Background: Professional identity formation (PIF) is a life-long process, starting even before professional education. High levels of motivation for medical school are essential for effective learning and academic success. Both are key factors in future physicians’ professional and personal development, and according to self-determination theory, professional identity (PI) and students’ levels of motivation could be closely linked. Therefore, we sought to investigate whether PI and strength of motivation for medical school are associated in new medical students. Methods: In a cross-sectional survey, all new medical students in Munich, Germany, were asked to complete the Macleod Clark Professional Identity Scale (MCPIS-9) and the Strength of Motivation for Medical School-Revised questionnaire (SMMS-R) as well as to provide information about age, gender, and waiting time before starting medical school. Results: Eight hundred eleven out of 918 new medical students participated in the survey. A positive correlation between the MCPIS-9 and the SMMS-R (p < 0.001) was found. Female students showed higher scores in the SMMS-R (p < 0.05) and the SMMS-R-subscale Readiness to Start (p < 0.001). The amount of waiting semesters showed a positive correlation with the total SMMS-R score (p < 0.01) as well as with the subscales Readiness to Start and Persistence (both p < 0.001). Discussion: We found an association between PI and strength of motivation for medical school in a large cohort of new medical students. Female gender and more waiting semesters were associated with higher levels of self-perceived motivation and higher scores on the SMMS-R-subscale Readiness to Start. More research is needed to better understand this topic to further improve medical education.

Background: Case-based learning (CBL) is a highly interactive instructional format widely used in medical education. One goal of CBL is to integrate basic biomedical knowledge and its application to concrete patient cases and their clinical management. In this context, we focus the role of teacher questions as triggers for reproductive vs. elaborative student responses. Specifically, our research questions concern the kinds of questions posed by clinical teachers, the kinds of responses given by students, the prediction of student responses based upon teacher questions, and the differences between the two medical disciplines in focus of our study, internal medicine and surgery.Methods: We analyse 19 videotaped seminars (nine internal medicine, ten surgery) taught by clinicians and attended by advanced medical students. Multiple raters performed a low-inference rating process using a theory-based categorical scheme with satisfactory interrater-reliability.Results: We found that medical teachers mostly posed initial (instead of follow-up) questions and that their questions were more often closed (instead of open). Also, more reasoning (than reproductive) questions were posed. A high rate of student non-response was observed while elaborative and reproductive student responses had a similar prevalence. In the prediction context, follow-up reasoning questions were associated with low non-response and many elaborative answers. In contrast, the highest student non-response rate followed open reproduction questions and initial reasoning questions. Most reproductive statements by students were made following closed reproduction questions.Conclusions: These results deepen our understanding of interactive, questions-driven medical teaching and provide an empirical basis for clinical teachers to use questions in didactically fruitful ways.

Expert professionals excel in their domains not only because of their superior knowledge about how to proceed to attain goals, but also because of their experiential knowledge about what may endanger the attainment of a goal and should therefore be avoided. This negative knowledge is researched here by means of a case study with practitioners in elder care nursing. It explores (1) what forms of workplace errors negative knowledge is related to, and (2) draws conclusions on error-producing conditions at the participants' workplaces. The results indicate that negative knowledge mainly, but not exclusively, relates to knowledge- and rule-based errors. Moreover, it provides insights into underlying tensions at the elder care nurses' workplaces, such as the requirement to make the residents follow medical suggestions, while also respecting their biography and autonomy. With regard to its potential for better understanding the competence of professionals to avoid errors, it is concluded that the concept of negative knowledge should more purposefully be developed at the individual and the organizational level.

This paper empirically investigates elder care nurses' negative knowledge. This form of experiential knowledge is defined as the outcome of error-related learning processes, focused on how something is not, on what not to do in certain situations or on deficits in one's knowledge or skills. Besides this definition, we presume the existence of other forms of negative knowledge that relate to elder care nurses' professional competence and practice. Data were collected by means of the prompting-task methodology, which was applied among 37 elder care nurses from a nursing home institution. Content analysis confirmed declarative, procedural, and self-reflective negative knowledge to be relevant in the investigated domain. Additionally, the elder care nurses voiced vicarious negative knowledge. This knowledge was focused on what certain nursing home residents' are not able to do or are not aware of. For each of these forms of negative knowledge, different subfacets are identified and illustrated through sample statements. Moreover, the relationship of different types of workplace errors is outlined. We conclude that negative knowledge represents failure-critical aspects of work situations and, thus, represents a valuable resource for professionals' competence and practice.