A Matter of Trust: Online Proctored Exams and the Integration of Technologies of Assessment in Medical Education

Abstract

Issue: Technology is pervasive in medicine, but we too rarely examine how it shapes assessment, learning, knowledge, and performance. Cultures of assessment also shape identities, social relations, and the knowledge and behavior recognized as legitimate by a profession. Therefore, the combination of technology and assessment within medical education is worthy of review. Online proctoring services have become more prevalent during the Covid-19 pandemic, as a means of continuing high-stakes invigilated examinations online. With criticisms about increased surveillance, discrimination, and the outsourcing of control to commercial vendors, is this simply “moving exams online”, or are there more serious implications? What can this extreme example tell us about how our technologies of assessment influence relationships between trainees and medical education institutions? Evidence: We combine postdigital and postphenomenology approaches to analyze the written component of the 2020 online proctored United Kingdom Royal College of Physicians (MRCP) membership exam. We examine the scripts, norms, and trust relations produced through this example of online proctoring, and then locate them in historical and economic contexts. We find that the proctoring service projects a false objectivity that is undermined by the tight script with which examinees must comply in an intensified norm of surveillance, and by the interpretation of digital data by unseen human proctors. Nonetheless, such proctoring services are promoted by an image of data-driven innovation, a rhetoric of necessity in response to a growing problem of online cheating, and an aversion, within medical education institutions, to changing assessment formats (and thus the need to accept different forms of knowledge as legitimate). Implications: The use of online proctoring technology by medical education institutions intensifies established norms, already present within examinations, of surveillance and distrust. Moreover, it exacerbates tensions between conflicting agendas of commercialization, accountability, and the education of trustworthy professionals. Our analysis provides an example of why it is important to stop and consider the holistic implications of introducing technological “solutions”, and to interrogate the intersection of technology and assessment practices in relation to the wider goals of medical education.

Keywords:

• online proctoring
• assessment technology
• trust
• norms
• postphenomenology
• postdigital

Introduction: the technology of assessment

Technology is pervasive in medicine and medical education. Respiratory monitors, mobile phones, digital patient records, social media, and digital education platforms have all changed knowledge, practice, and relationships.^1–4 Technologies have reshaped professional roles and specialisms such as radiology and pharmacy.⁵ Alongside the many benefits, there are also risks. Technology changes more than how we work and learn; it also influences our wider moral relations, beliefs, norms and values.^6,7 As educators negotiate new technologies, they are confronted not only with technical challenges but also highly-complex, moral, and pedagogical ones.⁵ Despite this, technology often goes unexamined by those who use it,⁸ or our understanding is limited to questions about individual interactions, experiences, learning, and outcomes.⁹

Cultures of assessment also shape identities, social relations, and the legitimate knowledge and behavior recognized by a profession.^10–13 Assessment practice and culture have, in turn, been shaped over time by technologies such as rubrics, mark sheets, virtual learning environments, and plagiarism detection software.¹⁴ Hodges,¹⁵ speculating on future directions of technology in assessment, warns of an intensification of performativity in high stakes examinations through surveillance and automated judgements. Thus far, research on assessment technologies (and assessment more generally)¹³ has focused on individual outcomes, framed around neutral and objective tools, rather than issues of equity, ethics, or values.¹⁶

One technology worth investigating is online proctoring—a service that creates invigilated examination conditions outside of the exam hall.¹⁷ Such services existed before the Covid-19 pandemic, but their use increased significantly in 2020 as institutions sought continuity of secure assessment.¹⁸ While exam halls still represent the standard to which it aspires, online proctoring has been positioned as an alternative to “not being able to run exams at all”.^18(p8) Across a variety of services,¹⁹ a combination of regular software updates and data-driven approaches produces a sense of innovation^18,20 which, along with efficiency, is a key factor in technology adoption in assessment.²¹ However, proctoring has been criticized as introducing new risks around learner privacy, foregrounding distrust,¹⁸ discriminating against nonwhite and disabled people, and misusing data.²²

