BackgroundRole modelling is widely accepted as being a highly influential teaching and learning method in medical education but little attention is given to understanding how students learn from role models. This study focuses on role modelling as an active, dynamic process, involving observational learning and aims to explore the process involved, including strategies that learners and medical teachers use to support this.MethodsTo gain insight into medical students’ and clinical teachers’ understanding of learning through role modelling, a qualitative, interpretative methodology was adopted, using one-to-one semi-structured interviews. Six final year medical students and five clinical teachers were purposefully sampled and interviewed. Interviews were audio recorded and transcribed. The data were then analysed using open and axial coding before codes were combined to develop broader themes.ResultsStudents could identify ways in which they learnt from role models but acknowledged that this was complex and haphazard. They described selectively and consciously paying attention, using retention strategies, reproducing observed behaviour and being motivated to imitate. Students evidenced the powerful impact of direct and vicarious reinforcement. Clinical teachers reported using strategies to help students learn, but these were not always consciously or consistently applied or informed by teachers’ understanding of their students’ cognitive processing.ConclusionFindings illustrate in what ways the process of learning from role models in clinical settings is challenging. They also support the relevancy and usefulness of Bandura’s four stage social learning model for understanding this process and informing recommendations to make learning from role modelling more systematic and effective.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1251-x) contains supplementary material, which is available to authorized users.

ObjectivesThe introduction of competency-based training has necessitated development and implementation of accompanying mechanisms for assessment. Procedure-based assessments (PBAs) are an example of workplace-based assessments that are used to examine focal competencies in the workplace. The primary objective was to understand surgical trainees' perspective on the value of PBA.DesignSemistructured interviews with 10 surgical trainees individually interviewed to explore their views. Interviews were audio-recorded and transcribed; following this, they were open and axial coded. Thematic analysis was then performed.ResultsSemistructured interviews yielded several topical and recurring themes. In trainees' experience, the use of PBAs as a summative tool limits their educational value. Trainees reported a lack of support from seniors and variation in the usefulness of the tool based on stage of training. Concerns related to the validity of PBAs for evaluating trainees' performance with reports of ‘gaming’ the system and trainees completing their own assessments. Trainees did identify the significant value of PBAs when used correctly. Benefits included the identification of additional learning opportunities, standardisation of assessment and their role in providing a measure of progress.ConclusionsThe UK surgical trainees interviewed identified both limitations and benefits to PBAs; however, we would argue based on their responses and our experience that their use as a summative tool limits their formative use as an educational opportunity. PBAs should either be used exclusively to support learning or solely as a summative tool; if so, further work is needed to audit, validate and standardise them for this purpose.

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Central to the decolonial debate is how high-income countries (HICs) have systematically negated ways of knowing from low- and middle-income countries (LMICs), and yet the paucity of empirical decolonization studies leaves educators relatively unsupported as to whether, and how, to address privilege in higher education. Particularly in science, technology, engineering, mathematics and medicine (STEMM) institutions, there are few published examples of attempts to engage faculty in these debates. In 2018–19, we invited faculty on a master’s in public health course to engage with the decolonization debate by providing: (1) descriptive reading list analyses to all 16 module leads in the master’s programme to invite discussion about the geographic representation of readings; (2) an implicit association test adapted to examine bias towards or against research from LMICs; (3) faculty workshops exploring geographic bias in the curriculum; and (4) interviews to discuss decolonization of curricula and current debates. These initiatives stimulated debate and reflection around the source of readings for the master’s course, a programme with a strong STEMM focus, and the possibility of systemic barriers to the inclusion of literature from universities in LMICs. We propose the notion of epistemic fragility, invoking DiAngelo’s (2011) ‘white fragility’, because some of the responses appeared to result from the challenge to perceived meritocracy, centrality, authority, individuality and objectivity of the HIC episteme that this initiative invites. We posit that the effortful reinstatement of a status quo regarding knowledge hierarchies in the global context, although not a representative reaction, can lead to a significant impact on the initiative in general. Efforts to decolonize curricula require actions at both the individual and organizational levels and, in particular, a managed process of careful engagement so that fragility reactions, if and where they occur, are given the time and space to be navigated in the open. Based on our experiences, we offer recommendations for policy and practice for those engaged in this movement and potential research questions to explore epistemic fragility in higher education.

This case study from the Civil and Environmental Engineering department of a UK university presents an educational design that uses team-based learning (TBL) to prepare students prior to undertaking a group project. Our aim is to show how the established TBL approach can be used in a novel way as a precursor to a group project to improve the achievement of learning outcomes. The purpose of the TBL was to ensure pre-reading was completed, to instil a sense of subject matter mastery, to allow students to discuss complex issues and to develop collaborative and inclusive behaviours. These skills and knowledge were necessary to successfully complete the follow-on group project and importantly for success in their future careers. Student's end of module reflective statements indicated that they positively collaborated and communicated when working on a group project.