Medical Teacher最新文献

Faculty development in medical education may take different forms and approaches ranging from standalone workshops and short courses up to longitudinal programs and postgraduate qualifications, such as Certificates, Diplomas, Master's and PhD degrees in health professions education (HPE). Many places offer staff development opportunities to help people to learn how to teach health professional students more effectively. Yet higher degrees in HPE are expected not only to enable graduates to be better teachers or assessors but also to act on a strategic level to support institutional directions to advance teaching, learning, assessment and scholarship in HPE. This guide is for people who wish to develop programmes to provide a more systematic and deeper training for those people that see themselves as professional health professions educators and indeed, the leaders of the future. The guide discusses the rationale, plans, process of implementation and evaluation of postgraduate programs in HPE in ten phases. Different variables should be considered with respect to the local context, institutional support, readiness of expertise, availability of resources, alignment with the strategic plan of the college/university and methods to measure the impact of these PG programs.

Academic exploration of the Clinical Learning Environment (CLE) has evolved over time. In 2009, Asch et al. drew a direct connection between the CLE, training outcomes, and patient care, highlighting the importance of the CLE and inspiring further research in this domain. With a growing body of evidence articulating its significance, several organizations were prompted to publish conceptualizations of the CLE as a discrete concept, such that its components may be measured and thus improved upon. Since then, it has become increasingly clear that the CLE is not an isolated entity; it is continuously molded by external pressures including the intensifying polarizations within our global society and the political ramifications of these divides. And yet, the nuances of how these external forces influence our CLE, including how we should, or should not, adapt to accommodate them, has not yet been explicitly captured. In this commentary we will summarize the academic history of CLE, review how the shifting global landscape has influenced the CLE, and propose a way forward. As a professional community, we must understand the impact of these external factors such that we may proactively adapt and ensure quality training outcomes and positive outcomes for our patients.

Background: Resilience training shows moderate effect in combatting burnout, yet little is known about its cost-effectiveness. This study analyzes the cost-effectiveness of offering resilience training to medical students with elevated stress from a Dutch university medical center (payer) perspective compared to mental health support as usual.

Methods: We constructed a state-transition cohort (Markov) model to estimate quality-adjusted lifeyears and associated costs of offering resilience training to a cohort of 410 first-year medical students over a 6-year timeframe. Utility values were obtained through baseline data from the DEcrease STress through RESilience training for Students (DESTRESS) study. Data on transition probabilities and the effect of resilience training were based on the best available literature. We resampled all data to generate 10,000 simulations of incremental costs and effects in a probabilistic analysis.

Results: On average students gained 0.15 QALYs (95%CI 0.09, 0.20) at a cost-saving of €1076 (95%CI 412, 2008), making resilience training the dominant strategy. These savings resulted from an assumed reduction in study delay due to a reduction in symptoms of stress and burnout. For every euro the university invests in resilience training, we estimatea return of investment of €2.79.

Conclusions: This study provides evidence that offering resilience training to medical students is cost-effective and cost-saving.

Background: Recent advancements in artificial intelligence (AI) have enabled the customization of large language models to address specific domains such as medical education. This study investigates the practical performance of a custom GPT model in enhancing clinical knowledge acquisition for medical students and physicians.

Methods: A custom GPT was developed by incorporating the latest readily available teaching resources. Its accuracy in providing clinical knowledge was evaluated using a set of clinical questions, and responses were compared against established medical guidelines. Satisfaction was assessed through surveys involving medical students and physicians at different stages and from various types of hospitals. The impact of the custom GPT was further evaluated by comparing its role in facilitating clinical knowledge acquisition with traditional learning methods.

