Journal of Medical Education and Curricular Development最新文献

To enhance teamwork and patient safety, it is crucial to implement training in both inter- and intraprofessional communication within healthcare setting. Simulation-based learning provides a practical and structural approach, offering realistic, hands-on experiences to enhance communication skills. This study used a descriptive mixed-methods design to evaluate a 4-day simulation-based training programme developed to enhance the inter- and intraprofessional communication skills of medical students. A total of 216 students (eight cohorts) participated. The students participated in a variety of activities designed to stimulate the various roles of physicians, including hospital physicians, general practitioners, and public health physicians. These activities included the performance of authentic tasks such as the composition of referral letters, consultation with colleagues, and participation in multidisciplinary meetings (MDMs). The programme incorporated interactive assignments, standardized patient interactions, and real-time feedback, in addition to reflection and formative assessment, with the objective of reinforcing skills and preparing students for collaborative practice in a variety of healthcare settings. Quantitative evaluation results showed that students rated the outpatient clinic component with a mean score of 4.3 and the MDM with 3.3 on a five-point scale (1 = poor, 5 = very good). After participation in the simulation students perceived enhanced communication skills and increased understanding of the importance of collaboration across healthcare disciplines. Participants expressed a high level of satisfaction with the authenticity of the tasks and reported an increased sense of preparedness for their clerkships. These findings serve to demonstrate the perceived effectiveness of simulation-based education in the context of medical training. As the results are based on self-reported perceptions, they reflect perceived rather than demonstrated efficacy.

Medicine requires physician-leaders trained in interdisciplinary problem-solving and in responding to complex adaptive systems. The rapid pace of technological change poses an unmet need for physicians who have aptitude in engineering, informatics, systems design, entrepreneurship, and other creative problem-solving tools to improve the health of society. The Medical Innovators Development Program (MIDP) is a MD candidate training program that was designed to meet this growing need. MIDP blends various frameworks including Design Thinking, Biodesign, Lean Six Sigma, the Business Model Canvas, and others into a 4-year curriculum that is integrated into the core MD curriculum. The capstone experience is a 3-month immersive team-based course in stakeholder discovery, design prototyping, and pitching solutions to address clinical needs identified during clerkships. The MIDP offers a roadmap for MD students to gain skills in and apply innovation and design fundamentals to self-discovered clinical needs. MIDP students have seen success in various ways: presentations to the Board of Trust, participation in the prestigious I-Corps program, multiple entrepreneurial pitch competition wins, institutional pilots, and to date, four technology transfer intellectual property disclosures. MIDP's next steps focus on scaling impact. Specific aims include building internal infrastructure for further development of promising "orphan" ideas after students graduate, facilitating interprofessional opportunities for undergraduate and graduate student collaboration, maintaining an active alumni network, and inspiring other similar integrated MD programs.

This comprehensive review examines the emerging role of narrative medicine in radiation oncology education, exploring its theoretical foundations, implementation models, and reported outcomes. A systematic literature search was conducted across major databases, including PubMed/MEDLINE, Embase, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Scopus, ClinicalTrials.gov, and World Health Organization's International Clinical Trials Registry Platform for relevant studies published between January 2000 and March 2025. This comprehensive review approach enabled synthesis of diverse evidence types and implementation models in this emerging field. Despite the growing body of literature on narrative medicine in general medical education, its specific application within radiation oncology remains limited but promising. The review identifies several key domains where narrative medicine interventions show potential: Enhancing communication skills with patients undergoing complex treatments, developing resilience among trainees facing emotionally challenging clinical scenarios, and addressing burnout among radiation oncology professionals. Preliminary evidence, primarily from single-institution studies at large academic centers, suggests that structured reflective writing programs and narrative oncology curricula may effectively complement technical training in radiation oncology residency programs. However, significant gaps exist in the literature regarding standardized implementation approaches and rigorous outcome assessments. Cultural adaptations for implementing narrative medicine across different healthcare contexts are also explored. This review concludes that while narrative medicine offers promising approaches to humanize radiation oncology education, more robust research is needed to establish best practices, evaluate long-term impacts, and address implementation challenges in this highly technical specialty.

Background: Since 2020, Culinary Medicine (CM) has been offered as an elective for medical students at several German universities. Recently, innovative teaching models such as the inverted classroom have been introduced. This study investigates whether the inverted classroom model, using online self-learning modules in the CM elective, improves students' nutritional knowledge and counseling skills compared with traditional in-person lectures.

