Journal of Medical Education and Curricular Development最新文献

Contemporary medical education (ME) curricula are vastly devoid of affirmative integration of the social determinants of health (SDH) despite growing evidence of implications for future physicians' practice and influence on population health outcomes. Where incorporated, several programs still lack a population health-centric approach in curriculum design. Most publications focus on the academic implications from SDH integration in curricula. Our work extends to a more global perspective, highlighting the impacts of disparities in the integration of SDH on physicians' readiness and competence to influence population health outcomes. We highlight not just the inequitable integration across countries and ME programs, but also the significance for future physicians' thinking and approach to practice. From our work, we expect academic administrators to become more aware of the value of population-centric content in ME to address the global high burden of preventable diseases. We also hope to raise awareness among prospective students about the health needs of societies, driven by upstream determinants, and how such needs may reflect downward to patients' conditions. We conclude that affirmative SDH integration in ME is a necessary step to realigning medical practice for better population health outcomes, particularly in developing countries, where poorer health outcomes and socioeconomic conditions are closely interrelated. Our findings underscore the need for improving instructional design and content with a greater focus on global health impact, integrating the community as a learning space and source of co-educators, and realigning institutional policies to enable smoother SDH integration in curricula.

Background: Investing in developing the research skills of medical students is crucial for improving the healthcare systems. This study assesses the knowledge, attitudes, experiences, and barriers to research as perceived by undergraduate clinical year medical students at Addis Ababa University, Ethiopia.

Methodology: A cross-sectional study design was used to assess the knowledge, attitudes, experiences, and barriers to research among clinical year undergraduate medical students at Addis Ababa University, Ethiopia. The study population included clinical-year medical students at Addis Ababa University, College of Health Sciences, from April 1, 2023, to August 1, 2023. The final sample size was calculated to be 244. Stratified random sampling was used to select study participants. On the basis of the strata, 99, 70 and 75 responses were expected from 4th year, 5th year and 6th year medical students, respectively. The selected participants were requested to fill out the Google forms. ANOVA and t tests were used to study the associations between knowledge score and age, sex, and year of study.

Results: The average knowledge score ± SD of the participants was 43.1% ± 17.07%. There was no significant association between knowledge score and age (P-value .129), sex (P-value .774), or year of study (P-value .150). A total of 72.5% reported medical school as their primary source of education/training in research. In terms of the roles taken in the research, only 38 (15.6%) had participated as primary investigators. A total of 134 (54.9%) participants participated as data collectors, 59 (24.2%) participated in data analysis, and 25 (10.2%) participated in writing. Among the major barriers mentioned, lack of opportunity in research (56.1%) took the lead, followed by lack of time (54.1%), lack of guidance and supervision (48.8%), and lack of resources (28.3%). Data analysis and logistics and finances were reported as challenging factors for conducting research.

Conclusion: Overall, in this study, knowledge of clinical year medical students on research was inadequate. While research was noted as crucial by majority of the students in this study, lack of opportunity, time, resources, guidance, and supervision were the major barriers faced by the participants. This calls for collective action by the college administration to work on investing more resources and providing research opportunities to medical students.

Graduate education in laboratory medicine plays an increasingly important role in supporting precision diagnostics and interdisciplinary care; however, in oral specialty hospitals, training models largely remain derived from general medical laboratory paradigms. This misalignment limits students' ability to effectively engage with oral disease-specific biospecimens and integrate laboratory findings into oral healthcare practice. This article presents a practice-based, descriptive analysis of limitations in existing training curricula and their alignment with clinical diagnostic practice. Based on institutional diagnostic experience, a reform-oriented educational framework is proposed, emphasizing disciplinary integration through an "Oral + Laboratory" curriculum, clinical-research co-training pathways, and multidisciplinary collaboration mechanisms. The overarching goal is to inform educational innovation aimed at preparing laboratory professionals capable of supporting precision oral healthcare.

Background: Multiple-mini-interviews (MMIs) are the most commonly used non-academic assessment tool for British medical school admissions processes. Potential inconsistencies can arise from running MMIs, such as differing marking standards among interviewers and stations with varying levels of difficulty.

Methods: With the aim of analysing MMI data, the cumulative probit mixed model was deployed which accounts for latent sources of variation inherent to MMI scores - both external factors, such as interviewer behaviour and station complexity, as well as the factor of interest - candidates' true performance at interview. With the secondary aim of making this methodology more accessible to non-statistical experts, we developed a user-friendly application using R Shiny. The app was created to standardise MMI scores and generate feedback for interviewers without requiring prior knowledge of programming.