Research on online proctoring is just emerging. Reviews of the field often rely on journalistic sources,^18,23,24 and few studies have adopted critical approaches. Coghlin et al.²⁴ raise concerns about increasing distrust toward institutions and an acceleration of surveillance and control. Lee and Fanguy²⁵ apply Foucault’s “disciplinary governmentality”²⁶ to online proctoring at a South Korean university. They propose that surveillance constrains possibilities for thinking and behavior, and positions students as opponents in an atmosphere of competition. In Australia, Selwyn et al. analyze interviews, documents, and media to critically examine relations between universities, proctoring companies, and students.¹⁸ Alongside surveillance, they question “the surrender of control to commercial providers”, and the need for teachers to subvert the technology to maintain their educational values.

In medical education, online proctoring has not yet been subject to critical research. This is worrying, given medicine’s emphasis on cultivating practitioners with integrity and professionalism. The technologized process of proctoring may reassure medical schools, employers, and the public that results are fair and objective.²⁵ However, while “all forms of examination are surveillance”,^15(p3) and while normative conceptions of trust, professionalism, and knowledge were already embedded within traditional assessment practice in medical education,^27,28 it is important to consider whether something more is going on than simply “moving exams online”.

In this paper, we follow Veen and Ciancolo’s²⁹ suggestion to slow down, consider context, and reflect on the interplay between assessment technology and culture in medical education, and the kinds of knowledge and professional identity they promote. We combine postdigital and postphenomenology approaches to analyze the 2020 online proctored United Kingdoml College of Physicians (MRCP) membership exam. We examine the scripts, norms, and trust relations produced through this example of online proctoring, and locate them in historical and economic contexts. Through this, we consider what is valued in terms of knowledge, professionalism, and relations between trainees and medical education institutions, before drawing out implications for the integration of technologies of assessment in medical education.

Theoretical framework: combining the postdigital and postphenomenological

While medical education research has been largely preoccupied with individualism, and the treatment of knowledge as “private capital”,^30(p849) some have employed more complex frameworks to examine technology within medical education. Body pedagogics³ considers learning and practising as embodied processes that occur in interaction with the material environment (which includes technologies). Activity theory,^31,32 practice theory,³³ and other sociomaterial approaches³⁴ have helped us see how technology and people act together, in particular situations, such that neither can be understood in isolation. Such work focuses primarily on practice settings, and has not yet, to our knowledge, been used to examine assessment technology in medical education.

An emerging perspective for interrogating the complex entanglements of digital technology is that of the “postdigital”.^35,36 Related to sociomaterial understandings of technology, it asserts that anything “digital” must be understood as embedded in a broader context. Outcomes of technology are contingent on the methods by which it is used, and the purposes, values, and contexts of multiple stakeholders.³⁷ Further, encounters with digital activity are embodied and emergent. Online exams take place in physical settings with physical bodies, and there can be no straightforward online versions of traditional educational practices.^35,38,39 Online proctored exams inevitably involve a different reality from the exam hall, albeit with some commonalities.⁴⁰ To augment this broader perspective, we first employ a postphenomenology of technology approach,^41–44 for a closer interrogation of the human-technology relations (behavioral scripts, social norms, and trust relations) promoted by an instance of proctoring technology. We then zoom out to consider how the assessment reality created by this technology is embedded in historical, political, pedagogical, and economic contexts, and what this means for relationships between trainees, institutions, and cultures of assessment technology.

Both postdigital and postphenomenological perspectives reject the idea that reality is based on human, subjective interpretation and action alone. We do not fully determine the world around us. On the other hand, both perspectives also criticize the view that reality is just “out there” and we can know it objectively. The world around us does not fully determine us. Conversely, both perspectives emphasize that “reality arises in relations, as do the humans who encounter it”,^43(p568) and technology has a role in shaping these relations.

