Journal of Medical Education and Curricular Development最新文献

Background: The lifestyle of most people was forced to change due to the COVID-19 pandemic. Perhaps after the pandemic, we will find that these subtle changes in life and from the depths of our hearts are thorough and profound. They may form our conceptual consensus and behavioral habits, becoming part of our long-term personal consciousness. This study explored the impacts of the COVID-19 pandemic on the future life behavior intentions of medical and health-related students studying at universities in China.

Methods: Electronic questionnaires were distributed to students studying at 3 universities in China. A total of 251 valid questionnaires were obtained, and the chi-squared test was used to compare the corresponding groups.

Results: In the future, students plan to pay more attention to wearing masks and maintaining social distance in public places, do more online shopping, have more meals at home or in the canteen, engage in less international travel, and have fewer gatherings with friends. However, compared with Chinese students, more non-Chinese students plan to increase domestic and international travel and reduce online learning. Furthermore, only among non-Chinese students did gender, urban or rural origin, and family economic conditions influence how the COVID-19 pandemic affected their future life behaviors.

Conclusion: The COVID-19 pandemic changed the future life behavior intentions of medical and health-related students. The future behaviors of these students will impact the entire society. This study will help the government and policymakers predict and prepare for general lifestyle changes in our society.

Introduction: Negative attitudes towards mental illness are known to exist among medical students in Nigeria. However, the effect of undergoing a rotation in psychiatry on their attitudes is uncertain.

Objectives: It aimed to determine the effect of psychiatry posting during medical training on medical students' attitudes toward mental illness and examine the association of posting-related and demographic factors with their attitudes.

Methods: It is a prospective cohort study in which 187 medical students from three different universities were followed up during their psychiatry postings in two different posting sites. Questionnaires containing basic demography, posting-related variables, and the Community Attitude to Mental Illness (CAMI) scale were administered to all available students before and after the rotation in psychiatry. A paired t-test was applied to test the differences in the CAMI scores before and after posting, while ANOVA and hierarchical regression were utilized to determine the association of variables with the CAMI scores.

Results: There were significant differences between the pre-and post-rotation CAMI scores in CAMI's social restrictiveness (SR) and community mental health ideology (CMHI) domains, indicating improved attitudes. Demographic factors had no significant influence on the students' attitudes, but the length of posting, university of the students, and posting sites had varying impacts.

Conclusion: Psychiatry rotation has a positive impact on students' attitudes toward mental illness in both posting sites, particularly in the domains of SR and CMHI. This underscores the importance of psychiatry training in medical education in changing the attitudes of future healthcare professionals.

Objective: Physicians often use mobile apps for patient care, but few apps are dedicated to pediatric critical care medicine (PCCM). This study developed a mobile app specifically for Pediatric Critical Care Unit (PICU) residents to aid their onboarding process and aimed to assess whether it could enhance their confidence and comfort levels.

Method: From March 2020 to April 2021, 90 residents participated and completed pre- and post-rotation quizzes with 20 questions each. Quiz score differences between the control and app groups were analyzed using t-tests. A survey was also administered at the end of the rotation to compare comfort level and confidence in PCCM knowledge pre- and post-rotation.

Results: Enrollment included 50 residents in the control group and 40 in the app group. The participation rate was 100%, but not all participants completed both quizzes and survey. The app group showed a significantly greater improvement in quiz scores from pre- to post-rotation compared to the control group (increase of 0.23 questions vs 1.67, p = 0.045). However, the two groups had no significant differences in confidence in PCCM knowledge (p = 0.246) or comfort levels (p = 0.776) in the PICU.

Conclusions: This study found no significant difference in confidence levels between the App and control groups at the end of the PICU rotation. However, the App group outperformed the control group in knowledge assessments. Frequent use of the app likely reinforced essential concepts and facilitated adaptation to the PICU service. Overall, the app's positive impact on knowledge and adaptation indicates it is a valuable tool for enhancing medical residents' educational experiences in busy clinical environments.

Objectives: While medical education requires frequent interactions with attending physicians and supervisors, little research has explored the role of supervisory alliance in the learning process. In other learning environments, supervisory alliance, or the bond between a supervisor and trainee, is considered a key ingredient of effective supervision. Medical educators or attending physicians who aim to enhance learning and engagement in medical education may benefit from understanding specific factors that increase or decrease engagement and how those might intersect within a context that requires learning through supervision. This cross-sectional study examined associations between supervisory alliance and (a) program satisfaction, (b) educational engagement, (c) and career purpose.

