Journal of Medical Education and Curricular Development最新文献

Objective: The purpose of higher education, particularly in the medical fields, is to serve humanity, and reflect on core values such as compassion, care, and empathy. This study examines how medical students uphold moral values as they progress through their education, addressing a research gap in the Indian context.

Methods: After obtaining Institutional Ethics Committee approval, a cross-sectional survey was conducted using a self-administered Google questionnaire. Content validity was ensured through consultations with 5 experts, and reliability was confirmed with a Cronbach's alpha coefficient of .75. Data were collected from medical students in India using snowball sampling and analyzed using median, interquartile range, chi-squared test, Pearson correlation coefficient, and multiple regression analysis. The sample size was set at 518, taking into account the nonresponders.

Results: Of 1500 invites, 526 students responded, which corresponds to a response rate of 35.06%. Reliability analysis revealed a high internal consistency (α = .927), and the data were suitable for factor analysis (Kaiser-Meyer-Olkin = 0.929). Principal component analysis identified three factors: Authority and Materialism, Enjoyment and Adventure, and Ethics and altruism, which explained 56% of the variance. Significant gender differences in Ethics and altruism were found. Correlation analysis revealed moderate positive relationships between authority and materialism and both enjoyment and adventure and ethics and altruism. Multiple regression showed that authority and materialism significantly impacts ethics and altruism (β = 0.684, p < .001), whereas enjoyment and adventure had a nonsignificant influence. Women performed better than men in ethics and altruism. This finding is discussed taking into account the unequal gender distribution.

Conclusion: The study shows that medical students prioritize ethics and altruism over authority and materialism, with enjoyment and adventure playing a balancing role. The significant influence of authority and materialism on ethics and altruism suggests that competitive and materialistic values influence ethical priorities. Understanding how different factors impact values and well-being can guide educators and policymakers in fostering ethical practices and supporting student resilience.

Purpose: The demographic composition of United States (US) medical school leadership remains underexplored, despite growing recognition of workforce disparities in gender, race, and specialty. These gaps may affect patient care, mentorship, and education. This study examines demographic patterns in US allopathic medical school leaders relative to the broader physician and general US populations.

Methods: From June 2023 to January 2024, we reviewed 154 US allopathic (MD) medical schools. We analyzed individual leadership structures and patterns in each institution. Institutional websites and publicly available sources were used to collect data on leadership demographics (gender, race, age), academic background (degrees, specialty), prior leadership roles, and research productivity via PubMed searches.

Results: In total, 154 allopathic medical schools in 46 states met inclusion criteria. We identified 1097 individuals (56.97% male, 70.46% White/Asian) serving as Dean, Senior Associate Dean, Assistant Dean, or equivalent. Most leaders held an MD or equivalent (76.12%), while 23.79% held solely a PhD. The majority practiced nonprocedural specialties (61.71%) and had prior leadership roles, such as Department Chair/Vice Chair (34.28%) or Program Director/Associate Director for Residency or Fellowship (18.24%). Most held or had held professorships (68.55%).

Conclusions: Most allopathic medical school leaders come from nonprocedural specialties, which may influence students' mentorship access and specialty choices. With gender, race, and specialty disparities existing among medical leadership, diversification of these leaders could enhance the medical school learning environment, broaden mentorship, and help align the physician workforce with the population it serves.

Objective: To evaluate whether early exposure to cadaveric surgical simulation influences preclinical osteopathic medical students' interest in pursuing surgical specialties.

Design: This single-blinded, prospective cohort study utilized pre- and post-simulation surveys to assess changes in specialty interest among participants. Responses were analyzed using Wilcoxon signed rank tests with significance set at P < .05.

Setting: Pacific Northwest University of Health Sciences, College of Osteopathic Medicine (PNWU-COM), during the 2024-2025 academic year.

Participants: Thirty preclinical osteopathic medical students (OMS1 and OMS2) volunteered, with 29 completing all study components (response rate: 97%). Of these, 20 (69%) identified as female and 9 (31%) as male; 19 (66%) were OMS1 students, and 10 (34%) were OMS2 students.

Results: Following participation in two cadaver-based surgical simulations-cardiothoracic and orthopedic-students demonstrated significant increases in overall interest in surgery (P = .004), cardiothoracic surgery (P = .001), and orthopedic surgery (P = .007). Additionally, interest in procedural care and the likelihood of pursuing a surgical residency increased significantly (P = .028 and P = .014, respectively). Conversely, interest in family medicine (P = .022) and internal medicine (P = .021) declined. Notably, 86% of participants reported that the cadaveric simulations influenced their perception of surgical fields, with nearly all stating that early exposure impacted their career considerations.