Online proctored exams

Online proctoring creates a remote version of exam-hall conditions by monitoring and constraining possibilities for action and movement. The technology verifies each candidate’s identity, and that they are alone and isolated from resources that could aid their performance. Wearing earplugs or handling textbooks or mobile devices may be considered a “serious breach of exam protocol”.^45(p5) Some services require exam-takers to install software on their device to block access to documents, applications, and websites. Authentication normally requires permission for the software to control webcams and microphones, which monitor the environment during the examination. Other data can include keyboard strokes, network traffic, and computer memory usage.¹⁷ Monitoring can be live or retrospective via recordings, or both, and may involve an algorithm, or a human who is unknown to, and unseen by, the student. Before the exam, candidates must scan the examination space (often a bedroom, kitchen, or other private space within their home) with their webcams.

A recent example of high-stakes online proctoring is the United Kingdom’s Royal College of Physicians (MRCP) membership exam. This two-part exam acts as a gateway into specialist training.⁴⁶ It is “the largest high stakes postgraduate clinical examination in the world” with “5000 candidates examined each year”.^47(p2) Part One is an introductory, written examination. Part Two is more advanced, consisting of two, three-hour written exams, both sat on the same day. Finally, there is the Practical Assessment of Clinical Examination Skills (PACES). In 2020, MRCP offered the option of remote examination using different invigilation services for the different components. According to the MRCP guidance, proctoring would be performed “by a specialist provider” who would “be monitoring your activity throughout the exam, just as they would in a face to face exam encounter.”^45(p5)

In this paper, we limit our analysis to the written element in Part Two of the MRCP exam, excluding the practical component. While there are obvious concerns about the capacity for online proctoring to create equivalent assessment environments for demonstrating clinical skills, limiting our scope allows us to focus on how the technology creates constrained physical environments even for written assessments. In 2020, Part Two of the MRCP membership exam used the ProctorExam service. Examinees were required to choose a quiet location where they were “guaranteed” not be disturbed.⁴⁵ The exam space needed to be well lit and have reliable WiFi. Requirements included a laptop with webcam and microphone, Google Chrome browser, and a minimum Internet speed. ProctorExam did not measure eye movements or keystrokes, but prided itself as a “leader” in adding extra cameras (e.g. the candidate’s smartphone) for additional “accuracy”.⁴⁸ Screen and camera footage was recorded for “internal use” and not made available to candidates or examiners.⁴⁵

Human proctors (either ProctorExam or institutional employees) watched the candidates, to ensure they started at the correct time and to provide assistance when needed (e.g. where candidates felt unwell or needed the bathroom). Moreover, they ensured that the exam environment was secure. This supportive framework underplayed the primary function, which was to flag abnormal behavior as potential cheating. In such cases, the medical education institution would have the final say on any action taken. Proctors were not visible to candidates; communication occurred via text chat. Candidates had to remain seated at their computer until the end of the allocated time, even if they had finished earlier.⁴⁵

Postphenomology of proctoring: how technology creates reality

Postphenomenology, as developed by Ihde⁴¹ and Verbeek,⁴² challenges the idea that technology is an instrument designed with a certain purpose that simply does what we intend it to do.⁴⁹ Instead, technology mediates relations between human and world in non-neutral ways.⁵⁰ With this lens, we scrutinize how technology offers users particular scripts that shape how they can act in the world, and how technology presents the world to them.

