Journal of Medical Education and Curricular Development最新文献

Background: Health professional education is essential for training effective clinicians and skilled health workers, supporting universal healthcare. It includes disciplines like medicine, nursing, and allied health across various institutions. The educational climate significantly affects teaching, learning, and student satisfaction, impacting curriculum success and academic achievement. A competency-based curriculum (CBC) focuses on applying knowledge, skills, attitudes, and values, enhancing graduates' readiness for the labor market. While instructors have concerns about CBC adoption, its proper implementation can improve educational quality and graduate competencies. This study will examine the experiences and challenges faced by university instructors in implementing CBC in Ethiopian health science colleges and seek strategies to address these challenges effectively.

Methodology: This study adheres to the phenomenological theory and uses a qualitative research methodology. The study includes 20 male and 16 female instructors, school deans, department heads, and module coordinators from 2 universities. The investigation focuses on themes related to training, administration, motivation, and resources as well as potential strategies to overcome the challenges in CBC implementation.

Results: The study investigated various factors affecting the implementation of CBC. The findings indicate that the most common challenges are inadequate training for instructors regarding the curriculum and shortage of educational resources necessary for its implementation. Additionally, challenges related to motivation, administration, and resources were identified as contributing factors that hindered CBC implementation. Beyond identifying these barriers, the study proposes context-specific strategies, including targeted faculty development programs, optimized resource allocation, and enhanced administrative support, which collectively aim to improve curriculum adoption and effectiveness. These findings provide actionable insights to inform policy and practice in similar educational environments facing implementation hurdles.

Conclusion and recommendation: To effectively implement a CBC in Ethiopian health science colleges and prepare graduates for the job market, several key actions are necessary. University administrators, departments, and instructors must engage in discussions to identify solutions. Continuous awareness, capacity-building training, and organized workshops on CBC are crucial for overcoming the major challenges. Moreover, prioritizing human and material resources, equipping demonstration and simulation rooms, and expanding practical sites are essential interventions to facilitate its implementation. Additionally, effective communication with all stakeholders is vital for successful CBC implementation.

Background: The ability to provide informed consent (IC) is a critical component of patient autonomy. Medical training programs have recognized the importance of training physicians to become skilled in obtaining IC, but few have reported curricula that address IC separately from broader ethical principles. This review aims to consolidate current methodologies and outcomes regarding medical education on informed consent.

Methods: Adhering to PRISMA-ScR guidelines, studies were obtained from PubMed and MedEdPORTAL that focused on evaluating the need for informed consent education and on assessing strategies to teach informed consent. Educational programs or assessments that focused broadly on medical ethics without a specific focus on the teaching of informed consent were excluded.

Results: Of 142 abstracted articles, 59 were included for analysis. 34 were categorized as needs-assessments, while 25 were interventions. Across various medical and surgical specialties and training levels, there is a need for more robust education on informed consent. No standard process for training medical learners about this topic exists currently. Of the interventions examined, both didactic curricula and simulation-based modalities demonstrated efficacy in improving knowledge and comfort levels with IC.

Conclusions: This review summarized both studies on needs assessments of IC education in medical training and on interventions to improve trainees' skills in obtaining IC. Though obtaining IC is a critical clinical skill for nearly all clinicians, there is no consensus method to teach IC, satisfaction with current IC education is low, and debate exists on whether IC can ever be entrusted to trainees. These important gaps in IC education suggest a need to develop a structured, systematic approach to providing IC education in order to assure competency in this essential skill for patient safety and trainee wellness.

Coaching is a creative process of inquiry and feedback that helps individuals increase self-awareness and build on strengths. Although individualized executive-style coaching has become popular among physicians, empowering physicians to adopt coach-like communications skills in medical education and clinical encounters could extend the benefits of coaching across medicine. However, professional coaches undergo lengthy training, and most physicians do not have the time, inclination, or need to become certified coaches. Therefore, we created an intensive, streamlined "physician coaching-as-communication" (PCC) curriculum to train physicians in a select subset of essential coach-like communication skills to use during spontaneous encounters with colleagues, medical trainees, and patients. Our goal was not to prepare physicians to provide formal coaching; rather, our aim was to help them cultivate a coaching mindset, identify everyday situations that could benefit from coach-like conversations, and apply some key coach-like communication skills during appropriate interactions. Here we describe the 2-phase development of the PCC curriculum, highlight the coach-like skills that support effective communication, and outline the key curriculum features that situate training into a clinically relevant and feasible framework for practicing physicians. We also present findings from a quality improvement evaluation that assessed acceptability and feasibility of the coaching curriculum for medical faculty and resident trainees. Lastly, we outline the key elements needed for a successful intensive program to help clinicians become skilled with using coach-like communication behaviors in appropriate clinical situations.

