Advances in Medical Education and Practice最新文献

Background: The Oman Medical Specialty Board (OMSB) Internal Medicine Residency Program addressed challenges like fatigue, burnout, and academic stress by implementing programmatic changes. These interventions aimed to improve certification exam pass rates, scholarly productivity, and work-life balance, ultimately enhancing academic performance and resident well-being within the program.

Objective: To evaluate the impact of four integrated programmatic interventions-reduced duty hours (24-hour to 12-hour shifts), restructured academic days, simulation-based workshops, and enhanced research mentorship-on academic performance, scholarly productivity, well-being, and resident satisfaction in an IM residency program.

Methods: A mixed-methods study was conducted in the OMSB IM Residency Program during the 2022/23 academic year. Interventions included: (1) restructuring Internal Medicine Academic Days (IMAD) into full-day structured learning incorporating dedicated lectures (8 am-1 pm) and simulation-based workshops (1-3 pm), (2) reducing duty hours from 24-hour to 12-hour shifts, and (3) enhancing research training and mentorship. The quantitative component analyzed 78 residents in the pre-intervention period and 114 residents in the post-intervention period, measuring OMSB Part 1, Part 2, and Objective Structured Clinical Examination (OSCE) pass rates, as well as annual peer-reviewed resident publications. Independent z-tests compared outcomes between periods (p < 0.05). The qualitative component included semi-structured interviews with 13 purposively selected residents (third and fourth-year trainees), analyzed using Braun and Clarke's thematic framework.

Results: Part 2 exam pass rates significantly improved (85.0% to 98.0%, p = 0.014), and resident publications doubled (10.5 to 21.0 annually, p = 0.007). Interviews revealed reduced fatigue, better work-life balance, and improved satisfaction with academic days and simulations. However, concerns were raised regarding scheduling conflicts and continuity of care.

Conclusion: Structured educational and wellness-focused interventions improved academic outcomes, scholarly output, and resident well-being. These findings support integrating similar strategies into residency programs, though further research is needed to assess long-term sustainability and broader applicability.

Introduction: Three-dimensional (3D) printing technology has revolutionized the treatment of bone defects. However, medical education has lagged in integrating 3D printing into clinical training, limiting its widespread adoption. This study aimed to promote the dissemination of 3D printing technology through a novel, targeted teaching method.

Methods: First, we implemented a bibliometrics aiming to identify core research forces and potential breakthrough directions. Then, from January 2022 to January 2025, a prospective cohort of 278 trainees (102 residents and 176 fellows) at a single center participated in a structured six-stage educational program encompassing: (1) foundational 3D printing knowledge, (2) video-assisted learning, (3) hands-on practice with 3D printed anatomical models, (4) virtual reality (VR)-based surgical simulation, (5) multidisciplinary treatment (MDT) discussions, and (6) supervised surgical operations. Teaching effectiveness was evaluated using pre- and post-training theoretical exams, operational assessments, and comprehensive self-evaluation questionnaires.

Results: Through the bibliometrics, 3D printing technology has been maintaining a high level of research hotspot, but the targeted education is still vacant. For the teaching study, both resident and fellowship doctors demonstrated statistically significant improvements in theoretical knowledge scores, rising from 14.3 to 32.7 in residents and from 19.1 to 33.3 in fellows (P < 0.001). Residents exhibited a greater magnitude of improvement compared to fellows. Operational metrics showed significant reductions in completion time and intraoperative blood loss (P < 0.001), alongside a marked increase in the proportion of "excellent" or "good" procedural quality ratings. Comprehensive ability assessment revealed significant gains across all evaluated domains (P < 0.001), except for self-study ability, which remained stable The total self-evaluation scores improved from 19.5 to 30.1 for residents and from 20.9 to 33.6 for fellows.

Conclusion: This targeted, multimodal teaching method significantly enhances theoretical understanding, operative proficiency, and clinical competence in the use of 3D printing technology for bone defect repair.

Aim: To evaluate the effectiveness of a combined Problem-Based, Case-Based, and Team-Based Learning (P-C-T) teaching mode in improving academic performance and self-reported learning outcomes among postgraduates specializing in infectious diseases.

Methods: This study enrolled 100 postgraduates (Master of Medicine (MM) and Doctor of Medicine (MD)) specializing in infectious diseases from five medical colleges in Hebei Province between Jan 2020 and Dec 2024. Participants were assigned to either the P-C-T integrated teaching group (n = 68) or the traditional teaching control group (n = 32). The curriculum included infectious disease teaching rounds and lectures. Comparative assessments included pre- and post-class theoretical tests, time-motion analysis of test completion, and a comprehensive questionnaire evaluating teaching satisfaction and competency development.

Results: Baseline pre-class scores showed no significant difference between groups (P > 0.05). Post-intervention, the P-C-T group had significantly higher median total test scores (94.00 [IQR 92.00-95.00] vs 88.50 [IQR 86.25-90.00]; P < 0.001) and shorter completion times (43.09 ± 5.92 min vs 47.66 ± 5.39 min; P < 0.001) than the control group. Additionally, the P-C-T group reported significantly higher questionnaire-based satisfaction and perceived learning outcomes (P < 0.001).

