Journal of Medical Education and Curricular Development最新文献

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.

Background: Medical education has been experiencing a transition from time- to competency-based. Since their introduction by Olle ten Cate in 2005, entrustable professional activities are a part of this process. We implemented a set of EPAs for the first 3 years of training at our hospital, encompassed by informational materials for trainees and supervisors.

Objectives: Our objective was to assess barriers and facilitators for the implementation of entrustable professional activities in pediatric residency in a German tertiary hospital. Furthermore, our aim was to explore how they foster self-regulated learning and feedback, and to identify barriers and facilitators on the path to more confidence and safety.

Methods: We applied a qualitative approach with focus-group discussions (adhering to COREQ guidelines), 3 each with residents and supervisors. Focus groups were recorded, transcribed verbatim, and de-identified. Data analysis was conducted based on qualitative content analysis.

Results: Three months after the implementation, no resident had fulfilled the required assessments. In the discussions, we identified barriers to and facilitators of the process. Both may be attributed to internal and external factors. The concept was supported by residents and supervisors, but time, priorities in the clinical routine, lack of initiative, and an inhibition on the part of the residents to approach the supervisors were the main reasons for the concept to fail. We identified a higher degree of structure, as well as commitment and accountability, as possible facilitators.

Conclusion: Entrustable professional activities are a promising means of promoting self-regulated learning and a positive feedback culture to increase confidence and safety in clinical practice. Our findings expose the factors that disrupt or promote this process. Our data provide guidance for implementation in a setting with little experience with this tool.

Background: Engaging students in curriculum development provides valuable insights and promotes alignment with their learning needs. Premedical curricula often overemphasize basic sciences, highlighting the need to incorporate social sciences and earlier patient exposure. This study involved students as key stakeholders in redesigning and evaluating the curriculum's clinical relevance.

Methods: A two-phase mixed-methods study was conducted, guided by the context, input, process, product (CIPP) evaluation model. Phase one (context and input) utilized a 5-point Likert-scale questionnaire to assess perceptions of 380 students on premedical learning and its relevance to the preclinical curriculum, alongside open-ended suggestions. Student group activities identified key curriculum issues, informing revisions made in collaboration with the curriculum committee and student representatives, aligned with national medical competency standards. In phase two (process and product), 90 third-year students evaluated the revised curriculum using the same questionnaire with student representatives leading the process. Statistical analyses (Cramér's V, Chi-square, and t-tests) and content analysis were employed.

Results: In the previous curriculum, only 38.48% of students agreed/strongly agreed that premedical subjects aligned with preclinical learning, citing limited clinical relevance and disconnected content (n = 21). A student-led review, in collaboration with the curriculum committee, reduced pure science subjects and integrated them into more clinically relevant content, including early patient exposure in community settings, while maintaining alignment with national medical competency standards. The revised subjects were well received by students. Following these changes, 64.45% of students agreed/strongly agreed that it aligned with preclinical learning, and overall perception scores significantly increased from 18.03 ± 0.16 to 19.08 ± 0.35 (t = 2.819, p = .003).

Conclusion: A student-driven approach, supported by the CIPP model, helped redesign the premedical curriculum. It integrated relevant basic sciences with early community and clinical exposure to enhance alignment, engagement, and preparedness for clinical training.

[This corrects the article DOI: 10.1177/23821205251328952.].

Objectives: To explore the efficacy of a novel teaching model based on the Monaco planning system in radiation oncology education.

Methods: Forty clinical undergraduate medical interns were randomized and equally divided into a control group and an experimental group. The experimental group underwent the Monaco planning system-based teaching model, while the control group received conventional clinical teaching activities. Upon completion of the internship, both groups were simultaneously assessed mini clinical evaluation exercise (Mini-CEX), direct observation of procedural skills (DOPS), and end-of-rotation theoretical and clinical skills assessment. A satisfaction survey was also conducted. The assessment scores were compared to evaluate the teaching effectiveness.

Results: The experimental group demonstrated significantly better scores than the control group according to the 7 core evaluation indicators of Mini-CEX, DOPS assessment results, final departmental exam performance, and satisfaction scores, with statistically significant differences (P < .05).

Conclusion: The Monaco planning system-based teaching model significantly enhances clinical competency and learner satisfaction in radiation oncology education compared to traditional methods.