Conclusion: This pilot study strongly suggests that cadaveric surgical simulation significantly increases interest in surgical careers among preclinical osteopathic medical students. The impact was particularly strong in specialties directly represented in the simulations and among first-year students. These findings highlight the potential value of integrating structured surgical experiences into the early curriculum at osteopathic institutions, especially those without direct affiliations to major academic medical centers. Such interventions may help address the underrepresentation of osteopathic graduates in surgical residency programs and ultimately broaden diversity in surgical care.

Objectives: This study aims to reform and optimize laboratory diagnostics education by developing an innovative teaching model based on M-STEM (Medical Science, Technology, Engineering, and Mathematics).

Methods: Students majoring in clinical medicine at South China University of Technology were included in this study and were randomly assigned to either a traditional group or an M-STEM learning group. The M-STEM instructional design emphasized interdisciplinary integration, role-based learning, and hands-on inquiry. Both quantitative data and qualitative feedback were collected to evaluate learning outcomes and teaching effectiveness.

Results: For laboratory lectures, the proportion of students who were very satisfied was significantly higher in the M-STEM group compared to the traditional group (79.3% vs 51.6%, P = .025). All participants in the M-STEM group expressed approval of the learning design, while those in the traditional learning group did not reach a full consensus. Both groups demonstrated a relatively low willingness to engage in course design (61.0%). A survey on students' participation in curriculum design revealed that when confronting complex clinical problems, students were most inclined to seek assistance from professionals in the roles of doctors and laboratory technicians. When queried about which interdisciplinary integration is likely to offer greater support, students from both groups predominantly selected social psychology. Nevertheless, there existed a notable difference: the proportion of students in the traditional group who opted for economics was significantly higher than that in the M-STEM group (32.3% vs 10.3%, P = .04). In contrast, M-STEM students tend to focus more on integrating key disciplines and are reluctant to involve an excessive number of disciplines.

Conclusion: The M-STEM pedagogy can stimulate students' interest and promote multidisciplinary integration, enabling learners to gain a deeper understanding of the disease and develop effective solutions.

Purpose: The addition of ultrasound training to undergraduate medical education (UME) curricula is on the rise. Despite widespread adoption, there is little focus on the learning theories that guide implementation or how student learning is transferred from one training setting to another. Using our school's UME ultrasound curriculum, we studied how changes implemented in the pre-clerkship curriculum (grounded in specific learning theories) influenced student learning and performance during clerkship rotations.

Materials and methods: This was a retrospective study of an existing educational database of student responses and ultrasound submissions obtained during clerkship rotations. Data were collected using Qualtrics, de-identified, and exported to Excel for data analysis.

Results: After the curriculum change students reported requiring less assistance in the process of obtaining their ultrasound images while the quality of student obtained images remained the same. When broken down by clerkship, there were noted variations in image quality and need for assistance with students on the surgery clerkship showing the greatest increase in independence during the study period. Analysis of assistance by clerkship showed substantial differences in the type of assistance provided.

Conclusion: Theory-based curriculum change in the pre-clerkship setting can have a measurable impact on student learning behavior in the clerkship setting. The results of this quantitative study provide evidence to guide further qualitative research to better understand how students apply pre-clerkship learning experiences in the clinical environment.

Purpose: Traditional discussions of race-related health inequities in medical education often focus on the racialized individual, neglecting the role of systemic racism and other oppressive structures that drive resource inequities. Structural competency equips healthcare providers and trainees to critically analyze how structural racism creates health disparities.

Method: This study used focus groups with medical students (n = 56) and key informant interviews with faculty (n = 9) at a single academic medical center to explore experiences and perceptions of discussions about structural competency and the health effects of structural racism in small group learning communities. Activity Theory served as the analytical framework to understand environmental factors shaping these discussions, highlighting primary and secondary contradictions within the model activity system.

Results: The analysis revealed several tensions within the activity system that impacted discussions about race, structural racism, and inequities including, (1) questions of whether structural competency should be an explicit medical school outcome, (2) persistent biases in the curriculum, (3) faculty discomfort and limited expertise in leading discussions, (4) questions about who bears responsibility for facilitating these conversations, and (5) implicit and explicit rules shaping which types of knowledge are prioritized.

Conclusions: These findings inform the development of educational tools and faculty support strategies to enhance teaching and learning around structural competency in medical education.

Objectives: The COVID-19 pandemic led to a rapid adoption of telehealth technologies, particularly in terms of treatment delivery and trainee education. Prior work has found that virtual training (in which supervisors and trainees are not co-located and interact via virtual communication platforms) is well-received and supports effective supervisor/trainee working relationships. However, there is limited assessment of the effectiveness of virtual training in supporting clinical skill development or working relationships. Given the growing adoption of telehealth in health professional education, an evaluation was conducted in collaboration with the Clinical Resource Hubs (CRH), a national telehealth program within the Veterans Health Administration (VHA) offering clinical training opportunities within a virtual work environment.

