Journal of Medical Education and Curricular Development最新文献

Purpose: Physician involvement in healthcare leadership is essential for improving healthcare systems, yet medical students' interest in future leadership roles is underexplored. This study aimed to examine first- and final-year medical students' interest in leadership roles.

Methods: In 2021, online questionnaires were distributed to both cohorts, yielding response rates of 94% (109/116) and 87% (95/109), respectively. A mixed-methods approach was employed to examine leadership interest. Free-text responses were first analyzed through inductive content analysis and subsequently, a quantification analysis was performed. Cohort comparisons were conducted to evaluate differences, and age and gender data were collected as background variables.

Results: First-year students exhibited greater optimism, viewing leadership as a natural extension of their careers. Final-year students increasingly prioritized clinical roles, reflecting the influence of physicians' identity formation and the demands of clinical practice. Final-year students exhibited lower levels of strong interest in leadership and higher levels of disinterest than first-year students. The quantified results aligned with these findings, as 38.5% of first-year students expressed strong interest, compared with 30.5% of final-year students. Conditional interest was higher among first-year students (30.3%) than among final-year students (24.2%), whereas disinterest was higher among final-year students (37.9%) than among first-year students (24.8%). Uncertainty regarding leadership roles was observed in both groups (6.4% of first-year and 7.4% of final-year students).

Conclusions: Differences in leadership interest suggest that increasing clinical responsibilities and physicians' identity formation may influence students' interest in leadership roles. Integrating early and longitudinal leadership education into clinical practice-emphasizing its clinical relevance and alignment with physicians' professional identity-may help sustain interest, support career-aligned leadership decisions, and better prepare future physician leaders.

Background: Surgical skills training in low-resource settings, such as Uganda, often relies on traditional didactic methods with limited hands-on experience, resulting in competence gaps among graduates. The flipped classroom model, a student-centered approach where foundational content is learned outside the classroom, and in-class time is used for active practice, offers a promising alternative, particularly for skill-based instruction. This study explored the feasibility and effectiveness of a simulation-based flipped classroom in teaching surgical suturing skills to third-year medical students at Soroti University.

Methods: This was a quasi-experimental study in which 55 third-year students participated in a flipped learning module that incorporated pre-class materials (videos, readings, and suturing kits) and in-class simulations using porcine skin. Outcomes were measured through pre-, post-, and 3-month follow-up multiple-choice tests for knowledge, as well as Objective Structured Assessment of Technical Skills (OSATS) scores for skill performance.

Results: Post-test knowledge scores showed a marked improvement compared to pre-test scores (mean gain = 39.9, P < 0.0001), with a normalization gain of 70%. In the OSATS observation checklist, most students were rated as competent (49%) or excellent (33%) immediately after training. At 3 months, knowledge retention was 88% despite a statistically significant decline (P < 0.0001). Interestingly, OSATS performance scores improved at 3-month follow-up (+3 points, P = 0.0011), suggesting procedural consolidation over time.

Conclusion: The flipped simulation model appears feasible and may be effective in enhancing early surgical skill, and knowledge acquisition and retention among medical students in low-resource settings. It fosters experiential learning and improves both cognitive and psychomotor competence. These findings support the potential for expansion to other skills and subsequent integration of this approach into undergraduate surgical training curricula in LMICs.

Clinical trial number: Not applicable.

Health professions education (HPE) is undergoing rapid transformation, yet the historical foundations of healthcare remain underexplored in most educational curricula. This paper presents a conceptual and instructional innovative model designed to integrate historical inquiry into HPE, with a focus on geriatric care and rehabilitation. Grounded in transformative learning theory, the model uses historical materials as disorienting dilemmas to challenge students' assumptions about aging, healthcare, and professional identity. Implemented within a blended learning format, the framework includes asynchronous engagement with curated historical sources, collaborative in-class analysis, and individual reflection. The pilot, launched in the Master of Science in Physiotherapy, Specialty Sports physiotherapy at Bern University of Applied Sciences, is designed to be adaptable across healthcare disciplines, including medicine, nursing, occupational therapy, and public health. The model promotes critical reflection, empathy, and ethical awareness by exposing students to the socio-cultural evolution of elderly care. It highlights how societal narratives have shaped clinical priorities, funding structures, and professional roles, insights often missing from traditional HPE. By engaging with historical voices and contexts, learners develop a deeper understanding of the contingent nature of healthcare practices and the importance of socially responsive care. Scalable and adaptable, the framework aligns with global trends in competency-based education, digital integration, and lifelong learning. It provides a replicable approach for institutions aiming to enrich curricula with historical depth and foster transformative learning. Ultimately, this model equips future health professionals to navigate complex clinical environments with contextual awareness, ethical principles, and a historically informed outlook.

Background: Patient safety, quality improvement, and health equity training in graduate medical education are important. However, effective curriculum development in these complex domains remains challenging.

Objective: To evaluate the impact of EQuIPS (Equity, Quality Improvement, and Patient Safety), a mandatory, longitudinal curriculum for family medicine residents using Kirkpatrick Model of evaluation.

Method: This study employed a quasi-experimental design across three phases (pre-EQuIPS, during EQuIPS rollout, post-EQuIPS) with retrospective data collection. We analyzed data from residents graduating from academic years 2016 through 2024 where EQuIPS was implemented a multifaceted bundled intervention. The outcomes were measured using Kirkpatrick Levels 2, 3, and 4 defined as completion of certification, reported participation in projects, and leadership of projects demonstrated by presentation or publication. Demographics between the three groups were evaluated using the Chi-squared test for comparability. Statistical Process Control (SPC) charts were used for 3-phase analysis, while Kruskal-Wallis, Wilcoxon rank sum tests, and Poisson regression analysis were applied to draw inferences of association.