Introduction: Teaching faculty is vital to the success of academic institutions. Academic biomedical faculty has faced greater workloads, and limited access to development opportunities. The Academy of Educational Scholars (AES) was designed as a community of practice with an embedded educational research fellowship to address the challenges of building and sustaining educational scholarship as recognized value for academic biomedical faculty careers.

Methods: An educational project-based, one-year faculty fellowship served to identify faculty motivated to join a community of practice. Fellowship curriculum development was guided by a literature review, internal needs' assessment, and the Kerns six-step framework. The program comprised ten 3-hour workshops and two project critique sessions delivered at monthly intervals over 12 months. Immediate session evaluations and a comprehensive program evaluation were conducted, assessing program value, and improvements in educator confidence in knowledge and skill. Outcome measures included presentations at local and national conferences, numbers of abstracts submitted, publications, grant submissions and new educational roles taken on.

Results: Fellowship graduates from first 2 cohorts demonstrated a statistically significant improvement in knowledge about educational scholarship (p = 0.01) and related skills (p = 0.01). Program satisfaction was 93%. Content analysis revealed the most impactful program features were networking and joining a community focused on educational scholarship. AES fellow-produced scholarship includes 7 local/regional presentations, 10 abstracts, 6 publications, 4 grant submissions, 2 funded educational grants, and 4 new educational leadership roles. AES community activities include an annual retreat, monthly journal clubs, a teaching excellence recognition program, and a scholarship consult service.

Conclusion: Embedding an educational research fellowship into a community of practice is an effective model for building a sustainable teaching academy. Identifying local talent and incorporating member service expectations has minimized cost while incentivizing a volunteer model. Building the community of practice entailed intentional recruitment of mature educational scholars and novice fellows.

Background and objectives: Faculty development plays a pivotal role in enhancing teaching, research, educational, and clinical leadership, as well as in fostering career and professional development, which helps improve medical education. Despite its importance, engagement in faculty development programs is roughly variable among educators. This study aimed to identify and explain the factors influencing the participation of basic and clinical science faculty members in an online medical education faculty development course at medical universities.

Methods: This study was conducted in Iran between July 2022 and May 2023. Data were collected through an online qualitative survey and semi-structured telephone interviews with faculty members who were actively involved in or graduated from a virtual master's program in medical education. An online qualitative survey was first conducted with 86 participants in the faculty development program to obtain a wide understanding of their experiences. Subsequently, follow-up telephone interviews were conducted with faculty members who were engaged in the program to gain richer and deeper information, and this continued until data saturation was achieved (N = 8). All data were analyzed thematically to identify factors linked to faculty participation.

Results: Five major themes emerged: (1) professional and occupational factors, highlighting the importance of career advancement and job requirements; (2) individual factors, focusing on intrinsic motivation and self-efficacy; (3) social factors, reflecting the influence of peer support and social status; (4) educational and academic factors, emphasizing the necessity of innovative teaching methods; and (5) managerial/leadership and organizational factors, addressing the significance of institutional support and leadership in promoting development.

Conclusion: This research provides valuable insights into the factors affecting faculty participation in development programs. By understanding these dynamics, educational institutions can consider initiatives (such as material and immaterial incentives, flexibility in program delivery, balancing teaching, research, and clinical service delivery, and promoting organizational culture and support) that enhance faculty engagement.

Introduction: ChatGPT has shown remarkable performance in medical licensing examinations such as the United States Medical Licensing Examination. However, limited research exists regarding its performance on national medical licensing exams in low-income countries. In Nepal, where nearly half of the candidates fail the national medical licensing exam, ChatGPT has the potential to contribute to medical education.

Objective: To evaluate ChatGPT's (GPT-4) performance on the Nepal Medical Council Licensing Medical Examination (NMCLE).

Methods: The NMCLE-May 2024 dataset, comprising 900 multiple-choice questions, was used to assess ChatGPT's performance. After excluding 8 questions that contained figures or were not compatible with text-only input, 892 questions were analyzed. Specific prompt, including a background description, question, and choices, was entered. The response generated by ChatGPT was compared taking responses from experienced clinicians as a reference. Descriptive statistics were used to present the results, and regression analysis was employed to determine the association between variables, including set, question type, pattern, and subject, and incorrect responses.

Results: GPT-4 generated 783 correct responses in 892 questions, an accuracy rate of 87.8%. Incorrect responses were more likely with questions requiring logical reasoning (odds ratio 14.7, 95% confidence interval [CI] 8.94-24.16).

Conclusions: ChatGPT-4 performs at a standard comparable to or above that of medical graduates on the Nepalese undergraduate medical licensing examination. Incorrect responses were mainly in questions requiring logical reasoning, underscoring the need for caution when relying on its outputs in the same. These findings are encouraging and highlight the need for further studies to evaluate its role as an educational resource in Nepalese medical education.

Objective: The purpose of higher education, particularly in the medical fields, is to serve humanity, and reflect on core values such as compassion, care, and empathy. This study examines how medical students uphold moral values as they progress through their education, addressing a research gap in the Indian context.

