a Simulation-Based Communication Education Program . . . . . . . 1039 J. Sokol and M. Heywood 55 Effective Feedback Conversations in Clinical Practice . . . . . . . . . . 1055 C. E. Johnson, C. J. Watling, J. L. Keating, and E. K. Molloy 56 Supervision in General Practice Settings . . . . . . . . . . . . . . . . . . . . 1073 James Brown and Susan M. Wearne 57 Conversational Learning in Health Professions Education: Learning Through Talk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1099 Walter J. Eppich, Jan Schmutz, and Pim Teunissen 58 Underperformance in Clinical Education: Challenges and Possibilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1119 Margaret Bearman Part V Assessment in Health Professions Education . . . . . . . . . . . . . 1133 59 Approaches to Assessment: A Perspective from Education . . . . . . 1135 Phillip Dawson and Colin R. McHenry 60 Measuring Attitudes: Current Practices in Health Professional Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1149 Ted Brown, Stephen Isbel, Mong-Lin Yu, and Thomas Bevitt 61 Measuring Performance: Current Practices in Surgical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1177 Pamela Andreatta, Brenton Franklin, Matthew Bradley, Christopher Renninger, and John Armstrong xiv Contents 62 Programmatic Assessment in Health Professions Education . . . . . 1203 Iris Lindemann, Julie Ash, and Janice Orrell 63 Entrustable Professional Activities: Focus on Assessment Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1221 Andrea Bramley and Lisa McKenna 64 Workplace-Based Assessment in Clinical Practice . . . . . . . . . . . . . 1235 Victor Lee and Andrea Gingerich 65 Focus on Selection Methods: Evidence and Practice . . . . . . . . . . . 1251 Louise Marjorie Allen, Catherine Green, and Margaret Hay 66 Practice Education in Occupational Therapy: Current Trends and Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1277 Stephen Isbel, Ted Brown, Mong-Lin Yu, Thomas Bevitt, Craig Greber, and Anne-Maree Caine 67 Practice Education in Lockdown: Lessons Learned During the COVID-19 Global Pandemic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1303 Luke Robinson, Ted Brown, Ellie Fossey, Mong-Lin Yu, Linda Barclay, Eli Chu, Annette Peart, and Libby Callaway Part VI Evidence-Based Health Professions Education: Focus on Educational Methods and Content . . . . . . . . . . . . . . . . . . . . . . . . . 1323 68 Team-Based Learning (TBL): Theory, Planning, Practice, and Implementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1325 Annette Burgess and Elie Matar 69 Learning with and from Peers in Clinical Education . . . . . . . . . . . 1355 Joanna Tai, Merrolee Penman, Calvin Chou, and Arianne Teherani 70 Simulation for Procedural Skills Teaching and Learning Taylor Sawyer, Lisa Bergman, and Marjorie L. White 71 Simulation for Clinical Skills in Healthcare Education . . . . . . . . . 1395 Guillaume Alinier, Ahmed Labib Shehatta, and Ratna Makker 72 Screen-Based Learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1417 Damir Ljuhar 73 Artificial Intelligence in Surgical Education and Training . . . . . . . 1435 Melanie Crispin 74 Coaching in Health Professions Education: The Case of Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1447 Martin Richardson and Louise Richardson . . . . . . . 1375 Contents xv 75 Developing Health Professional Teams . . . . . . . . . . . . . . . . . . . . . . 1463 John T. Paige 76 Developing Care and Compassion in Health Professional Students and Clinicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1485 Karen Livesay and Ruby Walter 77 Developing Patient Safety Through Education . . . . . . . . . . . . . . . . 1501 David Pinnock 78 Supporting the Development of Professionalism in the Education of Health Professionals . . . . . . . . . . . . . . . . . . . . . . . . . 1519 Anne Stephenson and Julie Bliss 79 Supporting the Development of Patient-Centred Communication Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1535 Bernadette O’Neill 80 Contemporary Sociological Issues for Health Professions Curricula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1553 Margaret Simmons 81 Developing Clinical Reasoning Capabilities . . . . . . . . . . . . . . . . . . 1571 Joy Higgs Part VII Governance, Quality Improvement, Scholarship and Leadership in Health Professions Education . . . . . . . . . . . . . . . . . . . . 1589 82 Professional Bodies in Health Professions Education . . . . . . . . . . . 1591 Julie Browne 83 Scholarship in Health Professions Education . . . . . . . . . . . . . . . . . 1611 Lisa McKenna 84 Developing Educational Leadership in Health Professions Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1627 Margaret Hay, Leeroy William, Catherine Green, Eric Gantwerker, and Louise Marjorie Allen 85 On “Being” Participants and a Researcher in a Longitudinal Medical Professional Identity Study . . . . . . . . . . . . . . . . . . . . . . . . 1657 Michelle McLean, Charlotte Alexander, and Arjun Khaira 86 Health Care Practitioners ‘Becoming’ Doctors: Changing Roles and Identities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1671 Michelle McLean and Carla Pecoraro xvi Contents Part VIII Future Directions for Health Professions Education . . . . . 1691 87 Health Professional Education in 2020: A Trainee Perspective . . . 1693 Karen Muller and Savannah Morrison 88 Future of Health Professions Education Curricula . . . . . . . . . . . . 1705 Eric Gantwerker, Louise Marjorie Allen, and Margaret Hay 89 Competencies of Health Professions Educators of the Future . . . . 