Educacion Medica最新文献_第4页

How can a micro-level communication training intervention help medical students learn about patient-centered care and empathy? Qualitative results of a design-based research 微观层面的沟通训练干预如何帮助医学生学习以病人为中心的护理和同理心？基于设计的研究的定性结果

Q2 Social Sciences

Educacion Medica

Pub Date : 2026-03-01 Epub Date: 2025-12-19 DOI: 10.1016/j.edumed.2025.101135

Carme Nogueras , Daniëlle Verstegen , Cinthya Landa , Yolanda López , Miriam Moreno , Helena Manjón , Vanesa Oropeza , Ramón Miralles

Introduction

Doctor-patient communication, patient-centered care, and empathy are all crucial in health care. These topics should be addressed throughout the undergraduate medical curriculum, but this is not always feasible due to the significant resources required. Micro-level interventions are more feasible; however, the effects on students and the means of achieving them are unknown. Therefore, this study focuses on a micro-level, theory-based communication training intervention to help medical students understand the importance of patient-centered care and empathy.

Methods

We conducted a design-based research study. We implemented a three-hour, role-playing-based communication seminar for forty-six fifth-year medical students at the Universitat Autònoma de Barcelona, applying cognitive apprenticeship principles. The following qualitative data were collected: students' written reflections, interviews with students and teachers, and seminar observations.

Results

The written reflections indicated that students believe patient-centered care and empathy are not merely skills and attitudes to possess but values inherent to the medical profession. The interviews show that involvement in role plays, teacher guidance, and a positive learning atmosphere were essential to the intervention.

Conclusion

The intervention helped improve students' awareness and their attitude, allowed them to practice skills related to patient-centered care and empathy, and see them as values of the profession.

医患沟通、以病人为中心的护理和同理心在医疗保健中都是至关重要的。这些主题应该贯穿整个本科医学课程，但由于需要大量资源，这并不总是可行的。微观层面的干预更为可行；然而，对学生的影响和实现这些目标的手段是未知的。因此，本研究着重从微观层面、基于理论的沟通训练干预来帮助医学生了解以病人为中心的护理和共情的重要性。方法采用基于设计的研究方法。我们运用认知学徒原则，为巴塞罗那Autònoma大学的46名五年级医学生举办了一个为期三小时、基于角色扮演的交流研讨会。收集了以下定性数据：学生的书面反思，与学生和老师的访谈，以及研讨会的观察。结果学生认为以病人为中心的关怀和同理心不仅仅是一种技能和态度，而且是医学职业所固有的价值观。访谈显示，参与角色扮演、教师指导和积极的学习氛围对干预至关重要。结论干预有助于提高学生的意识和态度，使他们能够实践以患者为中心的护理和同理心的相关技能，并将其视为职业价值观。

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引用次数: 0

Análisis de la influencia del baremo en la prueba para médico interno residente (MIR) e impacto de su modificación 分析比例尺对住院医师测试的影响及其修改的影响

Q2 Social Sciences

Educacion Medica

Pub Date : 2026-03-01 Epub Date: 2025-11-20 DOI: 10.1016/j.edumed.2025.101132

Jose Curbelo , Diana Monge Martín , Emilio Cervera Barba , Santiago Álvarez Montero , Cristina García de Leonardo , María Carnero González , Francisco Campos Lucas , Juan Vega Villar , Fernando Caballero Martínez

Introduction

Currently, the academic score accounts for 10% of the final result in the Spanish MIR (Medical Residency Entrance Exam). This study aims to analyze the relationship between academic score and exam performance, and to evaluate the impact of modifying the weight of the academic score to 0%, 25%, or 50%.

Methods

Official results from the 2020/2021 and 2021/2022 MIR exams were analyzed. Net scores were assessed in relation to academic scores adjusted for country of origin, and the changes in ranking positions were calculated for scenarios where the academic score weight was set at 0%, 25%, and 50%.