Scripts and norms

Technological objects have a script, that is an “inclination or trajectory that shapes the ways in which they are used.”^43(p569) For example, fountain pens require us to think ahead and compose sentences before writing them down, while word processors invoke quick, flexible writing that mimics speech. One can write slowly and quickly with either, but each promotes a certain type of use while discouraging others.^43,51 Moreover, technologies are socially embedded and shape cultural norms. Early ballpoint pens were thought to impair children’s quality of work by eliciting quicker, sloppy writing, whereas fountain pens were seen as producing neat and careful work.⁴³

In online proctoring, examinees behavior is governed by the technology’s surveillance function. ProctorExam claims to provide a pure context, with greater security and accuracy, through their multi-camera solution.⁴⁸ Purity of context is, however, undermined by the strict control of examinees’ behavior, and by the inevitable interpretation by examiners.⁵¹ In exam halls, candidates only need to purify their person (e.g. by excluding prohibited notes or devices); in online proctoring, they must purify their whole environment and range of bodily movement.

Thus, although exam hall invigilation also involves surveillance and interpretation of behavior (e.g. does looking toward a neighbor imply cheating or mind-wandering?), there are important differences. Firstly, whereas in the exam hall, (potential) cheating is framed as looking at prohibited resources, or speaking to other candidates, in online proctoring it is framed more widely: looking away from the screen, moving in an atypical fashion, unsanctioned use of the device being used for exam-taking, poor Internet connectivity, other technical issues, someone entering the room, etc. While many students do not seem to experience online proctoring as overly intrusive, and some forget about being watched or become apathetic to it,¹⁸ strict monitoring of bodily movements, nonetheless, compels them to conform to an ideal model of an examinee.^22,27

Secondly, in online proctoring, there is a variety of behavioral data (e.g. eye-movement, keystrokes, video feeds), and each represents a digitized slice of the test world. These data cannot directly confirm whether behavior is inappropriate. Proctors must “read” the benchmarks that indicate cheating, and examinees are encouraged by the technology to adapt to these standards. Thirdly, candidates cannot see online proctors, and neither they, nor their assessors, have access to how the software works, disrupting normal trust relations of exam hall invigilation.^24,25 Examinees are at a disadvantage, since their behavior is minutely recorded, while their understanding of what proctors do and observe is nearly absent.

Trust

Online proctoring technology intensifies norms of surveillance over trust by enforcing stricter protocols, while also conveying a false sense of objectivity. Technology becomes transparent to us when we use it (as with proctored examinees who forget they are watched).^18,43,50 We expect pens to write, Google to yield search results and proctor technology to identify cheaters. Nguyen applies the concept of trust, not only to relations between people, but also to those (technological) objects that we trust constantly.⁵² To cope with an overwhelming world that poses demands beyond our physical and cognitive limitations, we outsource agency to human others, animals, and objects.⁵² We may outsource our sight to a guide dog, the education of our children to teachers, and exam surveillance to proctor technologies. In each case, trust implies an unquestioning attitude to the technology’s reliability. Consider a novice mountaineer, who requires training to forget their rope,⁵² trusting it to stop them from falling, so that they can direct their precious attention elsewhere. The technology is no longer visible, or has become transparent. To work effectively with proctoring technology, examinees must learn to trust it not to flag them inappropriately, while examiners must trust it to appropriately detect cheating.

While multiple video feeds seemingly create objectivity for proctors, for examinees, the assessment is located in a highly-contrived reality in which their bodies are constrained, monitored, and controlled by external forces, in more detail than in exam halls. Breakdowns of transparency are provoked by notifications and warnings produced by the software when a candidate engages in potentially suspicious behavior (e.g. looking in the wrong place or moving in the wrong way). These forces are conveyed by proctoring companies as benevolent or neutral, but their primary function is enforcing constraint and reporting subversion through the minute technological scripting of movement and environment.

A postdigital view of online proctoring

We have argued that online proctoring involves a tighter script and more interpretation than exam hall invigilation. In this section, we broaden our postdigital view to zoom out and investigate the historical and economic contexts and assessment cultures in which the MRCP exam is located.

Historical context

Online proctoring is interpreted through a lens colored by the historical context of traditional examination settings. As Carless⁵³ argues, we trust exams, in part, due to their long tradition. They “represent continuity and stability, whilst other more innovative forms of assessment may be seen as risk-taking.” ^53(p82) Further, equivalence between online and traditional exams is necessary for comparing candidates over time.

