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Medical education in Georgia. 佐治亚州的医学教育。
IF 3.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-07-04 DOI: 10.1080/0142159X.2024.2370899
Salome Voronovi, Gaiane Simonia, David C M Taylor

Since 1991, there have been significant changes in medical education in Georgia. Key changes include adapting national legislation toward international standards, establishing the National Center for Education Quality Enhancement (NCEQE), which was recognized in 2018 by the World Federation for Medical Education (WFME) as an accrediting agency and opening the Association for Medical Education in Europe (AMEE) International Networking Center in 2019. Undergraduate medical education, regulated by the Ministry of Education, Science and Youth of Georgia, spans six years. MD graduates then have options for further career paths, including working as junior doctors, residency, and/or pursuing PhD research.The main challenges the country presently faces are:the need to reduce the increasing number of (mainly) private medical schools. Recent updates to the national standards for undergraduate medical education have imposed stricter accreditation requirements for MD programs, resulting in the closure of schools that fail to meet these standards;postgraduate medical education is governed by the Ministry of Internally Displaced Persons from the Occupied Territories, Labor, Health and Social Affairs of Georgia (MOH) and needs further reform due to limited and paid residency positions;continuous professional development (CPD) was optional until recently, which led to an increase in professional inaccuracy and malpractice cases. To address this, regulatory bodies, including the MOH and professional associations, are preparing the legal basis for introducing compulsory CPD.

自 1991 年以来,格鲁吉亚的医学教育发生了重大变化。主要变化包括根据国际标准调整国家立法,建立国家教育质量提升中心(NCEQE),该中心于 2018 年被世界医学教育联合会(WFME)认可为认证机构,并于 2019 年开设欧洲医学教育协会(AMEE)国际网络中心。医学本科教育由格鲁吉亚教育、科学和青年部监管,为期六年。医学博士毕业生可以选择进一步的职业道路,包括担任初级医生、住院医师和/或攻读博士学位。格鲁吉亚目前面临的主要挑战是:需要减少日益增多的(主要是)私立医学院。最近更新的国家医学本科教育标准对医学博士课程提出了更严格的认证要求,导致未能达到这些标准的学校被关闭;医学研究生教育由格鲁吉亚被占领土境内流离失所者、劳动、卫生和社会事务部(MOH)管理,由于住院医师职位有限且带薪,因此需要进一步改革;直到最近,持续专业发展(CPD)仍是可选的,这导致专业不准确和渎职案件增加。为解决这一问题,包括卫生部和专业协会在内的监管机构正在为引入强制性持续专业进修准备法律基础。
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引用次数: 0
Rise and fall in medical education research 1999-2019. 1999-2019 年医学教育研究的兴衰。
IF 3.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-07-02 DOI: 10.1080/0142159X.2024.2371528
Laetitia Rollin, Joel Ladner, Gaetan Kerdelhué, Ariane Leroyer, Julien Grosjean, Jean-François Gehanno
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引用次数: 0
An untapped potential: Curiosity in medical school. 一个未开发的潜力:医学院的好奇心。
IF 3.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-07-01 Epub Date: 2023-12-04 DOI: 10.1080/0142159X.2023.2288546
Tim Alexander Schwarz, Christoph Nikendei, Anna Cranz, Hans-Christoph Friederich, Till Johannes Bugaj

Background: There seems to be a common perception among medical educators that curiosity is untapped or even subjugated in medical education. This review aims to summarize research on curiosity across the fields of psychology, neuroscience, and education and report its potential to advance medical education.

Methods: For this narrative review multiple online libraries were searched using variations of the terms curiosity and school/education/learning. Additional studies were reviewed using the reference lists of included studies, and all studies were assessed for quality and relevance.

Results: This review of previous research on curiosity shows that curiosity can significantly impact characteristics relevant to medical education, particularly mental health and learning. In addition, the authors outline how curiosity is linked to other epistemic emotions such as anxiety, novelty, surprise, and uncertainty. Finally, an epistemic-emotion-framework (EEF) is proposed to help educators encourage curiosity in medical students.

Conclusion: By drawing from other research fields, medical educators can learn valuable lessons about the importance of curiosity and how to influence it. This review provides an overview of current research and a framework for how the potential of curiosity can be harnessed to play an important role in students' medical education.