1727 Louise Marjorie Allen, Eric Gantwerker, and Margaret Hay Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1737 About the Editors Debra Nestel has worked at the University of Hong Kong, China, Imperial College, United Kingdom, the University of Melbourne and Monash University, Australia, for over 35 years. Her first degree was in sociology, and her doctorate was in program evaluation and communication skills education in medicine and dentistry. Currently, her education and research activities focus on faculty development for health professional, surgical, and simulation educators. Dr. Debra is an experienced editor-in-chief (EIC) and has edited several books. She was the foundation EIC of Advances in Simulation and is EIC of the International Journal for Healthcare Simulation. Dr. Debra is a Fellow of the Academy of the Society for Simulation in Healthcare (United States) and is also a Fellow of the Academy of Medical Educators (United Kingdom). In 2021, Dr. Debra was appointed as Member of the Order of Australia for her service to medical education and simulation. She has received the Ray Page Lifetime Simulation Service Award and a Presidential Citation from the Society for Simulation in Healthcare. Gabriel Reedy has led the interprofessional postgraduate program in health professions education at King’s College, London, the largest health sciences university in Europe, for most of his academic career. His research focuses on how healthcare professionals and emergency responders learn, how to support and train them more effectively, with a focus on the power of simulated environments, and how they can help train individuals, teams, departments, organizations, and inter-agency systems. He is a Principal Fellow of the Higher xvii xviii About the Editors Education Academy (United Kingdom), a Fellow of the Academy of Medical Educators (United Kingdom), and a Fellow of the Academy of the Society for Simulation in Healthcare (United States). He has served on the Scientific Committee of the Society for Simulation in Europe (SESAM) and the Research Committee for the Society for Simulation in Healthcare (United Kingdom). He is Editor-in-Chief of Advances in Simulation. Lisa McKenna has worked at Monash University and La Trobe University, Australia, for over 30 years. Her initial qualifications were hospital-based nursing and midwifery certificates with her first degree in education. She has since completed postgraduate degrees in education, business administration, and history, and a PhD in nursing. Lisa is currently the Dean of the School of Nursing and Midwifery at La Trobe, and EIC of Collegian: The Australian Journal of Nursing Practice, Scholarship and Research from 2014 to 2022. Prof. Lisa has published extensively on nursing, midwifery, and health professions education. Her recent research has focused on health workforce development and competence. In 2022, Prof. Lisa was inducted into the Sigma International Nurse Researcher Hall of Fame. Suzanne Gough is an Associate Professor of Physiotherapy and Associate Dean of Learning and Teaching at Bond University, Australia. She is a member of the Bond Translational Simulation Collaborative team, with national and international experience in healthcare simulation education. Suzanne transitioned from clinical to academic practice in 2004, as a Senior Lecturer at Manchester Metropolitan University. She is a Principal Fellow of the Higher Education Academy (United Kingdom). As Principal Investigator, she has led international project teams to develop simulated patient governance frameworks and training resources for use across the United Kingdom, on behalf of Health Education England. Suzanne’s current research interests include the use of virtual reality across diverse patient groups, simulation and technology-enhanced learning, stress and burnout, and curriculum design. Contributors Charlotte Alexander Emergency Department, Gold Coast University Hospital, Gold Coast, QLD, Australia Guillaume Alinier Hamad Medical Corporation Ambulance Service, Doha, Qatar School of Health and Social Work, University of Hertfordshire, Hatfield, UK Weill Cornell Medicine Qatar, Doha, Qatar Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK Louise Marjorie Allen Monash Centre for Professional Development and Monash Online Education, Monash University, Clayton, VIC, Australia Pamela Andreatta The Norman M. Rich Department of Surgery, Uniformed Services University & the Walter Reed National Military Medical Center “America’s Medical School”, Bethesda, MD, USA John Armstrong University of South Florida Morsani College of Medicine, Tampa, FL, USA Julie Ash Prideaux Centre for Health Professions Education, Flinders University, Adelaide, SA, Australia Chris Attoe Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK Linda Barclay Department of Occupational Therapy, Monash University – Peninsula Campus, Frankston, VIC, Australia Margaret Bearman Centre for Research in Assessment and Digital Education (CRADLE), Deakin University, Melbourne, VIC, Australia Georgia Behrens School of Medicine, Sydney, University of Notre Dame, Sydney, NSW, Australia Lisa Bergman The Office of Interprofessional Simulation for Innovative Clinical Practice, University of Alabama at Birmingham, Birmingham, AL, USA xix xx Contributors Thomas Bevitt Faculty of Health, The University of Canberra Hospital, Canberra, Bruce ACT, Australia Jeff Bezemer Institute of Education, University College London, London, UK Helen Bintley Barts and The London, School of Medicine and Dentistry, Queen Mary University of London, London, UK James Birt Faculty of Society and Design, Bond University, Gold Coast, QLD, Australia Michelle Bissett Discipline of Occupational Therapy, Griffith University, Gold Coast, QLD, Australia Simon C. Blackburn The Learning Academy, Great Ormond Street Hospital for Children, London, UK Julie Bliss Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK Matthew Bradley The Norman M. Rich Department of Surgery, Uniformed Services University & the Walter Reed National Military Medical Center “America’s Medical School”, Bethesda, MD, USA Andrea Bramley Department of Dietetics and Human Nutrition, La Trobe University, Melbourne, VIC, Australia Victoria Brazil Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia James B. Brown Eastern Victoria GP Training, Churchill, VIC, Australia