Journal of Medical Education and Curricular Development最新文献

Objective: The education of basic sciences in Pakistan encounters various problems, such as large classroom sizes, insufficient faculty, and a lack of institutional resources. These limitations have fostered a dependence on passive, lecture-centric pedagogies, leading to diminished student engagement and critical analysis. Similar tendencies are observed worldwide in resource-limited higher education settings. Therefore, this study aims to investigate the justification and feasibility of implementing team-based learning (TBL) in basic sciences education in Pakistan, utilising global literature to evaluate its adaptability, relevance, and efficacy in similar educational contexts.

Methods: A literature-based methodology was utilised, referencing 29 peer-reviewed publications from databases such as MEDLINE, PubMed, ERIC, Scopus, and Web of Science. Studies were chosen with a modified PEOT (Population, Exposure, Outcome, Type of study) framework and subjected to thematic analysis. The Confidence in the Evidence from Reviews of Qualitative Research (CERQual) and the Kirkpatrick New World Model (KNWM) were employed to assess confidence in findings and educational effects.

Results: Two analytical themes emerged: (1) TBL as a facilitator of active and collaborative learning, and (2) its function in augmenting critical thinking and knowledge application. High confidence substantiated TBL's efficacy in enhancing engagement, collaboration, and profound learning. Moderate confidence was attributed to themes related to implementation issues in resource-limited environments.

Conclusion: TBL offers a feasible educational solution for tackling systemic difficulties in Pakistan. Through adequate faculty training, curricular alignment, and gradual implementation, TBL can markedly improve the quality and efficacy of basic sciences education in the country.

Objective: This survey study assessed trainee attitudes and perceptions of the longitudinal public speaking curriculum at Mayo Clinic Pediatric and Adolescent Residency Program.

Methods: This 3-part survey of Mayo Clinic pediatric residents was conducted from 2013 to 2017 and utilized yes/no questions, Likert scales, and open-ended questions. Code book content analysis was used to analyze open-ended questions.

Results: A total of 121 participants (96.8%, n = 121/125) completed the survey. Most respondents (93.3%, n = 111/119) either agreed or strongly agreed that the public speaking requirement enabled them to be more effective in delivering information to large groups. Most respondents (89.2%, n = 107/120) agreed or strongly agreed that they incorporated feedback from previous public speaking feedback sessions into subsequent presentations. The 2 activities that respondents found most useful for preparing later presentations were setting goals for future presentations in a feedback session and discussing performance in a feedback session.

Conclusions: There was a perceived effectiveness of a longitudinal public speaking curriculum among pediatric residents at our program. Multidimensional feedback seems to be a critical aspect of a public speaking curriculum in graduate medical education.

Introduction: Generative artificial intelligence (AI) has transformative potential in medical training, and its role in medicine holds drastic implications for patients, healthcare providers, and society; however, its current use by medical students is unknown. The study aims to characterize the use, frequency of use, and perceptions of generative AI by Canadian medical students.

Methods: A cross-sectional survey was distributed to 6 medical schools in Ontario, Canada, to investigate how medical students use generative AI in education, clinical settings, and for communication, and to assess the perceived barriers and enablers that influence their use.

Results: A total of 167 respondents completed the survey (60.8% female, 69.3% in first and second year), and over 78.9% of respondents reported using generative AI, with ChatGPT being the most popular model; 53.0% of respondents were frequent users and reported using generative AI tools at least once a week. In clinical settings, students report using generative AI for learning and reviewing medical content, summarizing clinical guidelines, and generating differential diagnoses; 92.8% of students were willing to learn how to use generative AI to integrate it into their future clinical practice. At the same time, most medical students appreciated the limitations of generative AI in terms of its risk for inaccuracy (91.6%) and bias (78.9%); 75.9% of participants agreed that generative AI should be implemented as a resource or formal teaching topic in medical training.

Discussion: The findings of this study may help guide medical education institutions in adapting curricula and developing policies to promote the ethical and appropriate use of generative AI in medicine.

Purpose: This systematic review for medical professionals aimed to characterize the pleiotropic effects of emotional intelligence (EI) training programs, with an emphasis on the transfer of leadership skills and their impact on the performance of physicians, healthcare organizations, and patient care.

Major findings: Of 4034 articles, 40 articles were included for the final review, including 26 from the United States, with a total of 2373 participants (1431 medical students, 692 residents, and 250 physicians). All 40 articles (19 on medical students and 21 on residents/physicians) reported using quantitative and/or qualitative methods of assessing EI among the participants with 7 being randomized and 31 considered moderate to strong evidence. Only 2 studies demonstrated the beneficial effect of EI training on patient satisfaction (Kirkpatrick 4C) and 3 studies on organizational benefits (Kirkpatrick 4A); 19 studies demonstrated effects on participant's performance, such as reduction of stress and burnout (Kirkpatrick 4B). Nearly all studies scored 2 or more on the scale for best practices, with 5 studies scoring 6/7. Bar-On Emotional Quotient Inventory (EQ-i 2.0) was the most frequent tool to gauge improvements in participant EI (9 studies); a mean improvement of 4% to 8% in EQ-i 2.0 total score was reported after EI training.

