Emmaline Brouwer

Ever considered where your learning tools come from as you study or teach medicine? So many teaching materials in medicine are mass-produced, environmentally unfriendly, and reproduce the same kind of bodies. We need a drastic rethinking of our teaching tools. But rather than new inventions, what if the innovations we need are already out there? Our first issue of Clinical Tools: A DIY Catalogue for the Creative celebrates the abundance of ideas for teaching materials that already exist in medical education. Inside you will find gorgeous illustrations, clear instructions for how to make tools and insightful essays exploring the ideas behind DIY in medical education. Get your making supplies ready!

Adaptability is a key element of being a healthcare professional. Previous research has investigated how adaptability manifests in clinical workplaces, but insight into what adaptability means to m...

Purpose: Gossip has been found to influence feedback, but the interplay between gossip and feedback is unclear. Given the importance of feedback for resident development, the education community needs to better understand how gossip and feedback are connected, and the implications of that relationship. For purposes of this study, the authors used an established definition of gossip as “evaluative talk about a person who is not present.” Method: The authors used constructivist grounded theory to iteratively conduct and analyze semi-structured interviews from November 2024 to April 2025 with 16 resident participants from 7 programs—including pediatrics, obstetrics-gynecology, internal medicine, and psychiatry—in the United States and the Netherlands. Interview questions focused on the experience of gossip in residency and the interplay between gossip and feedback. Results: The analysis revealed that gossip and feedback relate to each other in 4 distinct ways, particularly when there are barriers to feedback. “Gossip catalyzes feedback,” encouraging its delivery , whether explicitly or subconsciously. “Gossip replaces feedback” when giving critical feedback is challenging or when there is no forum for feedback. Sometimes, “gossip is feedback” when feedback conversations are indirect or the feedback provider maintains anonymity. Finally, “gossip follows feedback” when it helps trainees process the emotional experience of receiving challenging feedback and guards against peers receiving similar feedback. Conclusions: The authors theorize gossip as a mechanism for navigating formal feedback systems in practice. Gossip, as much as it is commentary about individuals, is metacommentary on our systems of feedback. The authors call on educators to understand when gossip is used in feedback as a means to further understand barriers to formal feedback. Educators grappling with their feedback systems without considering gossip are missing the looming third party.

Introduction: Adaptability is the capacity to make appropriate responses to changed or changing situations. Whereas clinicians’ adaptability is framed as a vital part of adaptive expertise, clinical medical students may be adaptable even when they are not yet experts. Investigating this early-stage adaptability can reveal how adaptive expertise first begins to take shape. This study examines how undergraduate medical students experience and enact adaptability during their clerkship rotations. Methods: Through 20 semi-structured interviews with clinical medical students from two universities, in Belgium and The Netherlands, this qualitative study explores how students perceive and demonstrate adaptability. Results: The study identifies two domains in which students’ adaptability takes shape: their role as future doctors and their role as learners. In these two domains adaptability functions as both a means to navigate clinical complexity and as a process of professional growth. Results highlight a duality: students need adaptability to thrive during rotations while simultaneously engaging in a process of further developing their adaptability. Discussion: The ongoing interaction between being adaptable and developing adaptability plays a crucial role in clinical education. Previous research shows that adaptive expertise helps explain how learners turn their experiences of adaptability, central to this study, into skills that support their ongoing professional growth. By making visible how students act and develop adaptability in everyday practice, our findings guide reflection on the implications for clinical education and the build of the foundation of later adaptive expertise.

Gossip is pervasive in residency programs and may play a key role in resident development. In this study, conducted from a constructivist vantage point, we aim to explore residents' experience of gossip in the residency workplace. Constructivist grounded theory was used to iteratively conduct and analyze interviews with 16 resident participants from pediatric, internal medicine, obstetrics-gynecology, and psychiatry programs located in the United States and the Netherlands. Interview questions focused on residents' personal experiences with gossip in training. We found that gossip has multiple emotional impacts on participants, while also helping them navigate the learning environment. Gossip participation itself must be navigated, but how participants do so varies, with each following a different map, or unspoken rules surrounding gossip etiquette, often routed by social connectivity and trust. We theorize gossip as a social resource in residency training. Gossip influences residents' emotions and, through gossip, residents learn what is expected of them and from others. However, gossip is not uniformly available. Residents likely experience differential emotional support and requisite information gained through gossip. Program leaders should be aware of the influence of gossip and seek to understand social connectivity in their programs.