背景:在医学教育者中似乎有一种共同的看法,即好奇心在医学教育中未被开发甚至被征服。本综述旨在总结心理学、神经科学和教育领域关于好奇心的研究,并报告其促进医学教育的潜力。方法:在这篇叙述性综述中,使用好奇心和学校/教育/学习这两个术语的变体搜索了多个在线图书馆。使用纳入研究的参考文献清单对其他研究进行审查,并对所有研究的质量和相关性进行评估。结果:本研究回顾了以往关于好奇心的研究,发现好奇心可以显著影响与医学教育相关的特征,特别是心理健康和学习。此外,作者还概述了好奇心与其他认知情绪(如焦虑、新奇、惊讶和不确定)的联系。最后,提出了一个认知-情感框架(EEF),以帮助教育者鼓励医学生的好奇心。结论:通过借鉴其他研究领域,医学教育者可以学到关于好奇心的重要性以及如何影响好奇心的宝贵经验。这篇综述概述了当前的研究,并为如何利用好奇心的潜力在学生的医学教育中发挥重要作用提供了一个框架。
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引用次数: 0
Twelve tips for implementing trigger or content warnings in healthcare professions education. 在医疗保健专业教育中实施触发或内容警告的十二条提示。
IF 3.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-07-01 Epub Date: 2023-12-17 DOI: 10.1080/0142159X.2023.2290995
Helen Anne Nolan, Lesley Roberts

Trigger warnings are statements offering prior notification of sensitive content, allowing recipients to prepare for and avoid ensuing distress. Students are increasingly reporting expectations for warnings in classrooms and learning contexts. Discussions regarding use of warnings have clear relevance to healthcare education, which regularly explores sensitive content. Their use has been positioned as a measure for inclusive education and as a means to enhance trauma awareness and empathy. Expectations for warnings need to be considered in the context of preparedness for professional practice. This Twelve Tips paper explores the evidence in relation to warnings and its applicability to social learning contexts. These tips highlight considerations and strategies for the use of warnings in the context of healthcare education, balancing issues of inclusivity, learner and educator wellbeing, and professional preparedness. These discussions are situated within the context of current classroom-based healthcare education.

触发警告是对敏感内容进行事先通知的声明,可让接收者做好准备,避免随之而来的困扰。越来越多的学生表示希望在课堂和学习环境中使用警告。关于使用警告的讨论显然与医疗保健教育有关,因为医疗保健教育经常涉及敏感内容。警告的使用被定位为全纳教育的一种措施,也是增强创伤意识和移情能力的一种手段。对警告的期望需要在为专业实践做好准备的背景下加以考虑。本 "十二条建议 "探讨了与警告有关的证据及其在社会学习环境中的适用性。这些提示强调了在医疗保健教育中使用警告的注意事项和策略,平衡了包容性、学习者和教育者的福祉以及专业准备等问题。这些讨论是在当前基于课堂的医疗保健教育背景下进行的。
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引用次数: 0
Draw & Doodle Simulation: A colorful strategy to prepare medical teams for electronic dance music festival emergencies. 绘画与涂鸦模拟:丰富多彩的策略,让医疗队做好应对电子舞曲音乐节突发事件的准备。
IF 3.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-07-01 DOI: 10.1080/0142159X.2024.2372083
Anthony Seto, Connor Hass, Ella Krane, Liam Montgomery, David Lam, Michael McCue

Educational challenge: Electronic dance music (EDM) festivals - crowded, loud, low-resource environments - pose unique challenges to event medical teams. Simulation can prepare teams to manage clinical presentations in this unconventional context. Without access to simulation infrastructure, a low-technological, low-fidelity simulation modality is warranted.

Solution: Draw & Doodle Simulation (D&D SIM) is a low-fidelity simulation where patients are hand-drawn (i.e. on paper, whiteboard, or digitally) instead of utilizing manikins or live actors. Facilitators draw all patient findings, while participants doodle any possible interventions.

Solution implementation: Two D&D SIM cases (serotonin toxicity and refractory anaphylaxis) were piloted in classrooms. Participants included paramedics, medical students, lifeguards, and first aiders. Facilitators conducted simulations using chart paper, with each participant doodling contributions using differently colored markers.

