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The Impact of Infographics on Surgical Education: Enhancing Learning and Performance 信息图表对外科教育的影响:提高学习和表现
Pub Date : 2023-11-07 DOI: 10.5812/jme-140953
Amin Habibi, Babak Sabet, Masomeh Kalantarion
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引用次数: 0
Factors Affecting Learning Essential Procedural Skills in Pediatric Residents: A Cross-Sectional Study 影响儿科住院医师学习基本程序技能的因素:一项横断面研究
Pub Date : 2023-10-18 DOI: 10.5812/jme-123083
Soleiman Ahmady, Bahareh Abshari, Amin Habibi, Masomeh Kalantarion
Background: Clinical education is a vital component of physician education, where medical students learn by attending to patients and applying their knowledge and reasoning to solve their problems. However, many medical students struggle to acquire procedural skills, the ultimate goal of clinical education. Procedural skills are expected to be learned by the residents according to their academic year and are essential for providing better health services to children and families. Objectives: This study evaluates the status of the training provided and the level of learning the necessary procedural skills in pediatric residents based on standards. Methods: This research was a descriptive cross-sectional method from 1998 to 99. In the first part of the researcher-made questionnaire, the implementation of the educational program on all pediatric residents (115) of Mofid Children's Hospital was evaluated. In the second part, the residents' views on the current state of their learning of essential procedural skills were determined. Results: All residents from years one to four participated in the study. After assessing the status of skills acquired by residents with a questionnaire and comparing the average of each skill acquisition procedure with the desired standards, the average of all skills in all three methods was under the standards approved by the Ministry of Health, except for independent subcutaneous, intramuscular and intravenous injection skills and the skill of working with a ventilator. Also, according to the Friedman test, the lowest score for gaining skills in performing procedures was related to NG tube placement skills and subcutaneous, intramuscular, and intravenous injection skills. According to the statistical results obtained from the Spearman coefficient in all procedures, the level of subcutaneous, intramuscular, and intravenous injection skills had a significant correlation with independent skills. Conclusions: According to the specialized assistants of children participating in this study, the current training program of essential procedural skills implemented at Shahid Beheshti University of Medical Sciences was generally useful and effective. But there were also obstacles and limitations. Therefore, it is recommended to review the implementation of the training programs and implement effective measures, including providing more exposure conditions for independent procedures.
背景:临床教育是医师教育的重要组成部分,医学生通过照顾病人和运用他们的知识和推理来解决他们的问题。然而,许多医学生很难掌握临床教育的最终目标——程序技能。预计住院医生将根据学年学习程序技能,这些技能对于向儿童和家庭提供更好的保健服务至关重要。目的:本研究以标准为基础,评估儿科住院医师的培训状况和必要程序技能的学习水平。方法:1998 ~ 1999年采用描述性横断面研究方法。在研究者制作的问卷的第一部分,对Mofid儿童医院所有儿科住院医师(115名)的教育计划实施情况进行了评估。第二部分,确定住院医师对其基本程序技能学习现状的看法。结果:所有一至四年的住院医师都参与了研究。通过问卷调查对居民技能获取状况进行评估,并将各技能获取程序的平均值与期望的标准进行比较,除了独立的皮下、肌肉和静脉注射技能以及使用呼吸机的技能外,三种方法的所有技能的平均值均低于卫生部批准的标准。此外,根据Friedman测试,获得执行程序技能的最低分数与NG管放置技能和皮下、肌肉内和静脉注射技能有关。根据各程序Spearman系数的统计结果,皮下、肌肉、静脉注射技能水平与独立技能有显著相关。结论:根据参与本研究的儿童专业助理,目前在Shahid Beheshti医学科学大学实施的基本程序技能培训计划总体上是有用和有效的。但也有障碍和限制。因此,建议对培训计划的实施情况进行审查,并采取有效措施,包括为独立程序提供更多的暴露条件。
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引用次数: 0
Emplying Large Language Models for Surgical Education: An In-depth Analysis of ChatGPT-4 运用大语言模型进行外科教育:对ChatGPT-4的深入分析
Pub Date : 2023-10-17 DOI: 10.5812/jme-137753
Adrian Hang Yue Siu, Damien Gibson, Xin Mu, Ishith Seth, Alexander Chi Wang Siu, Dilshad Dooreemeah, Angus Lee
Background: The growing interest in artificial intelligence (AI) has spurred an increase in the availability of Large Language Models (LLMs) in surgical education. These LLMs hold the potential to augment medical curricula for future healthcare professionals, facilitating engagement in remote learning experiences, and assisting in personalised student feedback. Objectives: To evaluate the ability of LLMs to assist junior doctors in providing advice for common ward-based surgical scenarios with increasing complexity. Methods: Utilising an instrumental case study approach, this study explored the potential of LLMs by comparing the responses of the ChatGPT-4, BingAI and BARD. LLMs were prompted by 3 common ward-based surgical scenarios and tasked with assisting junior doctors in clinical decision-making. The outputs were assessed by a panel of two senior surgeons with extensive experience in AI and education, qualitatively utilising a Likert scale on their accuracy, safety, and effectiveness to determine their viability as a synergistic tool in surgical education. A quantitative assessment of their reliability and readability was conducted using the DISCERN score and a set of reading scores, including the Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Coleman-Liau index. Results: BARD proved superior in readability, with Flesch Reading Ease Score 50.13 (± 5.00), Flesch-Kincaid Grade Level 9.33 (± 0.76), and Coleman-Liau index 11.67 (± 0.58). ChatGPT-4 outperformed BARD and BingAI, with the highest DISCERN score of 71.7 (± 2.52). Using a Likert scale-based framework, the surgical expert panel further affirmed that the advice provided by the ChatGPT-4 was suitable and safe for first-year interns and residents. A t-test showed statistical significance in reliability among all three AIs (P < 0.05) and readability only between the ChatGPT-4 and BARD. This study underscores the potential for LLM integration in surgical education, particularly ChatGPT, in the provision of reliable and accurate information. Conclusions: This study highlighted the potential of LLM, specifically ChatGPT-4, as a valuable educational resource for junior doctors. The findings are limited by the potential of non-generalizability of the use of junior doctors' simulated scenarios. Future work should aim to optimise learning experiences and better support surgical trainees. Particular attention should be paid to addressing the longitudinal impact of LLMs, refining AI models, validating AI content, and exploring technological amalgamations for improved outcomes.
