JMIR Medical Education最新文献

Unlabelled: Health care has widely adopted behavioral economics to influence clinical practice, with documented success using defaults and social comparison feedback in electronic health records. However, online medical education, now the dominant modality for continuing professional development, remains designed on assumptions of rational learning that behavioral science has disproven in clinical contexts. This viewpoint examines the paradox of applying sophisticated behavioral insights to clinical work while designing digital learning environments as if learners are immune to cognitive limitations. We propose digital choice architecture for medical education: intentional integration of behavioral design principles into learning management systems and online platforms. Drawing from clinical nudge units and implementation science, we demonstrate how defaults, social norms, and commitment devices can be systematically applied to digital continuing education. As medical education becomes increasingly technology-mediated, behavioral science provides the theoretical foundation and practical tools for designing online learning environments that align with how clinicians actually make decisions.

Background: Artificial intelligence (AI) shows promise in clinical diagnosis, treatment support, and health care efficiency. However, its adoption in real-world practice remains limited due to insufficient clinical validation and an unclear impact on practitioners' competence. Addressing these gaps is essential for effective, confident, and ethical integration of AI into modern health care settings.

Objective: This study aimed to evaluate the effectiveness of informed AI use, following a tailored AI training course, on the performance of general practitioners (GPs) and internists in test-based clinical competence assessments and their attitudes toward clinical AI applications.

Methods: A pre-post intervention study was conducted with 326 physicians from 39 countries. Participants completed a baseline test of clinical decision-making skills, covering diagnosis, treatment planning, and patient counseling; attended a 1.5-hour online training on effective AI use; and then took a similar postcourse test with AI assistance permitted (GPT-4.0). Test performance and time per question were compared before and after the training. Participants also rated AI accuracy, efficiency, perceived need for structured AI training, and their willingness to use AI in clinical practice before and after the course.

Results: The average test scores improved from 56.9% (SD 15.7%) to 77.6% (SD 12.7%; P<.001), and the pass rate increased from 6.4% (21/326) to 58.6% (191/326), with larger gains observed among GPs and younger physicians. All skill domains (diagnosis, treatment planning, and patient counseling) improved significantly (all P<.001), while time taken to complete the test increased slightly from before to after the course (mean 40.25, SD 16.14 min vs 42.29, SD 14.02 min; P=.03). By the end of the intervention, physicians viewed AI more favorably, reporting increased confidence in its accuracy and time efficiency, greater appreciation for the need for structured AI training, and increased confidence and willingness to integrate AI into patient care.

Conclusions: Informed use of AI, based on tailored training, was associated with higher performance in test-based clinical decision-making assessments and greater confidence in using AI among GPs and internists. Building on previous research that often lacked structured training, focused primarily on model performance, or was limited in clinical scope, this study provides empirical evidence of both competence and perceptual improvement following informed AI use in a large, multinational cohort, enhancing the generalizability. These findings support the integration of structured AI training into medical education and continuing professional development to improve clinical performance and promote competent use of AI in clinical practice.

Background: Physician empathy is important not only for improving patient satisfaction and health outcomes but also for increasing physician job satisfaction and protecting against burnout. However, amid concerns over declining empathy levels in medical education, there is a need for innovative teaching approaches that address the empathy gap, a critical element in patient-centered care.

Objective: This study aimed to use a mixed-methods analysis to explore the effectiveness of a virtual reality (VR) intervention versus traditional lecture methods in enhancing empathy among medical students.

Methods: Overall, 50 first- and second-year medical students were randomized to either a VR intervention, which simulated patient experiences, or a control group receiving traditional empathy lectures. Both groups watch 2 videos with reflections gathered after each video to capture students' experiential learning. Empathy was measured using the Jefferson Scale of Empathy-Student Version before and after the intervention.

Results: Quantitative analysis revealed significant increases in empathy scores post intervention for both groups (lecture group: mean increase 4.71, SD 11.01; VR group: mean increase 5.6, SD 10.02; P<.001), indicating that both interventions enhanced empathy. The VR group exhibited a significant difference in qualitative empathy coding after the second video (U=165.5; P<.001) compared to the lecture group. Qualitative feedback from the VR group emphasized a more profound emotional and cognitive engagement with the patient perspective than the lecture group.

