International Journal of Medical Education最新文献

Objectives:  The purposes of this study were to identify reflective processes from patients' points of view for difficult patient-doctor interactions and learn how the processes made medical students and residents aware of their own medical practice.  These processes were compared in two countries (US and Japan).

Methods:  The study was a descriptive qualitative study utilizing semi-structured interviews.  Participants were from US and Japan.  We analyzed the data using reflective thematic analysis of the implementation of reflections (from a patient's point of view) into medical clinical education and training from a constructivism paradigm.

Results:  We included twenty participants each from US and Japan by convenience sampling.  The participants were medical students during clinical clerkship and post graduate year-1, 2, and 3 medical residents.  Medical students and residents realized four cognitions (different expectations of patients and doctors, language communication barrier, time restriction and healthcare system challenges) from reflections from patients' perspectives.  Subsequently, medical students and residents identified three types of awareness (appropriate communication, empathy, and patient-doctor relationship of trust).  During these reflections from patients' perspectives, the medical students and residents had a willingness to change future behavior.

Conclusions:  This study revealed one aspect of medical students' and residents' cognitions and awareness of clinical experiences through reflection from patients' perspectives.  This cognitive process aligns the ideas of medical students and residents more closely with the patients' perceptions and influences their willingness to change their behavior. This process enables comprehensive realization in person-centered care.

Objectives: The aim of this study was to confirm and evaluate the learning effect of a physician-facing e-learning course on genetic medicine for improving genomic literacy.

Methods: We employed qualitative and quantitative methodology to survey 103 physicians who took the course at a national university in Japan. Evaluations were conducted at the levels of participant feedback, learning, and behaviour. Participants completed a questionnaire and test (full score = 100) before and after the course. Pre- and post-test scores were compared using paired-samples t-tests and Mann-Whitney U test was used to compare the difference their clinical experience. The effect size was estimated using Cohen's d.

Results: Responses were obtained from 96 physicians. Approximately 80% (n = 75-93) of participants responded positively to the course, a result supported by the qualitative data. The mean scores for the pre- and post-test showed an increase from 71.25 to 74.58 (p=0.008). In particular, mean test scores increased significantly from 68.94 to 75.53 (p<0.001) in physicians with no clinical experience in genetic medicine, while no significance was observed scores for physicians with clinical experience in genetics from 73.47 to 73.67 (p=0.903). Behavioural assessment was carried out for 28 participants; however, no statistically significant differences were identified.

Conclusions: Our findings indicate that our e-learning course was useful for physicians with no experience of genetic medicine. For those with experience, it may be necessary to provide more practice-based education and educational methodologies. Behavioural assessment needs to be examined further.

Objectives: To explore how mentors perceive and perform their role in a longitudinal mentorship programme with the objective of guiding medical students in becoming reflective learners.

Methods: A qualitative exploratory study was conducted using semi-structured interviews with 16 mentors from the Ghent University medical education mentoring programme. Participants were selected by purposeful sampling on gender, years of experience and area of specialisation. Interview transcripts were analysed using inductive thematic analysis. Afterwards, all transcripts were re-analysed combining the resulting themes to identify different mentoring profiles.

Results: Our analysis yielded three themes. First, the basic conditions for mentorship showed wide differences in competencies that mentors considered necessary. Second, goals and purposes of mentoring identified roles ranging from ombudsperson, confidential advisor, role model to guide towards professional and personal growth. Third, attitudes to the mentoring programme revealed a wide variation from fully embracing to rejecting the reflective method. Further analysis led to three mentor profiles: reflective, sharing and advising. Even reflective mentors struggled in varying degrees with applying the guidelines, mostly depending on prior experience with reflection. Advising mentors found the intervision techniques too constrictive and expressed doubts about the usefulness of the programme.

Conclusions: In this reflection-based mentoring programme, different mentor perceptions strongly determined how reflection is being taught to medical students. This may affect the students' professional identity formation. Training should enable mentors to reflect on their beliefs and mentoring style. Further research is needed on the effects of reflection in mentoring and on mentor selection.

Objectives: This study aimed to enhance the learning experience among medical students by empowering them to co-create learning tools and classroom activities.

