Journal of Medical Education and Curricular Development最新文献

Objectives: This study investigates the differences between in-person versus virtual format of an advanced communication skills OSCE through thematic analyses of post-OSCE debrief transcripts.

Methods: Two cohorts of senior medical students participated in either a 2019 in-person or 2021 virtual advanced communication skills OSCE. Students were grouped in triads and rotated through three of five possible cases. Afterwards, students participated in a faculty-led debrief (in-person in 2019, virtual in 2021). Inductive thematic analysis was used to compare the themes and the ratio of comments related to the themes were compared between the virtual and in-person OSCEs.

Results: Thematic analyses for both in-person and virtual OSCEs identified the same four major themes (Case Review, Emotional Response, Feedback, and Reflection) and 11 subthemes. However, the ratio of comments related to Case Review was lower in the virtual OSCE compared to in-person (P < .0001). Analysis of subthemes within Case Review revealed the percentage of comments was higher for Content and lower for Challenges in the virtual OSCE compared to in-person (both P < .0001). There were no differences in the ratios of comments related to Emotional Response, Feedback, and Reflection, or their subthemes.

Conclusion: A virtual advanced communications skills OSCE for medical students showed identical qualitative themes to that from a prior in-person OSCE. However, students in the virtual OSCE focused more on matter-of-fact discussions about case content and less about the challenges they experienced. The findings suggest that some medical students may struggle with experiential learning in the virtual format, and have difficulty accessing or practicing their reflective observation skills based on Kolb's learning theory. Differences may be attributable to the additional cognitive load in the virtual setting, inadequate structural safeguards, and/or other limitations of virtual communication.

Improving physical and mental healthcare delivery to incarcerated patients and people with carceral histories provides an opportunity to improve health equity more broadly. This article provides a medical curriculum perspective led by the firsthand narratives of two women with lived expertise of incarceration in collaboration with interdisciplinary health professions students and faculty. Together we state that recognizing the humanity of individuals with carceral involvement precedes the ability to provide ethical or equitable healthcare: this humanity begins with students and the community sharing places and spaces together. We herein detail our experiences in honoring community educators with lived expertise of incarceration while pioneering a grant-funded, interdisciplinary medical education event offering early exposure to experiential learning in hopes of preparing future clinicians to transcend the status quo of substandard care through individual-level and systems-level advocacy. By sharing humanity and building relationships directly with community experts, we endeavor to offer future clinicians the relational framework to inform their advocacy efforts to improve healthcare systems from the bottom up throughout their clinical training and lifelong careers. Most importantly, we highlight the reasons why we believe medical curricula aiming to dismantle inequities facing people with carceral histories must be taught alongside those with lived expertise.

Background: There are few opportunities in undergraduate medical education that provide formal training in engineering and scientific innovation. Institutions have sought to address student-specific career goals through combined degree programs such as the Medical Scientist Training Program and MD/MBA. However, only a small percentage of medical students pursue these additional degrees. Partnerships between medical schools and Medical Technology (MedTech) accelerators may create unique opportunities for medical students to gain real-world experience with scientific innovation and entrepreneurship.

Methods: An internship program was developed by the Keck Translational Biotechnology Association and the West Coast Consortium for Technology & Innovation in Pediatrics (CTIP), a Food and Drug Administration-funded pediatric medical device accelerator. Students and companies applied to participate and were paired based on students' interests and experience, and project plans were developed together. An initial orientation provided an overview of the program structure and expectations. Students and mentors met biweekly to address questions or concerns surrounding the progress of their projects. Students gave final project presentations and completed program evaluations. Data from 3 iterations of the program are reported.

Results: Student program satisfaction was measured across 5 domains. Students felt that working with CTIP was valuable to their education (mean score = 3.7 of 5.0) and encouraged them to pursue future careers in MedTech (mean score = 4.0 of 5.0). Students provided a few suggestions to improve the program, including more structure, clear expectations around time commitment and deliverables, and stipends for students. Participation in the program grew over time.

Conclusions: The initial iterations of the internship program were well received by students. Several opportunities for improvement were noted. The program grew over time. Partnerships with accelerator programs at medical schools and academic medical centers may provide key real-world opportunities for students to learn about MedTech.