Results

A strong correlation was found between net scores and academic performance (0.65 and 0.64 for the 2020–2021 and 2021–2022 MIR exams, respectively), which increased when analyzing only Spanish candidates. Across all academic score ranges, Spanish candidates achieved higher net scores than foreign candidates. Assigning a 0% weight to the academic score led to a median worsening in ranking of 4 positions for Spaniards and 17 positions for foreigners in the 2020–2021 exam (p < 0.001). Conversely, increasing the academic score weight to 50% resulted in a median worsening of 21 positions for Spaniards and an improvement of 97 positions for foreigners (p < 0.001). Similar results were observed for the 2021–2022 cohort.

Conclusions

A high academic score is associated with better MIR exam performance, particularly among Spanish candidates. Increasing the weight of the academic score does not benefit Spanish applicants.

目前，学术成绩占西班牙医学住院医师入学考试最终成绩的10%。本研究旨在分析学业成绩与考试成绩之间的关系，并评估将学业成绩的权重调整为0%、25%或50%的影响。方法对2020/2021年和2021/2022年MIR考试的官方结果进行分析。净分数与根据原籍国调整的学术分数进行了评估，并计算了学术分数权重设置为0%、25%和50%的情况下排名位置的变化。结果发现净分数与学业成绩之间存在很强的相关性（2020-2021年和2021-2022年MIR考试分别为0.65和0.64），仅分析西班牙考生时，这一相关性增加。在所有学术分数范围内，西班牙候选人的净分数高于外国候选人。在2020-2021年的考试中，学术分数的权重为0%，导致西班牙人排名中位数下降4位，外国人排名中位数下降17位（p < 0.001）。相反，将学术分数权重增加到50%，导致西班牙人的排名中位数下降了21位，而外国人的排名中位数提高了97位（p < 0.001）。在2021-2022年队列中观察到类似的结果。结论学业成绩越高，MIR考试成绩越好，尤其是在西班牙语考生中。提高学术分数的权重对西班牙申请人没有好处。

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引用次数: 0

La importancia de la fisiología comparada en las titulaciones en ciencias de la salud y de la vida 比较生理学在健康和生命科学学位中的重要性

Q2 Social Sciences

Educacion Medica

Pub Date : 2026-03-01 Epub Date: 2026-02-17 DOI: 10.1016/j.edumed.2026.101154

Daniel Cabello-Rivera, María del Nogal Avila

Comparative physiology provides an integrative framework to understand the biological mechanisms of living organisms in an evolutionary and ecological context. Its study enables the identification of unique physiological adaptations across species that inspire therapeutic solutions and biomedical advances. Research using both traditional and non-conventional animal models have revealed mechanisms of neural protection, hypoxia tolerance, thermoregulation, and tissue regeneration applicable to humans. Additionally, biomimetics has contributed to the development of innovative drugs, such as ACE inhibitors, and biomedical technologies inspired by biological systems. Integrating these concepts into health sciences curricula enhances critical thinking, scientific reasoning, and prepares professionals capable of applying fundamental biological principles in clinical practice, research, and industry. This work highlights the importance of comparative physiology for education, research, and therapeutic innovation.

比较生理学提供了一个综合的框架来理解生物体在进化和生态背景下的生物学机制。它的研究能够识别不同物种之间独特的生理适应，从而激发治疗解决方案和生物医学进步。利用传统和非传统动物模型的研究已经揭示了适用于人类的神经保护、缺氧耐受性、体温调节和组织再生机制。此外，仿生学有助于创新药物的开发，如ACE抑制剂，以及受生物系统启发的生物医学技术。将这些概念整合到健康科学课程中，可以增强批判性思维和科学推理能力，并为能够在临床实践、研究和工业中应用基本生物学原理的专业人员做好准备。这项工作突出了比较生理学对教育、研究和治疗创新的重要性。

引用次数: 0

Impact of the large language model and prompt specificity in generating psychiatric multiple-choice questions 大语言模型和提示特异性在生成精神病学多项选择题中的影响

Q2 Social Sciences

Educacion Medica

Pub Date : 2026-03-01 Epub Date: 2026-02-17 DOI: 10.1016/j.edumed.2026.101161

Luis Miguel Rojo-Bofill , Gràcia Ribes Jordán , Llanos Monedero Carrasco , Juan Pablo Carrasco Picazo , Vicent Balanzá-Martínez , Lucas Giner , Eduardo Jesús Aguilar García-Iturrospe , Yavuz Selim Kiyak

Introduction

The use of large language models (LLMs) can assist in creating Multiple-Choice Questions (MCQs) for enhancing psychiatric education. This study evaluates the performance of LLMs in generating psychiatry case-based MCQs, focusing on the influence of the model used and the specificity of the prompt.

