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The Impact and Feasibility of a Student-led Program to Connect Patients and Caregivers via Synchronous Audiovisual Technology During Restricted Visitation Policies. 在限制探视政策期间,通过同步视听技术连接患者和护理人员的学生主导计划的影响和可行性。
IF 2 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-09-23 eCollection Date: 2024-01-01 DOI: 10.1177/23821205241284381
Marc Levine, Meloria A Hoskins, Sevan Yedigarian, Justin Ceasar, Nathan Cannon, Jacob Feiertag, James Mellen, Nancy Lokey, Natasha L Romanoski

Objective: During the SARS-CoV-2 pandemic, hospital visitation restrictions hindered patients' access to vital social support. This study explores the impact and feasibility of a student-led program facilitating audiovisual communication between inpatient rehabilitation patients and their caregivers.

Methods: The study design employed a prospective observational approach, and convenience sampling enrolled 99 participants, including 33 patients, 33 caregivers, and 33 medical students. From September 2021 to March 2022, eligible patients admitted to an inpatient rehabilitation hospital identified a caregiver and participated in a 30-minute audiovisual call organized by a medical student. Post-visit surveys via RedCap were completed by all participants and covered limitations in video calls, program benefits, comfort levels in video conferencing, and overall program ratings. The study adopted a quantitative research paradigm for data analysis. Statistical analysis utilized pairwise McNemar's and Wilcoxon's test for inter-group comparison.

Results: Patients, caregivers, and medical students all reported positive outcomes in program offerings including providing social support, decreasing feelings of isolation, and providing a feeling of connection. Patients rated the program 4.82 ± 0.47 on a Likert scale, with 97% recommending it to others, even beyond visitation restrictions. The most common diagnosis among patients was stroke (30%), highlighting the program's potential applicability across diverse patient populations. Caregivers rated the program 4.59 ± 0.87 and expressed a desire for its continuation post-restrictions (80%). Medical students (81%) recommended the program, citing benefits in reducing social isolation and gaining clinical experience. No statistical differences were observed between groups in emotional and humanistic domains.

Conclusion: This study highlights the potential for programs to utilize technology to address social isolation in the healthcare setting. When public health restrictions occur, medical educators should consider opportunities to support and foster innovation for student-led programs. Further research should explore broader impacts on healthcare outcomes and medical education.

目的:在 SARS-CoV-2 大流行期间,医院的探视限制阻碍了病人获得重要的社会支持。本研究探讨了由学生主导的促进住院康复患者与护理人员之间视听交流的项目的影响和可行性:研究设计采用了前瞻性观察方法,方便抽样招募了 99 名参与者,包括 33 名患者、33 名护理人员和 33 名医科学生。从 2021 年 9 月到 2022 年 3 月,符合条件的康复住院患者确定了一名护理人员,并参加了由医学生组织的 30 分钟视听通话。所有参与者都通过 RedCap 完成了访问后调查,调查内容包括视频通话的局限性、计划的益处、视频会议的舒适度以及对计划的总体评价。本研究采用定量研究范式进行数据分析。统计分析采用成对 McNemar 检验和 Wilcoxon 检验进行组间比较:结果:患者、护理人员和医科学生都报告了项目提供的积极成果,包括提供社会支持、减少孤独感和提供联系感。患者在李克特量表上的评分为(4.82 ± 0.47)分,97%的患者向他人推荐该项目,甚至超出探视限制。患者中最常见的诊断是中风(30%),这突显了该计划在不同患者群体中的潜在适用性。护理人员对该计划的评分为 4.59 ± 0.87,并表示希望在限制后继续开展该计划(80%)。医科学生(81%)推荐该计划,认为它有利于减少社会隔离和积累临床经验。在情感和人文领域,各组之间未发现统计学差异:本研究强调了利用技术解决医疗环境中社会隔离问题的潜力。当公共卫生受到限制时,医学教育者应考虑支持和促进学生主导项目创新的机会。进一步的研究应探讨对医疗保健结果和医学教育的更广泛影响。
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引用次数: 0
The Differences in Content of Health Care Plans of Medical and Nursing Students in Interprofessional and Uniprofessional Education. 跨专业教育和非专业教育中医护学生保健计划内容的差异。
IF 2 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-09-23 eCollection Date: 2024-01-01 DOI: 10.1177/23821205241283304
Carolyn Teuwen, Hanke Scheffer, Suheda Sekmen-Algin, Rashmi A Kusurkar, Hermien Schreurs, Hester Daelmans, Saskia Peerdeman

Background: With a growing population of older people in all Western countries, interprofessional education (IPE) can help to prepare students for the complex care for these patients. Which aspects of this complex care could benefit from IPE? In this study we evaluated the differences in content of health care plans made by students who participated in IPE.