Introduction: Inpatient psychiatry faculty manage complex clinical, administrative, and legal issues amid increasing mental health service utilization rates, limiting time for (1) focusing on lifelong learning and (2) connecting. We examined the impact of a monthly journal club on inpatient psychiatry faculty's (1) confidence that their practice is evidence informed, (2) stress related to board recertification, and (3) sense of connectedness with peers.

Methods: We employed a primarily qualitative approach using semi-structured interviews and brief survey questions to elicit input from inpatient psychiatry faculty at an academic medical center on their experience participating in a monthly journal club, including perceived changes in one's practice of evidence-based medicine, recertification stress, and connectedness with peers.

Results: Thirteen faculty who participated in the journal club responded to at least one survey or interview. Many faculty reported feeling more confident that their clinical practice was evidence informed, less stressed about board recertification, and more connected to peers at 6 and 12 months following the commencement of the journal club. Following in-person attendance, video-based learning (an innovative method of participating in the journal club) was found to be the second most preferred method of participation among respondents. All respondents noted that the journal club was a valuable use of their time and enjoyable.

Conclusion: A monthly journal club has the potential to increase hospital psychiatry faculty confidence in evidence-based clinical practice, reduce board recertification stress, and improve sense of peer connectedness. Future research should examine the journal club experience and impact among a larger number of faculty and incorporate additional measures of learning outcomes.

Objectives: Instilling the principles of ethical and responsible medical research is critical for educating the next generation of clinical researchers. We developed a responsible conduct of research (RCR) workshop and associated curriculum for undergraduate trainees in a quantitative clinical research program.

Methods: Topics in this 7-module RCR workshop are relevant to undergraduate trainees in quantitative fields, many of whom are learning about these concepts for the first time. These topics include: (1) research collaboration and mentoring, (2) human subjects and privacy, (3) rigor, reproducibility, and responsibility in data analysis, (4) data safety, security, and sharing, (5) responsible authorship, peer reviews, and conflicts of interest, (6) research misconduct and whistleblowing, and (7) social responsibility and contemporary ethical issues. The workshop adopts an active learning approach and is intended to encourage peer-to-peer learning through a critical review of case studies and contemporary media reports. Workshop materials and discussions are designed to address experiences relevant to undergraduate trainees. For example, for the discussion on human subject protection, trainees are asked to review their own university's policies for engaging students as research subjects. Student perceived knowledge and understanding of research ethics were obtained from pre- and post-workshop surveys, with responses ranging from 1 (low level of understanding) to 5 (high level of understanding).

Results: Survey responses from 38 trainees across 4 years demonstrated marked increase in perceived knowledge and understanding of research ethics, from 64% in pre- to 96% in post-workshop responses with scores of 3 and up. Trainees noted the effectiveness of the active learning format of the workshop and relevance of the topics on their own research projects.

Conclusion: Intentional instruction is vital to help trainees discern between good and bad science in research. The presented RCR curriculum can be adapted by other programs designed for trainees engaged in medical research and education.

Background: Undergraduate training in research principles is often mandated by healthcare profession regulators in Ireland to prepare graduates for higher specialist training. Students can be offered the opportunity to participate in extracurricular research activities, in addition to those embedded in the curricula. This cross-sectional study aims to explore student attitudes towards research and to understand their motivations for engaging in research-related activities and any barriers that might prevent them from doing so.

Methods: Students participating in the Royal College of Surgeons in Ireland Research Summer School (RSS) 2023 completed a questionnaire at the start of the program to assess research experience as well as attitudes and motivations towards research.

Results: Of the 120 participants in the summer research school, only 50 participated in the questionnaire. Of these 50, 42 were medical students. Twenty-nine students were undertaking a supervised research project, while 21 were enrolled in a 4-week taught research skills program. Five students had completed a previous undergraduate or postgraduate degree, and 29 had previously participated in research-related activities. The reasons for participating in the RSS program were to gain experience and skills, followed by having an interest in biomedical research. Twenty-nine students said their motivation was to participate in a more exploratory learning process beyond the syllabus. Thirty students felt the main factor preventing them from gaining research experience was the lack of research opportunities available to them.

