This article introduces key concepts of activity theory and expansive learning. Expansive learning builds on the foundational ideas of the cultural–historical activity theory (CHAT). It is a research approach designed for studying the complexities and contradictions in authentic workplace environments. Change Laboratory is a formative intervention method developed for studying workplaces in transition and for stimulating collaborative efforts to design improved patterns of activity. We present concrete examples of formative interventions in healthcare, where good patient care was compromised by the fragmentation of care and disturbances in collaboration between the healthcare experts. This implies that physicians are challenged to develop collaborative and transformative expertise. We present three spearheads into a zone of proximal development, representing opportunities for change of medical expertise: (1) reconceptualizing expertise as object-oriented and contradiction-driven activity systems, (2) pursuing expertise as negotiated knotworking, and (3) building expertise as expansive learning. While medical expertise needs to expand, medical education must also look for ways to evolve and meet the challenges of the surrounding society. We call for adopting an interventionist approach for developing medical education and intensifying collaboration with the practitioners in healthcare units, their patients, and target communities.

Background: Despite numerous studies exploring medical students’ attitudes to communication skills learning (CSL), there are apparently no studies comparing different experiential learning methods and their influence on students’ attitudes. Aims: We compared medical students’ attitudes to learning communication skills before and after a communication course in the data as a whole, by gender and when divided into three groups using different methods. Method: Second-year medical students (n = 129) were randomly assigned to three groups. In group A (n = 42) the theatre in education method, in group B (n = 44) simulated patients and in group C (n = 43) role-play were used. The data were gathered before and after the course using Communication Skills Attitude Scale. Results: Students’ positive attitudes to learning communication skills (PAS; positive attitude scale) increased significantly and their negative attitudes (NAS; negative attitude scale) decreased significantly between the beginning and end of the course. Female students had more positive attitudes than the male students. There were no significant differences in the three groups in the mean scores for PAS or NAS measured before or after the course. Conclusions: The use of experiential methods and integrating communication skills training with visits to health centres may help medical students to appreciate the importance of CSL.

This AMEE guide discusses theoretical principles and practical strategies for health professions educators to promote impactful mentoring relationships. Traditional definitions are challenged, distinctions are made between roles such as mentor, advisor, coach and sponsor. As educational environments change and options for professional development expand, we argue that the traditional dyadic format of mentoring alone will not help mentees to maximise their professional growth. Newer formats of mentoring are discussed in detail and their advantages and disadvantages compared. We use a variety of theoretical concepts to anchor the practice of mentorship: self-focussed and other-focussed motives; psychological safety; personal interpretive framework; Daloz model for balancing support and challenge; zone of proximal development; communities of practice; and development along multiple layers of competence. Recommended strategies for effective mentoring are based on extensive review of literature, as well as combined professional mentoring experiences of the authors. We use key principles from the theories described and phases of mentoring relationships as foundations for the suggested best practices of mentorship. Finally, we emphasise the role of mentees in their own professional development and provide tips for them on seeking mentors, expanding their mentoring network and taking the lead in setting the agenda during mentoring meetings and formulating action plans for their own advancement.