Journal of Medical Education and Curricular Development最新文献

Background: Point-of-care ultrasound (POCUS) is endorsed by multiple national societies as an important skill in internal medicine (IM). Despite its growing importance, current evaluation methods for POCUS competence focus primarily on image acquisition and interpretation, overlooking clinical decision-making.

Objectives: We developed and evaluated an objective structured clinical examination (OSCE) that assesses IM residents' ability to select appropriate ultrasound examinations, interpret pathological images, and integrate these findings into clinical decision-making.

Methods: Over both the 2022 and 2023 academic years, 110 postgraduate year-2 IM residents participated in a longitudinal POCUS curriculum. Eighty-one of these residents participated in a 40-min OSCE case 9 months later. In the OSCE, residents encountered a clinical case involving a patient with systemic lupus erythematosus and respiratory distress, requiring both lung and cardiac ultrasounds. Residents' performance was evaluated using a 50-question rubric that assessed image quality, interpretation, and clinical reasoning. This is a cross-sectional study.

Results: Most residents successfully identified the appropriate examinations and interpreted pathological images, with 91% performing a lung ultrasound and 96% performing a cardiac ultrasound. However, many residents did not conduct a comprehensive lung exam, and many faced challenges obtaining certain cardiac views. Despite these gaps, most residents articulated appropriate differential diagnoses and management plans.

Conclusions: Our OSCE was able to evaluate the scanning patterns of the residents and test their ability to apply abnormal findings to a case, despite variability in the residents' scanning skills. This OSCE highlights opportunities to improve our POCUS curriculum in emphasizing comprehensive examination techniques and integration of clinical reasoning.

Introduction: Population Health and System Science, a longitudinal course at a new medical school in northeast Texas, incorporates case-based learning and experiential field visits during an 18-month pre-clerkship phase. The course integrates content from public and population health, preventive medicine disciplines, and health administration and leadership.

Materials and methods: A cross-sectional survey assessed student self-reports on achievement of session objectives and introduction to national core curricular, cross-cutting, and systems thinking domains.

Results: Of 36 students, 33 responded. Most rated objectives favorably. Open-ended responses highlighted relevance to future practice and requested more content on biostatistics, epidemiology, health equity, and healthcare economics, financing, and policy.

Discussion: Findings suggest the course effectively introduces key concepts, with opportunities to enhance foundational content in measurement, policy, and financial aspects of healthcare. Future studies should investigate application during required clinical rotations.

Objective: Although video feedback is incorporated into medical education research, its broad implementation in the practical teaching of procedural skills remains challenging. Thus, we aimed to investigate the practical effects of the mobile video feedback teaching method in clinical skills training for abscess incision and drainage.

Methods: A total of 72 second-year medical students majoring in a 5-year clinical medicine program were randomly allocated (1:1) to either the traditional teaching (TT) group or the mobile video feedback teaching (MVFT) group. All students received the same foundational theoretical knowledge, followed by distinct practical training sessions corresponding to their group allocation. The final procedural assessment on a simulation manikin was conducted by 2 examiners simultaneously, and each student's final score was calculated as the average of both examiners' scores. Effects were further assessed using the Mini-Clinical Evaluation Exercise (Mini-CEX), in addition to evaluations of teaching performance and self-perception.

Results: Students in the MVFT group achieved a significantly higher average final score than those in the TT group (78.67 ± 6.72 vs 75.00 ± 7.95, P = .038). Additionally, 4 initially lower-performing students in the MVFT group scored significantly higher than 4 comparable students in the TT group (67.50 ± 1.29 vs 63.00 ± 3.16, P = .039). The MVFT group achieved significantly higher scores in clinical judgment, physical examination, organizational skills, and overall performance (P = .000, P = .000, P = .037, P = .040, respectively). Furthermore, students in the MVFT group reported significantly greater satisfaction across several domains, including their perception of the teaching methodology, comprehension of learning materials, and ability to perform self-directed learning with tools (P = .042, P = .032, P = .041, respectively).

Conclusion: This study demonstrates that the mobile video feedback method enhances comprehension and procedural proficiency in clinical skills, particularly for initially lower-performing students, supporting its integration into the curriculum to improve educational outcomes. The method's accessibility and low cost further facilitate its adoption as a scalable tool for self-directed learning and targeted remediation.