背景:对人工智能(AI)日益增长的兴趣刺激了外科教育中大型语言模型(llm)可用性的增加。这些法学硕士有可能为未来的医疗保健专业人员增加医学课程,促进远程学习体验的参与,并协助个性化的学生反馈。目的:评估LLMs协助初级医生为日益复杂的常见病房手术方案提供建议的能力。方法:本研究采用工具性案例研究方法,通过比较ChatGPT-4、BingAI和BARD的反应,探索法学硕士的潜力。llm根据3种常见的基于病房的手术场景进行提示,并负责协助初级医生进行临床决策。结果由两名在人工智能和教育方面经验丰富的资深外科医生组成的小组进行评估,定性地利用李克特量表评估其准确性、安全性和有效性,以确定其作为外科教育协同工具的可行性。使用DISCERN分数和一组阅读分数(包括Flesch reading Ease score、Flesch- kincaid Grade Level和Coleman-Liau指数)对它们的信度和可读性进行定量评估。结果:BARD具有较好的可读性,Flesch Reading Ease评分为50.13(±5.00),Flesch- kincaid Grade Level为9.33(±0.76),Coleman-Liau指数为11.67(±0.58)。ChatGPT-4的表现优于BARD和BingAI,最高的分辨力得分为71.7(±2.52)。外科专家小组使用基于李克特量表的框架,进一步肯定了ChatGPT-4提供的建议对第一年的实习生和住院医生是合适和安全的。经t检验,三种ai的信度均有统计学意义(P <0.05),仅在ChatGPT-4和BARD之间具有可读性。这项研究强调了LLM整合外科教育的潜力,特别是ChatGPT,在提供可靠和准确的信息方面。结论:本研究强调了LLM,特别是ChatGPT-4作为初级医生宝贵的教育资源的潜力。研究结果受限于使用初级医生的模拟情景的潜在非普遍性。未来的工作应旨在优化学习经验,更好地支持外科学员。应特别注意解决法学硕士的纵向影响,完善人工智能模型,验证人工智能内容,并探索技术合并以改善结果。
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引用次数: 0
Introducing child survival and development topics into the medical curriculum of a developing country. 在发展中国家的医学课程中引入儿童生存与发展主题。
Pub Date : 1988-12-01 DOI: 10.1097/00001888-198812000-00007
M M Aung, A M Han, L R Berger, A Kochi, N N Yi
Introducing problem-oriented medical education in Burma with 4 modules on child survival development (CSD) to replace the traditional lecture and rote learning method was met with preliminary success. Burma has 3 medical schools graduating 500 physicians yearly with all preclinical training based on lectures and all clinical training in hospitals. Yet community health is implemented by township medical officers with less training in child health than village health workers. 4 modules were created by groups of 12 medical faculty on acute respiratory infections high-risk pregnancy protein-energy malnutrition and dengue hemorrhagic fever in 1987. Modules concentrated on physicians roles: identify children at risk for malnutrition assess severity provide acute and long-term clinical management and coordinate growth monitoring and promotion of community programs. Students face obstacles such as life-time career of rote learning by lecture scarcity of text- books closed shelves for journals daytime-only library hours no copying machines and limited audiovisual equipment. Despite these limitations students learning scores increased from 36-86% their attitudes on a Likert scale improved and they volunteered approval of many specific aspects of the student-centered approach.