Methods: Participants were medical trainees from the rural Northeast (n = 108, response rate = 81%) who completed an electronic and anonymous survey.

Results: Multiple linear regression was used to examine whether total supervisory alliance independently predicted behavioral and emotional engagement in learning while controlling for hours slept, hours worked, and burnout. Supervisory alliance predicted trainees' career purpose, program satisfaction, and emotional engagement in learning.

Conclusions: Findings from this study lay groundwork for consideration of the role of supervisory alliance in medical learning processes. Future research might explore whether targeted mentorship programs or faculty enhancement training that focuses on the supervisory relationship might positively impact learning outcomes.

Postgraduate medical education in clinical settings poses many challenges secondary to the large volume of knowledge to be acquired, competing clinical responsibilities, and fatigue. To address these challenges, a microlearning curriculum using flipped classroom methodologies was created to facilitate the mastering of fundamental physiology formulas by pediatric critical care medicine fellows. Forty physiology formulas were distilled into 5-minute microlearning sessions. Fellows were provided the weekly formula and encouraged to self-study prior to the face-to-face learning. The 5-minute session took place at the beginning of a regularly scheduled clinical care conference where normal values, explanatory diagrams, and board-like questions were discussed. A faculty or fellow facilitator then provided a more in-depth explanation and shared clinical pearls related to the formula. Following the session, an e-mail summarizing the learning points was sent. The curriculum was well received by fellows and faculty. Over 5 years, the curriculum evolved through phases of active development, implementation, minor modifications, transition to a virtual platform, shift to senior fellow-led instruction, and harmonization with other curricular activities. Engagement and sustainability were addressed with a fully flipped classroom, where senior fellows served as teachers to junior fellows. Microlearning in a multimodal manner is an excellent method for teaching busy postgraduate clinical trainees fundamental physiology formulas that underpin pediatric critical care decision-making. The gradual transition from individual learning to a flipped classroom taught by peers with faculty support was well tolerated and consistent with adult learning theories. The transition was essential to ensure the sustainability of the curriculum.

Objectives: This study sought to examine the views of international graduates regarding how they perceived the Joint Medical Program Bachelor of Medicine (JMP BMed) undergraduate training prepared them to practice in a health system different from that in which they had studied. Eighteen international graduates of the JMP between 2010 and 2017 inclusive agreed to be interviewed face-to-face.

Methods: JMP BMed international graduates were interviewed using 18 standardized questions to elicit perceptions of their preparedness to practice and reflections on their training experience. The interview data were qualitatively analyzed, and the main themes were identified and categorized.

Results: Overall, the international graduates of the JMP BMed curriculum felt well-prepared for tasks associated with communication, self-directed learning, and approaching mental health issues. Conversely, they perceived the level of clinical exposure and experience as inadequate in preparing them for the expected level of medical knowledge and responsibility. They also felt underprepared for navigating a different health system.

Conclusions: The strengths and weaknesses identified in the JMP BMed program in its preparation of international graduates, particularly those who chose to practice in their country of origin, are of relevance for all medical schools that enrol international students. Greater awareness of the needs of international medical students returning home to practice may be of value for future curriculum planning purposes to ensure that medical schools optimally prepare their graduates to practice with confidence in a range of healthcare systems.

I am a healer, yet sometimes I do more harm than good…David Hilfiker, 1984.

Objectives: Medical error is common and significantly impacts patients, physicians, learners, and public perception of the medical system; however, residents receive little formal training on this topic. Research on error response in practicing physicians is limited, and even more so on medical education interventions to improve this. This study evaluates a curriculum developed to foster the sharing of faculty medical error stories, practice of constructive coping strategies, and growth in resident confidence in managing error.

Methods: Researchers identified factors related to effective physician error management and recovery to develop a targeted intervention for family medicine residents. The intervention consisted of three one hour didactic sessions in a medium-sized midwestern, urban family medicine residency program over the course of 6 months. Instructional methods included guided reflection after mentor storytelling, small group discussion, role play, and self-reflection.

Results: Of the 30 residents, 22 (73%) completed the preintervention survey, and 15 (50%) completed the postintervention survey. While most residents reported having experienced error (55%), fewer than half of the residents reported they knew what to do when faced with medical errors (46%). This increased to 93% after intervention. Personal error stories from mentors were the most desired type of training reported by residents preintervention, but this was surpassed by legal and malpractice concerns in the postintervention survey. Rates of reported error story sharing increased after the intervention. Residents reported self-efficacy (I can be honest about errors) and self-awareness (I acknowledge when I am at increased risk for error) also increased with intervention. However, these changes did not reach statistical significance.