Methods: After obtaining Institutional Ethics Committee approval, a cross-sectional survey was conducted using a self-administered Google questionnaire. Content validity was ensured through consultations with 5 experts, and reliability was confirmed with a Cronbach's alpha coefficient of .75. Data were collected from medical students in India using snowball sampling and analyzed using median, interquartile range, chi-squared test, Pearson correlation coefficient, and multiple regression analysis. The sample size was set at 518, taking into account the nonresponders.

Results: Of 1500 invites, 526 students responded, which corresponds to a response rate of 35.06%. Reliability analysis revealed a high internal consistency (α = .927), and the data were suitable for factor analysis (Kaiser-Meyer-Olkin = 0.929). Principal component analysis identified three factors: Authority and Materialism, Enjoyment and Adventure, and Ethics and altruism, which explained 56% of the variance. Significant gender differences in Ethics and altruism were found. Correlation analysis revealed moderate positive relationships between authority and materialism and both enjoyment and adventure and ethics and altruism. Multiple regression showed that authority and materialism significantly impacts ethics and altruism (β = 0.684, p < .001), whereas enjoyment and adventure had a nonsignificant influence. Women performed better than men in ethics and altruism. This finding is discussed taking into account the unequal gender distribution.

Conclusion: The study shows that medical students prioritize ethics and altruism over authority and materialism, with enjoyment and adventure playing a balancing role. The significant influence of authority and materialism on ethics and altruism suggests that competitive and materialistic values influence ethical priorities. Understanding how different factors impact values and well-being can guide educators and policymakers in fostering ethical practices and supporting student resilience.

Purpose: The demographic composition of United States (US) medical school leadership remains underexplored, despite growing recognition of workforce disparities in gender, race, and specialty. These gaps may affect patient care, mentorship, and education. This study examines demographic patterns in US allopathic medical school leaders relative to the broader physician and general US populations.

Methods: From June 2023 to January 2024, we reviewed 154 US allopathic (MD) medical schools. We analyzed individual leadership structures and patterns in each institution. Institutional websites and publicly available sources were used to collect data on leadership demographics (gender, race, age), academic background (degrees, specialty), prior leadership roles, and research productivity via PubMed searches.

Results: In total, 154 allopathic medical schools in 46 states met inclusion criteria. We identified 1097 individuals (56.97% male, 70.46% White/Asian) serving as Dean, Senior Associate Dean, Assistant Dean, or equivalent. Most leaders held an MD or equivalent (76.12%), while 23.79% held solely a PhD. The majority practiced nonprocedural specialties (61.71%) and had prior leadership roles, such as Department Chair/Vice Chair (34.28%) or Program Director/Associate Director for Residency or Fellowship (18.24%). Most held or had held professorships (68.55%).

Conclusions: Most allopathic medical school leaders come from nonprocedural specialties, which may influence students' mentorship access and specialty choices. With gender, race, and specialty disparities existing among medical leadership, diversification of these leaders could enhance the medical school learning environment, broaden mentorship, and help align the physician workforce with the population it serves.

Objective: To evaluate whether early exposure to cadaveric surgical simulation influences preclinical osteopathic medical students' interest in pursuing surgical specialties.

Design: This single-blinded, prospective cohort study utilized pre- and post-simulation surveys to assess changes in specialty interest among participants. Responses were analyzed using Wilcoxon signed rank tests with significance set at P < .05.

Setting: Pacific Northwest University of Health Sciences, College of Osteopathic Medicine (PNWU-COM), during the 2024-2025 academic year.

Participants: Thirty preclinical osteopathic medical students (OMS1 and OMS2) volunteered, with 29 completing all study components (response rate: 97%). Of these, 20 (69%) identified as female and 9 (31%) as male; 19 (66%) were OMS1 students, and 10 (34%) were OMS2 students.

Results: Following participation in two cadaver-based surgical simulations-cardiothoracic and orthopedic-students demonstrated significant increases in overall interest in surgery (P = .004), cardiothoracic surgery (P = .001), and orthopedic surgery (P = .007). Additionally, interest in procedural care and the likelihood of pursuing a surgical residency increased significantly (P = .028 and P = .014, respectively). Conversely, interest in family medicine (P = .022) and internal medicine (P = .021) declined. Notably, 86% of participants reported that the cadaveric simulations influenced their perception of surgical fields, with nearly all stating that early exposure impacted their career considerations.

Conclusion: This pilot study strongly suggests that cadaveric surgical simulation significantly increases interest in surgical careers among preclinical osteopathic medical students. The impact was particularly strong in specialties directly represented in the simulations and among first-year students. These findings highlight the potential value of integrating structured surgical experiences into the early curriculum at osteopathic institutions, especially those without direct affiliations to major academic medical centers. Such interventions may help address the underrepresentation of osteopathic graduates in surgical residency programs and ultimately broaden diversity in surgical care.