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引用次数: 0
Survey of practices in evaluating teaching in U.S. medical schools, 1978 and 1986. 美国医学院教学评估实践调查,1978年和1986年。
Pub Date : 1988-12-01 DOI: 10.1097/00001888-198812000-00005
C J Lancaster, G R Ross, I K Smith
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引用次数: 9
Differences in the use of consultations by family medicine and internal medicine physicians. 家庭医学和内科医生使用会诊的差异。
Pub Date : 1988-12-01 DOI: 10.1097/00001888-198812000-00009
M T Wayland, D Culik, W Bonzelaar, J Lukas, R Dunchok, T Coombs
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引用次数: 3
Students' certainty during course test-taking and performance on clerkships and board exams. 学生在课程考试中的确定性以及在职员和董事会考试中的表现。
Pub Date : 1988-12-01 DOI: 10.1097/00001888-198812000-00001
C Zeleznik, M Hojat, C E Goepp, P Amadio, O D Kowlessar, B Borenstein

Psychometric aspects of multiple-choice tests were investigated using a confidence-weighted scoring technique. The contributions of two indices, overconfidence and underconfidence, in the prediction of subsequent academic performance of examinees were studied. A total of 444 sophomore students (entering classes of 1982 and 1983) in one medical school were asked to indicate their confidence, on a 5-point scale (100, 75, 50, 25, and 0), in the correctness of their responses to each multiple-choice item on an Introduction to Clinical Medicine examination. Examinations were scored in two ways: in the conventional way, using the total number of correct responses, and by a confidence-weighted technique based on the level of certainty indicated for each response by the examinee. Only the conventional score determined the grade; the confidence-weighted score was calculated for the purely experimental purposes of this study. Overconfidence and underconfidence indices were also calculated by using the indicated levels of certainty. Improvements in the psychometrics of the examinations were observed when confidence-weighted scoring was used. In multiple-regression models, the confidence-weighted scores and indices of over- and underconfidence contributed significantly to predicting scores of the students studied on Parts I and II of the National Board of Medical Examiners examinations, whereas the conventional score did not contribute to the prediction of Part II scores. Significant differences on junior clerkship examinations and ratings were observed between those who were highly overconfident and those who were slightly overconfident. The highly overconfident students also estimated higher future incomes than did those who were slightly overconfident.

多项选择测试的心理测量学方面使用信心加权评分技术进行了调查。研究了过度自信和不自信两个指标对考生后续学业成绩的预测作用。一所医学院的444名大二学生(1982年和1983年的新生)被要求以5分制(100、75、50、25和0)来表明他们对临床医学导论考试中每个选择题答案的正确性的信心。考试以两种方式评分:一种是传统的方法,使用正确回答的总数,另一种是基于考生对每个回答的确定程度的置信度加权技术。只有常规分数才能决定成绩;计算置信度加权分数纯粹是为了本研究的实验目的。过度自信指数和信心不足指数也通过使用指示的确定性水平来计算。当使用置信度加权评分时,可以观察到考试心理测量学的改善。在多元回归模型中,置信度加权分数和过信度指数和欠信度指数对预测国家医学检查委员会考试第一部分和第二部分成绩有显著贡献,而常规分数对第二部分成绩没有贡献。在初级职员考试和评分上,高度过度自信者和轻度过度自信者之间存在显著差异。高度过度自信的学生也比那些稍微过度自信的学生对未来收入的估计更高。
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引用次数: 16
Sources of resistance to an intern support group. 实习生支持小组的阻力来源。
Pub Date : 1988-12-01 DOI: 10.1097/00001888-198812000-00004
C Kaplan, M Marshall

When senior house officers were observed to be resistant to an intern support group, they were surveyed in order to identify the sources of their resistance. Sixty-nine percent of house officers in postgraduate year two (PGY-2) and PGY-3 responded to an anonymous seven-item survey. Although their attitudes toward supportive programs were generally favorable, a minority of the house officers felt that residents expressing the need for support were less competent than other residents or needed to change to a less rigorous specialty. A majority felt that it was unfair to require senior house officers to provide coverage for interns attending a support group. They felt that support should be made available to all house officers rather than interns only and that stress would be reduced by eliminating the sources of stress as well as by providing supportive programs. Training program directors need to be aware of and anticipate these attitudes before designing supportive programs.

当观察到高级家政人员对实习生支持小组有抵触情绪时,对他们进行了调查,以确定其抵触情绪的来源。69%的研究生二年级(PGY-2)和PGY-3年级的院务人员回答了一项由七个项目组成的匿名调查。尽管他们对支持性项目的态度总体上是有利的,但少数住院医生认为,表达支持需求的住院医生不如其他住院医生称职,或者需要转到不那么严格的专业。大多数人认为,要求高级住院部官员为参加支助小组的实习生提供保险是不公平的。他们认为应该向所有住院部官员提供支持,而不仅仅是向实习生提供支持,而且通过消除压力来源和提供支持方案可以减轻压力。培训项目主管在设计支持性项目之前,需要意识到并预料到这些态度。
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引用次数: 5
Use of interviews in the selection of pediatric house officers. 在选择儿科住院医师时使用面谈。
Pub Date : 1988-12-01 DOI: 10.1097/00001888-198812000-00010
A J Kovel, J K Davis
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引用次数: 9
Computerized medical records. 电脑医疗记录。
Pub Date : 1988-12-01 DOI: 10.1097/00001888-198812000-00011
J A Shrader
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引用次数: 0
期刊
Journal of Medical Education
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