Journal of Medical Education and Curricular Development最新文献

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.

Objective: The rapid emergence of generative artificial intelligence (GAI) in higher education necessitates redesign of learning activities and assessments to uphold academic integrity and foster AI literacy. This article presents a structured approach to developing educational strategies that mitigate GAI misuse while enhancing students' understanding of GAI, with a focus on collaborative faculty engagement and curricular adaptation in physiotherapy education.

Methods: Using the Quality Implementation Framework (QIF), we conducted a comprehensive review of all courses within a Swedish physiotherapy program employing a problem-based learning (PBL) model. Faculty-wide, time-bound development initiatives were implemented, including targeted AI literacy training. A student survey was conducted to assess GAI usage patterns and perceptions.

Results: Assessment formats were adapted to emphasize clinical reasoning and critical thinking, reducing opportunities for GAI misuse. Standardized guidelines on acceptable GAI use were integrated across all courses. The survey results 2 months after implementation indicated diverse usage patterns: 13% of students reported daily use of GAI, while 24% had never used it. Additionally, 42% felt adequately informed about GAI. Faculty AI literacy and confidence improved through structured group work and feedback, supporting the integration of AI-related tasks into the curriculum.

Conclusions: The systematic approach using QIF and PBL, expert support, faculty champions, problem-solving strategies, and feedback, enabled meaningful curricular changes within 4 months. The variability in student GAI use underscores the need for equitable AI literacy education. This approach not only reduced the risk of GAI misuse but also enhanced faculty preparedness, offering a scalable model for other health sciences programs.

Background: Mental health, including well-being, coping strategies, and resilience, is a crucial aspect of overall wellness. In higher healthcare education, students' mental well-being poses challenges for both learners and educators. While self-care is often emphasized in patient care during daily clinical practice, students' own self-care needs are frequently overlooked. Incorporating self-care practices into healthcare education has been shown to enhance well-being and reduce burnout. This study aimed to demonstrate the impact of self-care plans on the mental health of undergraduate physiotherapy students.

Methods: This quasi-experimental study involved two undergraduate physiotherapy cohorts (n = 192). The intervention consisted of developing and implementing a self-care plan. Both cohorts were instructed on the self-care plan; however, Cohort 1 received the plan after their first clinical placement, while Cohort 2 received it beforehand via an instructional video. A survey assessed self-care, perfectionism, self-doubt, and idealized images of everyday hospital life. Descriptive analyses were conducted for all outcomes, with a binomial test evaluating self-care perceptions and Pearson chi-square tests comparing cohorts and clinical placement timing.

Results: Eighty students completed the survey. Students' professional self-image in Cohort 1 became significantly less dependent on treatment success (χ² = 10.9, P = .012), and coping with self-doubt improved after the second clinical placement (χ² = 14.4, P = .001). After the second and third placement, 86% disagreed that clinical decision-making was difficult (χ² = 93.4, P < .001). A significant association was found between Cohort 1 and 2, with substantially more students in Cohort 2 understanding what a self-care plan was (P = .002).

Conclusion: Video instructions and information about a self-care plan impacted undergraduate physiotherapy students in some assessed parameters. To ensure effective implementation, enhancing cognitive learning and self-awareness through increased contact hours and more practice sessions seems essential.

Trial registration: Study registration number REES: ID: #19600.1v1.

Introduction: Indigenous populations continue to experience health inequities that are exacerbated by systemic barriers in medical education. These challenges both limit the success of Indigenous students and leave the broader physician workforce underprepared to provide culturally safe care.

Methods: This narrative literature review explores the educational experiences of Indigenous medical students and examines evidence-informed strategies to enhance cultural competency and inclusion within medical curricula. Studies were identified through database searches using Ovid MEDLINE and relevant MeSH terms, followed by citation chaining. A total of 13 studies were included in the final narrative review.

Results: Key themes from the selected literature include structural marginalization in curricula, lack of Indigenous representation, and the emotional burden faced by Indigenous learners. Promising interventions include Indigenous-led simulations, cultural immersion programs, and experiential learning in community settings. However, implementation challenges-such as time constraints, faculty training gaps, and financial barriers-persist.

Discussion: A longitudinal, integrated model of cultural humility, embedded throughout medical education, is recommended. Such an approach supports both Indigenous and non-Indigenous learners in delivering more equitable healthcare.

Conclusion: Medical education reform must incorporate Indigenous knowledge systems, address institutional racism, and center Indigenous voices to achieve cultural safety and reduce health disparities.

