Journal of Medical Education and Curricular Development最新文献

Background: Racialized health inequities are poorly addressed in medical education, often presenting race without social context and perpetuating racialized biases. Reframing the understanding of race as a social construct and incorporating anti-racism education into medical curricula are essential to mitigate health inequities. Our study describes an anti-racism curriculum audit conducted for the University of Ottawa Undergraduate Medical Education pre-clerkship program. This audit informed the development of an anti-racism toolkit designed to serve as a systematic guide for medical schools undertaking curriculum reforms.

Methods: A comprehensive anti-racism curriculum audit was conducted on pre-clerkship curriculum content from May 2020 to August 2021. Content flagged for concern was categorized into 4 themes: insufficient representation of racialized populations, race-based generalizations, cultural insensitivities, and reinforcement of stereotypes.

Results: The curriculum audit evaluated 772 course modules, completed by 18 medical students. A total of 224 (31.6%) modules contained one or more racial biases. The most prevalent concern was insufficient representation of racialized populations, identified in 145 flagged comments (55.1%). Curriculum content also perpetuated race-based generalizations (n = 75 flagged comments, 28.5%), racial stereotypes (n = 23 flagged comments, 8.8%), and cultural insensitivities (n = 20 flagged comments, 7.6%).

Conclusions: This anti-racism curriculum audit revealed a lack of diverse representation, alongside the persistence of race-based generalizations, stereotypes, and cultural insensitivities in a large proportion of the pre-clerkship curriculum. An anti-racist lens and curriculum are necessary to reduce bias in medical education and empower medical students to provide equitable care to the diverse Canadian patient population.

Background: Case-based collaborative learning (CBCL) is an instructional method designed to promote active learning (AL). In CBCL, students learn the basics independently and apply their knowledge to case scenarios collaboratively. While theoretically the cognitive principles underlying AL in CBCL should be generalizable, implementation is shaped by local and cultural contexts. This study explored the feasibility of implementing CBCL at the University of Guadalajara, Mexico, where lectures dominate higher education and passive learning is the norm.

Methods: This study used a quasi-experimental design and an explanatory mixed-method approach. Ninety-nine fourth-year medical students, enrolled in a virtual evidence-based medicine (EBM) course, were assigned into a group taught via CBCL or a comparison group taught using lectures. Both groups covered identical EBM content: framing clinical questions, database searching, critical appraisal of randomized trials and diagnostic studies, evaluating systematic reviews, and applying evidence to patient care. Students' knowledge (cognitive skills) and attitudes (affective dimensions) were assessed using course exams, survey data, and focus groups. Thematic analysis was used to explore the intervention's impact and feasibility.

Results: Both groups performed comparably on the knowledge assessments (CBCL 10 vs CL 9.5 out of 10, P = .72). Themes from self-determination theory were identified as underlying concepts for how specific instructional design (ID) elements influenced student perception of the CBCL intervention. Qualitative results showed how ID elements promoting autonomy (eg, clear objectives, readiness assessments), competence (eg, solving clinically relevant problems), and relatedness (eg, collaborative group work) were associated with intrinsic motivation.

Conclusion: CBCL proved feasible and valued by students accustomed to lecture-based approaches. Our findings led to a conceptual model linking specific ID elements in CBCL with motivational domains. This model can guide educators seeking to adapt CBCL or similar AL approaches to their local context and inform future research.

Introduction: To promote international collaborative partnerships, the master's program in occupational therapy at Tokyo Metropolitan University was developed in English as a part of the Asian Human Resource Development Project (AHRD project) for Medical Professionals funded by the Tokyo Metropolitan Government.

Objective and methods: In this paper, we focus on describing key concepts underpinning its development and implementation, as well as its successes, and the challenges associated with building partnerships with educational institutions in Asian countries. The AHRD project was implemented to enable the development of human resources from Asian countries to acquire advanced medical skills in Tokyo and contribute to the improvement of medical skills in their home countries, and to act as a bridge between Tokyo and Asian countries and promote both global partnerships with educational institutions and students' international awareness.

Result and conclusion: Through the AHRD project, graduates from the master's program are expected to contribute to the improvement of health professions in their home country. In addition, based on the network established through this project, we have deepened our ties with Asian countries, developed global education through the continued international exchange of faculty and students, and enabled the development of international collaboration in education and research.