Conclusion: The P-C-T integrated teaching mode was associated with higher theoretical test performance, greater learning efficiency, and improved student satisfaction compared with traditional methods. By fostering critical thinking and active engagement, this structured approach may serve as a feasible instructional framework for postgraduate medical education and may help bridge the gap between theoretical learning and complex clinical practice.

Background: Simulation has emerged as a transformative method in surgical education, offering reproducible training in risk-free environments. While widely adopted in Western Europe and North America, traditional apprenticeship remains dominant in Central and Eastern Europe, raising concerns about skill acquisition and standardization.

Objective: This study compared obstetrics and gynecology residents' perceptions of simulation-based versus apprenticeship laparoscopy training in Poland, focusing on expectations, skills acquisition, instructor engagement, and training structure.

Methods: A cross-sectional survey was conducted among 59 residents: 29 completed structured VR simulation-based courses and 30 participated in operating room apprenticeship. Data were collected using two course-specific questionnaires, from which nine comparable parameters were extracted. Chi-square tests were applied where distributions allowed; other items were analyzed descriptively.

Results: Simulation participants reported significantly greater fulfillment of expectations (96.6% large/very large vs 6.7% apprenticeship; χ²=48.35, p<0.05) and higher skill acquisition (86.2% high/very high vs 10% apprenticeship; χ²=40.60, p<0.05). Training duration and repetitions were more often judged optimal in the simulation group (82.8% and 93.1%, respectively) than in the apprenticeship group (33.3% and 10%). Instructor engagement was markedly higher in simulation (96.6% high/very high vs 3.3% apprenticeship; χ²=52.24, p<0.05). Nearly all simulation residents (96.6%) endorsed making such training mandatory, with most recommending introduction between residency years two and four.

Conclusion: VR Simulation-based laparoscopy training was perceived as superior across expectations, skills acquisition, and structural factors. These findings, aligned with international literature, support integrating simulation as a mandatory component of gynecology residency curricula in Poland to improve both resident competence and patient safety.

Objective: To assess the utility of metaverse and virtual reality as an educational platform for teaching pharmacology.

Methods: An experimental mixed-method study was conducted, in which participants were allocated to either metaverse-based or conventional teaching. The metaverse group included a 3D animated model of opioid receptors. To evaluate the effect of the teaching method, a knowledge retention test was performed within 24 hours of the session, and the scores, and time to complete the test were compared between the two groups. The metaverse group was asked to complete a survey that measured their satisfaction and attitude and to provide feedback using open-ended questions.

Results: Ninety-eight students were included in the study. Forty-eight students (48.9%) were allocated to the metaverse group. Participants in the metaverse group scored higher in the knowledge retention test (3.3 vs 2.6; p < 0.0001) and required less time to complete the test (4.8 vs 5.3; p=0.034). Students in the metaverse group reported a positive attitude and comfort with the teaching platform.

Conclusion: Metaverse-based pharmacology teaching may offer an effective tool to enhance the learning experience and effectiveness of teaching.

Introduction: Within the basic medical education system, morphological experiment courses constitute the cornerstone for building students' medical cognitive framework. However, the traditional "see-and-memorize" teaching model readily traps students in the cognitive dilemma of "seeing the trees but not the forest.".

Methods: Based on years of teaching practice and reflection, this paper proposes a systematic teaching reform plan centered on the "Three-Tier Observation Method." This scheme aims, through progressive training in "macroscopic localization → microscopic identification → logical reasoning", to resolve the issue of passive student learning and guide them through a cognitive upgrade-from static morphological recognition to the interpretation of dynamic pathological processes. This article presents this approach as a descriptive educational innovation, detailing its theoretical rationale, operational procedures, and illustrative case analyses.

Results: This paper presents the "Three-Tier Observation Method" as a descriptive educational innovation. It details the method's theoretical rationale, operational procedures, and illustrative case analyses to demonstrate its potential to help students construct a solid bridge between basic medical science and clinical practice.

Discussion: We aim to provide educators with a practical and replicable teaching framework that fosters deeper cognitive integration, thereby contributing to the pedagogical toolkit for enhancing clinical reasoning skills in basic medical education.

Background: Understanding factors associated with medical school academic performance can inform selection and student support. Traditional measures such as high school grades and standardized test scores are incomplete. Emerging data emphasize the importance of age, gender, entrance route, and exam history on academic outcomes. This study explored associations of age, gender, admission route, nationality, and CBSE attempt number with cumulative basic sciences overall grade point average (GPA) and Comprehensive Basic Sciences Examination (CBSE) scores at Tehran University of Medical Sciences, providing insights for optimizing selection strategies and educational interventions.

Methods: Academic records of medical students from 2019 to 2022 were retrospectively collected. Data from the first 5 semesters (2.5 years) of course grades, cumulative GPAs, and CBSE scores were included in the analysis. We conducted univariate and multivariate analyses to examine associations and predictors.