Methods: The CM elective consisted of seven modules on dietary principles and disease-specific dietary therapy. The in-person cohort attended traditional lectures, while the inverted classroom cohort completed weekly online self-learning modules covering the same nutrition therapy content. Both groups participated in identical hands-on cooking sessions in teaching kitchens. Teaching effectiveness was assessed using standardized self-assessment questionnaires on counseling competencies, nutrition knowledge, eating habits, and mental well-being (WHO-5), administered before and after the elective. Paired and unpaired t-tests were used for analysis.

Results: The study included 69 students in the inverted classroom and 80 in the in-person cohort. Both formats, when combined with hands-on cooking courses, led to significant improvements in nutritional knowledge, self-reported counseling skills, and practical abilities. No significant differences were observed between the cohorts.

Conclusion: The inverted classroom model is as effective as in-person lectures when combined with hands-on cooking courses in a CM curriculum. Institutions can select the format based on local resources without compromising teaching outcomes. This study highlights the advantages and disadvantages of each method, supporting institutions in the development of improved CM curricula.

Background: Motivation is a key determinant of engagement, learning, and well-being for medical students. Guided by Self-Determination Theory, this study examined the intrinsic and extrinsic contributions to motivation across the medical school curriculum using the Work Extrinsic and Intrinsic Motivation Scale (WEIMS).

Methods: This longitudinal study surveyed medical students using the 18-item WEIMS at 5 timepoints: 0 months (matriculation), 12 months, 18 months, 30 months, and 48 months (graduation). Subscales represented 6 motivational types: Intrinsic, Integrated, Identified, Introjected, External, and Amotivation. While the first three subscales reflect forms of autonomous or self-driven motivation, the latter three capture motivation influenced by external pressures or the absence of motivation, altogether. Composite indices included the Work Self-Determination Index (W-SDI), which summarizes how much a person's motivation comes from within themselves versus outside pressures. Reliability was assessed with Cronbach's alpha, and longitudinal differences were evaluated with 1-way analysis of variance and Welch t-test (Holm-corrected).

Results: A total of 1828 surveys were analyzed. Overall, Work Self-Determined Motivation was significantly higher than Work Non-Self-Determined Motivation at all measured timepoints. W-SDI scores were significantly higher at matriculation (mean (SD): 15.387 (5.99)) compared to 18 months (12.13 (6.94), P < .0001), 30 months (12.50 (7.16), P < .0001), and 48 months (13.59 (6.89), P < .01). This decrease in W-SDI arose from significant (P < .0001) increases in external regulation at 18 months (0.52), 30 months (0.54), and 48 months (0.52), as well as a significant increase in amotivation at 18 months (0.32, P < .01) and 30 months (0.29, P = .012).

Conclusions: Medical students' motivation is dynamic throughout training. Self-determined motivation is higher than non-self-determined motivation at all time points but declined slightly throughout training. These results may help guide the development of curricula that enhance autonomy, competence, and relatedness to sustain intrinsic motivation throughout medical education.

Background: Peer-assisted learning (PAL) has been increasingly adopted in undergraduate medical education as a strategy to enhance the acquisition of clinical skills. Its potential to promote collaborative learning, cost-effectiveness, and professional development makes it an attractive pedagogical approach. However, the evidence surrounding its implementation and outcomes in clinical skills teaching remains scattered.

Methods: We conducted a scoping review following the PRISMA-ScR guidelines to map the extent, range, and nature of the literature on PAL in undergraduate clinical skills education. Relevant studies were identified through searches of PubMed, Scopus, Web of Science, and ERIC from inception to 17 September 2024. Articles were included if they examined PAL interventions involving undergraduate medical students in clinical skills training. Data were extracted on study characteristics, implementation strategies, outcomes, and reported challenges.

Results: A total of 95 studies met the inclusion criteria. PAL was applied across a range of clinical skills including history taking, physical examination, procedural skills, and communication training. Reported benefits included improved student confidence, enhanced skill acquisition, and positive perceptions of peer tutors and learners. Challenges included variability in tutor training, assessment methods, and sustainability of programs. Evidence gaps were noted in long-term outcomes and standardization of evaluation tools.

Conclusions: PAL is a valuable educational approach for teaching clinical skills in undergraduate medical education, with benefits for both tutors and learners. Further research is needed to establish standardized frameworks, assess long-term impact, and guide integration into formal curricula.

Background: Multiple-choice questions (MCQs) remain central to assessment in medical education, but their development is resource intensive. Generative artificial intelligence (AI) offers a potential solution by automating MCQ creation. However, little is known about the psychometric quality of AI-generated MCQs compared with human-authored items, particularly in pediatric education.

Objective: This study aimed to directly compare the quality of AI- and human-generated MCQs in pediatrics using item analysis grounded in classical test theory.

