Threshold concepts in medical education: A scoping review.

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Title: Threshold concepts in medical education: A scoping review.
Authors: Jones, Helen, Hammond, Lucy
Source: Medical Education. Oct2022, Vol. 56 Issue 10, p983-993. 11p. 3 Diagrams, 4 Charts.
Subjects: School environment, Teaching methods, Systematic reviews, Conceptual structures, Experience, Fieldwork (Educational method), Responsibility, Students, Intellect, Professional identity, Clinical medicine, Medical practice, Patient care, Medical education, Science, Medical logic
Abstract: Introduction: The threshold concept framework (TCF) was first described nearly 20 years ago, but its application in the field of medical education has recently seen a significant growth of interest with a diverse range of literature published on the subject. The transformative nature of threshold concepts (TCs) offers potential for the design of learning experiences and curricula across the medical education continuum. A scoping review was conducted to map the extent of the current literature regarding TCs in medical education—to describe the types of available evidence and its focus—and identify research gaps. Methods: The review followed the JBI Manual for Evidence Synthesis approach for scoping reviews. Four databases and two additional websites were searched for articles exploring TCs in medical education. Data were analysed using quantitative and qualitative thematic approaches. A framework of conceptual change was used to synthesise the TCs identified. Results: Thirty‐six papers, spanning undergraduate, postgraduate and continuing medical education, were included in the final analysis. The most frequent application of the TCF was in the identification of TCs, which related to basic scientific knowledge, ways of thinking and ways of practising in medicine. Uncertainty, patient care, clinical reasoning and professional identify formation were themes that emerged at multiple stages of training. Several papers evaluated the use of the TCF in teaching. Conclusion: The understanding and embodiment of TCs increases in complexity across the medical education continuum, with TCs recurring with changes in clinical environment and responsibilities. This lends support to a holistic approach to curriculum design spanning all stages of training. Further research is needed to develop a consistent approach for describing and applying the TCF in medical education and to address how the TCF can be used in teaching and how threshold crossing can be measured. Understanding and embodiment of threshold concepts across the medical education continuum is argued through this review to support a holistic approach to curriculum design. [ABSTRACT FROM AUTHOR]
Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Threshold concepts in medical education: A scoping review.
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  Data: <searchLink fieldCode="AR" term="%22Jones%2C+Helen%22">Jones, Helen</searchLink><br /><searchLink fieldCode="AR" term="%22Hammond%2C+Lucy%22">Hammond, Lucy</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Medical+Education%22">Medical Education</searchLink>. Oct2022, Vol. 56 Issue 10, p983-993. 11p. 3 Diagrams, 4 Charts.
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  Data: <searchLink fieldCode="DE" term="%22School+environment%22">School environment</searchLink><br /><searchLink fieldCode="DE" term="%22Teaching+methods%22">Teaching methods</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22Conceptual+structures%22">Conceptual structures</searchLink><br /><searchLink fieldCode="DE" term="%22Experience%22">Experience</searchLink><br /><searchLink fieldCode="DE" term="%22Fieldwork+%28Educational+method%29%22">Fieldwork (Educational method)</searchLink><br /><searchLink fieldCode="DE" term="%22Responsibility%22">Responsibility</searchLink><br /><searchLink fieldCode="DE" term="%22Students%22">Students</searchLink><br /><searchLink fieldCode="DE" term="%22Intellect%22">Intellect</searchLink><br /><searchLink fieldCode="DE" term="%22Professional+identity%22">Professional identity</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+medicine%22">Clinical medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+practice%22">Medical practice</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+care%22">Patient care</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+education%22">Medical education</searchLink><br /><searchLink fieldCode="DE" term="%22Science%22">Science</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+logic%22">Medical logic</searchLink>
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  Data: Introduction: The threshold concept framework (TCF) was first described nearly 20 years ago, but its application in the field of medical education has recently seen a significant growth of interest with a diverse range of literature published on the subject. The transformative nature of threshold concepts (TCs) offers potential for the design of learning experiences and curricula across the medical education continuum. A scoping review was conducted to map the extent of the current literature regarding TCs in medical education—to describe the types of available evidence and its focus—and identify research gaps. Methods: The review followed the JBI Manual for Evidence Synthesis approach for scoping reviews. Four databases and two additional websites were searched for articles exploring TCs in medical education. Data were analysed using quantitative and qualitative thematic approaches. A framework of conceptual change was used to synthesise the TCs identified. Results: Thirty‐six papers, spanning undergraduate, postgraduate and continuing medical education, were included in the final analysis. The most frequent application of the TCF was in the identification of TCs, which related to basic scientific knowledge, ways of thinking and ways of practising in medicine. Uncertainty, patient care, clinical reasoning and professional identify formation were themes that emerged at multiple stages of training. Several papers evaluated the use of the TCF in teaching. Conclusion: The understanding and embodiment of TCs increases in complexity across the medical education continuum, with TCs recurring with changes in clinical environment and responsibilities. This lends support to a holistic approach to curriculum design spanning all stages of training. Further research is needed to develop a consistent approach for describing and applying the TCF in medical education and to address how the TCF can be used in teaching and how threshold crossing can be measured. Understanding and embodiment of threshold concepts across the medical education continuum is argued through this review to support a holistic approach to curriculum design. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Medical Education is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/medu.14864
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        Text: English
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        PageCount: 11
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      – SubjectFull: School environment
        Type: general
      – SubjectFull: Teaching methods
        Type: general
      – SubjectFull: Systematic reviews
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      – SubjectFull: Conceptual structures
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      – SubjectFull: Experience
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      – SubjectFull: Students
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      – SubjectFull: Intellect
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      – SubjectFull: Professional identity
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      – SubjectFull: Clinical medicine
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      – SubjectFull: Medical practice
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      – SubjectFull: Patient care
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      – SubjectFull: Medical education
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      – SubjectFull: Science
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      – SubjectFull: Medical logic
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      – TitleFull: Threshold concepts in medical education: A scoping review.
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              Text: Oct2022
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              Y: 2022
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