Material and methods

Two experiments were carried out. In Experiment 1, ChatGPT-3.5 and ChatGPT-4 were used with a general-purpose prompt. In Experiment 2, ChatGPT-4o was used to compare the generic prompt with a psychiatry-specific version. A total of 90 questions were generated in each experiment (45 per condition), balanced across low, moderate, and high difficulty levels. A panel of psychiatry professors assessed the questions for diagnostic accuracy and difficulty.

Results

In Experiment 1, both ChatGPT-3.5 and ChatGPT-4 showed high diagnostic agreement with experts (κ = 0.889 and κ = 0.703), but little correlation with intended difficulty (ρ = 0.104, p = .496; ρ = − 0.087, p = .57). In Experiment 2, the psychiatry-specific prompt with ChatGPT-4o yielded more accurate MCQs (κ = 0.731 and κ = 0.624) and stronger correlations between intended and expert-rated difficulty (ρ = 0.630, p < .001; ρ = 0.436, p < .001). It also improved the inclusion of relevant clinical information and diagnostic diversity.

Conclusion

LLMs can effectively generate psychiatry MCQs, especially when guided by domain-specific prompts. The psychiatry-specific prompt developed in this study is a useful tool for supporting medical education through high-quality, clinically relevant assessments.

使用大型语言模型（llm）可以帮助创建多项选择题（mcq），以加强精神病学教育。本研究评估法学硕士在产生基于精神病学案例的mcq方面的表现，重点关注所使用模型的影响和提示的特异性。材料与方法进行了两个实验。在实验1中，ChatGPT-3.5和ChatGPT-4使用通用提示符。在实验2中，chatgpt - 40被用来比较通用提示和精神病学特定版本。每个实验总共产生90个问题（每种情况45个），在低、中、高难度水平上平衡。一个由精神病学教授组成的小组评估了这些问题诊断的准确性和难度。ResultsIn实验1,chatgpt - 3.5和ChatGPT-4显示高与专家诊断协议(κ = 0.889和κ = 0.703),但是小相关困难(ρ = 0.104,p = .496;ρ = −0.087,p = .57)。在实验2中,psychiatry-specific提示与ChatGPT-4o产生更精确的mcq(κ = 0.731和κ = 0.624)和强之间的相关性和expert-rated困难(ρ = 0.630,p & lt; 措施;ρ = 0.436,p & lt; 措施)。它还改善了相关临床信息的纳入和诊断的多样性。结论llm可以有效地生成精神病学mcq，特别是在特定领域提示的引导下。本研究开发的精神病学特异性提示是通过高质量的临床相关评估支持医学教育的有用工具。

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引用次数: 0

Teaching oxygen pharmacology before and after the COVID-19 pandemic in the Faculty of Medicine at a public University in Peru 秘鲁一所公立大学医学院在COVID-19大流行前后教授氧气药理学

Q2 Social Sciences

Educacion Medica

Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI: 10.1016/j.edumed.2026.101149

Javier Tovar-Brandan, Daisy Flores-Cortez, Juan Rodriguez-Tafur Davila, Eduardo Villalobos Pacheco, Max Aliaga Chávez

Introduction

In 2020, the COVID-19 pandemic underscored the critical role of medicinal oxygen as a primary therapeutic resource to reduce morbidity and mortality. Despite its clinical relevance, it remains unclear whether undergraduate education at the Faculty of Medicine of the Universidad Nacional Mayor de San Marcos (UNMSM) adequately addresses the pharmacological aspects of oxygen. This study aims to analyze the inclusion of oxygen pharmacology in curricula and syllabus before and after the COVID-19 pandemic across various health professional schools at UNMSM.