Conclusions: Family medicine residents are receptive to learning from peers and mentors about error management and recovery. A brief intervention can impact the culture around disclosure and support. Future research should focus on the impact of targeted interventions on patient-oriented outcomes related to medical error.

Objectives: Proficiency in medical writing and publishing is essential for medical researchers. Workshops can play a valuable role in addressing these issues. However, there is a lack of systematic summaries of evidence on the evaluation of their impacts. So, in this systematic review, we aimed to evaluate all articles published on the impact of such workshops worldwide.

Methods: We searched Ovid EMBASE, Ovid Medline, ISI Web of Science, ERIC database, and grey literature with no language, time period, or geographical location limitations. Randomized controlled trials, cohort studies, before-after studies, surveys, and program evaluation and development studies were included. We performed a meta-analysis on data related to knowledge increase after the workshops and descriptively reported the evaluation of other articles that did not have sufficient data for a meta-analysis. All analyses were performed using Stata software, version 15.0.

Results: Of 23 040 reports, 222 articles underwent full-text review, leading to 45 articles reporting the impacts of workshops. Overall, the reports on the impact of such workshops were incomplete or lacked the necessary precision to draw acceptable conclusions. The workshops were sporadic, and researchers used their own method of assessment. Meta-analyses of the impact on the knowledge showed that workshops could nonsignificantly increase the mean or percentage of participants' knowledge.

Conclusion: In the absence of systematic academic courses on medical writing/publishing, workshops are conducted worldwide; however, reports on educational activities during such workshops, the methods of presentations, and their curricula are incomplete and vary. Their impact is not evaluated using standardized methods, and no valid and reliable measurement tools have been employed for these assessments.

Objectives: To create and implement a brief, self-directed course on immunotherapy (IT) best practices for trainees on a neuroimmunology elective rotation.

Methods: A working group of neurology faculty developed a curriculum covering the mechanism of action, indications, and necessary monitoring for different IT used in neurology practice. The content was presented as a web-based course and hosted on local servers. Neurology residents and fellows participating in a neuroimmunology elective were given access to the curriculum over a 2-week period. A multiple-choice assessment and questionnaire assessing learner confidence with IT was administered prior to starting the course, and again upon course completion. Twelve months after implementation, the pretest and posttest were revised following an item analysis.

Results: Twenty-two neurology residents and fellows completed the course since July 2022. The average score on the first version of the pretest and posttest was 78% versus 92% (P = .02), and 51% versus 70% (P = .02) on the revised version. Trainee self-reported confidence with IT also improved, although only 59.1% of trainees completed the postcourse questionnaire. Respondents provided positive feedback on the format and content of the course and expressed a desire for a reference to the material for future use.

Conclusion: In this pilot study, our course improved resident confidence and knowledge of IT best practices. The course was well-received, and our methods can be implemented in a variety of clinical environments to supplement trainee learning.

Objectives: Research into interdisciplinary education, where concrete examples and empirical evidence of interdisciplinary teaching is explored, is limited. Furthermore, there are no standardized guidelines on best practices for designing and implementing an interdisciplinary curriculum. Recently, in healthcare settings there has been a drive to adopt interdisciplinary or transdisciplinary practices, creating a need for training individuals capable of working across discipline-specific boundaries, or to even adopt a transdisciplinary practice. This is partially attributed to recognizing that local and global complex health challenges are interlinked and share common factors and often require a new integrated approach to management. In response, a new interdisciplinary course using a modified snowflake model of interdisciplinary course design was launched at a medical school. The course aimed to provide a broad foundation for lifelong learning with a strong emphasis on the development of knowledge, skills, and professional values essential for interdisciplinary and transdisciplinary practice in applied health promotion for individuals and society.

Methods: A semi-structured focus group with students (n = 15% of the inaugural cohort) having completed at least 1 year of the course was undertaken to investigate student perspectives on best approaches for the development and delivery of interdisciplinary learning and teaching.

Results: Results highlighted the importance of providing training and opportunity for students to practice integration within the curriculum. Additionally, it was noted that including a module to introduce students to different disciplines and guiding students to explore their inherent interconnectedness is essential in helping them develop interdisciplinary thinking and skills. Crucially, the role of integrated assessments was also recognized as fundamental for demonstrating and practicing interdisciplinarity.

Conclusion: Overall, this study provides valuable insights and recommendations for educators with the objective of developing interdisciplinary learning in new or existing higher education courses or those seeking to prepare learners for contemporary and emergent societal challenges more generally.