Lessons learned: Participants responded positively, rating the serotonin toxicity case 4.31/5 (n = 13) and refractory anaphylaxis case 4.53/5 (n = 15). Participants appreciated the 'low-stakes', useful 'visual' representation of progress, 'fun and [interactivity]', and appropriate '[realism]' of D&D SIM. However, D&D SIM was perceived as 'less life threatening', would not be appropriate for physical skills (e.g. CPR), required everyone to be 'oriented in the same direction to see the drawing', and the chart paper risked becoming cluttered.

Next steps: Next steps include writing new cases, implementing D&D SIM in other teaching contexts, exploring its use in digital platforms, and studying its effectiveness against higher-fidelity simulation.

教育挑战:电子舞曲音乐节(EDM)--拥挤、喧闹、资源匮乏的环境--给活动医疗团队带来了独特的挑战。模拟可以帮助团队做好准备,在这种非常规环境中处理临床表现。在没有模拟基础设施的情况下,需要一种技术含量低、保真度低的模拟模式:Draw & Doodle Simulation(D&D SIM)是一种低保真模拟,病人是通过手绘(即在纸上、白板上或数字上)而不是使用人体模型或真人演员来完成的。主持人绘制所有患者的检查结果,而参与者则涂鸦任何可能的干预措施:在课堂上试用了两个 D&D SIM 案例(血清素中毒和难治性过敏性休克)。参与者包括护理人员、医科学生、救生员和急救人员。主持人使用图表纸进行模拟,每位参与者使用不同颜色的记号笔涂鸦:参与者反应积极,血清素中毒案例评分为 4.31/5(n=13),难治性过敏性休克案例评分为 4.53/5(n=15)。参与者对 D&D SIM 的 "低风险"、有用的 "可视化 "进度表示、"趣味性和[互动性]"以及适当的"[现实性]"表示赞赏。然而,D&D SIM 被认为 "对生命的威胁较小",不适合物理技能(如心肺复苏术),要求每个人 "朝同一方向看图",而且图表纸有可能变得杂乱无章:下一步工作包括编写新案例,在其他教学环境中实施 D&D SIM,探索其在数字平台中的应用,以及研究其与更逼真模拟的效果。
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引用次数: 0
VR and AR: Bridging the gap in social and professional development. 虚拟现实和增强现实技术:缩小社会和职业发展的差距。
IF 3.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-07-01 Epub Date: 2024-03-05 DOI: 10.1080/0142159X.2024.2323172
Sukhmunni Johal, Hannah Suh, Aditi Mukherjee
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引用次数: 0
Give me a break! Addressing observed structured clinical exam anxiety. 让我休息一下解决观察到的结构化临床考试焦虑。
IF 3.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-07-01 Epub Date: 2024-02-12 DOI: 10.1080/0142159X.2024.2313577
Karen L Forbes, Qaasim Mian, Jessica L Foulds

What was the educational challenge?: Medical students experience high rates of anxiety; frequent examinations are one contributing source. Students may perceive the observed structured clinical examinations (OSCEs) as particularly stressful. Strategies to reduce anxiety during OSCEs have not been described.

What was the solution?: We sought to implement and evaluate a simple, in-the-moment intervention aimed at reducing students' OSCE-related anxiety by making stress-reducing activities available during break stations during a summative pediatric OSCE.

How was the solution implemented?: Three break stations were included in an end-of-rotation, summative OSCE. Students were block-randomized to either control group with standard break stations, or intervention group with stress-reducing activities available in the break room. All participants completed the State-Trait Anxiety Inventory (STAI) before and after the OSCE, and a short questionnaire after OSCE completion.

What lessons were learned that are relevant to a wider global audience?: Third-year medical students have high levels of stress before and after OSCEs. More than half of students in the intervention group felt their anxiety improved with activities. While the inclusion of stress-reducing activities in break stations did not impact exam performance, some students subjectively felt their performance improved. If OSCE break stations are logistically required, they can be employed to allow students to briefly relax during a high-stress exam without negatively impacting performance.

