Journal of Medical Education and Curricular Development最新文献

This article examines the need for reform in medical school admissions to better align with the collaborative and patient-centered nature of contemporary healthcare. Traditional admissions processes prioritize academic excellence, often neglecting essential interpersonal and team-based skills. We advocate for several strategies to address this gap. Firstly, diversifying admissions committees to include healthcare professionals such as nurses and pharmacists, as well as patients can provide insights into candidates' teamwork abilities. Secondly, incorporating group interviews and exercises can better assess applicants' interpersonal skills and collaboration potential. We also propose leveraging the "Voice of the Consumer" (VOC) concept, using patient and family feedback to guide the selection of future physicians. This aligns with the shift toward shared decision-making in patient care. The paper underscores the importance of interprofessional education in addressing communication challenges within healthcare. By integrating these reforms early in medical education, we can cultivate physicians who excel in both evidence-based and patient-centered care. This perspective calls for a holistic evaluation process in medical school admissions, prioritizing patient-centered values and effective teamwork to develop healthcare professionals capable of navigating modern healthcare complexities.

Objective: During the severe acute respiratory syndrome coronavirus 2 pandemic, could be observed an established use of online information in the field of coronavirus disease worldwide. As a systematic review study, the present investigation aimed to evaluate related studies about digital health/e-health literacy among university students in the coronavirus disease 2019 era.

Methods: Three electronic bibliographic databases (PubMed/Medline, Scopus, and Google Scholar) were searched from 2020 until June 2022, and articles were screened according to pre-established inclusion criteria.

Results: Fifteen studies were included in this systematic review study. All of the studies were cross-sectional in design, and in total, 45,255 students were evaluated. The majority of studies report health literacy scores among university students that are lower compared to reference samples. Students' health literacy is influenced by different variables (age, gender, socioeconomic background, sources of online information, well-being, and satisfaction with data).

Conclusion: Digital health literacy (DHL) shapes health behaviors and actions. To enhance DHL, multidisciplinary teams from diverse fields can design curricula suitable for students. The internet's role in DHL is crucial, but it can also spread misleading content. Therefore, professionals should provide clear, evidence-based information and encourage critical data evaluation. Future studies should use robust sampling methods, consider students with limited internet access, and address the unique needs of specific populations, such as those with disabilities and low socioeconomic status.

Aim: Since COVID-19 has set the state of health of the country in an emergency, it is natural that in such circumstances, violation of some principles of professional ethics is inevitable. This study aimed to identify and prioritize ethical challenges in the clinical services of patients with confirmed coronavirus disease in Iran's hospitals.

Design: This study was a mixed method with an exploratory sequential design.

Methods: This study was done in 2 qualitative and quantitative phases. In the qualitative phase, a systematized review was conducted and in the quantitative phase, a questionnaire of 35 questions based on the results of Phase 1 was formulated and completed.

Results: The challenges related to the provider of clinical services (physicians and nurses), the recipients of clinical services (patients), and the organizational challenges had the most significant importance, respectively (P < .05, χ2 = 6.23).

Background: Belongingness is an important factor in the social development of medical students, and the ability to quantify belongingness in medical students may provide additional metrics by which we can compare different learning environments to help explore differential attainment. Previous studies looking at the measurement of belongingness have demonstrated good internal and external validity for tools designed to measure this facet of student experience. This study aimed to explore the use of the Exeter Belongingness Assessment Tool (EBAT) as one potential source of evidence in the study of student learning experience on clinical placements, which could be used to support quality assurance of clinical learning. This study sought to validate the use of the EBAT and carry out an initial pilot study to compare levels of belongingness in medical students in Belgium and the United Kingdom.

Methods: This study used a validated assessment tool self-administered via an online survey platform in undergraduate medical students in all years studying in Belgium and the United Kingdom.

Results: The EBAT described here demonstrated good internal validity in undergraduate medical students in the United Kingdom and Belgium and identified statistically significant differences between these medical student populations.

Conclusions: These results suggest that belongingness in undergraduate medical students varies between different demographic groups and provides further evidence that the EBAT described here is a valid tool to study this. It also supports the proposal that this may be a useful tool to monitor teaching environments.

Objectives: To explore whether training on the SICG-Peds© (Serious Illness Guide for Pediatrics) impacts a pediatric clinician's confidence and knowledge in participating and initiating/leading difficult conversations with families of children living with a serious illness.

Methods: Over 2 years, clinicians from BC and Ontario who care for children with serious illnesses attended training workshops on the SICG-Peds©. These workshops were evaluated using pre- and post-workshop questionnaires. Participants reported confidence scores on a scale of 1 to 10.

Results: In total, 134 and 140 clinicians attended the workshops in BC and Ontario, respectively. The majority of clinicians who completed the immediate post-workshop survey (N = 223, 94.5%), responded that the content enhanced their knowledge about pediatric serious illness conversations (SIC). Confidence scores in initiating/leading a SIC significantly increased from median 5 (interquartile range [IQR] 3-7) pre-workshop to 7 (IQR 7-9) immediately post-workshop (P < .0001). Confidence scores in participating as a non-leader in a SIC also significantly increased from median 7 (IQR 6-9) pre-workshop to median 8 (IQR 7-9) immediately post-workshop (P < .0001).

Conclusions: Overall, these workshops significantly improved participants' confidence. Effectiveness and knowledge enhancement were other areas where the majority of participants reported positive improvements. Areas for continued support were identified as more mentoring, and training for supporting the guide's use in a clinical setting.

Objectives: Mental practice, a cognitive technique for practicing skills without physical movement, holds promise for enhancing clinical outcomes in emergency medicine. This study investigates its recognition and the impact of a basic workshop on emergency physicians' attitudes toward mental practice.

