Journal of Medical Education and Curricular Development最新文献

Over the last decades, the amount of knowledge that is required from learners in the medical field has become incredibly wide and deep, posing a burden for all stakeholders including medical schools, training hospitals, students, and society. The trajectory that has been established will soon render medical education ineffective, both from the perspective of the students who will not be able to productively internalize and effectively integrate the information they receive, and of the institutions and medical programs that will be unable to keep up with the pace of the medical progress and the relevant subject matter that needs to be taught. To address this burden, sooner than later, bold actions should be taken toward the radical transformation of the medical curriculum both in terms of its duration and its implementation and of the type of knowledge that the medical students will need to excel in, as a prerequisite for their subsequent training.

Background: Medical students are often taught clinical reasoning implicitly, rather than through a formal curriculum. Like qualified health professionals, they engage in a wide range of information seeking and other practices as part of the clinical reasoning process. This increasingly includes seeking out information online and being informed by anecdotal information from social media or peer groups. The aim of this research was to investigate how anecdotes and icon arrays influenced the clinical reasoning process of medical students deciding to prescribe a hypothetical new drug.

Methods: A cross-sectional survey design was used. The survey required participants to respond to six hypothetical clinical scenarios in which they were asked to prescribe a hypothetical drug "polypill" for a specific patient. The order of delivery of the six scenarios was randomised for each participant. In response to each scenario, participants indicated how effective they perceived each drug to be. The study received ethics approval from the University of Sydney Human Research Ethics Committee: Protocol No: 2019/001. All participants provided written informed consent before agreeing to participate in the study.

Results: A total of 56 medical students fully completed the survey. Statistical analysis of the responses indicated that the icon array may be effective for highlighting how the polypill reduces CVD risk, reducing the impact of anecdotes on efficacy judgments. Without the icon array, both the positive and negative anecdotes made participants less willing to prescribe the polypill.

Conclusions: Medical student clinical reasoning processes appear to be influenced by anecdotal information and data visualisations. The extent of this influence is unclear, but there may be a need to actively educate students about the influence of these factors on their decision-making as they graduate into a world where they will be increasingly interacting with anecdotal information on social media and visualisations of electronic data.

Introduction: Research is important for the advancement of the medical field. Integrating research in the undergraduate medical curricula is crucial. Previous studies have explored medical students' knowledge of, attitude towards, and barriers to medical research in different countries. We aim in this study to evaluate the knowledge, attitude, and barriers of medical students towards research in a Moroccan medical school.

Methods: We conducted a cross-sectional study including all medical students at Oujda Medical School from the first year to their seventh year. Data were collected using an anonymous, self-administered online questionnaire that had been pilot-tested beforehand. The questionnaire was designed to evaluate students' knowledge, attitude, and perceived barriers regarding research. Additionally, we analyzed how students' attitude, knowledge and barriers scores correlated with various sociodemographic variables.

Results: We received 754 completed responses in total. The knowledge score was relatively low, with a median of 2 (IQR 1-3) across 8 questions, indicating limited understanding of research basics. However, the majority of students expressed a positive attitude towards scientific research, with a median score of 3.26 (IQR 3.04-3.5) on ATR scale. Numerous challenges were identified by the students, including time constraints (75.6%), insufficient funding (75%), and inadequate laboratory facilities (72.6%).

Conclusion: Moroccan students displayed a high level of attitude towards research, yet a low knowledge score. This discrepancy may be explained by several perceived obstacles towards research. To enhance students' engagement in undergraduate research, these barriers must be addressed.

Objectives: One of the major contributing factors to the opioid crisis, marked by a surge in opioid prescriptions, includes inadequate adherence to guideline-based pain management practices, highlighting the need for a comprehensive curriculum during residency training. In this study, we aim to assess opioid exposure prevalence among hospitalized patients and examine potential associations between disease conditions, patient demographics, and opioid prescriptions during their hospital stay.

Methods: In this retrospective cohort study at a southern California county teaching hospital, we analyzed the medical records of 2272 patients admitted to the IM resident inpatient teaching service for 1 year, from September 2017 through September 2018.

Results: The study found that 44% of patients received opioid prescriptions during their hospital admission, with 23% receiving prescriptions at discharge and 45% having prior opioid exposure. Patients with prehospital opioid exposure had a 2-fold increased risk at discharge (Relative Risk: 2.51; P < .0001). The hypothesis that factors such as gender, certain medical conditions, and previous opioid use influenced opioid prescriptions during hospitalization is disproved. Instead, hospital admission itself was the significant contributing factor to receiving opioids during acute care and at discharge, irrespective of the source of pain.

Conclusion: In conclusion, our study revealed that the primary determinant for opioid exposure during hospitalization is the inpatient admission itself rather than specific patient-related factors. The lack of a structured curriculum in residency training contributes to the default use of opioids for all pain types, highlighting the need for curricular reforms to focus on multimodal pain management principles.