Material and methods

This descriptive, cross-sectional, retrospective study was conducted in the Pharmacology Section of the Department of Dynamic Sciences, Faculty of Medicine. Pharmacology syllabus from the professional schools of Medicine, Nursing, Obstetrics, Nutrition, Medical Technology, and Clinical Toxicology were evaluated for the academic years 2016–2020 (pre-pandemic) and 2020–2025 (post-pandemic). The inclusion of topics directly or indirectly related to oxygen pharmacology was assessed through the search for key terms concerning pharmacodynamics, pharmacokinetics, adverse drug reactions (ADRs), and interactions. A descriptive approach, including percentage analysis, was employed for data analysis.

Results

The document analysis revealed that none of the reviewed syllabi included specific content related to oxygen pharmacology. This represents a significant educational gap, particularly in the post-pandemic context where medicinal oxygen has proven to be a critical component in patient care.

Conclusion

The findings demonstrate a clear deficiency in the training of future health professionals regarding their knowledge and competencies in oxygen pharmacology.

2020年，COVID-19大流行凸显了医用氧作为降低发病率和死亡率的主要治疗资源的关键作用。尽管具有临床意义，但尚不清楚圣马科斯国立马约尔大学（UNMSM）医学院的本科教育是否充分解决了氧气的药理学问题。本研究旨在分析UNMSM各卫生专业学校在COVID-19大流行前后在课程和教学大纲中纳入氧气药理学的情况。材料和方法这项描述性、横断面、回顾性研究在医学院动力科学系药理学部进行。对2016-2020学年（大流行前）和2020-2025学年（大流行后）医学、护理、产科、营养、医疗技术和临床毒理学专业学校的药理学教学大纲进行了评估。通过搜索有关药效学、药代动力学、药物不良反应（adr）和相互作用的关键术语来评估与氧药理学直接或间接相关的主题。数据分析采用描述性方法，包括百分比分析。结果文献分析显示，所审查的教学大纲均未包含与氧药理学相关的具体内容。这是一个重大的教育差距，特别是在大流行后的背景下，医用氧气已被证明是患者护理的关键组成部分。结论研究结果表明，未来卫生专业人员在氧气药理学知识和能力方面的培训明显不足。

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引用次数: 0

Reflection on the teaching reform of parasitology experiment course for foreign students under the background of the belt and road “一带一路”背景下留学生寄生虫学实验课教学改革的思考

Q2 Social Sciences

Educacion Medica

Pub Date : 2026-03-01 Epub Date: 2025-12-05 DOI: 10.1016/j.edumed.2025.101138

Yuting Ma , Afito Luciano , Yu Zhang , Fanming Meng

Parasitic diseases remain a significant public health issue in underdeveloped countries and regions along “the Belt and Road”. Parasitology laboratory courses offered by domestic medical colleges and universities are crucial for international medical students to understand and master the identification and diagnosis of parasites and related diseases. Therefore, ensuring the learning outcomes of international students and improving their comprehensive understanding and practical skills are the primary considerations in developing the experimental teaching of parasitology. This paper conducts an in-depth analysis and discussion on this topic and provides a reference for related educational reforms.

寄生虫病仍是欠发达国家和“一带一路”沿线地区的重大公共卫生问题。国内医学院校开设的寄生虫学实验课程，对于国际医学生了解和掌握寄生虫及相关疾病的鉴别诊断至关重要。因此，确保留学生的学习成果，提高学生的综合理解能力和实践能力，是开展寄生虫学实验教学的首要考虑。本文对这一问题进行了深入的分析和探讨，为相关的教育改革提供参考。

引用次数: 0

Propuesta de un modelo integrado de identidad médica 拟议的医疗身份综合模式

Q2 Social Sciences

Educacion Medica

Pub Date : 2026-03-01 Epub Date: 2025-10-10 DOI: 10.1016/j.edumed.2025.101093

Javier de la Maza Guzmán , Pedro Eliseo Esteves

This article proposes an integrated model of medical identity that envisions the physician as a multidimensional human being in constant development. Medical identity guides professional behavior and is constructed through the integration of three interrelated dimensions: personal, professional, and the experience of vulnerability of the physician as a patient. The model also acknowledges the influence of communities of practice and medical culture in this formative process. Explicitly incorporating the development of medical identity into the curriculum fosters reflection and dialog around physicians' values, contributing to the training of more empathetic, resilient professionals capable of delivering more human-centered care.