Conclusion: Undergraduate health professions students recognize the importance of engaging in research-related activities. Gaining research experiences to enhance knowledge and build professional relations is important, but the lack of opportunities is perceived to be a barrier preventing engagement. Given the value undergraduate students place on research experiences, institutions specializing in health professions education should create customized programs to eliminate obstacles and offer undergraduate opportunities that encourage the development of research-focused healthcare professionals.

Like many other low- and middle-income countries, Botswana has struggled to address the shortage of doctors, particularly specialists. In 2009, the country's first medical school offering an undergraduate medical program was established. A needs and feasibility assessment was conducted with relevant stakeholders to explore the need for specialty training programs in all medical school departments. As a result, three residency programs were established a year after the undergraduate program, but psychiatry was not included in this first crop of residency programs. Existing strengths in the university and healthcare systems were leveraged to successfully establish a four-year Master of Medicine residency program in psychiatry, which began in January 2020. The program aims to produce psychiatrists who are familiar with the local mental health needs. The first batch of students completed their training in December 2023. This paper reflects on and describes the development of a psychiatry residency program in Botswana and contributes a process grounded in educational program development models and educational theories that others can utilize. Botswana's experience may be helpful to other low- and middle-income countries, particularly in sub-Saharan Africa, that want to establish and run a locally developed residency program in psychiatry.

Background: Ethics and professionalism are fundamental elements in the practice of medicine consisting of a set of values, behaviors, and relationships that reinforce the trust and respect for the physician in a society. It consists of several key elements that are learnt during their formative years of study. This study aims to compare knowledge and self-reported practice of ethics and professionalism between preclinical and clinical undergraduate medical students.

Methods: We included 427 medical students including males and females of age 18 and above. They were further divided into preclinical and clinical groups. We assessed knowledge and practice of medical professionalism through a validated questionnaire containing 11 core elements (components) of medical professionalism and ethics. The assessment was carried out by comparing median scores assigned to the components of professionalism against each question. Data was analyzed through SPSS v.22 and GraphPad Prism v.8.

Results: Clinical medical students had significantly higher knowledge of medical professionalism as compared to nonclinical students (P = .0016). Moreover, among the components of professionalism, there was a significantly higher score for confidentiality (P = .006), communication skills (P = .001), self-directed learning (P = .011), peer and self-assessment (P = .0011) along with ethics in research and patient care (P = .0042) in clinical students as compared to preclinical medical students. However, no significant difference was found between students of preclinical and clinical years for honesty, accountability, respect, responsibility, compassion, and maturity (P > .05). The findings were comparable across students of different ethnicities in our study cohort (P > .05).

Conclusion: Our findings suggest that knowledge and practice of certain elements of ethics and professionalism are enhanced through clinical exposure, however, few remain consistent across different stages of study. Moreover, lack of significant differences in practice of professionalism based on ethnic differences underscores the potential universal standards in medical education.

The obstetrics and gynecology (OB/GYN) clerkship is a uniquely enriching and challenging rotation for medical students. Available literature prepares students for medicine and surgery clerkships, but few guides identify and discuss the unique characteristics of OB/GYN that impact student learning and performance during the clerkship. Here, we aim to highlight the specific clinical learning environments, emotionally sensitive experiences, and technical performance expectations that students should anticipate and be prepared for in the OB/GYN clerkship. We believe all students benefit from learning these skills to care for their future patients no matter their chosen specialty.

Background: The demographics of medical schools reveal a growing trend towards greater gender and underrepresented in medicine (UIM) representation among students, yet surgical residency lags behind. This study explores the demographics of first-year medical students (M1s) and their initial career interests.

Methods: A panel of faculty physicians and fourth-year medical students in surgical and nonsurgical specialties was held for M1s during orientation week. Demographic differences and career interests were collected.

Results: Fifty-six M1s, 31 (55%) female and 13 (24%) UIM, attended the event. While 35 students (62.5%) reported interest in surgery, only 7 (20%) identified as UIM and 16 (46%) as female.

Conclusion: Initial interest in surgery is comprised of mostly male and non-UIM students. Throughout medical school, this pattern persists, with current match rates into surgery not reflecting the population of students. Focusing on initial interest to surgery is crucial as it is the foundation for the pipeline of diversifying future surgeons.