Results: MMI data from Lancaster Medical School were analysed for the academic year 2022-2023. Applicant ability (n = 352) contributed to 22.94% of the total variance in MMI scores. Notably, interviewers (n = 83) contributed a smaller proportion of variance (10.79%). Station difficulty (n = 9) had a minor impact on variance (2.23%), with inter-station reliability being acceptable based on the Cronbach's alpha value (α = 0.7072).

Conclusion: The current method provides a statistically robust approach towards the analysis of MMI scores. In addition, its companion application can be used by admissions staff to communicate feedback to interviewers on their scoring patterns and identify stations that are better at discriminating applicants' ability. The illustrated approach can be adapted for use by other medical institutions that use MMI scores to rank candidates during their admissions processes. Future research could investigate how to extend the proposed modelling approach to address applicants' background factors, such as socio-economic status, for more comprehensive analysis and more equitable offer allocation.

Background: Chemical, biological, radiological, and nuclear (CBRN) emergencies pose major global health threats, especially in geopolitically sensitive and disaster-prone regions. Nurses, as key frontline responders, must possess sufficient knowledge, a positive attitude, and operational readiness to effectively manage such high-risk events. Simulation-based education-particularly tabletop exercises (TTEs)-is increasingly recognized as an effective method to enhance disaster preparedness in healthcare settings.

Objective: This study evaluated the effectiveness of a CBRN-focused TTE in improving nurses' knowledge, attitude, and preparedness in a hospital environment.

Methods: A quasi-experimental one-group pretest-posttest design was employed involving 60 hospital nurses in Iran. Participants completed validated tools measuring CBRN-related knowledge (26 items), attitude (11 Likert-scale items), and preparedness (modified 45-item Emergency Preparedness Information Questionnaire). A structured tabletop scenario was conducted, followed by re-assessment 1 week later. Paired t-tests and Pearson correlation analyses were performed.

Results: post-intervention analysis revealed statistically significant improvements across all domains: knowledge (mean difference = + 8.13, 18.5% improvement, P < .001), attitude (+2.35, 10.0% improvement, P = .039), and preparedness (+30.04, 32.4% improvement, P < .001).

Conclusion: TTEs effectively improve nursing competencies related to CBRN response. Findings indicate that preparedness showed the greatest relative improvement, supporting the integration of TTEs into regular professional development programs to build readiness capacities.

Introduction: Medical professionalism may be defined operationally as an amalgamation of behaviours, attributes, and adherence to standards. Assessing professionalism is challenging due to its broad and contextual nature, but also due to ambiguity around expectations of students within a given scenario. This qualitative study explores the respective opinions of students and teaching faculty at UK medical schools as to what constitutes "adequate professionalism" at defined milestones during undergraduate medical education.

Methods: Fifteen key professionalism themes were identified from published regulatory guidance. Four behavioural descriptors were written for each theme, using the lens of Miller's Pyramid to describe how a medical student might progress from "novice" to "proficient" across 4 defined milestones of their undergraduate medical school career. Using an online survey, students and faculty at UK medical schools were invited to provide their opinions as to what constituted "adequate professionalism" at each milestone, with respect to each theme.

Results: Eight medical schools participated in the study. A total of 112 responses were received from 74 (66.1%) medical students and 38 (33.9%) faculty members. The data mapped students' journeys from "novice" to "proficient" as they transited the respective milestones of entering medical school, first patient contact, regular patient contact, and graduation. Student and faculty respondents broadly agreed about what defined "adequate professionalism" at each milestone. However, faculty expressed higher expectations than students in 1 theme, while students had higher expectations than faculty for at least 1 milestone across 10 themes. In some themes, students were expected to perform above the "most novice" descriptor at the first milestone. In other themes, students were not expected to reach the "most proficient" descriptor by the final milestone.

Conclusions: This study benchmarks "adequate professionalism" for medical students at defined milestones in the undergraduate medical curriculum. Its insights provide opportunities for curriculum planning, granular assessment of professionalism, and raise several further research questions.

Advances in genomics have transformed histopathology, especially in oncology teaching. Histopathologists traditionally assess tissue morphology, but now integrate genomic data to enhance diagnostic accuracy and treatment precision. Students must grasp both disciplines and appreciate the multi-disciplinary nature of modern oncology. To address this, and deliver content in an engaging way, we developed a computer-based virtual reality laboratory experience (the VR-Lab), seamlessly integrating genomics and histopathology into case-based learning, and undertook descriptive evaluation of user engagement with the VR-Lab. This demonstrated enhanced student engagement compared to a conventional workbook, although the provision of a complementary workbook was beneficial for some. We conclude that integrating technology-enhanced learning approaches, such as the VR-Lab, alongside traditional resources like workbooks can enhance student engagement with teaching materials and provide students with the options to choose an approach that suits their learning preferences.

