Advances in Medical Education and Practice最新文献

Purpose: As the demand for humanistic and patient-centered care grows in clinical practice, integrating narrative medicine into residency training has become increasingly important. This study aimed to investigate the narrative competencies of obstetric residents undergoing standardized training and to evaluate the effectiveness of narrative medicine education empowered by case-based teaching in enhancing clinical practice and professional competency.

Patients and methods: A total of 46 obstetric residents enrolled in standardized training programs between October 2021 and May 2024 were randomly assigned to either the experimental group (n = 23) or the control group (n = 23). Residents in the experimental group received case-based narrative medicine education, while those in the control group received conventional clinical teaching. Following the obstetrics rotation, knowledge tests and objective structured clinical examinations (OSCEs) were administered. Subjective evaluations of narrative competencies and teaching effectiveness were assessed using validated questionnaires.

Results: After the obstetrics rotation, OSCE scores were significantly higher in the experimental group compared to the control group (P < 0.05). Narrative competencies also showed a significant improvement among residents in the experimental group after the training (P < 0.05). Moreover, residents in the experimental group reported higher narrative competency scores and greater satisfaction with teaching effectiveness compared to the control group (P < 0.05).

Conclusion: Narrative medicine education empowered by case-based teaching effectively enhances narrative competencies, obstetric clinical skills, doctor-patient communication abilities, critical thinking, and learning engagement among obstetric residents undergoing standardized training. This innovative teaching approach addresses the gap in humanistic medical education and provides an effective strategy for cultivating comprehensive professional competency in obstetric residents.

Purpose: Near-Peer Training (NPT) is increasingly used to teach clinical and procedural skills during undergraduate medical education. The impact of NPT programs on clinical practice is usually measured through OSCE stations that assess the trained skills. Little is known about the impact of a single NPT session on students' performance in OSCEs. This study aims to assess the impact of a single clinical skill NPT session on students' overall objective performance at a summative OSCE.

Patients and methods: This prospective study evaluated the impact of a two-hour NPT session focused on three system-related clinical situations on overall clinical performance. Third-year medical students (junior) practiced these specific clinical skills under the supervision of fourth-sixth year student tutors with students rotating roles as clinician, observer, or patient. Scores (0-100) at the 3^rd year summative OSCE served as indicators of objective performance.

Results: In 2022 and 2023, 210 out of 325 junior students underwent the NPT, with 50 tutors recruited for instruction. NPT participants significantly outperformed non-participants in the summative OSCE, with higher mean scores in global assessment (80.01± 7.64 vs 74.58± 6.71, p<0.0001), communication (83.39± 8.99 vs 79.70±10.10, p=0.0011), medical history taking (77.31± 8.93 vs 73.28±9.59, p=0.0006), and physical examination (73.52±10.66 vs 68.30±10.37, p<0.0001). However, there was no evidence of specific performance improvement in OSCE stations related to the trained system related clinical situations (effect of -0.0119±0.0598 on the normalized scores; p=0.8428).

Conclusion: A single NPT session improved junior students' general performance but not scores related to the trained clinical situations at a summative OSCE. More research is warranted to understand what really boosts student learning since NPT seems to be effective, independently of the clinical skills specifically trained.

Background: While massive open online course (MOOC)-based blended learning has gained popularity across disciplines, its adoption in medical histology education is underexplored, and its educational benefits for undergraduate medical students have yet to be clearly established.

Objective: This study examined the relative effectiveness of traditional and blended learning methods in terms of academic performance, student perceptions, and learning satisfaction among first-year medical students in China enrolled in a histology course.

Methods: In this study, two groups with similar age, gender, and academic background were analyzed. The control group (n = 44) received traditional lecture-based teaching (LBT group), while the blended learning group (n = 45) received hybrid teaching, which combined traditional lecture-based teaching and MOOC (LBTM group).

Results: The final examination score of the blended learning participants was significantly higher than that of the control participants (LBTM 81.00 ± 10.84 vs LBT 75.34 ± 12.50, P < 0.05). The LBTM group demonstrated higher mean scores among the middle 30% (Mann-Whitney U-test, P < 0.001) and the lower 50% (Mann-Whitney U-test, P < 0.01) of students. Additionally, the final examination score was significantly correlated with the in-class quiz score (R = 0.420, P < 0.01). The implementation of blended learning was well-received by students in the LBTM group, who preferred the blended learning model (64.44%). Moreover, higher satisfaction was observed with blended learning (LBTM 21.87 ± 4.36 vs LBT 15.20 ± 4.15, P < 0.001).

Conclusion: Blended learning led to significant improvements in students' performance, satisfaction, and perception compared with traditional learning.

