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ContextTransformative learning (TL) has been described as learning that challenges established perspectives, leading to new ways of being in the world. As a learning theory it has resonated with educators globally, including those in the health professions. Described as a complex metatheory, TL has evolved over time, eliciting divergent interpretations of the construct. This scoping review provides a comprehensive synthesis of how TL is currently represented in the health professions education literature, including how it influences curricular activities, to inform its future application in the field.MethodsArksey and O'Malley's six-step framework was adopted to review the period from 2006 to May 2018. A total of 10 bibliographic databases were searched, generating 1532 potential studies. After several rounds of review, first of abstracts and then of full texts, 99 studies were mapped by two independent reviewers onto the internally developed data extraction sheet. Descriptive information about included studies was aggregated. Discursive data were subjected to content analysis.ResultsA mix of conceptual and empirical research papers, which used a range of qualitative methodologies, were included. Studies from the USA, the UK and Australia were most prevalent. Insights relating to how opportunities for TL were created, how it manifests and influences behaviour, as well as how it is experienced, demonstrated much congruency. Conceptions of TL were seen to be clustered around the work of key theorists.ConclusionsThe training of health professionals often takes place in unfamiliar settings where students are encouraged to be active participants in providing care. This increases the opportunity for exposure to learning experiences that are potentially transformative, allowing for a pedagogy of uncertainty that acknowledges the complexity of the world we live in and questions what we believe we know about it. TL provides educators in the health professions with a theoretical lens through which they can view such student learning.

Global health education (GHE) continues to be a growing initiative in many medical schools across the world. This focus is no longer limited to participants from high-income countries and has expanded to institutions and students from low- and middle-income settings. With this shift has come a need to develop meaningful curricula through engagement between educators and learners who represent the sending institutions and the diverse settings in which GHE takes place. The Bellagio Global Health Education Initiative (BGHEI) was founded to create a space for such debate and discussion and to generate guidelines towards a universal curriculum for global health. In this article, we describe the development and process of our work and outline six overarching principles that ought to be considered when adopting an inclusive approach to GHE curriculum development.

This study is set in an era and a context in which extrinsic forms of motivation and reward are offered by higher education institutions as a means to enhance teaching, and in which teaching is effectively undervalued in relation to research. The study focuses on the role of agency in professional development and demonstrates the relevance of Margaret Archer's description of the interplay between structure and agency for understanding how academics enhance their teaching in research-intensive universities. Ten semi-structured interviews were conducted by a team of academic development advisors in order to obtain accounts of teaching academics of their becoming good teachers, in their own words. An analysis of the transcripts of the interviews with the lecturers demonstrates how dimensions such as biography, current contextual influences, individuals' dispositions and steps taken to enhance teaching interact in a spiralling manner to generate a sense of self-fulfilment and agency. Intrinsic, rather than extrinsic motivation, is shown to be significant in propelling individuals towards action. The article concludes with an assessment of the implications of the interplay between structure and agency, the need for an enabling environment with a key role for intrinsic motivation for professional development strategies, in research-intensive universities.

Participating in cross-disciplinary collaborative activities can pose a range of challenges for those involved therein. Typically disciplinary strongholds are entrenched, and collaboration is dependent on the building of relationships--relationships that can exist in tension as issues of power, identity and the trappings of academic status inhibit the establishment of truly collegial and trusting interactions (Jacobs, 2007). In this article we describe and critically reflect on an instance of interdisciplinary collaborative educational research that looked at how content learning and issues of language intersect. The contention that it is often difficult for students to discern the rules and norms that characterise a particular discipline (Gee, 1990; Jacobs, 2007) can be equally true for participants in interdisciplinary collaboration, even when these participants are peers and particularly when this collaboration is within a research endeavour. The understandings that emerge from this reflection emphasise the potential for participants in such an endeavour to, therefore, receive mixed messages and we make some recommendations as to how this can be addressed. Importantly, however, we emphasise the potential of collaborative projects to serve as "a social inquiry practice that promotes learning" (Lattuca & Creamer, 2005, p. 5).

An introduction to the journal is presented which includes articles on topics including the Stellenbosch University Rural Medical Education Partnership Initiative, a quality improvement project to strengthen infection prevention control, and capacity-building needs of rural health managers.

Context: The Medical Education Partnership Initiative (MEPI) is a $US 130 million program funded by the United States government supporting 13 African medical schools to increase the quantity, quality, and retention of physicians in underserved areas. This paper examines how community-based education (CBE) is evolving at MEPI schools to achieve these goals., Methods: We utilized data from the first two years of site visits and surveys to characterize CBE efforts across the MEPI network and provide detailed descriptions of three models of CBE among the MEPI programs., Results: There is widespread investment in CBE, with considerable diversity in the goals and characteristics of training activities among MEPI schools. Three examples described here show how schools are strengthening and evaluating different models of CBE to achieve MEPI goals. In Nigeria, students are being sent for clinical rotations to community hospitals to offload the tertiary hospital. In Uganda, the consistency and quality of teaching in CBE is being strengthened by adopting a competency-based curriculum and developing criteria for community sites. At Stellenbosch University in South Africa, students are now offered an elective year-long comprehensive rural immersion experience. Despite the diversity in CBE models, all schools are investing in e-learning and faculty development. Extensive evaluations are planned to examine the impact of CBE strategies on the health workforce and health services., Discussion: The MEPI program is stimulating an evolution in CBE among African medical schools to improve the quality, quantity, and retention of physicians. Identifying the strategies within CBE that are reproducible, scalable and optimize outcomes will be instructive for health professions training programs across the continent.