Journal of Medical Education and Curricular Development最新文献

Purpose: This study investigates medical students' experiences with a pre-clerkship critical medical humanities (CMH) curriculum that emphasized power, privilege, and inequities in healthcare.

Methods: Twenty-six third-year medical students at a semi-rural US medical school were interviewed in Fall-Winter 2023. Semi-structured interviews explored students' reflections on the curriculum's impact, and narrative analysis was used to identify key themes. Validation strategies included reflexivity, triangulation, and analysis of disconfirming cases.

Results: The results revealed 4 themes. First, students valued humanities learning but noted limitations of the classroom setting. Second, the facilitated self-reflection uncovered implicit biases and encouraged critical perspectives on medical knowledge. Third, despite a belief that the humanities were important for future practice, participants deprioritized them in favor of science courses. Finally, learning about diversity and equity concepts was perceived to be limited in racially homogenous groups.

Conclusion: The CMH curriculum encouraged critical thinking and cultural humility, though its full impact was constrained by systemic and cultural tensions in medical education prioritizing scientific knowledge. Embedding health humanities learning into clinical contexts and providing faculty development to address diversity and equity challenges may enhance curricular outcomes. Institutional support and national guidance are needed to align health humanities curricula with broader educational goals.

Objectives: Musculoskeletal ultrasound (MSKUS) is a required part of Physical Medicine and Rehabilitation (PM&R) residency training, yet there remains a lack of standardized educational framework guiding its implementation across residency programs. While structured MSKUS curricula exist, variability in institutional resources limits generalizability. Moreover, there has been comparatively less focus on the advantages of incorporating longitudinal, simulation-based learning, which has been proven to enhance skill acquisition, clinical confidence, and patient safety. This study aims to address gaps in MSKUS curriculum by presenting the development and evaluation of a longitudinal, simulation-based MSKUS curriculum tailored to an academic PM&R residency program.

Methods: A longitudinal, simulation-based MSKUS curriculum was developed and implemented for PM&R residents at an academic institution from 2021 to 2025. The curriculum underwent iterative refinement each year in response to resident feedback, institutional needs, and evolving best practices. Core components included simulation-based scanning, near-peer instruction, standardized patients (SPs), and structured assessments aligned with progressive learning milestones. The curriculum designed was informed by Kern's six-step model and guided by Miller's Pyramid to support skill development from knowledge acquisition to clinical application.

Results: Feedback from curriculum implementation demonstrated increased clinical confidence and competence in MSKUS skill. Residents highlighted the value of active learning, clinical relevance, and peer collaboration. Iterative refinements addressed logistical barriers and aligned content with learner progression across PGY levels.

Conclusion: This simulation-based MSKUS curriculum provides an adaptable framework for PM&R residency programs. By emphasizing hands-on practice with SPs, team-based learning, and iterative feedback, it fosters skill development, mentorship, and sustainable ultrasound education applicable across diverse training environments.

Background: Medical knowledge is expanding rapidly at the same time as the preclinical phase of medical education is being shortened. This uniquely challenges medical students to learn efficiently and retain a large amount of information. Spaced repetition is a widely used learning technique and can be implemented through the use of a free downloadable program called Anki. Limited data exists on the use of spaced repetition through Anki and its impact on student performance in preclinical assessment, such as the Comprehensive Basic Science Subject Exam (CBSE).

Methods: This study evaluated Anki usage among 36 medical students at the Kirk Kerkorian School of Medicine at UNLV. Students consented to export their deidentified Anki data through the Stat Scraper add-on. Stat Scraper provided metrics on matured cards (those with an interval >21 days), total study hours, and number of unsuspended cards. Variables were correlated with CBSE exam scores and students were stratified into groups below and above the mean for each variable. Using this data, independent t-tests, Pearson Correlation coefficients and linear regressions were performed.