Conclusions: This study supports the integration of VR into medical education as a complementary approach to traditional teaching methods for empathy training. VR immersion provides a valuable platform for students to develop a deeper, more nuanced understanding of empathy. These findings advocate for further exploration into VR's long-term impact on empathy in clinical practice.

Background: The medical education of French family medicine residents involves active, socioconstructivist-inspired small-group courses useful for skill acquisition. This is challenged by the increasing gap between the growing number of residents and the limited number of teachers. Blended courses have the potential to address this issue by reducing the duration of face-to-face sessions while preserving small-group courses.

Objective: This study aimed to compare the effects of blended vs traditional, face-to-face, active, socioconstructivist learning on the acquisition of knowledge and skills by family medicine residents.

Methods: We conducted a randomized controlled trial to compare a blended course and a traditional course. The blended course involved 2.5 hours of asynchronous e-learning and a 3-hour face-to-face session. The traditional course involved 5.5 hours of face-to-face teaching. Both courses were grounded in socioconstructivist principles and actively engaged residents. The primary outcome was residents' self-assessment of knowledge and skills. Secondary outcomes included satisfaction with knowledge- or skill-related learning objectives and academic achievement at 6 months.

Results: We included 155 family medicine residents (n=78, 50.3% in the blended course and n=77, 49.7% in the traditional course). There was no significant difference between groups regarding the primary outcome (mean difference 0.40 [maximum mean difference 20] points, 95% CI -0.21 to 1.02; P=.19; Cohen d=0.21). No significant differences were observed for the secondary outcomes except for knowledge self-assessment, which was higher in the blended course but not educationally meaningful (mean difference 0.40 [maximum possible 10] points, 95% CI 0.07-0.71; P=.02; Cohen d=0.39).

Conclusions: Blended courses can help sustain socioconstructivist small-group teaching methods while accommodating a growing family medicine resident population, with no deleterious impact on knowledge and skill self-assessments.

Background: Ultrasound is very important in medicine and teaching, but there are not many formal training programs. We also do not know much about what students think. To be good at using ultrasound, one needs to learn technical, thinking, and seeing skills. This is especially true in regional anesthesia (RA), where mistakes in reading images can cause problems. Training with simulations is a safe and good way to learn these skills. Some models are helpful for teaching how to perform procedures using ultrasound.

Objective: This study aimed to evaluate the effectiveness, localization time, and success rate of traditional teaching versus a new simulation-based teaching method for RA designed by the investigators among undergraduate medical students.

Methods: A prospective, randomized controlled trial was conducted at the University of Salamanca from April 2022 to January 2023. A total of 34 medical students in their fourth to sixth academic years were randomly allocated to either a simulation-based training group using the Haptic Ultrasound Probe or a traditional teaching group. The simulation approach used a realistic probe replica and a software-based ultrasound environment, whereas the traditional method comprised a theoretical lecture and curated audiovisual materials. Two days after training, participants underwent a blinded assessment requiring the identification of peripheral nerve plexuses using an ultrasound device. The primary outcome measured was the successful identification of nerves, and the secondary outcome was the time taken to complete each procedure. Data were analyzed using an intention-to-treat approach.

Results: A total of 34 medical students (fourth to sixth years) were recruited to compare traditional teaching with simulation-based training in ultrasound-guided nerve localization. No statistically significant differences were found in the success rates between the groups. For the interscalene approach, the traditional teaching group achieved a 100% (17/17) success rate compared to 82% (14/17) in the simulation group (P=.07). The time to task completion was similar across most procedures. In the sciatic nerve division, the traditional teaching group was significantly faster, with a mean time of 42.4 (SD 39.5) seconds (P=.02). The regression models showed no significant interaction between the intervention type and academic year. Both teaching methods had positive educational impacts.