Methods: Undergraduate nursing and medical students were included and attended four sessions in which they wrote a health care plan for a paper-based geriatric patient case. Approximately half of the students were included in the IPE-group. To evaluate the content of interprofessional collaboration between the students, the other half of the students were included in a 'uniprofessional education' (UPE) group. UPE-students made the health care plan alone. In the IPE-group a medical and a nursing students compiled the health care plan together. All health care plans were assessed by comparing them with a validated health care plan. We zoomed into the differences in the content of the health care plans, and calculated a score ratio, proportion of correct items.

Results: The health care plans made by IPE-students had an average score ratio of 0.31. The health care plans made by UPE-students had an average score ratio of 0.22. Most differences were found in the subcategories medication, nursing actions and aftercare. Specific items within these categories were more frequently thought of in the IPE-group than in the UPE-group, for example delirium interventions and consultation with a transfer nurse.

Conclusion: This study gives insights into which health care actions are more often considered by interprofessional couples in IPE than by students in UPE. Awareness of these items in clinical practice could make a difference in the care for older patients.

背景:在所有西方国家,老年人口都在不断增长,跨专业教育(IPE)可以帮助学生为这些病人的复杂护理做好准备。这种复杂护理的哪些方面可以从 IPE 中受益?在这项研究中,我们评估了参加 IPE 的学生所制定的医疗保健计划内容的差异:方法:护理专业和医学专业的本科生参加了四次课程,在这些课程中,他们为纸质的老年病人病例撰写医疗计划。大约一半的学生参加了 IPE 小组。为了评估学生之间跨专业合作的内容,另一半学生被纳入了 "非专业教育"(UPE)小组。UPE 学生单独制定医疗保健计划。在 IPE 组中,一名医科学生和一名护理专业学生共同制定了保健计划。我们将所有保健计划与经过验证的保健计划进行了对比评估。我们放大了保健计划内容的差异,并计算了得分率和正确项目的比例:IPE学生制定的保健计划的平均得分率为0.31。UPE 学生的保健计划平均得分率为 0.22。差异最大的是用药、护理措施和后期护理这几个子类别。在这些类别中,IPE 组比 UPE 组更经常考虑特定项目,例如谵妄干预和咨询转院护士:本研究揭示了 IPE 中的跨专业夫妇比 UPE 中的学生更经常考虑的医疗保健行动。临床实践中对这些项目的认识可能会对老年患者的护理产生影响。
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引用次数: 0
Bridging Visual-Spatial Ability and Skill Performance: The Impact of Perceived Quality of a Practical Seminar in Interventional Radiology Education. 连接视觉空间能力与技能表现:介入放射学教育实践研讨会质量感知的影响。
IF 2 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-09-23 eCollection Date: 2024-01-01 DOI: 10.1177/23821205241281647
Jakob Bartels, Joy Backhaus, Ralph Kickuth, Friederika Fluck, Anne Marie Augustin, Sarah König

Background: Medical education integrates skills training and simulation to prepare students for clinical tasks. A seminar on interventional radiology was restructured to include specific practical training utilizing a 3D-catheter model. We aimed to investigate the complex interplay between student evaluations, their visual-spatial ability and practical performance.

Methods: The seminar comprised a short plenary introduction followed by 3 practical training units. Students were tested for their visual-spatial ability and their catheter insertion performance. Students rated the seminar and their interest in the subject. Data were subjected to descriptive, factorial, regression, and moderating analysis.