Background: Undergraduate medical education in China faces significant gaps in integrating theory with practice, with 32.7% of graduates requiring remedial procedural training.

Objective: To implement and evaluate a competency-based reform targeting problem-solving and practical skills.

Methods: In a single-center RCT (Anhui, China; 2023-2024), 180 medical undergraduates were randomized to control (traditional pedagogy, n = 90) or intervention groups (reformed curriculum: 40% practice-oriented content, integrated PBL/TBL/CBT). Assessments used OSCE-aligned tools (clinical checklists: Cronbach's α = 0.89; case analysis rubrics: κ = 0.85).

Results: Intervention group showed significant improvements: theoretical scores (78.7 ± 3.9 vs 68.3 ± 4.8; t = -17.78, P < 0.01, d = 2.39); clinical skill excellence (80.4% vs 60.2%; χ² = 25.93, P < 0.001, OR = 2.67); PBL adaptability (70.1% vs 42.3%; χ² = 9.0, P < 0.05).

Conclusion: This reform bridges theory-practice gaps and enhances clinical decision-making, requiring institutional support for scalability.

Introduction: Nanotechnology has emerged as a promising field of study, aiming to revolutionize healthcare through the innovative development of drugs, diagnostic tools, and medical devices. As a result, healthcare professionals in training are constantly faced with the challenge of understanding and applying these emerging technologies. The objective of this study is to determine the factors to consider for including the teaching of nanotechnological tools in medical specialty postgraduate programs.

Methods: A study based on the Nominal Group Technique (NGT) was conducted to identify the factors that promote and hinder the implementation of nanotechnology in certain postgraduate programs where nanotechnology is employed, such as Internal Medicine, Critical Care Medicine, Family Medicine, and Clinical Pharmacology at the School of Medicine of Universidad de La Sabana. A framework analysis was used to analyze the collected data.

Results: Based on the two research questions, several aspects were identified for the inclusion of nanotechnology in the medical practice of specialties. Key challenges include lack of knowledge and resource availability, misinformation, and lack of knowledge, as well as paradigmatic analysis as the main obstacles to the use of nanotechnology.

Conclusion: The findings provide a first-time study on nanotechnology curricula within medical specialty programs in Colombia, with potential extrapolation to similar situations in other medical schools. These insights can inform the global development of medical education curricula by highlighting the need for structured nanotechnology training, fostering interdisciplinary collaboration, and addressing resource and knowledge gaps to prepare future healthcare professionals for advancing medical technology worldwide.

Purpose: The recently instituted Japan 2024 physician workstyle reform imposed upper limits on monthly overtime hours. However, the interpretation of these limits by different training hospitals for postgraduate medical trainees (PGY1-2) and their supervisors remains unclear. This study aimed to quantify program directors' perceptions of the "optimal" monthly overtime hours for: (1) achieving educational milestones (Q1), (2) maintaining trainees' well-being (Q2), and (3) complying with trainees' limits through supervisors' workload (Q3), and to compare urban and rural hospitals.

Patients and methods: We conducted a cross-sectional, web-based survey of all accredited postgraduate training programs (N = 644) between March 1 and April 30, 2024. Program directors responded to three single-choice questions, selecting a monthly overtime band (none, 10, 20, …100 h/month). Hospitals were classified as urban or rural based on the Ministry of Health, Labor, and Welfare criteria. Linear trends across categories were tested using the Cochran-Armitage trend test.

Results: A total of 151 directors responded (response rate: 23%). Across Q1-Q3, 40 h/month was the most frequently selected time (21-23%). However, the proportion endorsing ≥ 60 h/month was significantly higher in urban than in rural hospitals (Q1: 43% vs 23%, p = 0.0347; Q2: 34% vs 23%, p = 0.0419; Q3: 40% vs 27%, p = 0.0405). Notably, urban programs were twice as likely to consider ≥ 80 h/month appropriate for both trainees' well-being (21% vs 6%, p = 0.0066) and supervisors (21% vs 7%, p = 0.0137).

Conclusion: Although 40 h/month is the most frequent response by program directors, those from urban hospitals more commonly viewed extended hours acceptable, even exceeding the "A tier" limit of 45 h. Policy initiatives should tailor workload mitigation and task-shifting strategies to urban hospitals to safeguard the well-being of trainees and supervisors.

Introduction: The integration of technology in medical education has led to the adoption of hybrid teaching methods, combining online lectures with traditional face-to-face clinical practice. While this approach offers flexibility and safety, it raises questions about the impact of potential time lapses between theoretical learning and hands-on experience. This study aimed to investigate the effect of the time interval between online lectures and on-site clinical practice on medical students' performance in orthopedic rotation.