This study explores how physician mentors experienced their role within a preclinical patient safety and quality improvement (PSQI) project and the impact of mentorship on their professional development. Through qualitative interviews with 11 faculty mentors from diverse specialties, findings revealed that mentoring student-led PSQI projects enhanced mentors' understanding, confidence, and leadership skills in PSQI. Mentors described shifts in attitudes toward PSQI and increased motivation to lead future initiatives. The results suggest that mentorship not only supports learner development but also serves as an effective faculty development strategy to build PSQI capacity. These findings highlight mentorship as a practical approach to fostering faculty growth and leadership in PSQI and other emerging domains of medical education.

Purpose: This study assessed the association between holding an additional graduate degree beyond a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) and residency match outcomes. Specifically, the authors examined graduate degree attainment trends among residency applicants and evaluated whether graduate degree holders experience lower match rates than non-holders.

Methods: A retrospective, observational analysis was conducted using publicly available data from the National Resident Matching Program's Charting Outcomes in the Match reports (2016-2024). The 10 specialties with the highest applicant volumes were analyzed, encompassing 80 136 matched and 6820 unmatched U.S. MD and DO senior applicants. Trends in graduate degree attainment were evaluated using linear regression models. Match rates were stratified by graduate degree status and compared using two-proportion z-tests based on aggregated matched and unmatched counts for each specialty and overall.

Results: From 2016 to 2024, the proportion of graduate degree holders entering the match increased significantly for MD (15.77% to 18.29%, P = .0008) and DO (19.93% to 23.31%, P = .0151) applicants. Across all 10 specialties, graduate degree holders matched at lower rates than non-holders. Among MD applicants, graduate degree holders matched at 92.57% compared with 94.12% for non-graduates (P < .0001), with specialty-specific differences ranging from 0.22% in Psychiatry to 4.61% in Anesthesiology; five specialties demonstrated statistically significant disparities. Among DO applicants, graduate degree holders matched at 84.54% compared with 88.64% for non-graduates (P < .0001), with specialty-specific differences ranging from 1.44% in Family Medicine to 10.48% in Obstetrics and Gynecology; five specialties also reached statistical significance.

Conclusions: The proportion of graduate degree holders in the residency match is increasing, and these applicants experience lower match rates than non-holders. These findings challenge the assumption that additional graduate education provides a competitive advantage and underscore the need for further research into the applicant-level factors contributing to these disparities.

Background: Undergraduate research (UR) plays a pivotal role in medical education, fostering scientific thinking and professional development. At present, China lacks standardized tools to effectively appraise UR experiences among medical undergraduates. The Undergraduate Research Student Self-Assessment (URSSA), widely used in Western countries, has not been validated for Chinese populations and culture. This study aimed to translate and adapt the URSSA into Chinese and assess its psychometric properties for use with medical undergraduates.

Methods: The URSSA was translated following Brislin's model, including forward-backward translation, expert panel review, and pilot testing. The final Chinese version was administered to 165 medical undergraduates from Peking University Health Science Center with UR experience. Reliability was assessed using Cronbach's α and Guttman split-half coefficients. Confirmatory factor analysis (CFA) tested the four-factor structure (Skills, Thinking and Working Like a Scientist, Personal Gains, and Attitudes and Behaviors). Discriminant validity was examined by comparing scores across distinct subgroups.

Results: A total of 165 medical undergraduates were included, among whom 66.7% were majoring in clinical medicine. After rigorous translation and back-translation, we obtained the URSSA questionnaire suitable for the Chinese context. The Chinese URSSA demonstrated excellent reliability (Cronbach's α coefficients = .972; Guttman split-half coefficients = 0.956). CFA supported the original structure and related metrics for testing the overall fitness of the structural equation model, including χ²/df = 2.858, CFI = 0.790, and RMSEA = 0.106. Students with higher research engagement scored significantly higher on all four subscales (P<.01), confirming the capability of URSSA to differentiate among different groups of people.

Conclusions: The Chinese URSSA is a valid and reliable tool for assessing UR gains among medical undergraduates. Its adoption can aid in program evaluation and curriculum development. Future research should validate the tool nationally and explore its predictive validity for long-term academic outcomes.