Results: A total of 141 medical students enrolled in the seminar. They attributed a high didactic and practical quality and expressed great interest in the subject. Male students outperformed females in the cube perspective test. In the practical examination, males needed significantly less time on average (57.9 s) compared to females (73.1 s). However, there were no significant differences in the performance score, with a maximum of 5 attainable points: males 4.61 and females 4.51. The seminar evaluation explained a large portion of the variance (48.6%) in students' interest in the subject. There was a moderating role of practical quality (β = 0.12, P < .05) on the link between the cube perspective test and the practical examination: rated high practical quality could partly compensate for low cube perspective scores, enhancing performance in the practical examination.

Conclusions: Well-designed practical courses and a perceived high teaching quality may assist students with deficits in visual-spatial ability to acquire clinical-practical skills. Such initiatives not only enhance learning outcomes across diverse student groups but also stimulate interest in specialized fields like interventional radiology, thereby potentially guiding future career paths in medicine.

背景:医学教育将技能培训和模拟训练结合起来,为学生完成临床任务做好准备。我们调整了介入放射学研讨会的结构,加入了利用三维导管模型进行的具体实践训练。我们的目的是研究学生的评价、视觉空间能力和实际表现之间复杂的相互作用:研讨会包括一个简短的全体介绍,然后是 3 个实践培训单元。对学生的视觉空间能力和导管插入表现进行了测试。学生对研讨会和他们对该主题的兴趣进行评分。对数据进行了描述性分析、因子分析、回归分析和调节分析:结果:共有 141 名医学生参加了研讨会。结果:共有 141 名医科学生参加了研讨会,他们对研讨会的教学和实践质量给予了高度评价,并对该主题表现出浓厚的兴趣。在立方体透视测试中,男生的成绩优于女生。在实践考试中,男生平均所需时间(57.9 秒)明显少于女生(73.1 秒)。不过,在最高可得 5 分的成绩分数上,男生为 4.61 分,女生为 4.51 分,并无明显差异。研讨会评价解释了学生对该学科兴趣的大部分差异(48.6%)。实践质量起到了调节作用(β = 0.12,P 结论):精心设计的实践课程和可感知的高教学质量可帮助视觉空间能力有缺陷的学生掌握临床实践技能。这些举措不仅能提高不同学生群体的学习成果,还能激发他们对介入放射学等专业领域的兴趣,从而为他们未来的医学职业道路提供潜在的指导。
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引用次数: 0
Artificial Intelligence Readiness Among Jordanian Medical Students: Using Medical Artificial Intelligence Readiness Scale For Medical Students (MAIRS-MS). 约旦医科学生的人工智能准备情况:使用医学生人工智能准备度量表(MAIRS-MS)。
IF 2 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-09-19 eCollection Date: 2024-01-01 DOI: 10.1177/23821205241281648
Mohammad Hamad, Fares Qtaishat, Enjood Mhairat, Ahmad Al-Qunbar, Maha Jaradat, Abdullah Mousa, Baha'eddin Faidi, Sireen Alkhaldi

Background: Artificial intelligence (AI) application is increasingly used in all fields, especially, in medicine. However, for the successful incorporation of AI-driven tools into medicine, healthcare professional should be equipped with the necessary knowledge. From that, we aimed to assess the AI readiness among medical students in Jordan.

Methods: A cross-sectional survey was conducted among medical students across 6 Jordanian universities. Prevalidated Medical Artificial Intelligence Readiness Scale for Medical Students questionnaire was used. The questionnaire was distributed through social media groups of students. SPSS v.27 was used for analysis.

Results: A total of 858 responses were collected. The mean AI readiness score was 64.2%. Students scored more in the ability domain with a mean of 22.57. We found that academic performance (Grade point average) positively associated with overall AI readiness (P = .023), and prior exposure to AI through formal education or experience significantly enhances readiness (P = .009). In contrast, AI readiness levels did not significantly vary across different medical schools in Jordan. Notably, most students (84%) did not receive a formal education about AI from their schools.

Conclusion: Incorporation of AI education in medical curricula is crucial to close knowledge gaps and ensure that students are prepared for the use of AI in their future career. Our findings highlight the importance of preparing students to engage with AI technologies, and to be equipped with the necessary knowledge about its aspect.