Conclusions: Simulation-based learning effectively supports competency acquisition in RA and offers a safe, scalable alternative to traditional methods. Its integration into medical curricula may standardize training, improve skill consistency, and enhance patient safety. Further multicenter studies with larger, diverse cohorts are needed to validate these benefits and guide implementation in medical education.

Background: Therapeutic competence is a critical skill for health care professionals, encompassing communication, interaction, and guidance in vulnerable situations. Virtual reality (VR) and 360-degree video technologies have emerged as innovative tools in health care education, offering immersive and interactive learning experiences. However, there is limited research on their effectiveness in developing therapeutic competencies among health care students.

Objective: This pilot study aimed to explore the feasibility, usability, and perceived educational value of a virtual learning resource using VR and 360-degree video to enhance therapeutic competence in health care students.

Methods: A virtual learning resource was developed, consisting of three modules: (1) a virtual home visit, (2) observation of therapeutic conversations using a 360-degree video, and (3) practice of therapeutic conversations in a simulated environment using VR. The resource was tested with students (n=12) from occupational therapy, psychology, and dentistry programs. Data were collected through focus group interviews after the students completed the modules. Thematic analysis was conducted to identify key themes related to the educational value and learning outcomes of the resource.

Results: The analysis revealed four key themes: (1) active exploration, where students engaged deeply with the material and contextualized theoretical knowledge; (2) observation, which provided practical insights into therapeutic conversations; (3) practice and reflection, which allowed students to refine their skills and build confidence; and (4) translation of theoretical knowledge into practical skills. Students reported that the resource was engaging, immersive, and effective in promoting learning compared to traditional teaching methods. Some students found the VR experience intense but valuable for skill development.

Conclusions: This pilot study demonstrates the feasibility and potential educational value of integrating VR and 360-degree video into health care education. The findings provide preliminary insights into the resource's ability to enhance therapeutic competence and student engagement. Future research should focus on larger, multi-institutional studies to validate these findings and assess the resource's impact on measurable learning outcomes.

Background: Structured educational programs for physicians in healthy longevity medicine (HLM) remain scarce. No published data yet document the impact of longevity-focused medical education on physicians. This study assesses the ramification of the HLM curriculum, certified by the American Council for Continuing Medical Education (ACCME), on physicians' confidence in knowledge of HLM and clinical practice.

Objective: This study aimed to evaluate the impact of accredited HLM education on physicians' confidence in knowledge, and practice patterns, examining self-reported integration of HLM principles, professional attitudes, and career trajectories to determine the translational value of structured curricula in the emerging medical discipline.

Methods: A cross-sectional online survey was conducted between March and April 2024 among physicians who had completed accredited HLM courses between January 2023 and February 2024. Invitations were sent globally to 590 eligible physicians; trainees and students were excluded. A total of 113 respondents completed the survey and were included in the analysis. The survey assessed self-reported changes in clinical implementation, confidence in HLM-related knowledge, and professional attitudes following course completion. Descriptive statistics and logistic regression analyses were performed (p < .05, 95% CIs).

Results: Respondents represented 42 nationalities and were primarily trained in family medicine (27.4%) and internal medicine (15.93%). Overall, 96.5% reported increased confidence in HLM-related knowledge, with 47.8% indicating substantial improvement. More than half (55.8%) reported integrating HLM principles into routine patient assessments, and 80.5% reported more frequent discussions related to healthspan-focused care. Additionally, 23% initiated aging biomarker testing, 48.7% increased testing frequency, 52.2% reported a shift in their perspective on aging, and 73.5% anticipated full integration of HLM into mainstream medicine. Physicians practicing in specialized care demonstrated higher odds of reporting increased confidence in HLM knowledge compared with those in primary and preventive care (OR 4.46, 95% CI 1.55-12.79, p = .005).

Conclusions: Accredited education in HLM is associated with enhanced confidence in HLM knowledge, increased clinical engagement with HLM practices, and a shift in aging-related care paradigms. These findings underscore the critical role of structured HLM curricula in bridging the translational gap between geroscience and everyday medical practice. Nevertheless, systemic healthcare barriers impede widespread implementation, warranting policy-level strategies to support healthspan-oriented education and care models.

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