Results: A total of 51 residents graduated in the study period. The three groups were comparable with regards to gender or race while medical school background was significant (P < .001). SPC phase analysis revealed a process shift in resident engagement in interdisciplinary EQuIPS projects (Kirkpatrick Level 3) and completion of projects presented nationally or published (Kirkpatrick Level 4) post-implementation. The Kruskal-Wallis test indicated a significant difference in scholarly research involvement across the three phases (P < .001). Pairwise comparisons >10-fold increase in scholarly activity from pre- to post-implementation (P < .001) confirmed with Poisson regression after controlling for medical school.

Conclusion: The EQuIPS curriculum was associated with enhanced resident competency in equity, quality improvement, and patient safety. This model is a potentially valuable framework for other residency programs aiming to meet accreditation requirements and improvement and promote continuous improvement.

Background: Weight stigma in healthcare settings is implicated in lower quality of care for higher-weight patients. Physicians' implicit and explicit antifat bias can undermine rapport, reduce health education, and discourage preventive care, eroding patient trust and fueling healthcare avoidance. Because medical education shapes trainees' attitudes through both formal curricula and hidden cultural norms, it represents a critical leverage point for stigma reduction. Yet most interventions are stand-alone workshops that remain separate from core content and have limited reach.

Methods: We conducted a grounded theory analysis of the preclerkship nutrition curriculum at a large US medical school to examine how weight stigma is embedded in core teaching. Fifteen pre-recorded lectures (10.2 h) delivered by 13 faculty members were independently reviewed by a multidisciplinary team of medical students and a faculty expert in weight stigma. Reviewers documented potential instances of stigma in structured memos. Through iterative coding and team consensus, we developed conceptual categories and integrated these into broader themes.

Results: Reviewers generated 123 memos capturing stigmatizing language, attitudes, and framing. Five themes emerged: (1) stigmatizing terminology and imagery; (2) assumptions about the controllability of weight; (3) judgments about the behavior and health of higher-weight patients; (4) overemphasis on weight as a marker of health; and (5) statements that reinforce socially constructed body ideals and moralize food and eating. We propose a literature-informed framework for educators: adopt neutral, precise language; challenge weight-based stereotypes; highlight multifactorial determinants of health; avoid reinforcing body ideals or moralizing food; and use content warnings for sensitive topics.

Conclusions: Early exposure to weight-normative messages in foundational curricula can perpetuate antifat bias in clinical practice. Integrating stigma-reduction strategies into core teaching offers a promising approach to dismantle structural weight stigma and promote equitable, person-centered care, and warrants evaluation.

Background: Shame is an emotional experience in health professions education, often contributing to burnout, isolation, and threats to professional identity. Self-compassion has been identified as a protective factor against shame. This study describes the development and evaluation of an elective designed to foster shame resilience and cultivate self-compassion among health professions students.

Methods: A 6-h elective, Fostering Connection and Shame Resilience Through Self-Compassion, was offered over 3 monthly 2-h sessions. Each session included a shared meal, abbreviated large-group conceptual learning, reflective writing, guided self-compassion practices, and small-group discussions. Participants completed the Self-Compassion Scale-Short Form (SCS-SF) at the beginning and end of the course and the Shame Frequency Questionnaire in Medical Students (SFQ-MS) at the end. A control group of nonparticipating medical students completed the SFQ-MS for comparison. An anonymous program evaluation survey was also conducted.

Results: Of 21 learners who completed both pre and post SCS-SF scales, statistically significant improvements were observed in 7 of 12 items and in 4 of 6 subscales (Self-Kindness, Self-Judgment, Common Humanity, and Mindfulness). The total self-compassion score increased from mild to moderate. On the SFQ-MS, 6 of 12 items showed statistically significant differences between the postelective group and matched controls. Program evaluation data indicated that 62% reported significantly greater awareness of shame, and 57% reported significantly increased openness to practicing self-compassion.

Conclusions: This elective represents an innovative approach to improving emotional resilience in learners, integrating experiential learning, interpersonal connection, and small-group learning. Findings suggest that even brief interventions can positively impact learners' self-compassion and aspects of shame resilience. Curricula addressing these affective domains may offer valuable tools for enhancing well-being and professional identity formation in health professions education.

Background: After decades of feedback courses for supervisors, students now have access to courses on the interactional feedback process. However, this interactional feedback process requires students to be receptive to discussions in order to assimilate and apply the information shared. To achieve this, an active self-learning module (ASLM) offered students a reflective exercise and strategies based on the H.O.S.T. (humility, openness, shared explicitness and tenacity) behavioural model.

Methods: The purpose of this pilot study was to explore how the ASLM shaped students' understanding of the learning mindset within a sample of six students from the Francophone stream of the University of Ottawa MD Program. These students engaged in simulated clinicals and clinical rotations during which they receive feedback. Semi-structured interviews were used to explore students' perceptions of the module and the self-reflection it sparked. The data were analyzed using a rigorous thematic analysis.

Results: The thematic analysis identified two main themes and six sub-themes. Students perceived the module's reflective approach as promoting their engagement in student-supervisor interactions and the personal growth mindset necessary for emotional regulation. The importance of a two-way relationship with the supervisor was highlighted, raising the possibility of training intended for both supervisors and students.

Conclusion: The ASLM introduced to a small sample of learners allowed them to reflect on their learning mindset and to discover strategies that could help them receive and engage in feedback more effectively. Although participants viewed this reflective exercise as a promising initial step in influencing attitudes and behaviors related to feedback, further exploration with a larger population is needed.

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.