背景:人工智能(AI)越来越多地应用于各个领域,尤其是医学领域。然而,要将人工智能驱动的工具成功应用于医学领域,医护人员必须掌握必要的知识。因此,我们旨在评估约旦医科学生的人工智能准备情况:我们对约旦 6 所大学的医学生进行了横向调查。方法:我们对约旦 6 所大学的医科学生进行了横向调查,并使用了医科学生人工智能准备度量表。问卷通过学生社交媒体群组发放。采用 SPSS v.27 进行分析:共收集到 858 份答卷。平均人工智能准备得分率为 64.2%。学生在能力方面的得分较高,平均为 22.57 分。我们发现,学习成绩(平均学分绩点)与人工智能的总体准备程度呈正相关(P = .023),之前通过正规教育或经验接触过人工智能会显著提高准备程度(P = .009)。相比之下,人工智能准备程度在约旦不同医学院之间并无明显差异。值得注意的是,大多数学生(84%)没有从学校接受过有关人工智能的正规教育:将人工智能教育纳入医学课程对于缩小知识差距、确保学生为在未来职业生涯中使用人工智能做好准备至关重要。我们的研究结果凸显了让学生为接触人工智能技术做好准备并掌握必要的相关知识的重要性。
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引用次数: 0
Impact of USMLE Pass/Fail Step 1 Scoring on Current Medical Students. USMLE Pass/Fail Step 1 评分对在校医学生的影响。
IF 2 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-09-19 eCollection Date: 2024-01-01 DOI: 10.1177/23821205241281650
Andrew J Rothka, Megan Nguyen, Tonya S King, Karen Y Choi

Objectives: The aim of this study was to examine students' perceptions of pass/fail scoring for Step 1, particularly when applying to competitive specialties. This study also investigated whether this transition increased anxiety among medical students and elicited student perspectives on the most critical components of residency applications.

Introduction: The United States Medical Licensing Exam (USMLE) Step 1 Board Exam transitioned from a traditional numeric score to pass/fail for exams taken on or after January 26, 2022. One justification for this change, according to a statement from USMLE, was to ease the transition between undergraduate and graduate medical education. Although many factors are considered when selecting candidates to interview for residency, Step 1 scores were historically used as an important metric. Few studies specifically evaluated medical student's attitudes toward the change in Step 1 grading.

Methods: An online survey was distributed to Penn State College of Medicine medical students in the 2024 to 2027 classes. Statistical analysis was conducted on responses to research plans, attitudes regarding Step 1 pass/fail, match rates, and importance of application components.

Results: There was a 21.3% response rate (127/596) to the survey with 30.7% pursuing a competitive specialty. Students applying into competitive specialties felt their chances of matching changed significantly compared to students applying to other specialties (either increased (25.6% vs 10.2%, P < .001), or decreased (28.2% vs10.3%, P < .001). Majority of students (73.2%) agreed with the decision to make Step 1 pass/fail, however, students reported increased anxiety surrounding Step 2 scores. There was a significant association between which aspects students believed were most important for matching (letters of recommendation and performance on Acting Internships) and those they believed program directors would weigh heaviest (P < .001).

Conclusion: Medical students report increased anxiety with Step 2 after Step 1 became pass/fail, although students overwhelmingly agreed with this change. To address this, medical schools should offer further guidance and resources to students, focusing on mentorship and methods to optimize residency applications for their chosen specialties.