Gippsland Medical School, Monash University , Churchill, VIC, Australia James Brown Royal Australian College of General Practice, East Melbourne, VIC, Australia Gippsland Medical School, Monash University, Churchill, VIC, Australia Ted Brown Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University – Peninsula Campus, Frankston, VIC, Australia Julie Browne Centre for Medical Education, Cardiff University School of Medicine, Cardiff, UK Annette Burgess Faculty of Medicine and Health, Sydney Medical School, Education Office, The University of Sydney, Sydney, NSW, Australia Faculty of Medicine and Health, Sydney Health Professional Education Research Network, The University of Sydney, Sydney, NSW, Australia Anne-Maree Caine School of Allied Health Sciences – Occupational Therapy, Griffith University, Nathan, QLD, Australia Contributors xxi Libby Callaway Department of Occupational Therapy, Monash University – Peninsula Campus, Frankston, VIC, Australia Elizabeth Cardell Discipline of Speech Pathology, Griffith University, Gold Coast, Australia Rachel Cardwell Austin Health, La Trobe University, Melbourne, VIC, Australia V. Chao National Heart Centre, Singapore, Singapore Neville Chiavaroli Department of Medical Education, University of Melbourne, Melbourne, VIC, Australia Calvin Chou Department of Medicine, University of California, San Francisco and Veterans Affairs Health System, San Francisco, CA, USA Eli Chu Department of Occupational Therapy, Monash University – Peninsula Campus, Frankston, VIC, Australia David J. Coker Department of Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia Discipline of Surgery, University of Sydney, Camperdown, NSW, Australia John P. Collins University Department of Surgery, University of Melbourne, Melbourne, Australia Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK Green Templeton College, Oxford, UK Claire Condron RSCI University of Medicine and Health Sciences, Dublin, Ireland Richard L. Conn Centre for Medical Education, Queen’s University Belfast, Belfast, UK Nick Cooling School of Medicine, College of Health & Medicine, University of Tasmania, Hobart, TAS, Australia Melanie Crispin Monash Health & The University of Melbourne, Melbourne, Australia Christine M. Cuthbertson Monash Rural Health, Bendigo, Monash University, North Bendigo, VIC, Australia Kirsten Dalrymple Department of Surgery and Cancer, Imperial College London, London, UK Deborah Davis University of Canberra and Canberra Hospital and Health Services, Canberra, ACT, Australia Jenny Davis School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia xxii Contributors Phillip Dawson Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Geelong, VIC, Australia Giskin Day Imperial College London, London, UK Roberto di Napoli Centre for Innovation and Development for Education, St. George’s University of London, London, UK Peter Dieckmann Copenhagen Academy for Medical Education and Simulation (CAMES), Center for Human Resources and Education, Herlev and Getofte Hospital, Herlev, Denmark Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark Michele Drummond-Young School of Nursing, McMaster University, Hamilton, ON, Canada Walter J. Eppich RCSI SIM Centre for Simulation Education and Research, RCSI University of Medicine and Health Sciences, Dublin, Ireland Hege Langli Ersdal Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway Yang Yann Foo Office of Education, Duke-NUS Medical School, Singapore, Singapore Jan Forber School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW, Australia Kirsty Forrest Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia Ellie Fossey Department of Occupational Therapy, Monash University – Peninsula Campus, Frankston, VIC, Australia Brenton Franklin The Norman M. Rich Department of Surgery, Uniformed Services University & the Walter Reed National Military Medical Center “America’s Medical School”, Bethesda, MD, USA Eric Gantwerker Northwell Health, Lake Success, NY, USA Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, USA F. J. Garivaldis School of Psychological Sciences, Monash University, Melbourne, VIC, Australia Riya E. George Barts and The London, School of Medicine and Dentistry, Queen Mary University of London, London, UK Contributors xxiii Simone Gibson Deparment of Nutrition, Dietetics and Food, Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia School of Clinical Sciences, Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia Andrea Gingerich Northern Medical Program, University of Northern British Columbia, Prince George, BC, Canada Gerard J. Gormley Centre for Medical Education, Queen’s University Belfast, Belfast, UK Suzanne Gough Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia Raymond Goy KKH Women and Children’s Hospital, Singapore, Singapore Andrew Grant Emeritus Professor Swansea University, Swansea, UK Craig Greber Faculty of Health, University of Canberra, Canberra, ACT, Australia Catherine Green Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia Jennene Greenhill Rural Clinical School, University of Western Australia, Perth, WA, Australia Lyn Gum College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia Pam Harvey La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia Margaret Hay Faculty of Education, Monash Centre for Professional Development and Monash Online Education, Monash University, Clayton, VIC, Australia M. Heywood The Royal Children’s Hospital Simulation Program, Department of Medical Education, The Royal Children’s Hospital, Melbourne, VIC, Australia Joy Higgs Professional Practice and Higher Education, Charles Sturt University, Sydney, NSW, Australia Wayne Hing Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia Graeme Horton Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia Rick Iedema Centre for Team-Based Practice & Learning in Health Care, King’s College London, London, UK Ian J. Irvine University of Newcastle, Newcastle, NSW, Australia Susan Irvine