What are the next steps?: Next steps include exploration of opportunities for integration of stress-reducing activities during OSCEs with other learner groups, and identification of other stress-inducing aspects of medical training to provide similar opportunities.

教育方面的挑战是什么?医科学生的焦虑率很高;频繁的考试是其中一个原因。学生可能认为观察式结构化临床考试(OSCE)尤其令人紧张。在 OSCE 考试中减轻焦虑的策略尚未见报道。解决方案是什么?我们试图实施并评估一种简单的即时干预措施,旨在通过在总结性儿科 OSCE 考试期间的休息站提供减压活动来减轻学生与 OSCE 相关的焦虑。在轮转结束后的总结性 OSCE 考试中包括三个休息站。学生们被随机分配到标准休息站的对照组或在休息室提供减压活动的干预组。所有参与者都在 OSCE 考试前后填写了状态-特质焦虑量表(STAI),并在 OSCE 考试结束后填写了一份简短的问卷。三年级医学生在 OSCE 考试前后压力很大。干预组中有一半以上的学生认为他们的焦虑在活动中得到了改善。虽然在休息站中加入减压活动并不会影响考试成绩,但一些学生主观地认为他们的成绩有所提高。如果 OSCE 休息站在后勤上有要求,可以采用这种方式让学生在高压力考试中短暂放松,而不会对成绩产生负面影响。下一步工作包括探索在 OSCE 考试期间与其他学习群体整合减压活动的机会,并确定医学培训中其他会引起压力的方面,以提供类似的机会。
{"title":"Give me a break! Addressing observed structured clinical exam anxiety.","authors":"Karen L Forbes, Qaasim Mian, Jessica L Foulds","doi":"10.1080/0142159X.2024.2313577","DOIUrl":"10.1080/0142159X.2024.2313577","url":null,"abstract":"<p><strong>What was the educational challenge?: </strong>Medical students experience high rates of anxiety; frequent examinations are one contributing source. Students may perceive the observed structured clinical examinations (OSCEs) as particularly stressful. Strategies to reduce anxiety during OSCEs have not been described.</p><p><strong>What was the solution?: </strong>We sought to implement and evaluate a simple, in-the-moment intervention aimed at reducing students' OSCE-related anxiety by making stress-reducing activities available during break stations during a summative pediatric OSCE.</p><p><strong>How was the solution implemented?: </strong>Three break stations were included in an end-of-rotation, summative OSCE. Students were block-randomized to either control group with standard break stations, or intervention group with stress-reducing activities available in the break room. All participants completed the State-Trait Anxiety Inventory (STAI) before and after the OSCE, and a short questionnaire after OSCE completion.</p><p><strong>What lessons were learned that are relevant to a wider global audience?: </strong>Third-year medical students have high levels of stress before and after OSCEs. More than half of students in the intervention group felt their anxiety improved with activities. While the inclusion of stress-reducing activities in break stations did not impact exam performance, some students subjectively felt their performance improved. If OSCE break stations are logistically required, they can be employed to allow students to briefly relax during a high-stress exam without negatively impacting performance.</p><p><strong>What are the next steps?: </strong>Next steps include exploration of opportunities for integration of stress-reducing activities during OSCEs with other learner groups, and identification of other stress-inducing aspects of medical training to provide similar opportunities.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Learning strategies for the advanced trainee in specialist training. 专科培训高级学员的学习策略。
IF 3.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-07-01 Epub Date: 2023-12-25 DOI: 10.1080/0142159X.2023.2289845
Kim Ekelund, Martin Grønnebæk Tolsgaard, Rikke Vita Borre Jacobsen, Doris Østergaard, Karlen Bader-Larsen

Background: A significant factor of clinicians' learning is based on their ability to effectively transfer acquired knowledge, skills, and attitudes from specialty-specific clinical courses to their working environment.

Material and method: We conducted semi-structured interviews with 20 anaesthesiologist trainees (i.e. residents) in four group and five individual interviews using SRL principles as sensitizing concepts. Data were collected and analyzed iteratively using thematic analysis.