Objective: This study aimed to investigate the evolution of specialty preferences among medical students at Ahvaz Jundishapur University, Iran, with a focus on identifying key factors influencing career decisions, including lifestyle considerations, migration intentions, and familial influences.

Methods: A mixed-methods approach was employed, combining quantitative surveys and qualitative interviews with 169 medical students at different training stages. Data were analyzed to track changes in specialty preferences before and after clinical exposure, with statistical significance assessed using paired t-tests and thematic analysis for qualitative insights.

Results: Findings revealed a significant shift toward lifestyle-oriented specialties during clinical training, with work schedule priority increasing by 133% (P < .001). Additionally, migration intentions rose by 143% (P = .003), highlighting growing concerns over career prospects in Iran. Despite these shifts, familial influences remained a persistent factor in specialty selection.

Conclusion: Clinical experiences substantially reshape medical students' career priorities, with lifestyle and migration potential becoming increasingly influential. These findings underscore the need for enhanced career counseling programs and policy reforms to address physician maldistribution and brain drain in Iran's healthcare system.

Background: Given recent advances in artificial intelligence (AI) in medical education and healthcare, it is essential to examine the perceptions and readiness of medical students. As future medical professionals, their ability to utilize this emerging technology effectively is crucial. Therefore, the present study aimed to examine medical AI knowledge, readiness, and perceptions among medical students in medical education and healthcare, and the risks and disadvantages associated with it in Iran.

Methods: This cross-sectional study was conducted among Iranian medical students in 2025. The questionnaire used in this study consisted of three parts: the first part, socio-demographic characteristics; the second part, basic knowledge and students' perceptions of medical education, healthcare, and risks and disadvantages of medical AI; and the third part, students' readiness for medical AI. The data were analyzed using SPSS 22 and Excel 2019 software.

Results: Of the total 280 medical students participating in the present study, 55.4% were female, and 60% were in the preclinical phase. The results showed that respondents demonstrated greater AI readiness in the dimensions of vision and ethics and possessed a high level of knowledge regarding the terms "artificial intelligence," "neural networks," and "deep learning." More than 70% of respondents reported a high perception of medical AI in its three dimensions. A significant relationship exists between the medical AI readiness score and gender, working family/close friends, knowledge of AI, and three dimensions of students' perceptions of medical AI.

Conclusion: Enhancing students' knowledge, readiness, and understanding of medical AI can equip professionals with improved medical and decision-making skills. These professionals can make more informed decisions and reduce medical errors with AI tools.

Background: Early clinical training in undergraduate medical education often occurs in unstructured environments, limiting student participation and competency development. The SimZones framework offers a progressive approach to simulation-based education, yet evidence for its implementation in first-year medical students remains limited.

Objective: To describe the design, implementation, and outcomes of a structured clinical simulation program for first-year medical students using the SimZones framework.

Methods: A descriptive study with mixed-methods analysis was conducted in 2024 with 116 first-year medical students at a Chilean medical school. Students participated in structured Zone 1 simulation activities throughout the academic year in small groups (5-6 students), using 12 validated assessment instruments developed and validated by a multidisciplinary expert panel comprising 202 specific procedural steps including 30 critical safety steps. Activities focused on technical, communication, and attitudinal skills with study guides, pre-tests, and formative rubrics. The program culminated with a Zone 2 integrative activity simulating primary care consultations using standardized patients, clinical documentation, and faculty debriefing using the Plus/Delta model. Performance was assessed using standardized rubrics, and qualitative observations were analyzed thematically.

Results: All 116 students completed the program. High performance was observed in attitudinal competencies (≥97%) and communication domains (≥89%), while technical skills showed variable achievement rates (range 63%-78%). Qualitative analysis identified strengths in empathy, professionalism, and teamwork, with areas for improvement in procedural technique, interview sequencing, and time management.

Conclusions: Early progressive simulation using the SimZones framework effectively develops foundational competencies in first-year medical students. The structured approach, combining deliberate practice with formative assessment and guided debriefing, supports competency-based medical education objectives while identifying specific areas requiring additional reinforcement in technical skill training.

Introduction: Lactating physicians face considerable challenges in achieving lactation goals due to inflexible schedules and a lack of break time. While federal mandates have outlined the necessity of lactation breaks, the frequency and duration of breaks are unspecified. The objective of this study was to fill this gap by designing and implementing an outpatient neurology resident clinic schedule with protected lactation breaks, ensuring support and quality of trainees' educational experience.