本文提出了一个医学认同的整合模型，将医生视为一个不断发展的多维人。医学身份指导专业行为，并通过三个相互关联的维度的整合来构建：个人、专业和医生作为病人的脆弱性体验。该模型还承认实践社区和医学文化在这一形成过程中的影响。明确地将医学身份的发展纳入课程，促进对医生价值观的反思和对话，有助于培养更有同情心、更有弹性的专业人员，能够提供更多以人为本的护理。

引用次数: 0

Formación médica y desafíos del dengue: una atención primaria 医疗培训与登革热的挑战：初级保健

Q2 Social Sciences

Educacion Medica

Pub Date : 2026-01-01 Epub Date: 2025-10-29 DOI: 10.1016/j.edumed.2025.101118

Aldo Medina Gamero

引用次数: 0

Correlación de competencias evaluadas en una evaluación clínica objetiva estructurada, un test de opción múltiple y un examen de casos clínicos por ordenador en estudiantes de último curso de Medicina 在结构化客观临床评估、多选择测试和基于计算机的医学研究生临床案例审查中评估的能力相关性

Q2 Social Sciences

Educacion Medica

Pub Date : 2026-01-01 Epub Date: 2025-10-22 DOI: 10.1016/j.edumed.2025.101113

Emilio Cervera-Barba , Sophia Denizon-Arranz , Raúl Castañeda-Vozmediano , José Manuel Blanco-Canseco , M. Isabel Gámez-Cabero , Irene Salinas-Gabiña

Background

Final-year medical students are required to complete a summative assessment through an OSCE (Objective Structured Clinical Examination). In some faculties, as an adaptation during the pandemic, a computer-based Cases Test (CCT) was introduced. This test was intended to assess competencies similar to those evaluated in the OSCE and is weighted as part of the final grade alongside the OSCE. In 2023, we compared an OSCE, a CCT, and a multiple-choice question (MCQ) exam, with the aim of analysing the concordance of overall and competency-specific results. Our hypothesis was that the CCT assesses a construct more closely related to the MCQ than to the OSCE.

Methods

A total of 108 students participated. They completed a 21-station OSCE, a CCT consisting of 10 computer-based clinical cases, and a 150-question MCQ exam based on 26 clinical scenarios aligned with the other two assessments. Five shared competencies were evaluated: history taking, physical examination, clinical reasoning, prevention/promotion, and professionalism. Internal consistency was analysed using Cronbach's alpha, and correlations between assessments were calculated using Spearman's rho coefficient.

Results

Scores were lowest in the MCQ. The OSCE and CCT coincided only in overall scores, not by individual competencies. The strongest correlation was observed between the MCQ and CCT (rho = 0.49), and the weakest between the OSCE and CCT (rho = 0.27). Significant correlations were found only in clinical reasoning and physical examination between the MCQ and the other assessments. The OSCE showed the highest internal consistency (α = 0.754).

Conclusion

The three assessments evaluate different dimensions. The CCT measures a construct more closely aligned with the MCQ. Competencies assessed by the OSCE and the CCT do not correlate.