Conclusions: Healthcare institutions and organizations need to incorporate EI training while developing their leadership development programs. EI can be built over time through direct practice and coaching and is important for future initiatives in medical curricula, raising hospital competitiveness, improving hospital disaster resilience outcomes, implementing effective digital healthcare, and addressing socioeconomic and racial health disparities. Several of our findings are supported by moderate to strong evidence, including 7 randomized studies. However, more research is necessary to standardize EI training approaches; EQ-i 2.0 may be preferred in future studies to ensure standardization and comparability of EI assessment between programs.

Introduction: The reliability of performance assessment scores can be affected by several factors, such as the number of students, raters, and the performance of raters. Minimizing inter-rater variability and ensuring its applicability are important factors in assessing medical education programs. This study aimed to examine the reliability coefficients derived from a generalizability study and a decision study (D-study) conducted within a two-facet cross-design using generalizability theory (G-theory) to assess performance in medical education.

Method: This study employed a two-facet, crossed-mixed design [b × p × m]. A total of 40 randomly selected students were evaluated by five raters (random facets) using 35 items (fixed facets) in a performance assessment setting. Data were analyzed using EduG software.

Results: Of the participants, 142 (60%) were female and 98 (40%) were male. The total mean score for the crossed-designed set of skills was 62.11, the percentage of individual estimated variance components was 33.90%, and the G-coefficient was 0.94. For the D-study, the reliability coefficients were 0.86 for two raters, 0.90 for three raters, 0.92 for four raters, 0.94 for five raters, 0.95 for six raters, and 0.96 for seven raters. In the G-faced analyses, there were no differences between the raters.

Conclusions: Inter-rater variability is a potential risk for limited performance evaluations, regardless of application design. Rater standardization is recommended to reduce the likelihood of such risks. In our study, rater standardization and D-studies were performed using applications with a crossed-mixed design. With the widespread use of these analyses, crossed designs strengthened by rater standardization in assessment and evaluation practices in medical education are preferred. Suitable rater standardization can make crossed designs a preferred option in performance assessment, and feedback can be obtained for subsequent ratings by analyzing them using G-theory.

This exploratory study investigates how first-year international medical students' perceptions of feedback may evolve during simulated patient consultations (SPCs). Over an 8-month period, 10 students participated in 4 SPCs and completed structured surveys after each session, ranking the value of 4 feedback sources: simulated patient feedback, observer feedback, video-annotated peer feedback, and group discussion sessions. Surveys combined Likert-scale ratings with open-ended questions to capture both quantitative and qualitative insights. The findings suggest a possible preliminary framework for feedback preferences. Early in the course, students most highly valued simulated patient feedback for its direct relevance to patient interaction. As the SPCs progressed, appreciation for observer feedback, video-annotated peer feedback, and group discussions increased. By the final SPC, group discussion sessions were frequently regarded as the most valuable, as they provided opportunities for collaborative reflection and shared learning. These preliminary observations point toward a framework in which learners' feedback needs may shift from immediate, patient-centered input to more reflective and collaborative forms as they gain experience. The study highlights the potential importance of tailoring feedback strategies to students' developmental stages. Given the small sample size and single-institution context, the results should be interpreted cautiously and considered hypothesis-generating. Future research with larger, multi-institutional samples is needed to test and refine this framework.

Background: Escape Rooms in medical education have been shown to improve learner satisfaction and reinforce knowledge in pulmonary and critical care medicine, yet virtual escape rooms (VER) as instructional strategies have remained understudied.

Objective: We aimed to evaluate participants' perception and knowledge acquisition after completing a VER as part of a national fellows' course.

Methods: We designed a prospective study conducted during the 2022 CHEST Pulmonary and Critical Care Medicine Fellow's Virtual course. This was a 2-day back-to-back national course targeting pulmonary and critical care fellows. The course had 5 virtual and 1 VER session, each lasting 50 min. A pre- and post-course knowledge assessment included 9 clinical questions (1 for each of the 5 virtual sessions and 4 for the VER session). A summative score and an individual session score were obtained. Participant's VER perceptions were analyzed using a 5-point Likert scale (1 = strongly disagree and 5 = strongly agree).

Results: Fifty-nine (34.5%) of the 165-course participants completed the pre-test, and 29 (17.8%) completed the post-course test. Higher clinical knowledge assessment total score and VER scores were seen in the post-test compared to the pre-test (77.8 ± 14.9 vs 59.6 ± 23.1 P < .001) and (77.3 ± 26.6 vs 62.5 ± 32.5, P < .05) respectively. VER perceptions in the course were positive across participants and sustained after deployment.

Conclusions: Implementing an educational VER in a national pulmonary and critical care fellows' virtual course may promote knowledge acquisition and could potentially lead to a positive perception among participants. Longitudinal studies in various contexts are required to further elucidate direct causality between gamification and learner centric outcomes.

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.