Advances in Medical Education and Practice最新文献

Purpose: Patient safety (PS) is a basic principle of healthcare worldwide. In Saudi Arabia, medical colleges have integrated PS modules into their regular curricula. This study investigated undergraduate medical students' and interns' attitudes regarding PS at King Abdulaziz University (KAU), Jeddah.

Methods: The survey was conducted at the Faculty of Medicine, Rabigh, KAU, Jeddah. Data were collected using the APSQ-III online questionnaire from medical students and interns. The questionnaire comprises 26 items covering various PS issues across nine domains.

Results: 493 students and interns participated (233 females, 47.3%, and 260 males, 52.7%). The participants were distributed as follows: 114 (23.1%) from the fourth year, 102 (20.7%) from the fifth year, 145 (29.4%) from the sixth year, and 132 (26.8%) interns. The participants' scores on most items showed a negative attitude. A gender comparison showed that males mean score was significantly higher than females in the few key domains such as "patient safety training received" (p = 0.001), "working hours as a cause of error" (p = 0.002), "team functioning" (p < 0.001), "patient involvement in reducing errors" (p = 0.002), and the "importance of patient safety in the curriculum" (p < 0.001). No significant variance was noticed between interns' and medical students' mean scores across the nine key domains.

Conclusion: The findings highlight that most participants' attitudes needed to be more positive. Gender disparities were found in PS attitudes among Saudi medical students and interns, while no significant variance was noted between interns' and medical students' scores.

Background: Feedback is defined as the regular mechanism where the effect of an action is to modify and improve the future action. Feedback is essential for developing students' competencies and their future work as professionals. The attention of feedback shifted from teachers' feedback techniques to learners' goals, acceptance, and assimilation of feedback and impact-focused approaches. This study explored the perceptions of medical students and faculty regarding the importance of constructive feedback and the process of feedback in medical education.

Methods: An explanatory, sequential, mixed-method approach was used, beginning with a survey followed by interviews. This study was conducted at Defense Services Medical Academy (DSMA), Myanmar, and Avalon University School of Medicine (AUSOM), Willemstad, Curacao, from November 2021 to October 2022. For the quantitative phase, 75 students of Phase I, M.B.B.S. program, 28 faculty from DSMA. 63 students of the M.D. program, and 13 faculty from AUSOM responded to the questionnaire survey. For the qualitative phase, ten students and ten faculty members from each university used in-depth interviews. We used MAXQDA software for thematic analysis.

Findings: Survey results showed that most faculty and students strongly agree that feedback is essential for students' learning and should highlight both strengths and weaknesses of student performance. Thematic analysis resulted in five themes: opinions regarding the feedback, obstacles in obtaining constructive feedback, incorporating constructive feedback to future professions, implementing feedback, and comparing the views of students and professors. The students wanted immediate feedback after the examinations. They preferred one-to-one feedback instead of group feedback, but the faculty was concerned about time limitations in providing constructive one-to-one feedback.

Conclusion: The students and faculty agree that constructive feedback is essential to improve performance. The students at both institutes preferred precise comments regarding performance. The barrier both faculty and students faced around giving and receiving feedback was time.

Introduction: The learning methods employed in medical education have substantially transformed from traditional face-to-face (FTF) instruction to online learning modalities. This study sought to quantitatively compare the impact of three learning methods on the academic performance of first-year medical and health sciences students enrolled in a Medical Terminology (MT) course. The learning methods examined include the FTF method, the online-synchronized method, and a blended learning method that combines elements of both. The scope of the analysis encompasses the academic years 2019, 2020, and 2023.

Methods: Academic performance was measured using overall scores and scores derived from the letter grades of 2446 first-year students assigned to the three learning methods that were compared.

Results: A significant improvement in 2023 was observed in the blended learning method, which consisted of 30% FTF and 70% online synchronized lectures for overall scores (p < 0.0) and the scores based on the A grades (p < 0.0) of students in the MT course, compared to the FTF learning method in 2019 or the online synchronized learning method in 2020.

Conclusion: The blended learning method, which combines FTF with online synchronized learning, appears to be a more effective method for enhancing the academic performance of first-year students compared to either the traditional FTF method or the solely online synchronized method.

Purpose: This study aimed to determine the perceptions of senior medical students and recent graduates from College of Medicine (CMED) at Qatar University regarding their undergraduate education and training related to prescribing, their confidence in achieving the learning outcomes specified in the curriculum and their preparedness to prescribe in practice.

Patients and methods: This was a cross-sectional web-based survey with qualitative elements, utilizing a 22-item pre-validated questionnaire developed through a multi-phase iterative process. The survey was administered to all senior medical students (year 4-6) and recent graduates of CMED at Qatar University.

