Association for the Study of Medical Education

Autologous costal cartilage grafting represents an alternative to iliac bone in alveolar cleft repair, yet long-term complications such as heterotopic ossification (HO) and secondary craniofacial deformities remain underreported. This case report describes the management of a patient with late-onset HO and secondary nasolabial deformity following costal cartilage grafting. A 23-year-old female presented 8 years after alveolar cleft repair with autologous costal cartilage graft, exhibiting maxillary protrusion, recurrent alveolar cleft, and orbicularis oris dynamic imbalance. The treatment involved a single-stage procedure comprising removal of the ossified graft, Mimics-based digital modeling-guided carving and reimplantation, orbicularis oris sling reconstruction, and alar suspension. Postoperative evaluation revealed significant improvement in facial symmetry and oral function. Computed tomography confirmed optimal graft adaptation within the alveolar defect. No internal fixation was used, and graft stability was achieved through anatomic interlocking and soft tissue reinforcement. Heterotopic ossification should be considered as a potential long-term complication of costal cartilage grafting in alveolar cleft reconstruction. A digitally guided, integrated approach combining graft reimplantation with dynamic soft tissue repair offers an effective strategy for managing such complex secondary deformities, emphasizing the role of biomechanical stability in achieving sustainable outcomes.

Although medical schools espouse a commitment to the educational mission, faculty members often struggle to develop and maintain their identities as teachers. Teacher identity is important because it can exert a powerful influence on career choice, academic roles and responsibilities, and professional development opportunities. However, most faculty development initiatives focus on knowledge and skill acquisition rather than the awakening or strengthening of professional identity. The goal of this Perspective is to highlight the importance of faculty members' professional identities as teachers, explore how faculty development programs and activities can support teachers' identities, and describe specific strategies that can be used in professional development. These strategies include the embedding of identity and identity formation into existing offerings by asking questions related to identity, incorporating identity in longitudinal programs, building opportunities for community building and networking, promoting reflection, and capitalizing on mentorship. Stand-alone faculty development activities focusing on teachers' identities can also be helpful, as can a variety of approaches that advocate for organizational change and institutional support. To achieve excellence in teaching and learning, faculty members need to embrace their identities as teachers and be supported in doing so by their institutions and by faculty development.

Significant developments in medical education are necessary if medical schools are to respond to the pressures from advances in medicine, changes in health care delivery, and patient and public expectations. This article describes 10 key features of the medical school of the future: the move from the ivory tower to the real world, from just-in-case learning to just-in-time learning, from the basic science clinical divide to full integration, from undervalued teaching and the teacher to recognition of their importance, from the student as a client to the student as partner, from a mystery tour to a mapped journey, from standard uniform practice to an adaptive curriculum, from a failure to exploit learning technology to its effective and creative use, from assessment of learning to assessment for learning, and from working in isolation to greater collaboration. A move in the directions specified is necessary and possible. With some of the changes proposed already happening, it is not an impossible dream.

Franklin Pierce Adams (1889–1960)• The vocabulary of higher education is being devalued. The use of ‘expert’ and ‘elite’ as pejorative terms undermines the trust on which successful societies are b...

Autoethnography is a methodology that allows clinician-educators to research their own cultures, sharing insights about their own teaching and learning journeys in ways that will resonate with others. There are few examples of autoethnographic research in medical education, and many areas would benefit from this methodology to help improve understanding of, for example, teacher-learner interactions, transitions and interprofessional development. We wish to share this methodology so that others may consider it in their own education environments as a viable qualitative research approach to gain new insights and understandings. This paper introduces autoethnography, discusses important considerations in terms of data collection and analysis, explores ethical aspects of writing about others and considers the benefits and limitations of conducting research that includes self. Autoethnography allows medical educators to increasingly engage in self-reflective narration while analysing their own cultural biographies. It moves beyond simple autobiography through the inclusion of other voices and the analytical examination of the relationships between self and others. Autoethnography has achieved its goal if it results in new insights and improvements in personal teaching practices, and if it promotes broader reflection amongst readers about their own teaching and learning environments. Researchers should consider autoethnography as an important methodology to help advance our understanding of the culture and practices of medical education.

Setting research priorities is important when exploring complex issues with limited resources. Only two countries (Canada and New Zealand) have previously conducted priority-setting exercises for medical education research (MER). This study aimed to identify the views of multiple stakeholders on MER priorities in Scotland. This study utilised a two-stage design to explore the views of stakeholders across the medical education continuum using online questionnaires. In Stage 1, key informants outlined their top three MER priorities and justified their choices. In Stage 2, participants rated 21 topics generated in Stage 1 according to importance and identified or justified their top priorities. A combination of qualitative (i.e. framework analysis) and quantitative (e.g. exploratory factor analysis) data analyses were employed. Views were gathered from over 1300 stakeholders. A total of 21 subthemes (or priority areas) identified in Stage 1 were explored further in Stage 2. The 21 items loaded onto five factors: the culture of learning together in the workplace; enhancing and valuing the role of educators; curriculum integration and innovation; bridging the gap between assessment and feedback, and building a resilient workforce. Within Stage 2, the top priority subthemes were: balancing conflicts between service and training; providing useful feedback; promoting resiliency and well-being; creating an effective workplace learning culture; selecting and recruiting doctors to reflect need, and ensuring that curricula prepare trainees for practice. Participant characteristics were related to the perceived importance of the factors. Finally, five themes explaining why participants prioritised items were identified: patient safety; quality of care; investing for the future; policy and political agendas, and evidence-based education. This study indicates that, across the spectrum of stakeholders and geography, certain MER priorities are consistently identified. These priority areas are in harmony with a range of current drivers in UK medical education. They provide a platform of evidence on which to base decisions about MER programmes in Scotland and beyond.