Anouk Wouters

If we want to create inclusive environments in (higher) education, diversity discomfort is both a significant challenge and an important resource. In our everyday experiences as researchers and tea...

Research suggests that students from “non-traditional” backgrounds (e.g., based on first-generation higher education status) are less likely to enrol in higher education programmes than their traditional counterparts. We explored students’ decision-making processes for participating in honours programmes and the factors contributing to this. We analysed data from semi-structured interviews with 28 students who were either enrolled in an honours programme, or were eligible but chose not to. We used both inductive and deductive data analysis informed by the expectancy-value cost model of motivation to gain deeper insights into factors informing students’ decisions on participation. The results highlighted that students’ decisions were shaped by values such as intrinsic interest in learning and specific subjects, positive personal and professional development, the value for CV building, as well as by social conditions (e.g. support and discouragement) and perceived costs (e.g. time and effort). Among students with stronger non-traditional backgrounds the lack of familiarity with the academic environment, and a related lack of confidence and sense of belonging played a role in decision-making, while participating in honours programmes seemed to fit better the smooth educational trajectory of some students with relatively traditional backgrounds. Differences in previous experiences along their education pathways may explain why students with relatively non-traditional backgrounds find the honours programmes less appealing. Our findings can inform strategies during the orientation and recruitment phases to enable and stimulate students less familiar with academia to enter honours programmes. This can include directed information provision and the use of role models.

Introduction: Clinical pharmacists are crucial for optimizing medication therapy and improving patient outcomes, yet their potential is underutilized in many low- to middle-income countries. Shifting from traditional dispensing to clinical roles requires professional development and identity transformation. In South Africa’s public healthcare system, this shift faces additional challenges, such as a lack of formal positions, limited resources, and role ambiguity. Understanding how clinical pharmacists navigate this transition and develop their clinical identity is essential for their integration into healthcare teams and for improving patient care. Methods: Using a constructivist approach, this qualitative study employed semi-structured interviews with clinical pharmacists (n = 12) across South Africa’s public healthcare sector. We analyzed data through the lens of boundary crossing. Through thematic analysis we explored how pharmacists navigate the complexities of transitioning from dispensing to broader clinical roles, and how these experiences shape their professional identity. Results: Clinical pharmacists navigated both intrapersonal and interpersonal boundaries in their evolving roles. Three key themes were identified: (a) Bridging the gap within: Pharmacists navigate intrapersonal boundaries for clinical identity formation, (b) Bridging the gap between: Pharmacists navigate interprofessional boundaries for collaboration and identity formation, and (c) Building bridges: Pharmacists employ strategies to promote collaboration and recognition. Discussion: This study uncovered the complex interplay between intrapersonal boundaries – such as role ambiguity, self-doubt, reconciling traditional dispensing roles with expanded clinical responsibilities, and the need for mentorship – and interpersonal boundaries, including hierarchical structures, unclear role expectations, limited recognition, and challenges in interprofessional collaboration, in shaping clinical pharmacists’ identities. Fostering boundary crossing competence and interprofessional collaboration can help overcome systemic barriers, enabling pharmacists to navigate their roles, advocate for their expertise, and gain recognition within healthcare teams, ultimately enhancing their integration and improving patient care in resource-constrained settings like South Africa.

Higher education institutions increasingly aim to implement equity in admissions. However, there is no one-size-fits-all solution to determine which equitable admissions procedures are suitable in a specific context, nor which groups should be its beneficiaries. Therefore, we applied the Formal Consensus Method (FCM) to investigate the support amongst experts and stakeholders for different equitable admissions policies and target groups within the context of Health Professions Education in The Netherlands. We found majority support (median of ratings ≥ 7 on a scale of 1 to 9) in both groups for the target groups ‘applicants with a low or average socio-economic status’ and ‘applicants with an underrepresented migration background’. The majority of participants was also in favor of Contextualized Admissions, especially when used to increase enrolment of applicants with a low or average socio-economic status, with an underrepresented migration background, and asylum status holders. Lastly, both groups supported lottery with extra tickets for applicants with an underrepresented migration background. However, as the range of ratings fell outside the FCM prescribed range of 5-9, no case in which there was majority support could be defined as a ‘consensus’. The expert group proposed the use of Bonded Medical Places for applicants from the Caribbean parts of the Dutch Kingdom. The policies and target groups for which broad support was found, could contribute to equitable admissions, improved student diversity, and enhanced quality of health education and future care. Our application of the FCM in the area of equitable admissions policies may be useful for researchers in other countries where equity principles are not (widely) used in admissions decisions.

Background: Health professions education research (HPE‐R) must be ethically sound. Ethical review decisions and other ethical considerations should be clearly reported in journal articles to allow readers to assess the ethical soundness of the research. We explored and evaluated how ethical review decisions and ethical considerations for HPE‐R are reported in health professions education (HPE) journal articles. Methods: We identified a 1‐year sample, for 2020, of eight HPE journals. We systematically assessed the reporting of ethical review and key ethical considerations in the articles in the sample. Results: The search yielded 2004 articles, of which 955 articles (47.7%) were eligible and were thus assessed. Most (83.4%) of the assessed articles mentioned a review by an ethical review board (ERB). In the category ‘research articles’, 92% articles reported the outcome of the ethical review. In the category ‘other articles’ (e.g. educational case reports), reporting of ethical processes was less common (32%). Overall, the reporting of key ethical considerations was limited, although these considerations were more reported in ‘research articles’ compared with ‘other articles’. Conclusions: ERB assessments and HPE‐R approval was reported in most research articles. This finding is an improvement compared with previous evaluations of ethical research practice in HPE‐R. All studies, particularly those that are exempted or not fully reviewed, should describe their key ethical considerations clearly to enable the HPE community to assess the ethical soundness. Our review revealed that the reporting of ethical considerations was limited and deserves attention from the research community.