Results: Mean CBSE score was 65.2% (SD 11.6%). Linear regression demonstrated a significant positive correlation between the number of mature cards and exam scores. Significant positive correlations were also found between CBSE scores and total hours studied (P = 0.013), number of matured cards (P = 0.002), and unsuspended cards (P = 0.010). Students with above-average mature card counts scored 71.5% on the CBSE compared to 60.0% for those below average. Total study hours and unsuspended card counts similarly predicted higher scores.

Conclusions: Greater time spent using spaced repetition learning techniques through the Anki application and a higher number of matured and unsuspended cards were associated with increased performance on the CBSE exam. These findings support spaced repetition as an effective way for medical students to master and retain medical knowledge in the preclinical phase. Further research with larger sample sizes and more diverse populations is needed to validate these findings further.

Background: Simulation-based medical education has become increasingly prevalent. However, the high cost and lack of comprehensive effectiveness evaluations have raised questions about its feasibility. This study introduces a novel approach to assess the cost-effectiveness of simulation training.

Methods: This study uses simulated data from 120 medical students, set in a teaching hospital scenario, and randomly assigns them to 6 groups with different training durations. This was done to determine the optimal length of VR training that maximizes knowledge and skills transfer efficiency while minimizing costs, using 4 analytical methods: the transfer effectiveness ratio (TER) quantifying time savings, the incremental TER (ITER) assessing individual gains, isoperformance curves mapping cost-effectiveness, and change-point analysis identifying diminishing returns.

Results: The overall TER of 0.66 indicates 0.66 units of time saved per simulation training unit invested; peak ITER variability occurred in the 3h cohort, reflecting divergent individual responses to incremental training; isoperformance curves established a 4.5min minimum operative time threshold, defining inherent procedural constraints; and an inflection point at 8 VR training hours (80th data point) marked the onset of diminishing returns.

Conclusions: The methodological innovation of integrating TER, ITER, isoperformance curves, and change-point analysis offers a new framework for evaluating the cost-effectiveness of simulation training in medical education. The findings highlight the potential for simulation training to reduce the time required to achieve clinical competency and to optimize training strategies.

Objectives: The COVID-19 pandemic has underscored the importance of equipping medical specialists from various fields with anesthesiology skills that are essential for medical practice, such as managing acute and chronic pain, preventing substance dependence, caring for critically ill patients, and ensuring airway security. This study analyzes the presence of these anesthesiology competencies in the curricular frameworks of medical residency programs in Brazil, Spain, and the United Kingdom, all of which have universal healthcare systems, to assess how effectively these programs prepare future specialists with these crucial skills.

Methods: We analyzed curriculum frameworks for medical residency programs and specializations in all 3 countries, focusing on anesthesiology competencies. All relevant documents, available on official government websites, were reviewed between July 1, 2023 and December 28, 2024, using Kripka's methodology.

Results: Significant differences were found in competencies related to stratifying anesthetic-surgical risk (P = .027), recognizing and analyzing palliative care (P = .023), mastering the basics of conscious sedation (P = .009), multidisciplinary teamwork (P < .001), and mastering the technique of local anesthesia (P < .001). Despite these differences, the number of anesthesiology competencies was similar across all 3 countries.

Conclusions: This study identified a potential gap in resident training for crucial skills such as pain management, sedation, airway management, and hemodynamic monitoring. These are essential for high-complexity procedures. The findings suggest a need for curriculum revisions and potentially an increase in specialty program slots focused on caring for critically ill patients.

Background: Informal learning resources can be considered supportive to formal learning resources in shaping future professional identity. This study aimed to assess dental students' preferences towards using informal learning resources, to explore challenges impacting students' choices and to find out the motivations for using these resources.

Methods: A mixed methods study design was conducted. A total of 1000 dental students completed a quantitative questionnaire data from different universities in Syria, and qualitative semi-structured interviews (15: postgraduate student and 30: undergraduate students) were fulfilled. Data were separately collected and analyzed.