Using the case study of a 12-year-old girl diagnosed with complex congenital heart disease at a student-led clinic (SLC) organized by Humanity Initiative (HI) in Karachi, the paper highlights the effectiveness of SLCs in providing accessible and comprehensive healthcare services. The article contributes to existing literature by demonstrating the practical benefits of SLCs in a real-world setting, particularly in resource-limited environments. It underscores the potential of SLCs not only to improve community health but also to enhance medical education by providing students with hands-on experience and fostering a sense of social responsibility. Collaborative efforts between medical students, professionals, and the community are essential to ensure the continuity and effectiveness of healthcare interventions. For the success of such initiatives, there is a need for sustainable funding, effective follow-up protocols, and reliable communication channels with patients, offering solutions like peer mentoring and technology integration to overcome these barriers.

Objectives: Leadership within medical academic institutions often adheres to hierarchical structures, relying on factors like seniority and context, with limited focus on leadership development. This study aims to develop a structured framework by examining the traits, aspirations, and pre-requisites of academic leaders within medical school faculties.

Methods: A cross-sectional study collected input from regular medical faculty and those in leadership roles through an online questionnaire, followed by quantitative and qualitative analyses. Data was curated, analyzed, and triangulated to establish subdomains, domains, and themes for the framework.

Results: Among 229 respondents, 121 held formal academic leadership roles, the remaining 108 were regular medical faculty. And 92% of regular faculty cited lack of experience and training as significant barriers to effective leadership. Both groups agreed on the need for intensive leadership training, as 85% of leaders and 66% of regular faculty lacked formal academic leadership training. The concept of affiliative leadership was favored by 45% of leaders. Qualitative analysis and subtheme triangulation led to the development of the 6 Es Framework for Leadership in Academic Medicine (FLAM). This framework encompasses: ethics (accountability and role modeling), education (structured curriculum and training), envision (clear path and talent identification), engagement (structural foundation and attainable goals), empowerment (fostering passion), and encouragement (financial incentives).

Conclusion: This research reinforces the necessity of structured leadership development in academic medicine. The unique attributes of the 6Es FLAM have the potential to enhance leadership in this field.

Objective: Remote teaching strategies have been widely adapted in recent years but their impact on dental students' learning outcomes is less well understood. The aim of this mixed-method pilot study was to examine the impact of remote teaching on undergraduate dental student's learning outcome as assessed by examination performance and student feedback in an orthodontics course.

Methods: Out of the lectures (19 in total), 10 were delivered remotely (live online lecture or video recording) and 9 as traditional classroom teaching in 2023. The course examination, completed by 47 of the 48 course participants, consisted of 38 single best answer multiple choice questions with 2 questions dedicated to each lecture topic.

Results: The average lecture attendance was 83% of the students enrolled in the course. Statistical analysis revealed no significant association between examination scores and the mode of teaching or the mandatory nature of the lecture (r_s  = -0.022, p = .897 and r_s  = -0.048, p = .773, respectively). However, individual students' examination scores correlated positively with the frequency of lecture attendance (r_s  = 0.416, p = .004). Students' preferences were in favor of blended learning approach, although notable individual differences in opinions were observed in the feedback received.

Conclusion: The findings of this study support the hypothesis that remote teaching generates an equally good learning outcome in orthodontics as classroom lectures, as reflected by examination performance.

Objective: Medical specialist trainees report dissatisfaction with both the usefulness and timing of feedback provided following summative examinations. This study aimed to explore ophthalmology trainee and supervisor experiences of feedback following final summative examination (the Royal Australian and New Zealand College of Ophthalmologists Advanced Clinical Examination (RACE)).

Methods: Semi-structured interviews were undertaken with ophthalmology trainees who had recently sat RACE (2017-2021) (n = 19) and supervising ophthalmologists who support trainees to prepare for RACE (n = 10). Interview data were thematically analyzed.

Results: Two themes were identified. Inadequate feedback related to trainee experiences receiving feedback relating to examination performance that was insufficient and unhelpful in identifying gaps in learning, explaining the reasons for failure and supporting preparation for resitting. Inability to contextualize feedback encompassed trainee and supervisor concerns regarding the inability to review examination manuscripts after sitting the examination, the absence of marking criteria, rubrics and model answers to understand the passing standard and the lack of opportunity to discuss performance with examiners.

Conclusions: Detailed, individualized task-level and process-level feedback on examination performance is needed for all trainees. Opportunities to view examination manuscripts, marking criteria and model answers, as well as speak with examiners, would improve transparency of the assessment process, enhance feedback and improve trainee success.

Objective: Stigma surrounding mental health persists as a significant impediment to adequate support and help-seeking behaviors in Slovenia, despite advancements in psychiatric care and education. This study investigates stigma among first-year medical students at the University of Maribor, Slovenia and how the stigma changes after completing a course in mental health literacy.

Participants: Participants were first-year medical students at the University of Maribor in the academic year 2023/2024. A total of 116 students participated in the baseline study, with 66 students participating in the follow-up study.

Study method: The intervention involved implementing the "Transitions" program, aimed at enhancing mental health literacy and reducing stigma. We conducted a baseline study and a follow-up study, then used Wilcoxon signed rank test for repeated measures to compare the differences in ranks before and after implementation of the program.

Findings: There was a significant reduction in stigma after intervention (Wilcoxon Z = -3.06, P < .01), suggesting a positive impact of the educational program. This reduction aligns with findings from similar programs globally, suggesting the efficacy of educational interventions in mitigating mental health stigma.

Conclusions: The study emphasizes the importance of integrating mental health education into medical curricula to foster stigma reduction and enhance mental health literacy among future medical doctors.