Victoria University, Melbourne, VIC, Australia xxiv Contributors Stephen Isbel Faculty of Health, University of Canberra, Canberra, ACT, Australia C. E. Johnson Monash Doctors Education, Monash Health and Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia Brian Jolly Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia School of Rural Medicine, University of New England, Armidale, NSW, Australia Anna Jones School of Medical Education, King’s College London, London, UK Anu Kajamaa Faculty of Education, University of Oulu, Oulu, Finland Suzie Kardong-Edgren Nursing Operations, Texas Health Resources Harris Methodist Hospital, Ft. Worth, TX, USA J. L. Keating Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne, VIC, Australia Michelle A. Kelly Curtin School of Nursing, Curtin University, Perth, Australia Arjun Khaira Psychiatry Department, Canberra Hospital, Canberra, ACT, Australia Debra Kiegaldie Faculty of Medicine, Nursing and Health Sciences, Monash University; Faculty of Health Sciences and Community Studies, Holmesglen Institute and Healthscope Hospitals, Melbourne, VIC, Australia Alec Knight School of Population Health and Environmental Sciences, King’s College London, London, UK Selena Knight School of Population Health and Environmental Sciences, King’s College London, London, UK Christopher Kowalski Oxford Health NHS Foundation Trust, Oxford, UK Arunaz Kumar Monash University, Melbourne, VIC, Australia Victor Lee Centre for Integrated Critical Care, The University of Melbourne, Melbourne, VIC, Australia Austin Health, Melbourne, VIC, Australia Kathleen Leedham-Green Medical Education Research Unit, Imperial College London, London, UK Iris Lindemann Prideaux Centre for Health Professions Education, Flinders University, Adelaide, SA, Australia Karen Livesay School of Health and Biomedical Sciences, College of Science, Engineering and Health, RMIT University, Melbourne, VIC, Australia Contributors xxv Damir Ljuhar Department of Surgical Simulation, Monash Children’s Hospital, Clayton, VIC, Australia Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia Kristen MacKenzie-Shalders Master of Nutrition & Dietetic Practice, Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD, Australia Lynne Madden School of Medicine, Sydney, University of Notre Dame, Sydney, NSW, Australia Ratna Makker Consultant Anaesthetist, Clinical Tutor, Clinical Director of the WISER (West Herts Initiative in Simulation Education and Research), West Herts Hospitals NHS Trust, Watford, Hertfordshire, UK S. D. Marshall Department of Anaesthesia and Perioperative Medicine, Monash University, Melbourne, VIC, Australia Maria Athina (Tina) Martimianakis Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada Elie Matar Faculty of Medicine and Health, Sydney Medical School, Education Office, The University of Sydney, Sydney, NSW, Australia Faculty of Medicine and Health, Sydney Medical School, Central Clinical School, The University of Sydney, Sydney, NSW, Australia Richard Matthews Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD, Australia Janie Maxwell Nossal Institute of Global Health, University of Melbourne, Melbourne, VIC, Australia Colin R. McHenry School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia Lisa McKenna School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia S. P. McKenzie School of Psychological Sciences, Monash University, Melbourne, VIC, Australia Michelle McLean Faculty of Health Sciences & Medicine, Bond University, Gold Coast, QLD, Australia Nancy McNaughton Wilson Centre for Research in Education, University of Toronto and University Health Network, Toronto, Canada Sarah E. M. Meek School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK xxvi Contributors Rebecca D. Minehart Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA Center for Medical Simulation, Boston, MA, USA E. K. Molloy Department of Medical Education, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia Christian Moro Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia Savannah Morrison General Medicine, John Hunter Hospital, Newcastle, NSW, Australia Karen Muller Orthopaedic Surgery, John Hunter Hospital, Newcastle, NSW, Australia M. Mundy School of Psychological Sciences, Monash University, Melbourne, VIC, Australia Ramesh Mark Nataraja Monash Children’s Hospital, Clayton, VIC, Australia Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia Debra Nestel Monash University Institute for Health & Clinical Education, Monash University, Clayton, VIC, Australia Department of Surgery (Austin), University of Melbourne, Parkville, VIC, Australia Hilary Neve Peninsula Medical School, Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, UK Delwyn Nicholls College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia Sydney Ultrasound for Women, Sydney, NSW, Australia Sarah O’Hare Centre for Medical Education, Queen’s University Belfast, Belfast, UK Maree O’Keefe Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia Bernadette O’Neill GKT School of Medical Education, King’s College London, London, UK Marilyn H. Oermann Duke University School of Nursing, Durham, NC, USA C. Ong KK Women’s and Children’s Hospital, Singapore, Singapore Robin Orr Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia Contributors xxvii Janice Orrell Prideaux Centre for Health Professions Education, Flinders University, Adelaide, SA, Australia John T. Paige Department of Surgery, Louisiana State University (LSU) Health New Orleans School of Medicine, New Orleans, LA, USA Claire Palermo Deparment of Nutrition, Dietetics and Food, Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia Monash Centre for Scholarship in Health Education, Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia Andrew Papanikitas Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK Sang E. Park Office of Dental Education, Harvard School of Dental Medicine, Boston, MA, USA Annette Peart Department of Occupational Therapy, Monash University – Peninsula Campus, Frankston, VIC, Australia Carla Pecoraro Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia Merrolee Penman Work Integrated Learning, The University of Sydney, Camperdown, NSW, Australia David Pinnock School of Health Sciences, University of Nottingham, Nottingham, UK Athanasios Raikos Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia Christopher Renninger The Norman M. Rich Department of Surgery, Uniformed Services University & the Walter Reed National Military Medical Center “America’s Medical School”, Bethesda, MD, USA Janet Richardson School of Nursing and Midwifery, University of Plymouth, Plymouth, UK Louise Richardson Epworth Hospital, Melbourne, Australia Martin Richardson Epworth Clinical School, University of Melbourne, Melbourne, Australia Carielle Joy Rio Faculty of Nursing, Universitas Pelita Harapan, Karawaci, Tangerang, Indonesia Luke Robinson Department of Occupational Therapy, Monash University – Peninsula Campus, Frankston, VIC, Australia Robert Roseby Monash Children’s Hospital, Clayton, VIC, Australia Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia xxviii Contributors Jenn Salfi Nursing, Brock University, St. Catharines, ON, Canada Aubrey L. Samost-Williams Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA Taylor Sawyer Division of Neonatology, Department of Pediatrics, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA, USA Jan Schmutz Department of Psychology, University of Zurich, Zurich, Switzerland Ben Schram Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia Patricia Nanya Schwerdtle Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University Melbourne, Melbourne, VIC, Australia Institute of Global Health, Heidelberg University, Heidelberg, Germany Rana Sharara-Chami Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon Ahmed Labib Shehatta Medical Intensive Care Unit, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar Clinical Anaesthesiology, Weill Cornell Medicine, Qatar, Doha, Qatar Teresa Shellenbarger Department of Nursing and Allied Health Professions, Indiana University of Pennsylvania, Indiana, PA, USA Margaret Simmons Monash Rural Health, Monash University, Churchill, VIC, Australia Judith Singleton School of Clinical Sciences (Pharmacy), Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia Flora A. Smyth Zahra Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, UK J. Sokol The Royal Children’s Hospital Simulation Program, Department of Medical Education, The Royal Children’s Hospital, Melbourne, VIC, Australia University of Melbourne Department of Paediatrics, Melbourne, VIC, Australia Christine Sommers Universitas Pelita Harapan, Jakarta, Indonesia Andrew I. Spielman New York University College of Dentistry, New York, NY, USA Jesse Spurr Intensive Care Unit, Redcliffe Hospital, Redcliffe, QLD, Australia Anne Stephenson School of Population Health & Environmental Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK Contributors xxix Sean Stevens Department of Surgery, Austin Health, University of Melbourne, Melbourne, VIC, Australia Allan Stirling Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia Jessica Stokes-Parish Hunter Medical Research Institute, Hunter New England Local Health District, Newcastle, NSW, Australia Zane Stromberga Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia Nancy Sullivan Johns Hopkins University School of Medicine and Nursing, Baltimore, MD, USA Linda Sweet Deakin University and Western Health Partnership, Melbourne, VIC, Australia Sandra Swoboda Johns Hopkins University School of Medicine and Nursing, Baltimore, MD, USA Rebecca A. Szabo Department of Obstetrics & Gynaecology and Department of Medical Education, Gandel Simulation Service The Royal Women’s Hospital, University of Melbourne, Melbourne, VIC, Australia Joanna Tai Centre for Research in Assessment and Digital Learning, Deakin University, Geelong, VIC, Australia Arianne Teherani Department of Medicine and Center for Faculty Educators, School of Medicine, University of California, San Francisco, CA, USA Pim Teunissen Faculty of Health Medicine and Life Sciences (FHML), School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands M. C. Turner School of Clinical Medicine, The University of Queensland, St Lucia, QLD, Australia Neil Tuttle Discipline of Physiotherapy, Griffith University, Gold Coast, QLD, Australia Ruby Walter School of Nursing and Midwifery, College of Science, Health and Engineering, LaTrobe University, Melbourne, VIC, Australia Helena Ward Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia C. J. Watling Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada Andy Wearn Medical Programme Directorate, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand xxx Contributors Susan M. Wearne Health Workforce Division, Commonwealth Department of Health, Canberra, ACT, Australia Academic Unit of General Practice, Australian National University, Canberra, ACT, Australia Jennifer M. Weller-Newton Department of Rural Health, Melbourne University, Melbourne, VIC, Australia School of Nursing, McMaster University, Hamilton, ON, Canada Nursing and Midwifery, Monash University, Melbourne, VIC, Australia Emmalee Weston Austin Health, Melbourne, VIC, Australia Marjorie L. White The Office of Interprofessional Simulation for Innovative Clinical Practice, University of Alabama at Birmingham, Birmingham, AL, USA Departments of Pediatric Emergency Medicine and Medical Education School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA Department of Health Services Administration School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA Leeroy William Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia Eloise Williams Northern Health, La Trobe University, Melbourne, VIC, Australia Raymond Yap Department of Surgery, Cabrini Hospital, Cabrini Monash University, Malvern, Melbourne, VIC, Australia Mong-Lin Yu Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC, Australia Introduction