Journal of Medical Education and Curricular Development最新文献

The evolving landscape of transgender healthcare in the United States has become more fraught with challenges following the 2024 presidential election and associated policy shifts, especially with the implementation of Executive Order 14168 (EO 14168). EO 14168 mandates a binary understanding of gender based on biological sex assigned at birth and imposes constraints on federal funding, academic freedom, and access to medical training related to gender-affirming care. Although the order is currently under legal challenge and its implementation remains uneven, it has already caused tangible disruptions in academic medical settings, with transgender clinics reporting increased patient anxiety, reduced visibility of LGBTQ +  content in federal resources, and institutional self-censorship of curricular content, even moreso in areas struggling with LGBTQ +  inclusion prior to EO 14168. Medical education, which has historically lacked comprehensive training on transgender health, is now at heightened risk of inadequate preparation for future physicians. Many medical schools continue to struggle with core curricula on gender-affirming care, leaving providers unprepared to meet the unique needs of transgender patients. This paper provides concrete examples of how EO 14168 has affected medical education and offers 5 evidence-based strategies, including as faculty development programs, protected simulation-based curricula, and institutional policy adaptations, to resist censorship and preserve high-quality, inclusive care training.

Background: It is increasingly important to create longitudinal advocacy education opportunities starting as early as medical school to train physicians capable of handling the complexities of the social determinants of health that they will encounter in their communities. This is a brief overview of the journey of medical students in developing an interdisciplinary, longitudinal advocacy curriculum at the University of New Mexico School of Medicine (UNM SOM).

Methods: The Healthcare Advocacy Initiative of New Mexico (HAINM) has disseminated information on the significance and structure of health policy in New Mexico through various educational opportunities by communicating with state representatives, community advocates, law students, professors, and professional advocacy organizations. To analyze the significance of these experiences, a survey was conducted at the capstone event.

Results: Pre- and post-test survey responses from the interprofessional "Med/Law/Psych Day 2025" event were analyzed using Wilcoxon signed-rank tests. Two events were found to be statistically significant (developing a plan to change policy related to healthcare issues and teaching other peers advocacy skills) with P < .05 and .04, respectively. Differences in survey data collected before and after the interprofessional advocacy event demonstrate that a majority of respondents reported a mild to moderate increase in proficiency after attending the event.

Discussion: HAINM has become a hub for a continuous medical advocacy curriculum that is available to medical students through all 4 years of training. This provides interested students with a solid foundation, a skill set, and a network to pursue interprofessional advocacy work successfully.

Purpose: A dermatoscope, a hand-held magnifying polarized illuminating device, is a powerful tool in the clinician's tool kit for skin cancer examination (SCE), allowing for better screening and diagnostic accuracy. Yet, few physicians are trained to leverage its potential. This scoping review explores current approaches to dermoscopy education among undergraduate medical trainees. A systematic scoping review was conducted by searching 5 databases: Medline, Embase + Classic, Scopus, Web of Science, and Education Resources Information Center.

Major findings: A total of 12 primary articles met the inclusion criteria published between 2012 and 2024 with a total of 1286 participating medical students, most of whom were clerks (n_studies = 6, 50.0%, n_participants = 498/1286 = 38.7%). Most studies were pre- and posttest control trials (n_S = 5, 41.7%, n_P = 980/1286 = 76.2%) assessing SCE performance after dermoscopy teaching. Short-term retention and performance were evaluated in 9 studies (n_S = 9, 75.0%, n_P = 884/1286, 68.7%), in which 5 studies reported immediate statistically significant improvement in posttest scores following their respective educational intervention (P < .05) (n_S = 5, 41.7%, n_P = 323/1286 = 25.1%). Long-term retention was assessed in 3 studies with heterogenous findings (n_S = 3, 25.0%, n_P = 432/1286 = 33.6%). Many studies lack explicit reference to a structured framework for teaching dermoscopy (n_S = 7, 58.3%, n_P = 849/1286 = 66.0%).

Conclusions: The literature has shown successful curricular implementation and effectiveness of dermoscopy teaching at this level. Future research may focus on strategies for curricular integration, long-term retention, and connections to later stages of training and patient care.