最后一年的医学生需要通过OSCE（客观结构化临床检查）完成总结性评估。在一些院系，作为大流行期间的适应措施，引入了基于计算机的病例测试（CCT）。该测试旨在评估与欧安组织评估的能力相似的能力，并与欧安组织一起作为最终成绩的一部分进行加权。在2023年，我们比较了欧安组织、CCT和多项选择题（MCQ）考试，目的是分析整体和能力特定结果的一致性。我们的假设是，CCT评估的结构与MCQ的关系比与欧安组织的关系更密切。方法共108名学生参与。他们完成了一个21站的OSCE测试，一个由10个基于计算机的临床病例组成的CCT测试，以及一个基于26个临床场景的150题MCQ测试，该测试与其他两个评估相一致。评估了五项共同能力：病史记录、体格检查、临床推理、预防/促进和专业精神。使用Cronbach's alpha分析内部一致性，使用Spearman's rho系数计算评估之间的相关性。结果MCQ得分最低。欧安组织和CCT只在总分上一致，而在个人能力上不一致。MCQ与CCT的相关性最强（rho = 0.49），而OSCE与CCT的相关性最弱（rho = 0.27）。MCQ与其他评估之间仅在临床推理和体格检查方面存在显著相关性。欧安组织的内部一致性最高（α = 0.754）。结论三种评价方法的评价维度不同。CCT测量的结构与MCQ更接近。欧安组织和CCT评估的能力并不相关。

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引用次数: 0

Desarrollo de habilidades clínicas en pediatría utilizando aprendizaje basado en casos: evaluación de su impacto en la enseñanza de pregrado 利用个案学习发展儿科临床技能：评估其对本科教学的影响

Q2 Social Sciences

Educacion Medica

Pub Date : 2026-01-01 Epub Date: 2025-11-17 DOI: 10.1016/j.edumed.2025.101128

Daniel Lozano-Moreno, Carlos Torres-Salinas, Kensey Solórzano-Quispe, Diego J. Castro

Introduction

Learning in health sciences requires constant updating and active methodologies; infrastructure, curriculum, and teacher training influence academic performance. Case-Based Learning (CBL) links theory and practice, fostering critical analysis and decision-making. This study evaluates the relationship between the development of clinical skills using CBL and academic performance in pediatrics, providing key evidence for medical education in Latin America.

Methodology

An observational, cross-sectional study was conducted among 117 students in a clinical skills development program with seven simulated pediatric case sessions. The relationship between attendance and academic performance was evaluated. Low, medium, and high attendance groups were compared using the Kruskal-Wallis test, with a p-value less than 0.05 considered statistical significance.

Results

A positive correlation was found between the number of attendances to clinical skills (CS) and academic performance: final exam (FE); r = 0.412, p < 0.001 and final grade (FG); r = 0.536, p < 0.001. While the analysis by attendance groups showed significant differences in FE (H = 21.84, p < 0.001) and FG (H = 30.99, p < 0.001), highlighting better performance with greater attendance at sessions CS.

Discussion

The findings suggest that greater participation in clinical skills development sessions using ABC is associated with better academic performance. Furthermore, the significant difference between groups reinforces the importance of practical implementation strategies in clinical skills development. These results support the importance of integrating ABC into medical education.

健康科学的学习需要不断更新和积极的方法；基础设施、课程和教师培训影响学习成绩。基于案例的学习（CBL）将理论与实践联系起来，培养批判性分析和决策。本研究评估了使用CBL的临床技能发展与儿科学业成绩之间的关系，为拉丁美洲的医学教育提供了关键证据。方法对117名参加临床技能发展项目的学生进行了一项观察性、横断面研究，其中包括7个模拟儿科病例。评估出勤率与学习成绩之间的关系。采用Kruskal-Wallis检验比较低、中、高出勤率组，p值小于0.05认为有统计学意义。结果临床技能（CS）出勤次数与期末考试成绩（FE）呈正相关；r = 0.412,p <； 0.001与最终成绩（FG）有关；r = 0.536,p & lt; 0.001。而出勤率组的分析显示，FE （H = 21.84,p <； 0.001）和FG （H = 30.99,p <； 0.001）存在显著差异，表明CS的出勤率越高，表现越好。研究结果表明，更多地参与使用ABC的临床技能发展课程与更好的学习成绩有关。此外，组间的显著差异强化了临床技能发展中实际实施策略的重要性。这些结果支持将ABC纳入医学教育的重要性。

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引用次数: 0