To reassure its customers, online proctoring mimics a preexisting distrust within the “established logics of university study” through which “students are placed in disempowered surveilled positions during any examination setting.”^18(p13) This mimicry of traditional invigilation practices is explicit in the MRCP guidance. It frames online proctors as working “just as they would in a face to face exam encounter”.^45(p5)

However, our case involved invisible online proctors, multiple cameras, control of shared environments, partnerships with 3^rd party companies, and more. Further, while ProctorExam’s datafication of behavior echoes the quantification of knowledge through exams, and a tradition of seeing numbers as more objective than other forms of information,^20,54 it is also part of an increasing trend of big data and algorithmically adjudicated truth.²⁰ With data-driven processes and constantly updating software, ProctorExam is imbued with a sense of relentless innovation,¹⁸ while also being perceived as a lower-risk practice of continuity.

Economic context

As a commercial product, proctoring technology must create value. First, it frames medical schools as clients, inserting itself into the relationship between assessors and students.^18,48 Having spent considerable money, the medical school is invested in the system, and it is in its interests for the technology to be perceived as a success. Moreover, it would be expensive and complicated to change to a different assessment format that did not require proctoring.¹⁸ This incentivises decision-makers to defend the technology against critiques, and to continue using it.

Second, proctoring technology frames students as potential cheaters and, therefore, as threats to the academic integrity of the medical school and the medical profession.²⁵ This is important for commercial sustainability, since the software is only necessary if people cheat.

Third, it also frames students as clients through its rhetoric of fairness and support. Online proctors are there to “assist you with any issues … They will not be visible on your screen but will be available should you need to alert them to a problem.”^45(p13) Hard-working, non-cheating students can be reassured that they are not disadvantaged by the cheating of others.^24,25 Finally, the technology’s perceived effectiveness is also contingent on students as sources that generate data,⁵⁵ with no choice but to comply if they want to pass the exam.

Assessment culture

Assessment has a powerful influence over what and how students learn, and over what is valued within education systems¹³ and professional disciplines.^10,56 Exams, for example, value “objective” knowledge, and constrain possibilities for demonstrating and validating other kinds of knowledge.¹⁰ All invigilation is aimed at creating an environment for fair assessment of performance, based on standardization and equality of experience.⁵⁷ Yet preventing access to external resources and controlling bodily behavior prioritizes individualized, abstract, and propositional knowledge⁵⁸ at the expense of embodied, social, material and collective knowledge on which trust, relationships, and teamwork are founded.⁵⁹ It marginalizes critical or creative knowledge and inhibits the development of future autonomous practitioners.¹⁰

What was already a narrow view of knowledge is further tightened through online proctoring. In exam halls, all candidates perform in the same physical location, and are allowed only a highly-restricted set of materials. In online proctored exams, anyone not considered by the technology to conform to its model of how a student should behave, move, or look during an exam is associated with signifiers of a lack of integrity. The restriction of gaze and movement to a single digital interface is a strong commitment to the denial of material, non-cognitive knowledge and of diverse bodily characteristics and conditions. This is harder for some than others, and there are reports of online proctoring services discriminating against candidates in relation to gender, race, disability, language, culture, and more.^22,24,55 These, along with other circumstantial disadvantages (e.g. those with shared living spaces, caring responsibilities, limited technological resources, or physical challenges) are at odds with fair and objective assessment.