Results: One hundred sixty-seven medical students and graduates responded to the survey (response rate ~45%). Overall, the participants expressed positive attitude towards curricular content related to prescribing that aimed to prepare them for practice, including pharmacology and therapeutics, history-taking, physical examination, diagnostic investigations, application of evidence-based medicine, and other skills. Over 60% of the participants believed that the prescribing components of the undergraduate curriculum made them competent in providing safe and effective prescriptions in practice. Notably, there was an association between seniority and perceived curricular effectiveness, highlighting the impact of clinical experience on participants' views. Recommendations for curriculum enhancement focused on practical integration, contextualized education, and a holistic approach to both theoretical and clinical learning.

Conclusion: The study revealed positive opinions regarding curricular content related to prescribing and identified areas for improvement in medical curriculum. Continuous monitoring, evaluation and refinement based on participants' feedback are crucial for ensuring the preparedness of medical graduates for safe and effective prescribing in real-world clinical practice.

Background: Videolaryngoscopes increased the safety of patients requiring endotracheal intubation. Their particular beneficiaries are healthcare providers inexperienced in intubation. We compared the learning curve of McGrath, UESCOPE, and Airtraq VLs among the first-year anesthesiology residents.

Methods: Sixteen residents were qualified for the study, none of whom has ever before used any VL nor had any experience with the Macintosh laryngoscope. The study was conducted during anesthesia without anticipated intubation difficulties and included 288 adult patients with BMI <25 and ASA ≤ II, without visible intubation difficulties. It was a randomized, controlled, and blinded crossover study. Each resident performed six intubations with a given VL in randomized order.

Results: There were no statistically significant differences in patient characteristics. In McGrath there was observed significant improvement of intubation time, confirmed intubation time, ease, POGO scale, effective intubation, thyroid pressure application, and intubation trauma. Intubation efficacy increased from 12 (75%) at first attempt, to 16 (100%) during third and following attempts. Residents used pressure 6 times (38%) during first attempt and 7 times (44%) during second attempt, and 1 (6%) at last attempt. McGrath traumatism was noticed in 4 (25%) patients at first two attempts, none during third and following attempts. In Airtraq, we observed a significant improvement of intubation time, time of confirmed intubation, force used, ease, effective intubation, and application of pressure to thyroid cartilage. Intubation efficacy increased from 10 (62%) during the first to 16 (100%) during the following attempts. Thyroid pressure was applied 7 times (44%) during first intubation and 0 times during the last two attempts. In the case of UESCOPE VL, we observed a significant improvement of intubation time, time of confirmed intubation, force used, and ease.

Conclusion: Results demonstrated that Airtraq VL having the best learning curve, and UESCOPE having the best first-time use. The results require confirmation in a larger study group. This study was approved on 14 November 2023 by the Medical University of Lodz Bioethics Committee (ref: RNN/160/23/KE).

Facing resource shortages and increasing gaps between regions and populations during the 20th century, around the 70s, the Chinese government authorized local governments to independently operate their own medical system, including medical education, to provide basic medical services and meet healthcare needs. These multiple independent but unparallel medical education systems throughout the nation inevitably created education quality disparities. Around the beginning of the 21st century, the Chinese government started a medical education standardization reform. This study aims to review and critically analyze these reform efforts toward standardization in medical schools and postgraduate and continuing education. All the background information, data, findings, government measures, etc. presented in this article were obtained through literature searches on PubMed, Baidu Scholar, and respective official online documents. Some of the key search criteria are, but not limited to, medical education reform in China and medical education history in China. These data were accessed in 2022. Standardization has been the core of reform in all three phases of medical education in China since the beginning of the 21st century. The three/five/eight principle, which refers to years of medical school, has been the backbone of medical school education in pursuing the "2030 healthy China" goal. The government streamlined postgraduate education further by establishing official licensing examination and launching a five+three+X model, which represents years required for medical school education, standardized residence, and specialty training, respectively. The standardization of continuing education is ongoing. Official and unified appraisal tests are in the pilot stage, whereas other areas have yet to change. Hopefully, this study will provide insight for future reform or research, or inform other countries.

Background: Numerous challenges exist in effectively bridging theory and practice in the teaching and assessment of clinical reasoning, despite an abundance of theoretical models. This study compares clinical reasoning practices and decisions between medical students and expert clinicians using a problem-solving framework from the learning sciences, which identifies clinical reasoning as distinct, observable actions in clinical case solving. We examined students at various training stages against expert clinicians to address the research question: How do expert clinicians and medical students differ in their practices and decisions during the diagnostic process?.

Methods: We developed a questionnaire about a pediatric infectious disease case based on the problem-solving framework from the learning sciences to probe clinical reasoning decisions. The questionnaire had four sections: medical history, physical examination, medical tests, and working diagnosis. The questionnaire was administered at Stanford University between January 2019 and June 2023 to collect data from 10 experts and 74 medical students. We recruited participants through maximum variation sampling. We applied deductive content analysis to systematically code responses to identify patterns in the execution of the practices and decisions across the questionnaire.

Results: This research introduces a highly detailed, empirically developed framework that holds potential to bridge theory and practice, offering practical insights for medical instructors in teaching clinical reasoning to students across various stages of their training. This framework involves nine practices, with a total of twenty-nine decisions that need to be made when carrying out these practices. Differences between experts and students centered on ten decisions across the practices: Differential diagnosis formulation, Diagnostic plan and execution, Clinical data reassessment, and Clinical solution review.