We believe Clinical Education for the Health Professions represents, supports, and advances scholarship and practice in the field of health professions education. The development process of this major reference work (MRW) is important to appreciate the contents. In this introduction, we outline the process of development, our editorial practices, and characteristics of the contributors and then provide an overview of each part. The Development Process One editor (Debra Nestel) was approached by the publisher to propose an MRW for clinical education. The Springer MRWs are intended to provide a “foundational starting point for students, researchers, and professionals needing authoritative, expertly validated summaries of a field, topic or concept.” (1) The MRW concept is also attractive because it enables individual chapters to be updated by authors as required. Some fields move more quickly than others, and so we believe that the MRW gives authors more flexibility in revising their work to maintain currency, rather than the traditional single volume with one publication date. One aim of the MRW was to present accessible and evidence-based content, on what is known about many facets of clinical education. While we acknowledged the proposed audience outlined in the Springer MRW, our main target audience was anticipated to be individuals involved in the design and delivery of educational activities for health professionals and students. Additionally, the likely audience will include researchers, policy makers, and others involved in any facet of health professional practice. In initial development, DN identified a small editorial team with diverse experiences of working in clinical education. While a slightly daunting prospect, once the editorial team was assembled and the proposal and specific aims were outlined, the project quickly shifted to one of honor and excitement as the editorial team reached out to our networks for contributions. The development process was fluid, with the initial proposal comprising 122 chapters across 9 parts. As we consulted with prospective authors, the proposal was adjusted to further reflect their expertise, and this meant some ideas initially xxxi xxxii Introduction proposed as independent chapters were combined (and, on some occasions, chapters were omitted). The COVID-19 pandemic also occurred during the commissioning process, which meant that some new chapters were added, and the entire project took longer than we had originally planned. We were keen to promote chapters with multiple authors facilitating diverse perspectives and, sometimes even within a chapter, to have authors from different parts of the world. Our editorial team typically appointed a senior author and, with support and guidance, agreed that final decisions about author team were for the senior author to make. We were also excited by the management of chapters through the Springer Meteor system, which is like online peer review systems for academic journals. This greatly assisted the management of the review process. All reviews were undertaken by the editorial team, with at least two reviewers for each chapter. The depth of content varies across chapters. This was intentional, as it reflects the diversity of topics we selected for inclusion, as well as the dynamic nature of the field of health professions education. Some topics are already well established in both scholarship and practice (e.g., feedback, supervision), while others have a very wide scope (e.g., history and trends chapters), or are relatively new contributions to the field (e.g., ecological systems theory, planetary education, etc.). Among other things, these different reasons for inclusion accounted for the varying levels of depth. The editorial team felt strongly that the final, published chapters in this MRW should reflect the professional and scholarly voices of the authors. While this is easy to claim, our experience as authors ourselves has been that editors can impose their own vision on the work so strongly that the voices of individual authors disappear. Instead, we saw our task as ensuring there was a consistent narrative to the overall MRW, as well as to each part within it, and to remind authors of what we thought would be valuable to the broad readership of the MRW. We hope that our editorial efforts have been successful, allowing authors’ voices to come through in individual chapters that fit together across the work. We are conscious of international differences in the terms used to describe health professions and their education and training. Rather than mandating language, or seeking to “standardize” terms, we left author teams to decide what was most appropriate. Our feedback encouraged authors to invite readers to consider how the terms might relate to their contexts, and to make connections across geographical, linguistic, and other contexts. The Editorial Team While as editors we had previously variously worked with each other, assembling as an editorial team was an exciting opportunity to bring our networks together. We have briefly sketched our profiles (see editor biographies). Our experiences are diverse, together with the places that we have worked. The institutions in which our networks have developed include large, long-established world-leading research-intensive universities associated with academic health sciences centers Introduction xxxiii and teaching hospitals and those that are relatively new, privately funded, and vocationally focused. Contributors to the MRW As editors, we looked at this MRW as a chance to help broaden the diversity of voices represented in the literature, and to provide opportunities to a range of scholars at various stages in their careers and from both clinical and academic backgrounds. This is an effort that we as individuals are committed to continuing – it is never complete, of course, due to the dynamic nature of the field. We surveyed our authors