Medical Teacher最新文献

Purpose: To explore graduating medical students' insights on the value of coaching experiences during each year of medical school while examining how coaching may support student development at various stages of training.

Methods: We invited all graduating students who participated in the coaching program from first through fourth year to participate in one 90-minute virtual focus group. We conducted a thematic analysis of all the focus group transcripts using inductive open coding to develop themes.

Results: Twenty-three students participated. In the pre-clerkship years, students valued the coaching experience as a support and a conduit through transitioning into becoming a medical student by nurturing reassurance, self-validation, and community building. As medical school progressed into clerkship years, students valued their coaching experience as a source of emotional support to navigate the challenges of transitioning to workplace learning. In the final year, students valued the longitudinal relationship with their coaches for perspective-taking, reflection, and growth as they transitioned to residency while exploring their values and interests and deciding on their specialty.

Conclusions: Our study describes the value of providing students with a longitudinal coaching relationship to support medical school transitions while helping students find meaning and growth in these liminal spaces.

What was the educational challenge?: Nurses play an essential role in the professional development of physician trainees within the clinical learning environment (CLE), but rarely receive formal training regarding this role.

What was the solution?: Utilizing a multifaceted, systematic approach, we developed an educational program for newly licensed nurses which addressed their role in the CLE and the professional development of physician trainees.

How was the solution implemented?: We delivered two 90-minute workshops to approximately 40 nurses during the 2021-2022 academic year. Participants completed workshop session evaluations and the Clinical Learning Environment Quick Survey (CLEQS). Data were descriptively analyzed. Workshops were positively received, with most participants rating them as very good/excellent (Workshop #1: 83.3% and Workshop #2: 72.2%). The CLEQS results suggested that the participants' CLEs were predominantly healthy and supportive, with most respondents indicating that they would recommend their unit to colleagues (before Workshop #1: 92.2% and after Workshop #2: 100.0%).

What lessons were learned that are relevant to a wider global audience?: Our educational program acknowledges the important role nurses play in the professional development of physician trainees, and equips them with tools to promote teamwork, communication, and a growth mindset towards interactions with physician trainees.

What are the next steps?: We continue to iterate our interactive workshops to prepare nurses for their important role in the professional development of physician trainees. To employ more active learning strategies, we developed pre-workshop videos. Thus far, we have delivered these workshops to nearly 600 nurses.

Introduction: Medical professionalism education is of paramount importance to the development of medical careers and medical students. Currently, there is a need for more research in China on the integration of artificial intelligence (AI) and medical professionalism education.

Methods: For this study, we collected 44 written reflections from first-year postgraduate students of clinical medicine in China during the spring semester of 2024 on the prospect of applying AI in conjunction with medical professionalism education. The data were transcribed, coded, and analyzed thematically. A framework for interpretation was provided in the form of a literature review.

Results: The findings indicate that Chinese medical students hold divergent views on the potential integration of AI with medical professionalism education. These perspectives encompass both the current paths of development and predictions of future trends. Thematic analysis was conducted using NVivo14, resulting in the identification of four themes:Technology application and medical ethicsDoctor-patient relationship and communicationEducation and career developmentSocial responsibility and public interest.

Conclusion: The study's findings underscore the potential benefits of AI in medical professionalism education, as perceived by Chinese medical students. These benefits could significantly enhance the quality and effectiveness of medical education. However, the students also highlighted potential risks and the need for careful oversight and management, indicating the practical implications of these findings for the future of medical education.

The Internet of Things (IoT) represents a paradigm shift in medical education, offering solutions to long-standing educational challenges. IoT-based systems provide real-time data, simulate clinical environments, and enable personalized learning, critical for preparing future healthcare professionals. This study implemented an IoT-based learning platform for a preclinical Doctor of Medicine (MD) course launched for 56 third-year students in a medical school from a developing country. This IoT-enabled learning environment provided students with active, hands-on learning activities that simulated real-world clinical practice. In all, the application of IoT in medical education has revolutionized it into something much more effective, engaging, and student-centered. As an innovative attempt, sharing this process at an early stage of development may inspire enthusiasm for implementing this approach and open the field for further development.

In adopting reductive instrumentalism as a dominant discourse medical education can be seen to have cultivated a values monoculture resistant to innovation. This culture characteristically retreats to the safety of conservatism rather than diversifying and innovating to embrace values beyond the functional - such as the ethical, aesthetic, and political. Here - where teaching displaces facilitation of learning - training is privileged over education, competence over capability, linearity over complexity, and information over knowledge. Drawing on the medical education research literature, ten symptoms of an undergraduate medicine 'compulsory miseducation' are described, paralleled by ways in which such a miseducation may be countered.

Purpose: Objective Structured Clinical Examination (OSCE) is a stressful exam assessing medical competencies. Stress coping strategies are expected to enhance students' performance during OSCE. The objective was to determine the effect of short preventive coping interventions on performance of medical students.