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Introduction: Gossip is pervasive in residency programs and may play a key role in resident development. Recommendations for how to deal with harmful gossip in residency programs have been proposed but, before addressing gossip, we need to more fully understand how gossip in residency programs functions as a social process and explore residents’ experiences with gossip across contexts. In this study, conducted from a constructivist vantage point, we aim to explore residents’ experience of gossip in the residency workplace. Methods: Constructivist grounded theory was used to iteratively conduct and analyze interviews with 16 resident participants from pediatric, internal medicine, obstetrics-gynecology, and psychiatry programs located in the United States and the Netherlands. Interview questions focused on residents’ personal experiences with gossip in training. Results: We found that gossip has multiple emotional impacts on participants, while also helping them navigate the learning environment. Gossip participation itself must be navigated, but how participants do so varies, with each following a different map, or unspoken rules surrounding gossip etiquette, often routed by social connectivity and trust. Discussion: We conceptualize gossip as a social resource in residency training. Gossip influences residents’ emotions and, through gossip, residents learn what is expected of them and from others. However, gossip is not uniformly available. Residents likely experience differential emotional support and requisite information gained through gossip. Because such support and information are critical in residency, program leaders should be aware of the influence of gossip and seek to understand social connectivity in their programs.

This article explores the essential elements for achieving excellence in international collaborations within health professions education (HPE), drawing on the Association for Medical Education in Europe (AMEE) ASPIRE Award criteria for International Collaboration. The International Collaboration award transcends recognition of excellence through the award; it aims to foster excellence in international HPE collaborations more broadly, by establishing a framework for evaluation and development that functions cross-culturally. This framework is based on five key elements that contribute to successful collaborations: mutually agreed goals; shared responsibilities and leadership structures; processes that support collaboration; demonstrated long-term impact and sustainability, and evaluation and practice sharing. Recognizing the historical context of unequal power dynamics in international partnerships, this article promotes the development of ethical and equitable collaborations. We advocate for integrating cultural competence, epistemic plurality, and leadership skills into HPE curricula to prepare future healthcare professionals for effective international collaboration.

International Medical Programmes (IMPs) form a distinctive modality in medical education, with diverse student populations, English as a language of instruction and 'globalized' curricula. A lack of common understanding of IMPs' purposes and role in the medical education landscape triggers critiques. This study aims to document the effects of different discourses used to justify the purpose of IMPs. We use a discourse analysis approach to explore the different ways in which the purposes of IMPs are constructed at the regulatory, institutional, and individual level, and how these discourses interact. The research situates in two IMPs, in the Netherlands and in Hungary. Key-informant interviews, policy documents, and scholarly literature form the archive. The purpose of IMPs is constructed discursively around three distinct narratives and associated practices: around serving the institutions that host them, around serving the (global) public interest, and around serving individual students. Co-existence and misalignments of these three discourses cause conflicting practices and confusion among stakeholders. This study illustrates how diverging perspectives on internationalization in medical education create tensions for learners and staff. Articulating a clear and explicit meaning to internationalization may reduce uncertainties, and may reinforce realistic expectations of what constitutes a good outcome.

Introduction Increasingly medical students pursue medical education abroad. Graduates from International Medical Programs (IMPs) practice globally, yet how to prepare students for an unknown international environment is complex. Following IMP graduates throughout their early careers, this study offers insights into gaps in current undergraduate education. Methods In this international, longitudinal, mixed-methods study, 188 graduates from seven IMPs completed baseline surveys on career choice and job preparedness. Forty-two participants completed follow-up until three years after graduation. Nine graduates participated in semi-structured interviews on individual experiences and the evolution of their perspectives. The multiphase, sequential design allowed data collected at baseline to inform further data collection instruments. Results Two typical student profiles emerged. The first depicts a student who, despite the challenges of studying abroad, pursues a medical degree ‘anyhow’, with a common aim of practicing in their home country. The other deliberately selects an IMP while envisaging an international career. Two years after graduation, the majority (> 70%) of our participants were practicing in a country other than their country of training. They reported challenges around licensing, the job application process and health system familiarization. Participants’ experiences point towards potential curriculum adaptations to facilitate cross-border transitions, including career guidance, networking and entrance exam preparation.