Background: Traditional, complementary and integrative medicine (TCIM) is acknowledged as integral parts of healthcare systems worldwide and thus increasingly integrated in medical education. Regarding undergraduate medical education, studies demonstrate the positive attitude of medical students toward TCIM and their general interest in it. However, their engagement in curriculum development has not yet been explored in this context.

Method: We conducted an exploratory qualitative descriptive study using a focus group discussion with fourth-year medical students to explore perspectives, experiences, and expectations in relation to a novel curriculum on TCIM at Fribourg University in Switzerland. The aim was to identify elements that could be of general importance for curriculum development of TCIM in undergraduate medical education.

Results: Main themes derived from the analysis were (a) the need for and usefulness of a curriculum about TCIM in undergraduate medical education, (b) satisfaction with the content and structure of the Fribourg curriculum, and (c) important competencies acquired or to be acquired during the curriculum. Most important, students agreed that TCIM is essential for all students and not just optional in medical school curricula. Students favored a longitudinal and transversal curriculum for TCIM, allowing cross-fertilization with other medical disciplines. Students emphasized the importance of a patient-centered and relationship-based approach to good patient care, which is integral to the definition of TCIM. Finally, students highlighted the diversity of attitudes, expectations, and perspectives as an inherent issue for academic teaching and learning as well as for patient care.

Conclusion: Our study demonstrates the usefulness and importance of engaging students in undergraduate medical curricula on TCIM through participation in the process of continuous curriculum development. Medical students in our study consider TCIM to be an essential subject, which advocates for its stronger inclusion in medical training to prepare future doctors to provide patient-centered care in increasingly complex healthcare systems.

Background: The cultivation of innovation skills is being recognized as a crucial component in medical education. While the effectiveness of the teaching assistant model in the classroom is well-documented, there has been limited exploration of their role in the medical innovation course, particularly those involving undergraduate teaching assistants (UTAs). This study aimed to investigate the role of UTAs in the medical innovation course and to assess their impact on students, the UTAs themselves, and the course as a whole.

Methods: In this study, based on the stimuli-organism-response model and social cognitive career theory, a questionnaire was designed and distributed to students participating in the course to explore their innovation skills, self-efficacy, and satisfaction in the context of UTAs' involvement. Additionally, semistructured interviews and an in-depth interview were conducted to assess the impact of the UTA model on the UTAs themselves and the course, with the interview content being recorded and analyzed.

Results: Firstly, the survey results indicated that UTAs had a positive impact on students' self-efficacy (β=0.102, P = 0.005). Students' self-efficacy was strongly correlated with both innovation and entrepreneurship (β=1.275, P < .001) and learning satisfaction (β=0.595, P < .001). Secondly, based on interview content, this study identified the reasons why undergraduate UTAs became TAs, skill enhancement, and intentions for continuous teaching. Lastly, through the in-depth interview, professors expressed that UTAs represented an innovative attempt in medical education, offering numerous advantages such as improving teaching effectiveness, relieving teaching pressure, and identifying outstanding students.

Conclusions: UTAs enhanced students' self-efficacy, thereby promoting the development of innovation and entrepreneurship skills, as well as course satisfaction. Moreover, this teaching model had unexpectedly positive effects on the UTAs' own skill development and course advancement. Therefore, the involvement of UTAs in the medical innovation course provided a reference for cultivating innovation capabilities in medical education.

Background: Medical students frequently observe social, ethical, and systemic challenges during clinical rotations but often lack formal avenues for reflection. Structured reflective writing can promote critical thinking, empathy, and professional identity formation.

Objective: To characterize the content and depth of student reflections on social elements of care during a neurology clerkship and assess the educational impact of a required reflective writing exercise.

Methods: This retrospective qualitative study analyzed 46 reflective logs submitted by third-year medical students during their neurology rotation at the Cleveland Clinic (June 2023-May 2024). Logs focused on bias, social determinants of health, healthcare inequities, system challenges, or quality improvement. Logs and corresponding faculty responses were analyzed to identify themes, emotional tone, and professional development insights.

Results: Most logs (77.3%) described bias, often related to gender or race. Students also noted communication barriers, access issues, and health inequities. Emotional tones included frustration (69.6%) and empathy (21.7%). Reflections often conveyed professional identity development (55%) and ethical reasoning (47.5%). Clerkship director responses were supportive, with frequent teaching points and validation.

Conclusions: Students regularly encounter and meaningfully reflect on complex social issues during clinical training. Structured reflection offers critical insight into students' evolving perceptions of equitable care and often fosters professional growth. Integrating such exercises into clinical curricula may enhance students' ability to recognize and respond to bias and inequity in real-world practice.