Tackett Sean, Steinert Yvonne, Mirabal Susan, Reed Darcy A, Wright Scott M
Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA.
Family Medicine and Health Sciences Education, McGill University, Montreal, Québec, Canada.
Teach Learn Med. 2025 Jan-Mar;37(1):75-85. doi: 10.1080/10401334.2023.2274991. Epub 2023 Oct 27.
All individuals and groups have blind spots that can lead to mistakes, perpetuate biases, and limit innovations. The goal of this study was to better understand how blind spots manifest in medical education by seeking them out in the U.S.
We conducted group concept mapping (GCM), a research method that involves brainstorming ideas, sorting them according to conceptual similarity, generating a point map that represents consensus among sorters, and interpreting the cluster maps to arrive at a final concept map. Participants in this study were stakeholders from the U.S. medical education system (i.e., learners, educators, administrators, regulators, researchers, and commercial resource producers) and those from the broader U.S. health system (i.e., patients, nurses, public health professionals, and health system administrators). All participants brainstormed ideas to the focus prompt: "To educate physicians who can meet the health needs of patients in the U.S. health system, medical education should become less blind to (or pay more attention to) …" Responses to this prompt were reviewed and synthesized by our study team to prepare them for sorting, which was done by a subset of participants from the medical education system. GCM software combined sorting solutions using a multidimensional scaling analysis to produce a point map and performed cluster analyses to generate cluster solution options. Our study team reviewed and interpreted all cluster solutions from five to 25 clusters to decide upon the final concept map.
Twenty-seven stakeholders shared 298 blind spots during brainstorming. To decrease redundancy, we reduced these to 208 in preparation for sorting. Ten stakeholders independently sorted the blind spots, and the final concept map included 9 domains and 72 subdomains of blind spots that related to (1) admissions processes; (2) teaching practices; (3) assessment and curricular designs; (4) inequities in education and health; (5) professional growth and identity formation; (6) patient perspectives; (7) teamwork and leadership; (8) health systems care models and financial practices; and (9) government and business policies.
Soliciting perspectives from diverse stakeholders to identify blind spots in medical education uncovered a wide array of issues that deserve more attention. The concept map may also be used to help prioritize resources and direct interventions that can stimulate change and bring medical education into better alignment with the health needs of patients and communities.
所有个人和群体都存在盲点，这些盲点可能导致错误、使偏见长期存在并限制创新。本研究的目的是通过在美国找出这些盲点，从而更好地了解它们在医学教育中是如何表现的。
我们进行了群体概念映射（GCM），这是一种研究方法，包括头脑风暴想法、根据概念相似性对其进行分类、生成代表分类者共识的点图，以及解释聚类图以得出最终概念图。本研究的参与者是来自美国医学教育系统的利益相关者（即学习者、教育工作者、管理人员、监管者、研究人员和商业资源生产者）以及来自更广泛的美国卫生系统的人员（即患者、护士、公共卫生专业人员和卫生系统管理人员）。所有参与者围绕焦点提示进行头脑风暴：“为了培养能够满足美国卫生系统患者健康需求的医生，医学教育应该减少对……的忽视（或更多关注……）”。我们的研究团队对这个提示的回答进行了审查和综合，以便为分类做准备，分类工作由医学教育系统的一部分参与者完成。GCM软件使用多维尺度分析合并分类解决方案以生成点图，并进行聚类分析以生成聚类解决方案选项。我们的研究团队审查并解释了从5到25个聚类的所有聚类解决方案，以确定最终概念图。
27名利益相关者在头脑风暴过程中分享了298个盲点。为了减少冗余，我们将其减少到208个以准备分类。10名利益相关者独立对盲点进行了分类，最终概念图包括9个领域和72个子领域的盲点，这些盲点与以下方面相关：（1）招生过程；（2）教学实践；（3）评估和课程设计；（4）教育和健康方面的不平等；（5）职业成长和身份形成；（6）患者视角；（7）团队合作和领导力；（8）卫生系统护理模式和财务实践；（9）政府和商业政策。
征求不同利益相关者的意见以识别医学教育中的盲点，发现了一系列值得更多关注的问题。概念图还可用于帮助确定资源的优先级，并指导能够促进变革并使医学教育更好地与患者和社区的健康需求保持一致的干预措施。