Background: Health professional education is essential for training effective clinicians and skilled health workers, supporting universal healthcare. It includes disciplines like medicine, nursing, and allied health across various institutions. The educational climate significantly affects teaching, learning, and student satisfaction, impacting curriculum success and academic achievement. A competency-based curriculum (CBC) focuses on applying knowledge, skills, attitudes, and values, enhancing graduates' readiness for the labor market. While instructors have concerns about CBC adoption, its proper implementation can improve educational quality and graduate competencies. This study will examine the experiences and challenges faced by university instructors in implementing CBC in Ethiopian health science colleges and seek strategies to address these challenges effectively.

Methodology: This study adheres to the phenomenological theory and uses a qualitative research methodology. The study includes 20 male and 16 female instructors, school deans, department heads, and module coordinators from 2 universities. The investigation focuses on themes related to training, administration, motivation, and resources as well as potential strategies to overcome the challenges in CBC implementation.

Results: The study investigated various factors affecting the implementation of CBC. The findings indicate that the most common challenges are inadequate training for instructors regarding the curriculum and shortage of educational resources necessary for its implementation. Additionally, challenges related to motivation, administration, and resources were identified as contributing factors that hindered CBC implementation. Beyond identifying these barriers, the study proposes context-specific strategies, including targeted faculty development programs, optimized resource allocation, and enhanced administrative support, which collectively aim to improve curriculum adoption and effectiveness. These findings provide actionable insights to inform policy and practice in similar educational environments facing implementation hurdles.

Conclusion and recommendation: To effectively implement a CBC in Ethiopian health science colleges and prepare graduates for the job market, several key actions are necessary. University administrators, departments, and instructors must engage in discussions to identify solutions. Continuous awareness, capacity-building training, and organized workshops on CBC are crucial for overcoming the major challenges. Moreover, prioritizing human and material resources, equipping demonstration and simulation rooms, and expanding practical sites are essential interventions to facilitate its implementation. Additionally, effective communication with all stakeholders is vital for successful CBC implementation.

Background: The ability to provide informed consent (IC) is a critical component of patient autonomy. Medical training programs have recognized the importance of training physicians to become skilled in obtaining IC, but few have reported curricula that address IC separately from broader ethical principles. This review aims to consolidate current methodologies and outcomes regarding medical education on informed consent.

Methods: Adhering to PRISMA-ScR guidelines, studies were obtained from PubMed and MedEdPORTAL that focused on evaluating the need for informed consent education and on assessing strategies to teach informed consent. Educational programs or assessments that focused broadly on medical ethics without a specific focus on the teaching of informed consent were excluded.

Results: Of 142 abstracted articles, 59 were included for analysis. 34 were categorized as needs-assessments, while 25 were interventions. Across various medical and surgical specialties and training levels, there is a need for more robust education on informed consent. No standard process for training medical learners about this topic exists currently. Of the interventions examined, both didactic curricula and simulation-based modalities demonstrated efficacy in improving knowledge and comfort levels with IC.

Conclusions: This review summarized both studies on needs assessments of IC education in medical training and on interventions to improve trainees' skills in obtaining IC. Though obtaining IC is a critical clinical skill for nearly all clinicians, there is no consensus method to teach IC, satisfaction with current IC education is low, and debate exists on whether IC can ever be entrusted to trainees. These important gaps in IC education suggest a need to develop a structured, systematic approach to providing IC education in order to assure competency in this essential skill for patient safety and trainee wellness.

Coaching is a creative process of inquiry and feedback that helps individuals increase self-awareness and build on strengths. Although individualized executive-style coaching has become popular among physicians, empowering physicians to adopt coach-like communications skills in medical education and clinical encounters could extend the benefits of coaching across medicine. However, professional coaches undergo lengthy training, and most physicians do not have the time, inclination, or need to become certified coaches. Therefore, we created an intensive, streamlined "physician coaching-as-communication" (PCC) curriculum to train physicians in a select subset of essential coach-like communication skills to use during spontaneous encounters with colleagues, medical trainees, and patients. Our goal was not to prepare physicians to provide formal coaching; rather, our aim was to help them cultivate a coaching mindset, identify everyday situations that could benefit from coach-like conversations, and apply some key coach-like communication skills during appropriate interactions. Here we describe the 2-phase development of the PCC curriculum, highlight the coach-like skills that support effective communication, and outline the key curriculum features that situate training into a clinically relevant and feasible framework for practicing physicians. We also present findings from a quality improvement evaluation that assessed acceptability and feasibility of the coaching curriculum for medical faculty and resident trainees. Lastly, we outline the key elements needed for a successful intensive program to help clinicians become skilled with using coach-like communication behaviors in appropriate clinical situations.

Introduction: Teaching faculty is vital to the success of academic institutions. Academic biomedical faculty has faced greater workloads, and limited access to development opportunities. The Academy of Educational Scholars (AES) was designed as a community of practice with an embedded educational research fellowship to address the challenges of building and sustaining educational scholarship as recognized value for academic biomedical faculty careers.