研究目的:本研究旨在考察学生对步骤 1 通过/未通过评分的看法,尤其是在申请竞争激烈的专业时。本研究还调查了这一转变是否增加了医学生的焦虑,以及学生对住院医师申请中最关键部分的看法:美国医学执业资格考试(USMLE)第一步考试从传统的数字评分过渡到 2022 年 1 月 26 日或之后参加考试的及格/不及格评分。根据 USMLE 的声明,这一变化的理由之一是为了缓解本科和研究生医学教育之间的过渡。虽然在选择住院医师面试候选人时会考虑很多因素,但步骤 1 分数历来被作为一个重要的衡量标准。很少有研究专门评估医学生对步骤 1 评分变化的态度:向宾夕法尼亚州立医学院 2024 至 2027 级医学生发放了一份在线调查。对研究计划的回复、对第一步通过/未通过的态度、匹配率以及申请内容的重要性进行了统计分析:调查的回复率为 21.3%(127/596),其中 30.7% 的学生选择了竞争激烈的专业。与申请其他专业的学生相比,申请竞争性专业的学生认为他们的匹配机会发生了显著变化(要么增加了(25.6% vs 10.2%,P P P 结论:医学生表示,在步骤 1 变为通过/失败后,他们对步骤 2 的焦虑增加了,尽管绝大多数学生同意这一变化。为了解决这个问题,医学院应为学生提供进一步的指导和资源,重点是导师指导和优化所选专业住院医师申请的方法。
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引用次数: 0
Resident Perceptions of Simulcast Teaching: A Qualitative Study. 住院医师对同步直播教学的看法:一项定性研究。
IF 2 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-09-19 eCollection Date: 2024-01-01 DOI: 10.1177/23821205241281350
Rachel S Casas, Jennifer L Cooper, Susan A Glod, Eliana V Hempel

Objectives: During the COVID-19 pandemic, medical education programs were challenged to optimize learning while balancing social interaction with exposure risk. In response, our internal medicine (IM) residency program transitioned to "simulcast" educational sessions. In simulcast sessions, multiple small groups of learners met in person in separate rooms and connected to the large-group session via videoconferencing. This qualitative study describes IM residents' perceptions regarding the advantages and disadvantages of learning in simulcast compared to virtual and in-person settings during the pandemic.

Methods: Categorical IM residents at Penn State during the academic year 2020-2021 were invited to participate. Eligible residents participated in one 30-min virtual, semistructured focus group. We used inductive thematic coding to analyze resident responses.

Results: Forty-eight percent (n = 29/60) of invited residents participated in focus groups. In the simulcast setting, participants felt more accountability to participate in their small groups compared to a larger group or virtual setting. Educational experiences varied based upon facilitator skill level. Overall, in-person settings were preferred to virtual, when possible, due to increased social connection. Respondents identified educator enthusiasm and presentation quality as key to engagement regardless of setting.

Conclusion: Residents had variable responses to the simulcast setting based upon their comfort with participation by group size, desire for social connection, and perception of teaching strategies. The key identified pitfalls to simulcast teaching were resident discomfort in small groups, heterogeneous learning experience, lack of engagement, and technology challenges. These pitfalls can be mitigated through strategic distribution of learners in groups, trained facilitators, and interactive teaching modalities. Given that simulcast and mixed (simulcast, virtual, and in-person) teaching settings are here to stay postpandemic, anticipating pitfalls and creating adaptable educational content that translates in multiple settings is crucial.