Methods: A retrospective study was conducted on 116 fifth-year medical students who completed their orthopedic rotation during the 2021/2022 academic year. Students underwent a one-week online course followed by three weeks of on-site clinical practice, with varying time lapses (0-38 weeks) between these periods. Performance was assessed through examinations including key features test (KF), multiple-choice questions (MCQ), multiple-essay questions (MEQ), objective structured clinical examination (OSCE), and long case examination. Spearman's rank correlation was used to analyze the relationship between time lapse and examination scores.

Results: The analysis revealed a significant negative correlation between the time lapse duration and KF scores (p < 0.05). However, no significant associations were found between time lapse and scores in MCQ, MEQ, OSCE, or long case examinations (p > 0.05).

Conclusion: This study demonstrates that the time lapse between online lectures and clinical rotation in orthopedic education significantly impacts students' performance in key features tests. However, other examination scores remained unaffected. These findings highlight the need for careful scheduling and potential interventions to mitigate the effects of extended time lapses on specific aspects of medical knowledge retention and application in orthopedic education.

The integration of artificial intelligence (AI) into China's medical physiology education has emerged as a transformative strategy to modernize pedagogical practices and address systemic challenges in healthcare training. Current initiatives leverage AI-driven tools such as machine learning algorithms for physiological simulations and virtual reality (VR) for immersive clinical training, aiming to standardize educational outcomes, enhance student engagement, and improve readiness for complex clinical scenarios. However, the rapid adoption of AI introduces critical challenges, including widening resource disparities between urban and rural institutions due to over-reliance on technology, risks to data privacy in educational and clinical data management, and potential erosion of humanistic care in training environments. These challenges are further compounded by concerns over academic integrity-evidenced by student use of large language models (LLMs) to substitute critical thinking in assessments-and the need to balance AI efficiency with traditional teaching methods, particularly in specialized fields like Traditional Chinese Medicine (TCM) where master-apprentice models remain foundational. To reconcile technological innovation with educational integrity, this review proposes a balanced framework encompassing five key strategies: adaptive curriculum design that synergizes AI tools with human oversight, ethical governance to ensure algorithmic transparency and data security, equitable resource distribution to bridge regional gaps, faculty development programs to enhance AI literacy, and mentorship ecosystems that integrate AI with personalized guidance. By harmonizing AI's potential with core pedagogical values, these strategies aim to cultivate a new generation of clinicians equipped with both technical proficiency and ethical discernment, ultimately advancing healthcare quality and accessibility across China.

The rise of digital technology has significantly impacted students' learning behaviors, resulting in shorter attention spans and decreased focus, especially in medical education. This article explores how the constant engagement with digital platforms contributes to these challenges and emphasizes the need for more effective strategies to counteract these trends. The article presents that while digital tools can enhance learning, they must be balanced with active, observation-based methods to maintain deep concentration and critical thinking. By focusing on the integration of traditional, hands-on learning with modern digital techniques, the article discusses how a hybrid approach could promote sustained attention and improve clinical reasoning skills. Additionally, the article proposes observation-based teaching learning and assessment methods for fostering both scientific and artistic domains of a medical students. The conclusion emphasizes the importance of integrating digital learning tools thoughtfully while prioritizing in-person, experiential learning to equip students with the skills needed for effective patient care and professional development.

Background: Artificial intelligence (AI) and large language models (LLMs) are transforming medical education by enhancing teaching and assessment methods. Research output has surged, but key bibliometric trends remain underexplored.

Methods: We retrieved 547 publications using the Web of Science Core Collection and conducted bibliometric analysis with CiteSpace and other bibliometric tools to examine publication volume, collaboration networks, citations, keywords, and other important bibliometric indicators.

Results: The United States, the United Kingdom and China lead publication output, with institutions like the University of London, the National University of Singapore and Harvard University at the forefront. JMIR Medical Education is a pivotal journal. Research on ChatGPT and LLMs dominates, with growing focus on nursing education, digital health, medical exams, and medical ethics. Clinical reasoning, undergraduate education, and virtual reality have been identified as underexplored areas of research.

Conclusion: AI and LLMs in medical education constitute a fast-evolving field, with journal calls shaping its bibliometric landscape and advancing the discipline. The field remains in a developmental phase, with subfields yet to be clearly defined. Topics such as nursing education, digital health, medical examinations, and conversational agents are gaining traction. Research on ChatGPT and LLMs holds a central and influential role. Emerging areas of focus include medical ethics, training methodologies, and skills development. Clinical reasoning, undergraduate education, and virtual reality in AI and LLMs for medical education are understudied, offering research opportunities.