Methods: A formative exam comprising both AI (Microsoft Copilot) and human-generated pediatric MCQs was administered to 4th-year medical students. Item analysis was performed to calculate difficulty indices, discrimination indices, item-total correlations, and distractor functioning. Reliability was assessed using KR-20. Descriptive and inferential statistics, including paired t-tests, compared performance between AI and human items.

Results: Human-authored questions outperformed AI-generated questions across all quality indicators. AI questions showed lower discrimination (mean 0.19 vs. 0.29) and a higher proportion outside the acceptable difficulty range (56% vs. 32%). Distractor analysis also favored human questions, with fewer nonfunctioning distractors and more items containing fully functional distractors. While some AI items met ideal psychometric thresholds, overall consistency was lower.

Conclusion: Generative AI in its current form cannot yet match human expertise in producing consistently high-quality MCQs for pediatrics. However, AI shows potential as a supplementary tool, particularly within hybrid human-AI workflows that combine efficiency with expert oversight. These findings highlight both the opportunities and limitations of AI in medical education assessment and underscore the importance of balancing reliability, validity, acceptability, and cost-effectiveness when integrating AI into assessment design.

Background: This study aims to determine the prevalence of perceived unfairness in authorship inclusion and byline ordering, two common concerns in the literature on authorship, among a sample of the physician population at the University of North Carolina School of Medicine.

Methods: We developed and distributed a survey among eight different departments at a large U.S. academic medical center, with questions pertaining to basic demographics, contributions to research, and perceptions of authorship inclusion and ordering on their publications. Responses were analyzed using chi-squared test for predictors of perceived author order misplacement or exclusion from authorship.

Results: Out of 83 respondents (9.2% response rate) from eight clinical departments, 52% perceived unfair authorship ordering and 34% perceived unwarranted exclusion from a project. Perceived lower positioning of the author byline was reported to occur more commonly in the earlier stages of training (medical student and resident levels). The most common reasons for these occurrences were related to issues with communication.

Conclusions: Difficulties around communication and the hierarchical nature of medical training contribute to the perceived unfairness of author ordering and authorship inclusion. Structured authorship agreements and education in publication ethics may reduce these perceived inequities.

Introduction: To deliver evidence-based care, medical professionals must be able to critically appraise scientific literature, a skill often underemphasized in traditional medical education.

Methods: Supported by the teaching commission of the Medical Faculty of Otto-von-Guericke-University Magdeburg, a novel didactic approach was developed, integrating elements of a Journal Club (JC) with e-learning modules, supervised by a mentor. This approach aims to deepen and apply scientific skills acquired in earlier stages of medical education. Final-year medical students independently select, critically evaluate, and present a scientific paper in a JC that is related to a specific patient. Simultaneously, they are required to complete six online modules (including an orientation module) covering the topics evidence-based clinical practice, literature search, Critical Appraisal Skills Program, basic statistical analysis, and effective presentation skills.

Results: In the pilot phase, 25 students and five mentors participated, with 20 students and four mentors completing the evaluation. Students rated the teaching project as relevant (mean 2.4, scale 1 - 4) but expressed mixed views on its suitability for final year (mean 2.5). Self-assessment scores improved across all five learning outcomes, with notable increases in students' confidence to evaluate clinical relevance and study strengths/weaknesses. Digital modules were rated as comprehensible (scores 1.5 - 2.0) and useful for JC preparation (scores 2.1 - 2.6). The overall teaching project received a mean rating of 2.8 (scale 1 - 6), with 58% (n = 19) of students recommending the course. Mentors unanimously rated the project as highly beneficial (100% recommendation rate).

Conclusion: The evaluation of the pilot phase indicates that this teaching project has the potential to significantly enhance students' ability to critically engage with scientific literature. Ongoing refinement based on feedback and planned implementation across all departments aim to promote sustainable scientific literacy in clinical training.

Background: Health professions education (HPE) is increasingly framed as a matter of social responsibility and accountability. This study examined how discourses of Total Quality Management (TQM), Quality Assurance (QA), and Quality Culture (QC) construct the meaning of quality in HPE.

Methods: A Foucauldian discourse analysis (DA) approach was conducted to examine how the discourses of TQM, QA, and QC construct meanings of quality in higher education (HE). Academic articles were systematically identified in Education Resources Information Center, and discursive patterns and power-knowledge relations were compared within and across the 3 frameworks.

Results: QC was portrayed as a participatory, value-driven approach, contrasting with QA's emphasis on external control and compliance. TQM framed quality as a strategic resource for competitiveness, mobilizing internal power toward market advantage.

Conclusions: Quality discourses function as regimes of truth that shape governance and institutional priorities. Hybrid models combining QC's cultural foundation with QA's regulatory mechanisms may support socially responsible quality development in HE and HPE.