Medical student exposure to women’s health concepts and practices: a content analysis of curriculum at Canadian medical schools

Anderson, Natalie N; Gagliardi, Anna R.

doi:10.1186/s12909-021-02873-8

Cited by 13 publications

(15 citation statements)

References 41 publications

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“…For example, Borgstrom et al 43 examined portfolio content to identify and analyse references to professional values. Anderson and Gagliardi 44 conducted a content analysis of women's health curricula to identify relevant curriculum content. Waterval et al 45 used the content of various documents to inform their research questions.…”

Section: Resultsmentioning

confidence: 99%

CARDA: Guiding document analyses in health professions education research

2022

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Introduction Documents, from policies and procedures to curriculum maps and examination papers, structure the everyday experiences of health professions education (HPE), and as such can provide a wealth of empirical information. Document analysis (DA) is an umbrella term for a range of systematic research procedures that use documents as data. Methods A meta‐study review was conducted with the aims of describing the current state of DA in HPE, guiding researchers engaging in DA and improving methodological, analytical and reporting rigour. Structured searches were conducted, returns were filtered for inclusion and the 115 remaining articles were critically analysed for their use of DA methods and methodologies. Results There was a significant increase in the number of articles reporting the use of DA over time. Sixty‐three articles were single method (DA only), while the others were mixed methods research (MMR). Overall, there were major lacunae in terms of why documents were used, how documents were identified, what the authors did and what they found from the documents. This was particularly apparent in MMR where DA reporting was typically poorer than the reporting of other methods in the same paper. Discussion Given these many lacunae, a framework for reporting on DA research was developed to facilitate rigorous DA research and transparent, complete and accurate reporting of the same, to help readers assess the trustworthiness of the findings from document use and analysis in HPE and, potentially, other domains. It was also noted that there are gaps in HPE knowledge that could be addressed through DA, particularly where documents are conceptualised as more than passive holders of information. Scholars are encouraged to reflect more deeply on the applications and practices of DA, with the ultimate aim of ensuring more substantive and more rigorous use of documents for understanding and constructing meaning in our field.

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Section: Resultsmentioning

confidence: 99%

CARDA: Guiding document analyses in health professions education research

2022

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“…Content reviews of medical curricula in a number of countries indicate relatively little attention to menstrual health ( 63 , 64 ). Medical curricula are known to under-address pain management and responses to pain in clinical skills training ( 65 , 66 ). This combination of under-representations creates a risk for women with endometriosis symptoms characterized by pain, with graduates having little preparation for responding to the needs of their patients with endometriosis symptoms.…”

Section: Discussionmentioning

confidence: 99%

Communicating Endometriosis Pain in France and Australia: An Interview Study

Ilschner¹,

Neeman²,

Parker³

et al. 2022

Front. Glob. Womens Health

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Endometriosis is characterized by persistent, fluctuating pain associated with menstruation, a biological function which is socially invisible. The degree and quality of pain cannot easily be measured, observed, or documented. Difficulties in communicating pain pose particular challenges when seeking diagnosis and support from health professionals. In this paper we explore the experiences and characterization of pain by thirteen Australian and thirteen French women with endometriosis. Data were collected through semi-structured interviews using a life-history approach to illness symptoms, diagnosis and treatment. We explore the experiences of women with endometriosis in two phases: from onset of symptoms to seeking advice from a clinician, and from first consulting a clinician to receiving a diagnosis. On average, initial pain symptoms were identified 2.1 years before consulting a health practitioner, after which women reported pain symptoms 8.5 years prior to diagnosis; that is, the time between consulting a clinician and receiving a diagnosis was almost four times the period between experiencing symptoms and consulting a doctor. Pain was often “made real” to doctors by findings consistent with endometriosis on ultrasound and MRI, mostly used in France, or laparoscopy, the predominant diagnostic tool in Australia. No woman described her practitioner using standardized pain assessment tools. Thus, the validation of pain relies largely on disease visibility and the clinician-classified degree of severity rather than self-reported grades of pain or impact on activities of daily living. The invisible and enigmatic pain of this chronic women's disease remains difficult to communicate to doctors, and the recognition of severe pain is often key to timely diagnostic procedures. Clinicians need to be more proactive about severe pain related to menstruation, taking into consideration women's individual circumstances, and maintain a high index of suspicion of underlying endometriosis as a condition characterized primarily by pain.

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“…There may be thematic silences within a curriculum related to health inequalities, or silences within our practice as educators and researchers when we are faced with inequitable practices within education. For example, silences on the topic of women's health, 20 women's physical examination, 21 and women's rights 22 persist within medical curricula. These silences make us complicit to the ongoing oppression of marginalised groups and issues of inequality that persist within medical education.…”

Section: How Silence and Acknowledgement Interactmentioning

confidence: 99%

On acknowledging silence within medical education

Brown

Collini

2023

Medical Education

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IntroductionSilence is a part of all interactions, yet its potential significance within medical education remains underexplored. Existing literature primarily focuses on its use as a skill, leaving a gap in understanding its broader implications. Emerging evidence from higher education suggests that conceptualising silence as a way of being and becoming could enrich personal and professional growth. Unfolding dialogue on equality, diversity and inclusion suggests that silence on inequity can be oppressive. However, medical education has yet to consider the possible implications of conceptualising silence in this way.MethodsWe explore silence through the philosophical lens of acknowledgement. Acknowledgement—communicative behaviour that grants attention to others—is a philosophy with roots in phenomenology. It is concerned with being and becoming, and silence can be part of the communicative behaviour that constitutes acknowledgement. Our aim in exploring the ontological nature of silence (silence associated with being) using acknowledgement is to offer a springboard for practitioners, educators, and researchers to consider how silence is connected with our existence as people.ResultsPositive acknowledgement involves a commitment to turning towards the other and valuing this connection. Silence can be a way of demonstrating this—for example, giving patients the space they need to express their thoughts and emotions. Negative acknowledgement is the opposite and involves dismissing, ignoring or invalidating another's experiences. In the context of silence, negative acknowledgement may involve ignoring a person or group's ideas, or bystander silence when witness to discrimination.ConclusionsWithin this work, we consider the ramifications of conceptualising silence as ontological, rather than purely a skill to be taught. This is a novel way of conceptualising silence, and there is a pressing need to explore this further to expand our understanding of the impact of silence for diverse groups of learners, educators, practitioners and patients.

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Medical student exposure to women’s health concepts and practices: a content analysis of curriculum at Canadian medical schools

Cited by 13 publications

References 41 publications

CARDA: Guiding document analyses in health professions education research

CARDA: Guiding document analyses in health professions education research

Communicating Endometriosis Pain in France and Australia: An Interview Study

On acknowledging silence within medical education

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