Discussion

Integrity, professionalism, and surveillance

In exams, definitive answers, the exclusion of resources, and behavioral control close down possibilities of being, thinking, knowing, and acting.¹¹ Further, “objective” assessment requires breaking ability down into standardized and decontextualized knowledge at the potential expense of collective, collaborative, and complex professional performance.^59–61 In online proctoring, the flexibility of enabling trainees to take exams from home increases the requirements of rules and surveillance. We have argued that this intensifies existing problematic framings of examinees, trust, and knowledge, in which more authentic or meaningful forms of assessment are sacrificed in the name of “fairness.”²⁵

In the 2020 MRCP exam, online proctoring may also have exacerbated existing forms of discrimination by heightening performativity, through which learners contort themselves to portray an imagined ideal candidate.¹⁵ Surveillance in assessment is part of a broader process of normalization, through which “techniques of objectification… are constantly used to evaluate and control us because they exclude those who cannot conform to ‘normal’ categories.”^27(p445) Despite claims like the UK General Medical Council’s that “equality, diversity and inclusion are integral to our work as a regulator,”^62(p3) students may feel they need to amplify, sanitize, or suppress their ethnicity, “gender, sexuality, culture, religion, language or disability/ability.”^15(p3)

Further, surveillance may produce a kind of pseudo-integrity that is bound to conditions of being watched. This exacerbates a problem for exam assessment more generally, in how it prepares students to become part of and contribute to their disciplines,^10,63 since enforced integrity is likely to be counterproductive to the development of independent professionalism.^64–67 Technological surveillance promotes distrust between educators and students,⁶⁸ and the presence of cameras implies that students are potential cheaters who must be closely watched. Proctoring companies seek to normalize coercive and invasive measures in the homes of candidates, positioning surveillance as a “necessary evil” to protect the “academic integrity” of institutions and the rights of trustworthy students to a fair examination.¹⁸

It is in the commercial interest of proctoring companies to frame candidates as potential cheaters and cheating as a significant, growing, and dynamic problem,⁶⁹ with a technological solution.^18,22 MRCP’s use of online proctoring as a “temporary emergency solution” follows a broader trend of technological automation and establishes “private and commercial providers as essential infrastructural intermediaries between students and their universities”.^55(p2)

Complex perspectives on technology in medical education

Philosophical approaches allow analyses to go beyond the usual forms of evidence, which are often limited in terms of how they address complexity.¹¹ Our broader postdigital perspective helps us see that there is no straightforward equivalence between exam halls and online proctoring. The “digital” technology of the 2020 MRCP exam was embedded in an assessment culture in ways that are entangled in a historical and economic context. The postphenomenological lens draws attention to scripts and how they shape the assessment reality. Combined, these two approaches “provide a convincing and defensible account of both the practice and its effects.”^33(p219) These or other complex frameworks can, and should, be applied to other applications of technology in medical education. For example, we might question the kinds of learning promoted via learning analytics,^35,70 or what it means for on campus teaching to “move online”,⁷¹ since the social and material context of online learning⁷² is very different. In each case, the moral and ethical implications require looking beyond outcomes, terms, and conditions,⁴⁰ to how technology is embedded in particular cultures and practices.

Broader lessons for assessment technology in medical education

Nieminen and Lahdenperä call for research into how student agency in higher education assessment promotes or hinders future development.¹⁰ Professional doctors must not only be competent but also trustworthy, and act with integrity without being monitored. Furthermore, they should be professional members of teams and wider systems. Conversely, in online proctored exams, trainees are constructed not only as potential cheaters, but also as objects of control

who cannot think for themselves, take responsibility, or create new knowledge.¹¹

It is unclear what will happen with online proctoring as the Covid-19 situation stabilizes. The challenge ahead is not simply to decide whether online proctoring tools are worthwhile,⁷³ or whether we need to soften their scripts and surveillance. While we acknowledge that exams might be effective under certain conditions, and we would not advocate letting candidates do whatever they want, we call for medical educators to ask questions about how we conduct high stakes assessment and why it is so reliant on invigilation. Our aim here is not to propose alternatives to invigilated examinations, nor that educators should avoid technology in assessment. Rather, we aim to provoke critical consideration of how the combination of technology and assessment promotes particular kinds of knowledge, identity, professionalism, and trust relations.⁴³ This is no simple task. It involves confronting a longstanding reluctance, across education more broadly, to ask fundamental questions about the purpose of assessment, how it affects educational relationships, or how it relates to “truth, fairness, trust, humanity or social justice”.^74(p2) A good starting point is to engage in honest dialogue around how we currently do assessment, and how we might reimagine our practices in ways that reinforce relations between trainees and medical education institutions, such that we no longer place trust in technology above trust in our students.