Results: Peer learning scored a high level of engagement (undergraduates: 76.2%, postgraduates: 79.6%) as did the use of social media platforms (undergraduates: 79.4%, postgraduates: 80.6%). The challenges associated with utilizing open educational resources (undergraduates: 71.6%, postgraduates: 73.2%), social media platforms (undergraduates: 73.8%, postgraduates: 74.4%), and attending conferences and workshops (undergraduates: 75.4%, postgraduates: 76.2%) were rated at a high level. The undergraduate interview participants reported that lack of time was the most important limitation for using informal learning resources whereas online payment problem for open educational resources was basic challenge for postgraduate participants.

Conclusions: Reliance on informal learning resources is an efficient and vital tool for dental students. Faculty members can play an impact role in guiding students how effectively use of informal learning resources to enhance their educational experience.

Background and objectives: Communication is a complex skill and key component for professionals in healthcare. Complex skills are best learned through experiential learning like role-plays or simulated patient encounters. The aim of the present study is to explore how students and lecturers assess the conditions under which the use of an artificial intelligence (AI)-based feedback system can promote the learning process.

Methods: An interview study with health profession students and lecturers was conducted using a qualitative descriptive design. Recorded audio data was transcribed and evaluated by structuring qualitative content analysis. The research process was conducted and continually reflected by an interprofessional research team. Ethical approval was obtained.

Results: Using qualitative content analysis, 4 major themes were identified. These are "conditions," "communication scenarios," "AI-based learning platform" and "debriefing." Lecturers and students welcome the idea of AI providing output on verbal and para-verbal aspects. To implement AI-based output into a teaching programme AI functionality should be adaptable to the specific situation. Lecturers and students highlighted that AI could be particularly valuable for speech qualities which are often difficult for humans to assess. AI could give freedom to focus on additional aspects of the conversation by documenting desirable speech qualities. Lecturers and students prefer for the AI-based output to be given at the end of rather than within the role-play. Furthermore, they wish for communication scenarios to be analysed repeatedly in order to track progress.

Conclusion: Practicing in a safe environment and receiving competent credible feedback, with lecturers trained in facilitation, is a pre-requisite for the entire learning progress. The integration of an AI-based feedback system should be characterised by both flexibility of the AI application and standardisation of the communication scenario.

Objectives: Education holds transformative power in society, driving economic and social development. In medical education, training quality leads to well-prepared physicians and directly impacts patient care. In Brazil, a key measure of medical training quality is the National Student Performance Exam (Enade). This study aims to analyze the institutional, social, and economic determinants of the quality of medical education in Brazil through Enade scores.

Methods: An ecological study was conducted with all Brazilian higher education institutions participating in the Enade for the Medicine undergraduate course in the last 5 editions. Group comparisons and a multivariable logistic regression model were conducted to examine the associations between institutional, social, and economic aspects with the Enade score, categorizing institutions into high and low/medium score groups.

Results: Considering all editions, the average Enade score of medical schools in Brazil was 2.8. Geographic location was a determining factor of Enade results. The highest proportion of high scores was observed in South (62.4%) and Central-West (57.3%) regions, and low scores in the North (76.4%), Southeast (64.1%), and Northeast (52.6%). The proportion of medical schools with high Enade scores increased over time (P < .001), and they demonstrated significantly higher performance in general knowledge tests (+10.6%; 64.4 vs 58.20) and specific knowledge tests (+16.0%; 65.4 vs 56.4). Institutional factors associated with better student performance in Enade included a well-rated didactic-pedagogical organization (odds ratio [OR]: 1.62 [confidence interval (CI): 1.10-2.40]), a more qualified faculty (OR: 1.81 [CI: 1.27-2.59]), and being publicly administered (OR: 5.74 [CI: 3.44-9.95]).

Conclusion: This study highlights significant variations in training quality among medical schools nationwide, with the Center-South region showing a higher proportion of institutions achieving high Enade scores compared to more socioeconomically vulnerable regions in Brazil. Institutional characteristics such as well-rated didactic-pedagogical organization, a highly qualified faculty, and public administration are associated with better exam performance.