Results: A total of 1727 individual records were analyzed. Repeated attempts at the CBSE were associated with progressively lower GPA (P<0.001) and CBSE scores (P<0.001). The admission route had a significant impact on performance (P<0.001), with highly competitive exam entrants achieving the highest mean GPA and CBSE scores, while non-Iranian students had the lowest. Iranian students outperformed their non-Iranian counterparts in both GPA and CBSE (both P<0.001). Male students achieved slightly higher CBSE scores than females (P=0.011), although there was no gender difference in GPA. GPA exhibited modest variation across entry semesters (P=0.003), while CBSE scores remained consistent. The multivariable analyses revealed that admission route and entry year were the leading independent and consistent predictors of academic performance.

Conclusion: Repeated CBSE attempts, admission route, and nationality were associated with academic performance. Highly competitive entrants achieved the highest, while non-Iranian students and repeat examinees showed comparatively lower outcomes. These findings highlight the need for targeted academic support and early intervention strategies to promote equitable achievement among diverse medical student groups.

This cross-sectional pilot study examined associations between DISC personality traits (Dominance, Influence, Steadiness, Conscientiousness) and psychological well-being among 62 medical students from 10 countries at a private university in Saudi Arabia. Well-being was measured with the WHO-5 well-being index (mean=14.08, SD=4.99) using simplified self-categorization for DISC assessment. Steadiness (69.4%) and Conscientiousness (66.1%) were the most frequently endorsed traits, consistent with patterns observed in other medical trainee populations. No significant associations were found between any DISC trait and WHO-5 well-being scores. Effect sizes were small (Steadiness g=0.43, 95% CI -0.06 to 1.00; Influence g=0.34, 95% CI -0.17 to 0.89), and multivariable regression explained minimal variance (R²=0.074). Conscientiousness prevalence differed across countries (P=0.001), although subgroup sizes were small. These null findings suggest no association between DISC traits and well-being in this pilot sample, contrasting with recent studies reporting DISC associations with perceived stress. This divergence highlights important distinctions between stress reactivity and baseline well-being as outcomes. Broader contextual factors including academic workload, institutional support, and cultural context may be more relevant to well-being than behavioral style alone. DISC may be more appropriately applied to communication training and team development rather than well-being prediction. Future research should employ validated DISC instruments, larger culturally balanced samples, and examine both stress and well-being outcomes to clarify the differential predictive utility of personality profiles across psychological constructs.

Purpose: Training health services administration (HSA) professionals is essential for the effective functioning of hospitals. Evidence suggests that training should emphasize social and decision-making competencies, as HSA professionals collaborate in an interprofessional environment. Simulation training (ST) for HSA in an interprofessional context is a promising approach. This study evaluated the effectiveness of such a training program on leadership self-efficacy, examined differences across professions and tested whether there was an interaction between profession and training effects.

Participants and methods: This retrospective study was conducted at the simulation center of Metropole Savoie Hospital in France. The 3-day program was mandatory for all HSA professionals, and included customized simulation scenarios, interprofessional collaboration and integration of aviation sector for their expertise in leadership skills employed in crisis management. Self-efficacy was measured by a specifically constructed questionnaire administered at baseline (T0), post training (T1) and 4 months post-training (T2).

Results: The ST program significantly increased leadership self-efficacy. Self-efficacy improved post-training (p. < 001, mean change = 31.67, 95% CI [28.06, 35.28], d = 1.75) and increased self-efficacy was maintained for 4 months (p < 0.001, η²p = 0.70, T0-T1 Δ = 32.05 [26.71-37.39], T0-T2 Δ = 2.43 [-7.77-2.90], η²p = 0.70). There was a significant main effect of profession with executive physicians reporting lower self-efficacy than other professionals combined (p < 0.001, mean difference = -22.56, 95% CI [14.83-30.30], η²p = 0.66). No significant interaction between profession and program was observed (p > 0.05).

Conclusion: ST shows promise for enhancing leadership skills in HSA, particularly in an interprofessional context. Executive physicians remain a key group for targeted training, as their lower self-efficacy suggests, they may benefit from interventions aimed at strengthening leadership skills. Advancing in this direction will reinforce the findings.

Postgraduate training in clinical laboratory diagnostics (professional degree) in China operates under a "four certificates in one" framework tightly coupled with standardized residency training. However, a structural recruitment-training mismatch has emerged: eligible applicants increasingly come from clinical medicine undergraduate programs with limited early exposure to laboratory medicine governance, quality systems, and post-analytical assurance, contributing to persistent under-enrollment and heterogeneous training experiences across schools. Using a strengths-weaknesses-opportunities-threats (SWOT) framework, this review synthesized objective enrollment signals and analyzed how policy constraints, competency gaps, and evolving service expectations jointly shape training feasibility. We also examined recent "laboratory physician training" pilot/experimental classes that front-load laboratory exposure and improve pathway continuity and translated these pilots into a rotation-wide competency framework with corresponding teaching activities and workplace-based assessment tools to support implementation across varied settings. Because these pilots are recent and outcome data remains limited, the implications are primarily policy- and design-based. Overall, this review contributes an actionable competency-alignment perspective for medical education and training reform, highlighting early exposure, structured reskilling/upskilling in quality management, interpretive reporting and clinical communication, and context-sensitive incorporation of digital/AI-enabled workflows where available.