Introduction: There is a growing demand for more thoughtful and holistic healthcare. Whole-person integrative medicine (IM) is cost-effective and clinically effective for enhancing health and well-being. However, existing knowledge gaps in IM among healthcare professionals prevent the application of IM practices in patient care. This project aimed to develop and refine an IM elective to improve health education and learning, thereby enhancing future physicians' knowledge, skills, and self-care practices.

Methods: Three separate cohorts of third- and fourth-year medical students (n = 18) participated in a four-week immersive IM elective. Weekly and postelective evaluations were used to assess changes in attitudes, behaviors, and self-reported IM knowledge for each cohort. Descriptive analyses were performed, and just-in-time student feedback was used to iteratively refine the IM curriculum.

Results: Students attended at least 85% of class days. Anonymous weekly course evaluation ratings for meeting course expectations, education depth, and usefulness for patient care ranged between 4 and 5 on a Likert scale, with 5 as the most favorable. Postcourse evaluations and the impact of the course on attitudes related to patient care, personal lifestyle, and self-awareness also ranged from 4 to 5. Knowledge scores significantly improved (p < .01), with moderate to large effect sizes (Hedges g's > 0.8).

Conclusions: The implementation of an immersive elective curriculum in IM resulted in high levels of satisfaction, changes in attitudes and behaviors, as well as knowledge scores. Just-in-time feedback and curricular revisions made this curriculum effective for student training. We consider this our first step in integrating IM into the required curriculum for all students, ensuring that, as educators, we close the knowledge gap in IM among future physicians. Empowered with that knowledge, we anticipate them serving their future patients with a more holistic and patient-centered approach.

Background: Scholarly activity is a key requirement in pediatric subspecialty fellowship training. However, clear guidance on how to effectively support fellows in their scholarly endeavors remains limited.

Objective: This study assesses the impact of a week-long departmental scholarship curriculum designed to enhance fellows' research competencies.

Methods: In 2024, a curriculum was designed and delivered to first-year pediatric subspecialty fellows over 5 days, combining group learning sessions with individualized tasks. Pre- and post-curriculum surveys assessed fellows' confidence and knowledge across key scholarly domains. Daily session evaluations provided additional feedback. Fourteen fellows from 9 pediatric subspecialty programs participated.

Results: All first-year fellows (n = 14, 100%) participated. Improvements in fellows' confidence were observed across all domains (P < .05). While knowledge scores increased, the gains were not statistically significant. Participants rated the overall curriculum positively, and notably, appreciated the individualized tasks and experience of presenting their developing project.

Conclusions: This week-long curriculum increased fellows' confidence in their scholarly abilities, highlighting the value of a structured, departmental approach to fostering academic engagement. While knowledge improvements were modest, the overwhelmingly positive evaluations support this curriculum approach as a potential model for enhancing scholarly activity in fellowship programs. Further research is needed to explore the long-term impacts on fellows' scholarly productivity and career development.

Background: Despite growing interest in implementation and dissemination science as a driver of healthcare quality and equity, practical, competency-based curricula for advanced graduate and postgraduate students remain limited. Existing offerings are often introductory, with varied depth and limited focus on applied skill-building.

Objective: To describe the design and rationale of a competency-based Practical Implementation Science course developed to equip advanced learners with the skills needed to translate evidence into real-world practice.

Methods: The course was developed using the textbook Practical Implementation Science: Moving Evidence into Action as its primary source and structured around the Quality Implementation Framework. It was informed by constructivist, experiential, and adult learning theories and aligned with recognized dissemination and implementation science (IS) competencies.

Results: A flipped classroom model will be used to deliver instruction, supporting active, practice-based learning through pre-class preparation and in-class application of IS concepts. The course includes 15 weekly sessions covering core topics such as identifying practice gaps, adapting evidence-based interventions, stakeholder engagement, evaluation planning, and sustainability. Each session is designed to integrate theory with application via case studies, team exercises, and iterative project work. The course is intended to be flexible in delivery (in-person or online), interdisciplinary in scope, and adaptable to the needs of students in medicine, pharmacy, nursing, public health, and allied health. It targets beginner and intermediate competency levels and incorporates formative and summative assessments. Students will progressively develop capstone projects, with structured opportunities for peer and instructor feedback during interactive in-class discussions.