Methods: This pre-post survey study involved 20 medical professionals who participated in a 2-day workshop. Assessments were conducted before and after the intervention using a structured questionnaire.

Results: Initial findings revealed that 65% of participants were aware of mental practice, and only 10% utilized it in clinical settings. Postworkshop, familiarity, and perceived helpfulness significantly increased from 2.2 to 4.1 and 3.9 to 4.7, respectively, with marked improvements in confidence and the intention to apply these techniques clinically by 100% of the participants.

Conclusion: The results suggest that brief educational interventions can substantially influence medical professionals' engagement with mental practice, advocating its inclusion in medical training curricula to enhance procedural skills and patient care.

Objectives: Few opportunities exist for postgraduate physicians to learn to address racism in their professional practice. We created a virtual, 5-session antiracism course that included the development of a formal action project to address racism at participants' home institution.

Methods: We delivered this curriculum virtually to 2 cohorts (2021 and 2022) of postgraduate physicians, nationally. The curriculum had 3 educational aims: (1) to increase knowledge on antiracism, (2) to increase comfort and engagement in discussing antiracism at home institutions, and (3) to increase self-efficacy to execute an institution-based project. Theory-informed practice, community building, and project-based learning were used to achieve our educational aims. We analyzed changes in these domains in addressing racism using matched 7-item Likert-scale questions from pre- and post-course surveys and the Wilcoxon signed rank test. We assessed perceptions and impacts of the course with post-course survey items using descriptive statistics.

Results: Forty-three of 50 participants (86%) who completed pre- and post-course surveys were included in the analysis. We found pre-post course increases in mean scores (converted from Likert scales), for all 15 paired questions. For example, we found improvements in understanding the historical context of racism in medical institutions (mean score change: 5.12 [SD 1.00] to 6.42 [SD 0.76], P < .001), comfort in talking to colleagues about racism (5.21 [SD 1.08] to 6.19 [SD 0.70], P < .001), and capacity to address racism in patient care at their home institution (4.51 [SD 1.35] to 5.56 [SD 0.91], P < 0.001). 93% reported the course increased the likelihood of working to address racism at their institution.

Conclusion: This project-based antiracism course for postgraduate learners increased self-reported knowledge of, comfort with, and self-efficacy in addressing racism and was well received by participants.

The growing demand for medical professionals in undergraduate and graduate/postgraduate medical education to attain comprehensive health training has not abated and necessitates the development of curricula encompassing relevant issues pertaining to clinical practice as well as the educational context. Therefore, diversity in learning activities should be embedded in a teaching curriculum to achieve the required competencies. This includes considering at least the following during the design and analysis of a teaching curriculum: Harden's ten questions to be posed when designing a curriculum; Canadian Medical Education Directives for Specialists (CanMEDS) competency framework which has been approved by the Royal College of Physicians and Surgeons of Canada; 21st-century skills; Diana Laurilliard's conversational framework; and general quality measures to improve diversity in a teaching curriculum.

Artificial intelligence (AI) with its diverse domains such as expert systems and machine learning already has multiple potential applications in medicine. Based on the latest developments in the multifaceted field of AI, it will play a pivotal role in medicine, with a high transformative potential in multiple areas, including drug development, diagnostics, patient care and monitoring. In the pharmaceutical industry AI is also rapidly gaining a crucial role. The introduction of innovative medicines requires profound background knowledge and the latest means of communication. This drives us to intensively engage with the topic of medical education, which is becoming more and more demanding due to the dynamic knowledge landscape, among other things, accelerated even more by digitalization and AI. Therefore, we argue for the incorporation of AI-based tools and methods in medical education, including personalized learning, diagnostic pathways, and data analysis, to prepare healthcare professionals for the evolving landscape of AI in medicine and support the fluency in dealing with AI by regular contact with various AI-based tools (Learning with AI). Understanding AI's vast potential and its caveats as well as gaining a basic knowledge of how AI works should be an important part of medical education to ensure that physicians can effectively and responsibly leverage AI-based systems in their daily practice and in scientific communication (Learning about AI).

Introduction: A recent study on patients with acute lower limb ischemia showed that the proportion of inadequate examination of lower extremity circulation was associated with higher rate of amputation and death. The aim of this systematic review was to explore evidence for how practical competence in performing a peripheral vascular status of the lower limb among medical students and junior doctors should be taught and examined.

Methods: The systematic review followed PRISMA guidelines and was published in PROSPERO. Articles were searched for in PubMed, Cochrane Library and Embase. The result was processed by two researchers. After title- and abstract screenings, articles were scrutinized in full text for inclusion, result extraction, risk of bias assessment through Medical Education Research Study Quality Instrument (MERSQI), and evidence grading with the GRADE approach.

Results: Thirteen studies were included. Two studies were randomized controlled trials (RCTs). Study samples varied between medical students (n = 9), junior doctors (n = 3) and residents (n = 3). Interventions varied between theoretical, practical, repetitive training, feedback-based learning, and clinical experience. Assessed measurements (outcomes) were ankle-brachial index (ABI) (n = 9), theoretical knowledge (n = 4), pulse palpation (n = 1) and complete vascular status (n = 1). Experienced residents had better theoretical knowledge than inexperienced residents, but performance of the entire ABI procedure without any mistake according to guidelines was inadequate in both groups. One RCT showed that experimental training significantly increased ability to perform ABI measurements, but this ability decreased after six months without repetition.

Conclusion: Theoretical training alone is not sufficient in ensuring proficiency in vascular examination of the lower limbs. Continuous practice and clinical exposure are crucial to maintain proficiency in performing vascular examination of the lower limbs. Data is limited and heterogenous. The level of certainty for the evidence was judged to be very low.