Results: The custom GPT demonstrated higher accuracy (83.6%) compared to general AI models (65.5%, 69.1%) and was comparable to a professionally developed AI (Glass Health, 83.6%). Residents reported the highest satisfaction compared to clerks and physicians, citing improved learning independence, motivation, and confidence (p < 0.05). Physicians, especially those from teaching hospitals, showed greater eagerness to develop a custom GPT compared to clerks and residents (p < 0.05). The impact analysis revealed that residents using the custom GPT achieved better test scores compared to those using traditional resources (p < 0.05), though fewer perfect scores were obtained.

Conclusions: The custom GPT demonstrates significant promise as an innovative tool for advancing medical education, particularly for residents. Its capability to deliver accurate, tailored information complements traditional teaching methods, aiding educators in promoting personalized and consistent training. However, it is essential for both learners and educators to remain critical in evaluating AI-generated information. With continued development and thoughtful integration, AI tools like custom GPTs have the potential to significantly enhance the quality and accessibility of medical education.[Box: see text].

The provision of optimum health care services requires collaboration of health care professionals in integrated interprofessional (IP) teams. This guide addresses the practical aspects of establishing and delivering pre-licensure IP programs to prepare graduates of health professional programs to work in teams and wider collaboration, and consequently enhance the quality of health care. The main updated IP frameworks are presented to highlight commonalities that represent the essential competencies and outcomes of programs implementing interprofessional education (IPE). We discuss how these may be adapted to the local context, and present examples of models of implementation to guide the initial steps of establishing similar programs. Examples of pre-licensure IP practice-based learning, such as community-based, simulation-based, student-run and led clinics, and interprofessional training wards, and post-licensure interprofessional learning (IPL), are described. We consider assessment of IPL along the continuum of learning IP. This guide also emphasises the need to tailor faculty development programs for local contexts and consider factors affecting sustainability such as funding and accreditation. We finish with the governance of IP programs and how global IP networks may support interprofessional practice-based learning from development to delivery.

Community-based medical education (CBME) addresses real-world health problems and is characterized by its emphasis on reciprocity and collaboration with community stakeholders. Limited evidence shows that CBME is an effective learning strategy to care for underserved communities. However, medical schools and nursing schools struggle to implement CBME in their curriculum. In this article, we present four practical examples of CBME from medical and nursing schools in Belgium and the Netherlands. By taking the lessons learned derived from these practical examples into account, all students can have an authentic learning experience within the community, which empowers community members and increases their health.

Purpose: Traditional direct ophthalmoscopy (TDO) is the oldest method of fundus examination; however, it has fallen out of use due to its technical difficulty and limitations to clinical utility, amidst the advent of potentially better options. A spectrum of new technologies may help in addressing the shortcomings of TDO: simulation mannequins with non-tracked TDO, simulation models with tracked TDO, and smartphone ophthalmoscopy (SFO).

Methodology: A systematic search of PubMed, Embase, and Cochrane databases for all studies evaluating usage of simulation mannequins/models and SFO in ophthalmology education was performed, from inception till April 2023 with no language restriction. We ensured that we included all possible relevant articles by performing backward reference searching of included articles and published review articles.

Results: We reviewed studies on non-tracked TDO (n = 5), tracked TDO (n = 3) and SFO (n = 12). Non-tracked TDO and SFO were superior in training competency relative to control (TDO on real eyes). Intriguingly, tracked TDO was non superior to controls. SFO appears to enhance the learning effectiveness of ophthalmoscopy, due to real-time projection of the retina view, permitting instantaneous and targeted feedback. Learners reported improved ergonomics, including a wider field of view and more comfortable viewing distance. Retention of images and recordings permitted the audit of learning and paves the way for storage of such images in patients' electronic medical record and rapid dissemination for specialist referral.

Conclusions: Smartphone ophthalmoscopy (SFO) permits integration of both the practice and learning of ophthalmoscopy, and the auditing of both. These advantages over traditional methods (with simulation or otherwise) may lead to a paradigm shift in undergraduate ophthalmology education. However, the nascency of SFO necessitates preservation of traditional techniques to tide through this period of transition.