目标:在 COVID-19 大流行期间,医学教育项目面临着如何优化学习效果,同时平衡社会互动与暴露风险的挑战。为此,我们的内科(IM)住院医师培训计划过渡到了 "同步直播 "教育课程。在 "同步直播 "课程中,多个小组的学习者在不同的房间内会面,并通过视频会议连接到大组课程。本定性研究描述了大流行期间,住院医师对同步直播学习与虚拟和面对面学习的利弊的看法:邀请宾夕法尼亚州立大学 2020-2021 学年的住院医师参加。符合条件的住院医师参加了一个 30 分钟的半结构化虚拟焦点小组。我们使用归纳式主题编码来分析住院医师的回答:48%(n = 29/60)的受邀住院医师参加了焦点小组。在同步直播环境中,与大型小组或虚拟环境相比,参与者在参与小组活动时更有责任感。教育体验因主持人的技能水平而异。总体而言,在可能的情况下,受访者更愿意选择面对面的环境,而不是虚拟环境,因为这样可以增加社交联系。受访者认为,无论在哪种环境下,教育者的热情和演示质量都是参与的关键:住院医师对同步直播环境的反应各不相同,这取决于他们对参与小组规模的舒适度、对社交联系的渴望以及对教学策略的看法。已确定的同步直播教学的主要缺陷是住院医师在小组中的不适感、异质学习体验、缺乏参与性以及技术挑战。这些隐患可以通过有策略地分配小组学习者、训练有素的主持人和互动教学模式来缓解。鉴于同步直播和混合(同步直播、虚拟和面对面)教学环境将在流行后继续存在,因此,预测陷阱并创建可在多种环境中转换的适应性教育内容至关重要。
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引用次数: 0
Enhancing Anesthesia Education and Clinical Practice: A Comprehensive Review of GASMAN Simulation Software 加强麻醉教育和临床实践:全面回顾 GASMAN 仿真软件
IF 2.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-09-18 DOI: 10.1177/23821205241283804
Chao Chen, Shengfeng Yang, Xinglong Xiong, Yewei Shi, Xingfeng Zhong, Jing Shi
GASMAN software, a simulation tool for inhalational anesthetics’ pharmacokinetics and pharmacodynamics, has become essential in both anesthesia education and clinical practice. This review explores its applications, highlighting its effectiveness in enhancing medical education and its impact on clinical anesthesia management. In educational settings, GASMAN software facilitates a deeper understanding of anesthetic pharmacology through interactive and visual simulations, thereby improving students’ learning outcomes and engagement. Clinically, it aids anesthesiologists in optimizing anesthetic dosing, enhancing patient safety, and supporting real-time decision-making during surgeries. Despite its advantages, GASMAN software faces limitations such as the absence of physiological feedback and the need for continuous data model updates. Future directions include technical enhancements, integration with advanced patient simulators, and broader dissemination through educational partnerships. This review emphasizes the significant contributions of GASMAN software to anesthesia education and clinical practice and suggests pathways for future improvements and wider adoption.
GASMAN 软件是吸入麻醉药的药代动力学和药效学模拟工具,已成为麻醉教育和临床实践中必不可少的工具。本综述探讨了该软件的应用,强调了它在加强医学教育方面的有效性及其对临床麻醉管理的影响。在教育环境中,GASMAN 软件通过互动和可视化模拟,帮助学生加深对麻醉药理的理解,从而提高学习效果和参与度。在临床上,它可以帮助麻醉医师优化麻醉剂量、提高患者安全性并支持手术过程中的实时决策。尽管 GASMAN 软件具有诸多优势,但它也面临着一些限制,如缺乏生理反馈和需要持续更新数据模型。未来的发展方向包括技术改进、与先进的病人模拟器集成以及通过教育合作进行更广泛的推广。本综述强调了 GASMAN 软件对麻醉教育和临床实践的重大贡献,并提出了未来改进和更广泛应用的途径。
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引用次数: 0
Decreasing the Anxiety and Shame of Medical Students Not Placing into a Residency Using an Innovative Fifth-Year Educational Intervention 利用创新的五年级教育干预措施,减少医学生因未被安排住院实习而产生的焦虑和羞耻感
IF 2.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-09-18 DOI: 10.1177/23821205241284459
Heather P Ferrill, Amanda Brooks
US medical students, even before the COVID-19 pandemic, exhibited higher rates of mental health challenges than age-matched cohorts. The National Resident Matching Program (NRMP) match process, which places medical students into residency, is the culmination of medical school training and a well-recognized stressor that amplifies anxiety levels and the mental strain that accompanies medical school. Facing an unprecedented year with a decrease in 2021 NRMP placement percentages, Rocky Vista University College of Osteopathic Medicine (RVUCOM) introduced an innovative new program, the predoctoral internship (PDI), to support students who did not match into a residency program. At no extra expense to the student, this program offers a year-long opportunity to customize experiences in both clinical and academic settings, along with leadership training, aimed at bolstering their residency applications. Alternatively, students could participate in a Master's