Methods: An educational project-based, one-year faculty fellowship served to identify faculty motivated to join a community of practice. Fellowship curriculum development was guided by a literature review, internal needs' assessment, and the Kerns six-step framework. The program comprised ten 3-hour workshops and two project critique sessions delivered at monthly intervals over 12 months. Immediate session evaluations and a comprehensive program evaluation were conducted, assessing program value, and improvements in educator confidence in knowledge and skill. Outcome measures included presentations at local and national conferences, numbers of abstracts submitted, publications, grant submissions and new educational roles taken on.

Results: Fellowship graduates from first 2 cohorts demonstrated a statistically significant improvement in knowledge about educational scholarship (p = 0.01) and related skills (p = 0.01). Program satisfaction was 93%. Content analysis revealed the most impactful program features were networking and joining a community focused on educational scholarship. AES fellow-produced scholarship includes 7 local/regional presentations, 10 abstracts, 6 publications, 4 grant submissions, 2 funded educational grants, and 4 new educational leadership roles. AES community activities include an annual retreat, monthly journal clubs, a teaching excellence recognition program, and a scholarship consult service.

Conclusion: Embedding an educational research fellowship into a community of practice is an effective model for building a sustainable teaching academy. Identifying local talent and incorporating member service expectations has minimized cost while incentivizing a volunteer model. Building the community of practice entailed intentional recruitment of mature educational scholars and novice fellows.

Background and objectives: Faculty development plays a pivotal role in enhancing teaching, research, educational, and clinical leadership, as well as in fostering career and professional development, which helps improve medical education. Despite its importance, engagement in faculty development programs is roughly variable among educators. This study aimed to identify and explain the factors influencing the participation of basic and clinical science faculty members in an online medical education faculty development course at medical universities.

Methods: This study was conducted in Iran between July 2022 and May 2023. Data were collected through an online qualitative survey and semi-structured telephone interviews with faculty members who were actively involved in or graduated from a virtual master's program in medical education. An online qualitative survey was first conducted with 86 participants in the faculty development program to obtain a wide understanding of their experiences. Subsequently, follow-up telephone interviews were conducted with faculty members who were engaged in the program to gain richer and deeper information, and this continued until data saturation was achieved (N = 8). All data were analyzed thematically to identify factors linked to faculty participation.

Results: Five major themes emerged: (1) professional and occupational factors, highlighting the importance of career advancement and job requirements; (2) individual factors, focusing on intrinsic motivation and self-efficacy; (3) social factors, reflecting the influence of peer support and social status; (4) educational and academic factors, emphasizing the necessity of innovative teaching methods; and (5) managerial/leadership and organizational factors, addressing the significance of institutional support and leadership in promoting development.

Conclusion: This research provides valuable insights into the factors affecting faculty participation in development programs. By understanding these dynamics, educational institutions can consider initiatives (such as material and immaterial incentives, flexibility in program delivery, balancing teaching, research, and clinical service delivery, and promoting organizational culture and support) that enhance faculty engagement.

Introduction: ChatGPT has shown remarkable performance in medical licensing examinations such as the United States Medical Licensing Examination. However, limited research exists regarding its performance on national medical licensing exams in low-income countries. In Nepal, where nearly half of the candidates fail the national medical licensing exam, ChatGPT has the potential to contribute to medical education.

Objective: To evaluate ChatGPT's (GPT-4) performance on the Nepal Medical Council Licensing Medical Examination (NMCLE).

Methods: The NMCLE-May 2024 dataset, comprising 900 multiple-choice questions, was used to assess ChatGPT's performance. After excluding 8 questions that contained figures or were not compatible with text-only input, 892 questions were analyzed. Specific prompt, including a background description, question, and choices, was entered. The response generated by ChatGPT was compared taking responses from experienced clinicians as a reference. Descriptive statistics were used to present the results, and regression analysis was employed to determine the association between variables, including set, question type, pattern, and subject, and incorrect responses.

Results: GPT-4 generated 783 correct responses in 892 questions, an accuracy rate of 87.8%. Incorrect responses were more likely with questions requiring logical reasoning (odds ratio 14.7, 95% confidence interval [CI] 8.94-24.16).

Conclusions: ChatGPT-4 performs at a standard comparable to or above that of medical graduates on the Nepalese undergraduate medical licensing examination. Incorrect responses were mainly in questions requiring logical reasoning, underscoring the need for caution when relying on its outputs in the same. These findings are encouraging and highlight the need for further studies to evaluate its role as an educational resource in Nepalese medical education.