Conclusions: This proposed course represents a scalable and flexible model for preparing healthcare learners in applied IS. Future directions include pilot testing, formal evaluation, interprofessional adaptation, and global implementation to support a diverse and equity-oriented workforce capable of translating evidence into practice.

Purpose: A doctorate degree in surgery is awarded by universities in recognition of high-standard academic research. This study explores the global heterogeneity of PhD programs in surgery and evaluates them using a standardized rating scale.

Method: A cross-sectional survey was distributed electronically to surgical doctoral programs worldwide. A 25-point rating scale was developed to assess program quality across domains such as dissertation requirements, number and type of publications, journal quartiles, and authorship position. Programs achieving ≥15 points were classified as "excellence-PhD" (e-PhD). Scores were compared across world regions and by university ranking (Shanghai Ranking).

Results: A total of 949 PhD programs from the 193 United Nations member countries were contacted. Completed questionnaires were returned by 187 departments (response rate 19.7%) from 52 countries. Most departments, 138 out of 187 (73.9%) lacked clear requirements for dissertations based on a single research project, while more explicit criteria existed for thesis by publications: originality 77 out of 187 (41.2%), journal metrics 126 out of 187 (67.9%), and candidate authorship. Program scores showed wide heterogeneity, with higher scores more frequently associated with universities ranked higher in the Shanghai classification. Regional differences were also noted in funding opportunities and evaluation processes.

Conclusions: Global PhD programs in surgery demonstrate substantial variability in structure and quality, as measured by a newly developed rating scale. While the scale shows promise in identifying high-quality (e-PhD) programs, its practical application may be limited by response bias and differing academic norms. Nonetheless, these findings offer a framework for benchmarking and improving doctoral training in surgical research globally.

As medical education evolves in response to the transition of the United States Medical Licensing Examination (USMLE) Step 1 exam to a pass/fail system, there is growing momentum to shorten the traditional two-year preclinical curriculum. This reflective piece, co-authored by two medical students, explores the motivations behind this shift, including the desire for earlier clinical exposure, reduced academic pressure, and a curriculum better aligned with long-term clinical competence. The authors acknowledge potential benefits, such as enhanced student engagement and improved relevance of foundational knowledge, but caution against a rushed transition. Risks include compromised scientific understanding, inequities among students with differing backgrounds, and insufficient time for professional identity formation. The article calls for thoughtful, evidence-based reform that ensures equity, supports foundational competence, and incorporates diverse student perspectives. Ultimately, while the shortening of preclinical years may offer advantages, it must be implemented carefully to avoid undermining the very foundations of medical education.

The COVID-19 pandemic rapidly transformed medical education, exposing both challenges and opportunities in online, in-person, and hybrid instructional models. This Viewpoint proposes a five-pillar framework for effective hybrid medical education: curricular alignment, faculty development, interactive online pedagogy, flexibility with accountability, and data-driven feedback. Drawing on the experience of two medical students and the perspective of an anatomy professor, an award-winning educator and curriculum leader, we offer a framework for hybrid medical education. While our viewpoint centers on undergraduate medical education, we recognize concerns from graduate medical educators about downstream resident preparedness and the need for broader collaboration. Our framework addresses learner engagement, clinical preparedness, and equity. We recommend that academic leaders adopt and periodically audit curricula using this framework to ensure educational quality and readiness for future disruptions.

While anesthesia is frequently characterized by its technical demands and focus on procedural skills, our clinical experiences reveal an equally critical yet often overlooked, need for effective, humanistic communication. Unlike other specialties where rapport builds over time, anesthetists must establish trust, calm fears, and deliver essential information within minutes, often at moments of intense vulnerability for patients. These brief interactions, although fleeting, carry significant emotional and clinical weight. In this perspective, we argue that communication in anesthesia should be treated as a core clinical competency, rather than a peripheral soft skill. We propose low-resource strategies such as brief empathy prompts, simulation debriefs focused on interpersonal tone, and reflective exercises, to help make the hidden curriculum visible. Such interventions not only enhance patient care but also contribute to professional identity formation and may protect against clinician burnout. By elevating the role of communication alongside technical mastery, anesthesia education can better prepare students for the full scope of practice.