near the completion of the project and found that, based on those who responded, we have contributions from scholars and researchers representing 13 countries, a near balance of clinical and other backgrounds, more than a dozen health professions, and a near balance of gender identification. Within our author community are early-career scholars and long-time experts in their fields, and they are highly educated: over 80% of contributors reported having master’s qualifications, and over 60% reported having doctoral qualifications. While we sought a diverse mix of contributors, we had hoped to have an even more international group of authors. Especially missing were voices from the southern Americas, Africa, and Asia. This continues to be an area of weakness for the field, impoverishing our shared conversation and negatively impacting our work as educators. About the Major Reference Work The final version of the MRW is divided into eight parts, reflecting our attempts to meaningfully map the terrain of health professions education. Some chapters will only appear in an online version since they were unavailable at the time of publication. We focus first on the contemporary context of health professions education; shift focus to theoretical underpinnings, curriculum considerations, and approaches to supporting learning in clinical settings; a specific focus to assessment approaches; and then to evidence-based educational methods and content. Governance and other formal processes associated with the maturation of education programs are considered, including the increasing professionalization of clinical education. Finally, we look to the future drawing upon much of what has surfaced in the past and present. Part I: The Contemporary Context of Health Professions Education Part I comprises 17 chapters that examine the contemporary contexts of health professions education. Making meaning of contemporary practice is sometimes achieved by authors examining the origins of their practice, which is illustrated for education and training in surgery, nursing, midwifery, and dentistry. While there are similarities across professions, there are also many differences and particularities that justify the range of chapters offered. Even within medicine, the trends and contexts for specialties vary (e.g., general practice, surgery, anesthesia, etc.). We also xxxiv Introduction wanted to promote health professions that are often less well represented in mainstream literature; this led to chapters on mental health and allied health. There are sometimes very specific drivers for change in the structure and process of professional education. One chapter addresses structural issues in the provision of specialty training (e.g., decentralization of surgical training), while another chapter describes the provision of education in low- and middle-income countries. Part I finishes with a chapter outlining what is likely to become mainstream in educational approaches that were developed in response to the COVID-19 pandemic. Part II: Philosophical and Theoretical Underpinning of Health Professions Education There are frequent calls to improve the theoretical underpinnings of health professions education. While there are many classifications of educational theories (or theories that inform educational design and practice), we sought here to include theories that are either commonly cited in educational design or research studies, and that were most likely to inform readers’ practices. The theories vary in their focus on individuals or the settings in which the learning occurs and emphasize cognitive, behavioral, or constructivist approaches to learning. Each theory is likely to have most relevance to educational design and practice. From the 13 chapters, selected examples include: mastery learning, which has been popularized in simulationbased education for supporting the development of procedural skills; threshold concepts and troublesome knowledge, which has become a powerful influence in framing curriculum content; a framework from social semiotics, which fosters reflection of the ways in which clinicians make sense of, and the meanings they ascribe to, all facets of their work; the theoretical notion of communities of practice, including the role of professional identify development; reflective practice, such that it has become the essence of professional practice; and ecological systems theory, which that provides a lens to examine individuals’ development within the complex and dynamic systems of clinical learning and practice. Part II ends with a critical reflection on the philosophy of health professions education, offering a tool for readers to deepen their thinking and practice about education. Part III: Curriculum Considerations in Health Professions Education Conceptually, curriculum considerations could cover any amount of content, so in this part of the MRW, we have had to be selective. There is also some overlap between Parts III, IV, and V, meaning that in some cases we had to make editorial decisions about where to locate the chapter content within the broader scope of the MRW. While authors developed their chapters based on our brief, we respected the authors’ expertise to take the chapter in the directions they thought most appropriate. We have 14 chapters with an exciting range of considerations, such as: the role of public engagement in curricula; using simulation as substitution for clinical placements; how social media can inform curriculum design; exploring nuances in the educational design for teaching simple and complex psychomotor skills; debriefing practices in simulation-based education; and effective written feedback. Another important thread is the development of professional identity among students and trainees in the health professions. There are also explorations of contemporary issues, including the role of technology in health professions education; teaching Introduction xxxv about