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Institutional ethnography (IE), a term coined by sociologist Dorothy Smith, explores the nuances of institutions and their complex relationships in sociology. IE is an approach to studying and analysing social organization, and it provides a more holistic understanding of 'invisible' relationships that govern institutions and how those relationships interact with each other. Health sciences researchers in patient care, patient experience, and allied health professionals have recently become more interested in the use of this methodology and how to incorporate it into their research. However, in health professions education (HPE) there is little use of IE. We hypothesize this may be because of limited practical knowledge of this methodology. This paper serves as an introduction to the use of IE in HPE, describing the differences between IE and traditional ethnographies, recognizing the common pitfalls when utilising IE, and incorporating texts into IE. While ethnographies may be daunting to researchers less familiar with these approaches, the tips in this paper will provide an introduction and help educators and researchers successfully navigate the use of IE in health profession scholarship and education. [ABSTRACT FROM AUTHOR]

The shift to using outcomes-based competency frameworks in medical education in many countries around the world requires educators to find ways to assess multiple competencies. Contemporary medical educators recognize that a competent trainee not only needs sound biomedical knowledge and technical skills, they also need to be able to communicate, collaborate and behave in a professional manner. This paper discusses methodological challenges of assessment with a particular focus on the CanMEDS Roles. The paper argues that the psychometric measures that have been the mainstay of assessment practices for the past half-century, while still valuable and necessary, are not sufficient for a competency-oriented assessment environment. New assessment approaches, particularly ones from the social sciences, are required to be able to assess non-Medical Expert (Intrinsic) roles that are situated and context-bound. Realist and ethnographic methods in particular afford ways to address the challenges of this new assessment. The paper considers the theoretical and practical bases for tools that can more effectively assess non-Medical Expert (Intrinsic) roles. [ABSTRACT FROM AUTHOR]

Cultural competence resides at the core of undergraduate and postgraduate medical and health professional education. The evolution of studies on cultural competence has resulted in the existence of multiple theoretical frameworks and models, each emphasising certain elements of culturally appropriate care, but generally lacking in providing a coherent and systematic approach to teaching this subject. Following a meta-ethnographic approach, a systematic search of five databases was undertaken to identify relevant articles published between 1990 and 2022. After citation searching and abstract and full article screening, a consensus was reached on 59 articles for final inclusion. Key constructs and concepts of cultural competence were synthesised and presented as themes, using the lens of critical theory. Three key themes were identified: competences; roles and identities; structural competency. Actionable concepts and themes were incorporated into a new transformative ACT cultural model that consists of three key domains: activate consciousness, connect relations, and transform to true cultural care. This critical review provides an up-to-date synthesis of studies that conceptualise cultural competence frameworks and models in international medical and healthcare settings. The ACT cultural model provides a set of guiding principles for culturally appropriate care, to support high-quality educational interventions. [ABSTRACT FROM AUTHOR]