Methods: Survey instruments were developed and administered to CRH trainees and supervisors. Information was collected related to trainee and supervisor demographics, CRH training experiences, perceived quality of training and supervision, supervisor/trainee relationships, and perspectives on virtual training.

Results: Trainees and supervisors perceived virtual supervisor/trainee interactions to be equivalent or superior to in-person interactions in supporting the development of clinical competencies and experienced effective supervisory working relationships in a virtual environment. Trainees and supervisors differed in their preferences for virtual versus in-person training and views on the ideal combination of these modalities to support skill development.

Conclusion: Results suggest that virtual supervisor/trainee interactions can effectively support trainee clinical skill development and effective supervisor/trainee relationships. For many aspects of training, virtual training for health profession trainees within large healthcare settings can provide an effective experience that is an acceptable and viable alternative to in-person training.

Background: Cadaveric dissection is vital in medical education, offering essential hands-on experience in human anatomy. With cadavers regarded as the "first teacher," students confront the realities of death early in their training. All medical students are expected to participate actively in dissections. However, inconsistencies in attendance and engagement are common. In some cases, cadavers are abandoned midway through the course, possibly due to psychological, social, or structural barriers. Understanding medical students' attitudes and perceived social norms toward cadaveric dissection is crucial for improving educational experiences and outcomes.

Objective: This study explored the attitude and subjective norm of medical students at Makerere University toward cadaveric dissection.

Methods: Qualitative study design was employed, using seven Focus Group Discussions (FGDs) with first- and second-year medical students. Participants were purposefully selected to ensure diversity in gender and academic experience. Data were transcribed verbatim and analyzed thematically. Ethical approval was obtained, and measures to ensure participant anonymity and psychological support were implemented.

Results: Students' attitudes toward cadaveric dissection varied from strong enthusiasm and appreciation of its educational value to anxiety, fear, and emotional discomfort. While some viewed dissection as essential for learning, others expressed moral, religious, and psychological concerns. State of cadavers, peer influence, faculty support, and cultural beliefs, significantly influenced students change of attitude resulting to active participation or disengagement with cadaveric dissections.

Conclusion: Findings informed the development of the Integrated Model of Cadaveric Engagement, which highlights the complex interplay of psychological, social, and structural factors influencing dissection behavior.

Objective: To evaluate the impact of replacing a traditional midterm exam with a collaborative project-based assessment on student performance and engagement in an introductory graduate-level biostatistics course for public health students using R programming.

Methods: We conducted a retrospective study comparing 2 semesters of the same course at a US school of public health. In Fall 2023, students completed traditional midterm and final exams. In Fall 2024, the midterm exam was replaced with a structured project-based assessment, while the final exam format remained unchanged. Student performance was compared using midterm scores, final exam scores, overall course grades, and course evaluations. Additionally, we used the results of a postproject survey that students in the project-based cohort had completed to assess engagement, confidence, and satisfaction.

Results: Students in the project-based cohort (Fall 2024) had significantly higher and more consistent midterm scores (median 94.0 vs 91.1; P = .01) and final exam scores (median 93.7 vs 86.0; P = .03) than the exam-based cohort (Fall 2023). Final course grades were also higher and more consistent in the project- based cohort. Survey responses indicated high student satisfaction, improved confidence in data analysis and R programming, and increased appreciation for real-world applications. Students also identified challenges related to group dynamics and time management.

Conclusion: Replacing a traditional exam with a collaborative project-based assessment in biostatistics significantly improved student performance, engagement, and satisfaction. These findings support project-based learning as a valuable pedagogical strategy in public health education, particularly for developing applied data analysis skills with R.

Background: It is not entirely understood how medical students make their future career decisions or what influences them. Furthermore, the factors that affect the perception of pathology as a future career are diverse and related to the exposure of medical students to pathology education in their first 3 years in medical school.

Aim of the study: We aim to assess how medical students in Jordanian Universities perceive pathology as a potential job and the variables influencing their decisions. To identify the preferred medical specialties among medical students in Jordan.

Materials and methods: An observational cross-sectional study was conducted on a randomly selected sample of students from the faculties of medicine at Jordanian universities, including those in the second to sixth year and recently graduated students. Data was collected via a web-based self-administered questionnaire. Descriptive statistics were employed to summarize the responses. Pearson's Chi-squared test and Fisher's exact test were utilized for variable assessment. Statistical significance was defined as a P-value of <.05. All statistical analyses were performed in R 4.4.2 (Vienna, Austria).

Results: When comparing students based on their perceived adequacy of pathology training in the first 3 years of medical school, several significant differences emerged across key characteristics: the understanding of the pathologist's job, case-based learning led by pathologists, ratings for a separate pathology course, and the perception of pathologists as introverts. On the other hand, no statistically significant differences were found in age, gender, secondary school background, or whether students considered pathology as a future specialty across the different training exposure groups.