Conclusion

Assessment both reflects and shapes what is valued in medical education. Our analysis of the 2020 MRCP membership exam shows how online proctoring technology intensifies a norm of surveillance over trust that already exists in exam hall invigilation. This exacerbates some established tensions within the assessment culture of medical education, namely: a narrow conception of legitimate knowledge as standardized and decontextualized, a narrow model of the ideal, solitary exam candidate, and a default distrust of trainees. By examining the historical and economic contexts of the MRCP exam, we have showed how these tensions are reinforced by the commercial interests of proctoring companies that incentivise distrust and data-driven normative models of invigilation.

Veen and Cianciolo^{29(pp337-338)} wrote, in the paper that launched this series, to slow down and consider context “to examine carefully what we are doing to care for learners and improve their performance, professionalism, and well-being.” While we are confident that, in general, medical educators trust students, and work hard to support them to become trustworthy, we have argued that the assessment culture promoted by online proctoring technology, and our employment of assessment technology more widely, are in need of review. If, as Bearman⁷⁵ suggests, the test world shapes the practice world, we must also ask: what kind of world do we generate through our use of assessment technology?

Acknowledgements

Thanks to Mario Veen for the invitation and for help along the way. Thanks also to Anna Cianciolo and two anonymous reviewers for their comments.

Previous Philosophy in Medical Education Installments

Mario Veen & Anna T. Cianciolo (2020) Problems No One Looked For: Philosophical Expeditions into Medical Education, Teaching and Learning in Medicine, 32:3, 337-344, DOI: 10.1080/10401334.2020.1748634

Gert J. J. Biesta & Marije van Braak (2020) Beyond the Medical Model: Thinking Differently about Medical Education and Medical Education Research, Teaching and Learning in Medicine, 32:4, 449-456, DOI: 10.1080/10401334.2020.1798240

Mark R. Tonelli & Robyn Bluhm (2021) Teaching Medical Epistemology within an Evidence-Based Medicine Curriculum, Teaching and Learning in Medicine, 33:1, 98-105, DOI: 10.1080/10401334.2020.1835666

John R. Skelton (2021) Language, Philosophy, and Medical Education, Teaching and Learning in Medicine, 33:2, 210-216, DOI: 10.1080/10401334.2021.1877712

Zareen Zaidi, Ian M. Partman, Cynthia R. Whitehead, Ayelet Kuper & Tasha R. Wyatt (2021) Contending with Our Racial Past in Medical Education: A Foucauldian Perspective, Teaching and Learning in Medicine, DOI: 10.1080/10401334.2021.1945929

Chris Rietmeijer & Mario Veen (2021) Phenomenological Research in Health Professions Education: Tunneling from Both Ends, Teaching and Learning in Medicine, DOI: 10.1080/10401334.2021.1971989

Madeleine Noelle Olding, Freya Rhodes, John Humm, Phoebe Ross & Catherine McGarry (2022) Black, White and Gray: Student Perspectives on Medical Humanities and Medical Education, Teaching and Learning in Medicine, 34:2, 223-233, DOI: 10.1080/10401334.2021.1982717

Camillo Coccia & Mario Veen (2022) Because We Care: A Philosophical Investigation into the Spirit of Medical Education, Teaching and Learning in Medicine, DOI: 10.1080/10401334.2022.2056744

Associated Podcast

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Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

The author(s) reported there is no funding associated with the work featured in this article.