Methods: This quality improvement study began with developing a prototype schedule with input from lactating physicians, a lactation consultant, and neurology residency program leadership. Neurology residents and fellows with prior lactation experience were surveyed to determine if the proposed schedule would have fit their individual needs. The clinic schedule with protected lactation break time was then implemented, and lactating neurology residents were surveyed regarding their experience.

Results: Eleven previously lactating neurology residents and fellows who were surveyed about the proposed schedule agreed that the prototype schedule would suffice for their personal lactation needs. The clinic schedule was implemented for 5 neurology residents returning from maternity leave in 2022 to 2023, and 4 residents completed a survey of their experience. There was unanimous agreement that protected lactation breaks helped residents achieve their lactation goals and strongly benefited work/life balance and overall well-being. Despite this intervention, 75% of respondents stopped breastfeeding earlier than intended, and 100% of respondents experienced complications perceived to be related to inadequate pumping, such as diminished milk supply. Ongoing barriers to achieving breastfeeding goals included work interrupting lactation breaks, lack of lactation rooms, and lack of computer workstations in lactation rooms.

Conclusions: Inclusion of protected lactation breaks in outpatient clinic schedules helped neurology residents achieve their lactation goals as well as promoted work/life balance and overall well-being. However, more work is needed to address other barriers to achieving lactation goals.

Introduction: The success of a colonoscopy is highly dependent on the adequacy of bowel preparation. International guidelines recommend good bowel preparation in at least 90% of procedures, as measured by the Boston Bowel Preparation Scale. A quality review at our center revealed 25.7% of colonoscopies had inadequate preparation, which formed the needs basis for our intervention.

Methodology: We implemented a simulation-based educational intervention to improve healthcare workers' (HCWs) knowledge and confidence regarding colonoscopy preparation. The program included an interactive teaching session covering the essentials of bowel preparation, counseling stations with simulated patients with common clinical presentations, followed by debriefing using the Plus-Delta model. Participants completed pre- and post-intervention tests to assess knowledge improvement and a self-efficacy questionnaire evaluating confidence in key aspects of colonoscopy preparation. A postintervention chart review was conducted to assess the impact of the exercise.

Results: Twenty-eight gastroenterology HCWs participated. The mean pretest score increased from 58.6% to 75.7% (p < .05). Self-efficacy scores improved from 39.1 (71.1%) to 51.0 (92.8%) (p < .05). Qualitative feedback was overwhelmingly positive. A postintervention clinical review after 12 weeks demonstrated significant improvement in bowel preparation quality, with adequate preparation increasing to 92.8%(p < .05).

Conclusion: A simulation-based intervention was successful in an interprofessional healthcare cohort of HCWs in improving counseling skills, participant confidence and quality of clinical care through a measurable improvement in bowel preparation quality.

This paper describes the Medical Humanities Council (MHC), a student-led initiative to promote the health humanities at the Perelman School of Medicine (PSOM) at the University of Pennsylvania. Building on data-focused advocacy, peer benchmarking, and collaboration with curricular leaders, the MHC has become the cornerstone of a sustainable and flourishing health humanities infrastructure and programming targeted at medical students at PSOM. The MHC illustrates how student advocacy can advance the arts and humanities and serves as a model for student-led promotion of the health humanities, particularly when programing and/or institutional support are lacking.

Objective: To evaluate the effects of an educational intervention, the elective course "Humanistic Values and Contemporary Medicine," on medical students' empathy levels and to examine the predictive value of demographic and educational variables.

Methods: A cross-sectional survey was conducted among 112 medical students using a modified Toronto Empathy Questionnaire assessing empathy in both personal and clinical contexts. Demographic and educational data were collected and analyzed for associations with empathy scores.

Results: Most students recognized the importance of empathy, but only a subset had received formal education on the topic. Enrollment in the elective course was significantly associated with higher empathy scores. Gender showed a nearly significant effect, with female students tending to score higher. Other factors, including clinical training, living arrangements, and personal experience with chronic illness, were not significant predictors of empathy.

Conclusion: Empathy is amenable to structured educational interventions and should be intentionally cultivated during medical training to support future physicians' interpersonal competencies and emotional resilience.