the role of diversity; and planetary health in health curricula. Other chapters cover diverse topics such as learning and teaching ethics in healthcare; the hidden curriculum and its variants; and the role of the arts and humanities. Part IV: Supporting Learning in Clinical Settings In Part IV, comprising 14 chapters, the authors explore ways in which learning can be supported in various settings. While principles to support learning may be similar, their application can manifest in different ways derived from many factors. A key factor is that learning in clinical settings usually takes place alongside, or as part of, healthcare service delivery. There is expert commentary provided from an interprofessional perspective, from a nursing perspective relative to learning “at the bedside” and in “the operating theater.” Based on a scoping review, learning and teaching in the operating theater from a surgeon perspective is provided. The patient population can also influence opportunities to learn and teach, and we include an example from pediatrics. For clinical educators to function effectively, there are considerations for their development too. One chapter outlines the qualities of clinical educators, especially in their capacity to support learning in clinical settings, alongside care delivery. Another chapter considers well-being in health professions training. While simulation is not strictly a clinical setting, we have included it in this part, because the opportunity to learn using simulation often prepares healthcare professionals to optimize their learning in clinical practice. One chapter illustrates a process for setting up a simulation service in a healthcare institution, and another provides a specific example of a simulation program to promote the development of communication skills across a health service. Three chapters consider the role of interpersonal relationships and conversation in clinical settings – specifically, targeting feedback, supervision, and the ways in which trainees learn and develop through their telephone conversations. The final chapter considers underperformance, its recognition, and approaches to management. Part V: Assessment in Health Professions Education We have a focused part dedicated to assessment. We consider assessment as any form of measurement of individuals – and for purposes of entering, progressing, or completing professional training; final qualification within specialties; or ongoing professional registration. Nine chapters cover foundational and contemporary approaches to assessment in health professions education. There are specific examples from occupational therapy, surgery, and the impact of COVID-19 on assessment practices. Part VI: Evidence-Based Health Professions Education: Focus on Educational Methods and Content The 14 chapters in Part VI target evidence-based educational methods and content in health professions education. There is evidence of human-based strategies: team-based learning, peer learning, and coaching. Core practices for all health professionals are examined – patient-centered communication skills and clinical reasoning. Staying with the human focus, a chapter looks at key sociological concepts for health professions education. Contemporary technology-mediated educational methods are also explored and include examples from teaching procedural and other clinical skills, screen-based learning, and artificial intelligence. xxxvi Introduction Part VII: Governance, Quality Improvement, Scholarship, and Leadership on Health Professions Education In Part VII, the eight chapters cover governance in health professions education. This necessarily includes considerations of quality and improvement. The role of professional bodies is explored, as well as that of scholarship in professional education. This part reflects the maturation of the profession of clinical education, and of clinical educators. Part VIII: Future Direction for Health Professions Education In our educational practice, we value the importance of being future-focused. Embedded in many of the earlier chapters are hints at future directions. However, in this part, it becomes the sole focus. The first chapter reflects a future world in which junior doctors will learn. The chapter offers two contrasting scenarios, and what is key to success is the importance of productive human relationships, of which one form is mentoring. While not a new concept itself, the authors describe its prominence, potentially shifting career directions for individuals based on single encounters. In an era of workforce shortages and maldistribution, human relationships become even more important to nurture trainees. If the authors’ thoughtfulness reflects the future of the medical workforce, then we have much to look forward to. We also wish the authors success with their own specialty training. Two chapters are written by the same author team – first focusing on curriculums for healthcare professionals and the second on the competencies of those involved in education, in designing curriculums, and in their implementation. Technology is a focus in both chapters with implications for the curriculum itself and those who provide it. In summary, this MRW consists of almost 90 chapters of research and scholarship, which we and the authors hope will inspire your practice, expand your thinking, support your learners and trainees, and help you to create the future of health professions education. We are already using the chapters in our own teaching, having been inspired and impressed by the quality of the authors’ contributions. When we took on this project, we had high hopes for the MRW. Those hopes have been exceeded, as we were astounded by the quality, breadth, and depth of the contributions from our colleagues around the world. Although it has been a challenge, and the project has taken longer than we originally planned, it has been our pleasure and privilege to curate this MRW.