Methods: A cross-sectional study was conducted with 10 participants from Year 2 of the new curriculum volunteering to participate in this study. Five were selected based on their diversities and empowered to design learning tools and class activities. Student satisfaction was presented as mean scores. A comparison of self-confidence scores in subjects learned before and after the class was analyzed using the paired t-test. Comparisons of multiple-choice question (MCQ) scores before and after the class between Years 2 (n = 96) and Year 3 of the previous curriculum attending inclass teaching (n = 98) were analyzed using the independent sample t-test.

Results: A high level of satisfaction (M=87.5, SD=15.7%) and significant improvements in student self-confidence in subjects learned between before (M=46.4, SD=20.8%) and after (M=82.7, SD=16.9%) the class were noted (t ₍₂₂₃₎ = -23.73, p<.001). Additionally, Year 2 students achieved significantly higher MCQ scores after the class (M=85.6, SD=19.0%) compared with the scores from Year 3 (M=77.3, SD=23.6%) (t ₍₁₉₀₎ = 3.32, p<.001).

Conclusions: Empowering medical students to co-create learning tools and class activities could positively enhance their learning experience. The result of this study addressed the importance of student empowerment with well-designed student-centered learning strategies based on their learning environment. Additional qualitative research is required to better understanding the "why" and "how" behind the findings of this study.

Objectives: We aimed to explore healthcare students' intercultural sensitivity profiles and their relationship with empathy to develop effective education methods that promote non-discriminatory patient care.

Methods: We conducted a cross-sectional questionnaire study, involving a total of 508 international (n= 100) and local (n= 408) healthcare students in Hungary by convenience sampling. The survey included demographics, the Intercultural Sensitivity Scale, and the Interpersonal Reactivity Index. We applied latent profile analysis to identify distinct sensitivity profiles and used multinomial logistic regression to estimate the predictive power of several background variables on profile group membership.

Results: A four-profile solution emerged: "Interculturally average" (n= 241), "Interculturally uncertain" (n= 76), "Interculturally sensitive" (n= 132), and "Interculturally refusing" (n= 54). The model (R²= 0.123; p= 0.001) revealed that psychology major tended to predict "uncertain" group membership (OR= 0.56, p= 0.08) and higher personal distress was a significant predictor of this group (OR=1.11, p= 0.002). Male gender (OR= 3.03, p= 0.001), medicine major (OR= 5.49, p= 0.01), lower perspective-taking (OR= 0.91, p= 0.007) and higher personal distress (OR= 1.09, p= 0.028) were identified as predictors of "refusing" group membership, compared to the "average" group.

Conclusions: By exploring the ways students experience intercultural situations, a more personalized medical education can be developed with a special focus on vulnerable subgroups. For the "uncertain" group, the focus should be more on developing confidence, and intercultural experiences, whereas in the "refusing" group on strengthening empathy. In general, it can be useful to create mixed-gender, multidisciplinary, and intercultural learning environments.

Objectives: This study aims to fill the existing gap by examining the current status of off-the-job nursing ethics training in large hospitals in Japan and its integration with on-the-job training to provide targeted insights for enhancing future ethics training.

Method: A cross-sectional study was conducted among the nursing education staff of large Japanese hospitals [N=309] by self-administered questionnaire. The questionnaire was the following main points 1) current trends in nursing ethics training 2) planners' concerns, and 3) the link between training and clinical practice. Descriptive statistics were used, closed-ended questions were analyzed through simple tabulations while open-ended questions underwent textual analysis.

Results: The hospitals of 76.6% (309) conducted off-the-job nursing ethics training. Their training consists of a combination of lectures and exercises. The focus was to raise nurses' awareness of ethical problems or improve their analytical ability. The objectives were to be able to participate in discussions from an ethical perspective. The main problems were the lack of connection with on-the-job, and a shortage of training personnel.

Conclusions: The key to providing off-the-job and on-the-job is to create a mechanism for circulation. The implications of the results are the necessity of constructing ethics education in medicine to develop medical professionals who can discuss and act from ethical perspectives. Future research is expected to include the creation of a multidisciplinary ethics training program for the hospital.