PDI (MPDI), which allowed students to concurrently pursue a master's degree of their choosing with an external program. RVUCOM achieved 100% placement for students completing the PDI or MPDI program, aligning with the institution's historical graduate trends. Perhaps equally important, students in the program reported feeling supported and less ashamed, fostering loyalty to RVUCOM. Transparency in communication and leaning into institutional values reinforced trust within community partners. The intentional balance of rigor and support, coupled with faculty investment, proved crucial for success. The experience held students accountable, allowing personal and professional growth and fostering the development of a deeper professional identity. RVUCOM's innovative approach to unplaced students not only addresses the challenges faced by RVUCOM students not achieving a residency placement, but also transforms an unforeseen circumstance into an opportunity for growth, resilience, and the development of more competitive and accountable medical graduates.
即使在 COVID-19 大流行之前,美国医科学生的心理健康挑战率也高于同龄学生。国家住院医师配对计划(NRMP)配对过程是将医学生安排到住院医师岗位的过程,是医学院培训的顶点,也是公认的压力源,它放大了医学院的焦虑水平和精神压力。面对 2021 年 NRMP 分配比例空前下降的局面,洛基维斯塔大学骨医学院(RVUCOM)推出了一项创新的新计划--博士前期实习(PDI),为未能匹配到住院医师项目的学生提供支持。学生无需支付额外费用,即可在为期一年的实习中获得临床和学术方面的定制经验,并接受领导力培训,以帮助他们申请住院实习。此外,学生还可以参加硕士学位课程(MPDI),在攻读硕士学位的同时,还可以选择参加外部课程。完成 PDI 或 MPDI 项目的学生,RVUCOM 实现了 100% 的就业率,这与该学院历年的毕业生趋势一致。也许同样重要的是,参加该项目的人都表示感觉受到了支持,不再感到羞愧,从而提高了对 RVUCOM 的忠诚度。沟通的透明性和机构价值观的倾斜加强了社区合作伙伴之间的信任。严谨与支持的有意平衡,再加上教师的投入,被证明是成功的关键。这种经历让学生承担起责任,实现了个人和专业的成长,并促进了更深层次的专业认同感的发展。RVUCOM 针对未被安排实习的学生所采取的创新方法不仅解决了 RVUCOM 未被安排实习的学生所面临的挑战,还将不可预见的情况转化为成长、适应能力以及培养更具竞争力和责任感的医学毕业生的机会。
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引用次数: 0
Using Group History-Taking and Individual Reasoning to Identify Shortcomings in Clinical Reasoning for Medical Students. 利用集体病史采集和个人推理找出医学生临床推理的不足之处。
IF 2.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-09-16 DOI: 10.1177/23821205241280946
Kuan-Hao Cheng,Chi-Yu Lee,Yih-Jer Wu,Ching-Chung Lin
OBJECTIVEIt is crucial that teaching faculties determine and remain informed of medical school learners' clinical reasoning competence. We created an innovative assessment method for fourth-year medical students to identify deficiencies in various components of their clinical reasoning ability.METHODSThis was a cross-sectional observational study of fourth-year medical students' reasoning assessments from 2019 to 2022. Teams of four-five trainees questioned standardized patients in clinical scenarios, including fever, abdominal pain, and weight loss. They then individually documented key information to reflect comprehension of patient problems. Trainees were tasked with differentiating diagnoses and associated statuses and reaching the most likely diagnosis along with two tentative diagnoses. The correlations observed between 2020 and 2022 for abdominal pain were analyzed using student t-tests.RESULTSA total of 177 students participated in this study. Across the scenarios, there was no significant difference in key information representation scores (56%-58%). Reasoning ability scores were 49% for fever, 57% for abdominal pain, and 61% for weight loss. A comparison between 2020 and 2022 revealed a significant improvement in the objective structured clinical examination scores and differential diagnoses (P < .01). Shortcomings included brief chief complaint duration, lack of detailed presentation, and insufficient description of negative information. Differential diagnosis and diagnostic justification were inadequate for acute and chronic conditions, and disease location clarity within the organ system was lacking. On average, students presented two correct diagnoses.CONCLUSIONSFourth-year medical students exhibited inadequate reasoning abilities, particularly in fever and abdominal pain scenarios, with deficiencies in hypothesis generation and differential diagnosis. Group history-taking with individual reasoning assessment identified students' shortcomings and provided faculty feedback to improve their teaching strategies.