Conclusion: We were able to identify nuanced differences in clinical reasoning between students and expert physicians under one comprehensive problem-solving framework from the learning sciences. Identifying key clinical reasoning practices and decision differences could help develop targeted instructional materials and assessment tools, aiding instructors in fostering clinical reasoning in students.

Introduction: This study aimed to investigate how dental students at King Abdulaziz University Faculty of Dentistry transitioned from pre-clinical to clinical instruction and how this change affected their learning outcomes. Understanding this transition was crucial to identify the challenges faced by students and the support they required.

Methods: A mixed-methods approach was utilized, combining qualitative insights from focus group discussions with quantitative data from surveys. Focus groups gathered detailed student experiences regarding their transition, while surveys measured workloads, anxiety levels, and perceptions of clinical competence.

Results: The results showed that students have a lot of difficulties because of their heavier workloads, higher levels of anxiety, and the need for better integration of academic knowledge with practical abilities. Concerns over clinical competence and the necessity of improving communication with patients and healthcare teams are other characteristics of the transition phase. The findings highlighted how important structured support networks are for reducing transition-related stress and improving students' readiness for clinical duties. These networks include peer mentorship, orientation programs, and customized curriculum modifications.

Discussion: The study emphasized the value of early exposure to clinical settings and the inclusion of soft skill development in the curriculum, such as empathy and communication. The research advocated for comprehensive reforms in dental education, emphasizing the need for a holistic approach that addresses both the academic and emotional well-being of students. Dental faculties can contribute to the development of more competent and self-assured dental practitioners by improving support systems and incorporating practical experiences earlier in the educational timeline.

Introduction: Improving the quality of teaching placements in family medicine practice (FMP) could help to address the shortage of primary care physicians. This study aims to investigate students' evaluations of first-exposure FMP placements, to identify clusters of FMPs that might need to improve their placement quality, and to analyze students' perceptions of the FMP as a learning environment.

Methods: The design was a cross-sectional survey study, including all fourth-year undergraduate medical students at the University of Zurich, Switzerland, who completed a mandatory placement in FMP during 2019-2022. The placements consisted of individual teaching and training in the same FMP for 8 half days within an academic year. The primary outcome was the student Likert scale rating of the 14 key questions as indicators of teaching placement quality. Based on these indicators, cluster analysis was used to identify groups of FMPs with the potential for quality improvement. A framework analysis was used to analyze the students' perceptions.

Results: A total of 713 students (response rate 81%) and 249 FMPs (median [interquartile range]: 2 [1,4] students per FMP) were included. Overall, 86% of the students were satisfied with the placement, and 95% reported that the placement gave them realistic insight into FMP work. A cluster of 25 (10%) FMPs that may improve placement quality was identified. Students most liked the opportunity to gain FMP skills, insight into FMP work, and establishment of patient relationships.

Conclusion: Our study described students' experiences with FMP and a method for teaching evaluation to identify FMPs that may benefit from interventions to improve their learning environment. This could upgrade the medical education offered and increase the interest in family medicine as a response to the shortage of primary care physicians.

Background: Herbal medicine is integral to Saudi Arabia's Vision 2030, which seeks to improve the healthcare system and promote alternative practices while ensuring safety through education and research. This study aims to evaluate medical students' knowledge and perceptions regarding herbal medicine in Saudi Arabia.

Methods: A cross-sectional study was conducted among medical students in three medical colleges in Saudi Arabia over a six-month period from 1 February to 31 July 2024. Descriptive statistics were used to describe the participants' characteristics, and categorical variables were reported as frequencies and percentages. A chi-square test was used to test the relationships between variables. A p-value of < 0.05 was taken to indicate statistical significance.

Results: In total, 592 participants were included in the study. Females represented 65.7% of the participants. While 72.6% of the students agreed that medical students lack proper knowledge about the use of herbal medicines, 64.9% preferred having an elective course in complementary medicine (including herbal medicine). Also, 40.9% of students use herbal medicine believing they do not require expert knowledge and can safely experiment with various herbs, and 22.3% use it because they perceive it as having no side effects due to its natural ingredients. The most reported sources of information included family and friends (53.2%), whereas traditional herbalists (Attar) were the most reported sources of herbs (49.3%). The most used herbs among medical students were ginger (83%), turmeric (48.1%), chamomile (46.3%), and myrrh (26.5%). Only 37.7% of students who used herbs had an overall good knowledge and perception of them (P = 0.001). Gender showed a significant relationship with herb use among the students: 95.4% of female students used herbs, compared with 92.6% of male students (P = 0.049).

Conclusion: A considerable proportion of medical students demonstrated insufficient knowledge and perception regarding the use of herbal medicine. To improve their understanding, it is essential to integrate comprehensive courses, organize workshops led by experts, promote research and clinical experiences, and establish patient education initiatives.