Materials and methods: Double-blinded, randomized controlled trial with multiple arms and a superiority hypothesis. Enrolment was proposed to each fourth-year undergraduate medical student convened to the Lyon Est University OSCE in 2022. There was no exclusion criterion. Students were randomized to one of four groups: standardized breathing with cardiac biofeedback (BFB), mindfulness-based intervention (MBI), positive psychology intervention (PPI), or control (CTRL). Each intervention was video-guided, lasted six minutes, and occurred just before starting the OSCE. The primary outcome was the academic OSCE score, assessed through specific grids by university examiners blinded to the interventions. Secondary outcomes included specific performance scores, and student perception of the influence of the intervention on their performance.

Results: A total of 482 students were included. No difference was found between BFB (-0.17 [95%CI, -1.20 to 0.86], p = .749), MBI (0.32 [95%CI, -0.71 to 1.36], p = .540), or PPI groups (-0.25 [95%CI, -1.29 to 0.79], p = .637) on the academic OSCE score compared to the control group, nor regarding the specific performance scores. Compared to the control group, the students perceived that the intervention influenced more positively their performance (BFB +3 [95%CI, 0-8]), p < .001; MBI +4 [95%CI, 1-9], p = .040; PPI +1 [95%CI, 0-4], p = .040]).

Conclusions: A single six-minute cardiac biofeedback, mindfulness, or positive psychology intervention performed by fourth-year medical students just before an OSCE did not improve their following academic performance. Still, students reported that the interventions helped them to enhance their performance. Future research should aim to further explore the perception of intervention on performance and potential long-term effects for students.

Trial registration: The study protocol was registered on ClinicalTrials.gov Identifier: NCT05393219.

Purpose: A mixed-methods study to evaluate Bystander Intervention Training (BiT), a simulation-based small-group training programme designed to teach skills to tackle discrimination.

Materials and methods: Norwich Medical School delivered the intervention online between January 2020 and June 2023 to medical students, physician associate trainees, and qualified doctors. A sample of 569 participants was used in the main analysis. Participants completed pre- and post-training and follow-up evaluations.

Results: Paired post-training scores were significantly different (all p < 0.001) from the pre-training scores for all 12 questions, in favour of the post-training scores. Of the 159 participants who completed follow-up questionnaires, 27 (17.9%) reported having the opportunity to be an active bystander; of those, 23 (85%) intervened. Scores in the follow-up questionnaire were significantly higher than those in the pre-training survey and significantly lower than those in the post-training questionnaire (p < 0.001). Participants had an increased sense of responsibility to be an active bystander and were empowered to challenge discrimination. Participants from marginalised groups expressed positive views about the training.

Conclusions: Interventions that allow open discussion and carefully supported personal disclosure in safe spaces, where difficult and uncomfortable discussions can occur, with an opportunity to change behaviour, must be developed to tackle discrimination.

Purpose: Medical education requires competent faculty members with the ability to create change in medical education. The focus on teacher competency are emerged as the results of medical education movements toward learner competency. The purpose of this study was to identify medical faculties competencies in their main roles and to provide a competency framework.

Method: The integrative review approach was utilized for identifying competencies and expert opinions was conducted to assigned competencies to roles and academic ranks. The search strategies were conducted in online databases including PubMed, Scopus, WOS and Eric to detect studies published from May 2003 to May 2023.

Results: The identified competencies were classified to four themes including (1) essential personal competencies, (2) technical/functional competencies, (3) enabling competencies, and (4) meta-competencies.

Conclusion: According to the results, a competency framework was proposed which is a valuable tool for various important decisions related to faculty, such as promotions and tenurship.

Uncertainty is a fundamental aspect of medical practice, necessitating incorporation into undergraduate medical training. The integrative model of uncertainty tolerance (UT) developed by Hillen and Han serves as a comprehensive framework for exploring clinical uncertainty. While studies have extensively examined UT dimensions, including sources, responses, and moderators, the factors influencing the perception of uncertainty stimuli remain underexplored. However, students' ability to perceive uncertainty and their approach to uncertain stimuli play a crucial role in enabling them to develop adaptive responses to uncertainty, necessary for their comfort in these situations. Defining uncertainty as a metacognitive state suggests significant variability in its perception among individuals and within an individual over time. Moreover, several studies have demonstrated the substantial influence of various individual and contextual factors on how individuals perceive and respond to uncertainty. In this paper, the authors present multiple hypotheses to address the question of whether students genuinely perceive uncertainty stimuli when they should. The authors argue that students' personal relationship with their knowledge is essential in their ability to identify clinical uncertainty, particularly concerning the limits of medical knowledge. Therefore, they propose that an academic culture fostering doubt, through exposing students to a variety of perspectives, would enhance their ability to identify uncertainty zones in a clinical situation at an early stage. Drawing on Dewey's situational theory, the authors emphasize the importance of better understanding, in a work setting, the influence of contextual and situational characteristics on individual perceptions of uncertainty. In line with this idea, ethnographic studies would offer valuable insights into identifying the relationship between the students, their work environment, and their perception of clinical uncertainty.