目的教学部门确定并随时了解医学院学生的临床推理能力至关重要。我们为四年级医学生创建了一种创新的评估方法,以发现他们临床推理能力各方面的不足。由四五名学员组成的小组在发热、腹痛和体重减轻等临床场景中对标准化患者进行提问。然后,他们各自记录关键信息,以反映对患者问题的理解。受训人员的任务是区分诊断和相关状态,并得出最可能的诊断和两个初步诊断。使用学生 t 检验分析了 2020 年和 2022 年腹痛之间的相关性。在不同的情景中,关键信息表述得分(56%-58%)没有显著差异。推理能力得分分别为:发烧 49%、腹痛 57%、体重减轻 61%。2020 年和 2022 年的对比显示,客观结构化临床检查得分和鉴别诊断得分均有显著提高(P < .01)。不足之处包括主诉时间简短、缺乏详细描述以及负面信息描述不足。对急性和慢性疾病的鉴别诊断和诊断依据不足,器官系统内的疾病位置不够清晰。结论四年级医学生的推理能力不足,尤其是在发热和腹痛情景中,在假设生成和鉴别诊断方面存在缺陷。通过集体病史采集和个人推理评估发现了学生的不足,并为教师改进教学策略提供了反馈。
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引用次数: 0
What Does Men's Health Education Look Like in Australian University Health Curricula? A Formative Evaluation and Future Enhancement Opportunities 澳大利亚大学健康课程中的男性健康教育是什么样的?形成性评估与未来改进机会
IF 2.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-09-10 DOI: 10.1177/23821205241271564
Zac E. Seidler, Michelle Sheldrake, Ruben Benakovic, Michael J. Wilson, Neil Hall, Gary A. Wittert, Margaret A. McGee
OBJECTIVESDeveloping the capacity of the health system, and the practitioners within it, to provide quality gender responsive care to men and boys remains critical to advancing men's health, and reducing health inequities amongst men. The aim for this study was to undertake a formative evaluation of Australian university health curricula for men's health content and scope the opportunities for future enhancement.METHODSA two-stage evaluation first involved a review of online course information for a sample of medicine ( n = 10), nursing ( n = 10), pharmacy ( n = 10), clinical psychology ( n = 10), social work ( n = 12) and public health ( n = 15) university curricula for men's health and gender content and opportunities for curricula enhancement. Secondly, university staff completed a survey on the coverage of men's health in their course(s), and receptivity, barriers and facilitators to curricula enhancement.RESULTSThe curricula review found no dedicated men's health courses, and men's health was referenced in the information for 10 of 1246 courses (0.8%) in 8 of 67 curricula. Gender was rarely referenced in course information, particularly for the disciplines of medicine, nursing, pharmacy, and clinical psychology. There was an average of 16 enhancement opportunities per curricula with 40% relating to communicating and engaging with men within healthcare. Seventy staff from 25 universities and all target disciplines validated the curricula review findings of limited dedicated men's health content. Eighty-three percent were receptive to curricula enhancement, facilitated by content integration into existing courses.CONCLUSIONThis review provides clear evidence that there are gaps, opportunities, and educator receptiveness for improving and implementing content regarding men's health education and gender responsive care in Australian university health curricula.
目标提高医疗系统及其从业人员的能力,为男性和男童提供优质的性别关怀服务,对于促进男性健康和减少男性健康不平等现象至关重要。这项研究的目的是对澳大利亚大学的男性健康课程内容进行形成性评估,并确定今后的改进机会。方法评估分为两个阶段,首先是对医学(10 人)、护理学(10 人)、药学(10 人)、临床心理学(10 人)、社会工作(12 人)和公共卫生(15 人)等大学的男性健康和性别内容以及课程改进机会的在线课程信息进行抽样审查。其次,大学教职员工完成了一项调查,内容涉及其课程中有关男性健康的内容,以及对课程强化的接受程度、障碍和促进因素。结果课程审查发现没有专门的男性健康课程,在 67 门课程中,有 8 门课程的 1246 门课程中的 10 门课程(0.8%)的信息中提到了男性健康。课程信息中很少提及性别,尤其是医学、护理学、药学和临床心理学等学科。每门课程平均有 16 个提升机会,其中 40% 与医疗保健领域中与男性的沟通和接触有关。来自 25 所大学和所有目标学科的 70 名教职员工证实了课程审查结果,即专门针对男性健康的内容有限。83%的教职员工表示可以通过将课程内容整合到现有课程中的方式来加强课程内容。结论:本次审查提供了明确的证据,表明在澳大利亚大学卫生课程中,存在着改进和实施男性健康教育和性别护理内容的差距、机会和教育者接受度。
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引用次数: 0
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Journal of Medical Education and Curricular Development
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