Results: Advanced trainees are highly motivated to explore what they have learned in specialty-specific courses, but they often face several barriers in implementing their learning in the workplace environment. Four themes emerged from the interview data: 'Be ready to learn', "Take the 'take-home-messages' home', "Be ready to create your own opportunities', and "Face it, it's not entirely up to you'. Understanding the challenges regarding transferring knowledge from courses to the working environment is an important lesson for assisting trainees set their learning goals, monitor their progress, and re-evaluate their SRL processes.

Conclusion: Even for advanced trainees, successfully transferring knowledge from specialty-specific courses often requires adequate commitment and support. Medical supervisors and other relevant stakeholders must be aware of their shared responsibility for creating individual environments that support opportunities for trainees to self-regulate their learning.

背景:临床医生学习的一个重要因素是他们能否将从特定专业临床课程中获得的知识、技能和态度有效地转移到工作环境中:我们以 SRL 原则为感性概念,通过四次小组访谈和五次个别访谈,对 20 名麻醉科受训医师(即住院医师)进行了半结构化访谈。收集的数据采用主题分析法进行反复分析:结果:进修学员有很高的积极性去探索他们在专业课程中学到的知识,但他们在工作环境中实施所学知识时往往会遇到一些障碍。访谈数据中出现了四个主题:准备好学习"、"把'带回家的信息'带回家"、"准备好创造自己的机会 "和 "面对现实,这并不完全取决于你"。了解将知识从课程转移到工作环境所面临的挑战,对于帮助学员设定学习目标、监控学习进度和重新评估自学过程都是非常重要的一课:即使是高级学员,要成功地从特定专业课程中转移知识往往也需要足够的投入和支持。医务督导和其他相关人员必须意识到,他们有共同的责任创造个人环境,为学员提供自我调节学习的机会。
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引用次数: 0
Advancing primary care: Doctoral program for physician associates and nurse practitioners. 推进初级保健:医生助理和执业护士的博士项目。
IF 3.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-07-01 Epub Date: 2023-10-26 DOI: 10.1080/0142159X.2023.2271153
Kenneth Botelho, James Myers

The United States faces an impending crisis in primary care physician shortages, while Physician Associates (PAs) and Nurse Practitioners (NPs) are poised to help bridge the gap. This manuscript explores a groundbreaking solution: introducing a clinical doctorate program tailored to PAs and NPs, designed to equip them with the knowledge and skills to assume leadership roles in primary care. Unlike traditional medical education, this innovative approach allows these professionals to continue their clinical practice while advancing their education, addressing the workforce shortage and the need for advanced leadership within the primary care landscape. This comprehensive curriculum includes intensive didactic coursework, residency-like training, credentialing examinations, and research opportunities, positioning PAs and NPs as critical contributors to the future of primary care. By recognizing their untapped potential and investing in their advanced education, we can elevate the quality and accessibility of primary care, ensuring that healthcare delivery reaches new heights.

美国面临着初级保健医生短缺的迫在眉睫的危机,而医师协会(PA)和执业护士协会(NP)正准备帮助弥补这一差距。这篇手稿探索了一个突破性的解决方案:引入一个针对PA和NP的临床博士项目,旨在让他们具备在初级保健中发挥领导作用的知识和技能。与传统的医学教育不同,这种创新的方法使这些专业人员能够继续他们的临床实践,同时推进他们的教育,解决劳动力短缺和初级保健领域对高级领导的需求。这一综合课程包括强化教学课程、住院医师培训、资格考试和研究机会,将PA和NP定位为初级保健未来的关键贡献者。通过认识到他们尚未开发的潜力并投资于他们的高等教育,我们可以提高初级保健的质量和可及性,确保医疗服务达到新的高度。
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引用次数: 0
Harnessing the value of medical students in academic medical centers. 利用学术医学中心医学生的价值。
IF 3.3 2区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-07-01 Epub Date: 2024-02-21 DOI: 10.1080/0142159X.2024.2317925
Jenna D Reisler, Malvika Ramesh, Leonard Kuan-Pei Wang
{"title":"Harnessing the value of medical students in academic medical centers.","authors":"Jenna D Reisler, Malvika Ramesh, Leonard Kuan-Pei Wang","doi":"10.1080/0142159X.2024.2317925","DOIUrl":"10.1080/0142159X.2024.2317925","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139931950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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