Advances in Medical Education and Practice最新文献

Objective: This study explores the effectiveness of the cognitive apprenticeship teaching model in fostering critical thinking and clinical reasoning and decision-making skills among medical residents during their rotations in the critical care medicine department.

Methods: We selected medical residents undergoing standardized training during their rotations in the critical care medicine department at the First Affiliated Hospital of Chengdu Medical College as the study participants. We conducted a two-month clinical practice course using the cognitive apprenticeship teaching model and evaluated its outcomes.

Results: Prior to the teaching intervention, there were no significant statistical differences (P > 0.05) in the general information and pre-teaching assessment scores related to critical thinking and clinical reasoning and decision-making skills between the two groups of students. However, after the training, the experimental group demonstrated significant improvements in four dimensions: truth-seeking, systematic skills, confidence in critical thinking, and curiosity, compared to the control group. Furthermore, in the Mini-CEX assessment, the experimental group scored higher in six dimensions: medical history inquiry, humane care, communication skills, clinical judgment, organizational efficiency, and overall clinical competency, with statistically significant differences (P < 0.05) compared to the control group.

Conclusion: The cognitive apprenticeship teaching model enhances the critical thinking and clinical reasoning and decision-making skills of resident physicians, thereby improving the effectiveness of medical education.

Introduction: Understanding the perceptions of medical students and faculty members regarding unprofessional behavior is crucial to appropriately guide medical students' behavior. This study aimed to clarify the differences in perceptions of unprofessional behavior in clinical settings among Japanese medical students and faculty members.

Methods: This single-center, cross-sectional survey was conducted at the Faculty of Medicine, Saga University. Participants were faculty members who participated in a faculty development program on medical students' unprofessional behaviors in December 2024 and fourth-year medical students who attended a similar lecture in January 2025. The survey items were determined through identifying common unprofessional behaviors based on previous reports and following a discussion with faculty members responsible for pre-graduate education. Participants were divided into faculty and student groups, and differences in perceptions were analyzed using logistic regression analysis.

Results: Participants comprised 40 (response rate 22%) faculty and 65 (64%) students. The faculty group showed significantly lower perceptions of being unprofessional in the following behaviors than the student group: violation of privacy or confidentiality obligations (odds ratio 0.089, 95% confidence interval 0.010-0.766); false statements or misrepresentation (0.180, 0.034-0.940); inappropriate use of social networking services (0.150, 0.029-0.762); fabrication or falsification of data (0.228, 0.005-0.941); bullying, discrimination, and sexual harassment (0.047, 0.006-0.383). Multivariate logistic regression analysis identified "bullying, discrimination, and sexual harassment (0.058, 0.007-0.487)" as the only factor on which their perceptions differed significantly.

Conclusion: Both faculty members and medical students perceived the unprofessional behaviors of medical students similarly, except in the cases of bullying, discrimination, and sexual harassment. However, since faculty members considered five behaviors to be less unprofessional, their perceptions regarding unprofessional behaviors need to be realigned so that they can better guide medical students toward becoming better professionals in the future, thereby improving patient outcomes.

Background: General practice (GP) placement teaching can be challenging because of time constraints, ineffective teaching models, and a lack of consensus approaches. GP clinics are more frequently used for undergraduate students' learning to translate theoretical knowledge into clinical practice. Evidence suggests that a learner-centred approach is essential for facilitating deeper learning. "Student-led consultation under supervision" is one such learner-centred teaching model applied during GP placement, engaging both trainers and trainees in applying the core values of clinical thinking. This qualitative study intends to explore students' learning outcomes when implementing the innovative teaching model "Student-led consultation under supervision during GP clinical placement" for potential quantitative introduction as a formal GP placement curriculum.

Methods: A convergent mixed-method approach was applied using validated surveys and pre-designed questionnaires for individual reflection when implementing innovative teaching models in medical students' GP placements. Thirty-five medical students from China and Australia participated in the study. Survey and reflection data were collected for descriptive and semantic analysis.

Results: "Student-led consultation under supervision in a consultant's chair with discussion" was the students' most highly rated teaching model. Students' reflections on the use of these teaching models were semantically analysed using a validated questionnaire. The students' reflections highlighted the perceived academic benefits with identifying the enablers of and barriers to developing the formal GP placement curriculum.

Conclusion: This study shows that "Student-led consultation under supervision in a consultant's chair with discussion" is innovative in GP teaching. The demonstrated innovation embraces the concept of cognitive apprenticeship for improving learning outcomes. These teaching models incorporate students' reflection in curriculum design and extend the definitions of "cognitive apprenticeship" and "transfer of learning" in modern clinical teaching to improve trainees' placement learning. The identified enablers of and barriers to implementing these innovative teaching models will pave the way for future studies to confirm the practicality of implementing them in real-life clinical practice.

Objective: The selection of medical specialties by medical students (MS) and factors shaping their decisions represent critical determinants of the medical workforce landscape, warranting in-depth exploration. In many countries, infectious diseases (ID) fail to be acknowledged as a satisfying specialty. Furthermore, the shortage of ID specialists has become a critical challenge in China's healthcare system. Therefore, we undertook a survey to investigate MS' specialty preference, especially their interests in ID, and the determinants influencing their decision-making processes.

Methods: We recruited the fifth, sixth, and seventh year MS to carry out this investigation. Initially, 10 semi-structured interviews were conducted to gather qualitative insights. Subsequently, 117 participants completed a questionnaire.

Results: In the qualitative study of 10 MS, motivations for medical school included personal interest (6/10) and a desire to help others (5/10). All planned to practice medicine post-graduation, with intended specialties mainly surgery (5/10) and internal medicine (4/10); key career choice factors were specialty interest (9/10) and job availability (4/10). All were unfamiliar with ID, with limited exposure to ID. None intended to pursue ID careers, primarily due to greater interest in other specialties (10/10), plus concerns like occupational exposure (2/10). In the quantitative study of 117 participants, the majority of MS applied for medical school based on personal interests (76.9%), and most (88.9%) intended to practice medicine after graduation. Internal Medicine (31.6%) and Surgery (24.8%) were the most popular first-choice specialties, with work-life balance (82.1%), interest in the specialty (81.2%), and expected income (70.9%) being the top factors influencing specialty choice. Notably, only 6.8% of MS expressed interest in pursuing a career in ID, while 48.7% reported no interest. The primary reasons for disinterest included concerns about occupational exposure, lack of inherent interest in ID, and limited procedural opportunities. Multivariate logistic regression analysis identified the overall evaluation of the ID curriculum as the sole factor associated with MS' lack of interest in ID (OR 0.376, 95% CI 0.188-0.754, P=0.006).

Conclusion: In our study, MS showed limited interest in becoming ID specialists. To enhance the appeal of the ID specialty, efforts could focus on training students on occupational safety and protection, improving the quality of ID-related courses, and optimizing career incentives. These strategies might help increase MS' interest in ID and contribute to a more balanced medical workforce.

Purpose: This study aimed to assess the knowledge and attitudes changes of pharmacy students in Jordan toward pharmacogenetics (PGx) education.

Patients and methods: The study has involved both quantitative and qualitative approaches. The quantities part investigates the pre- and post-test scores of 95 pharmacy students studying PGx at the University of Jordan. The surveys were administered before and after the educational intervention, which lasted 14 weeks. The qualitative aspect included focus group discussions, where the participants deeply revealed their perceptions of PGx.

Results: The study showed that 66.3% of students "strongly agreed that genes received from parents are the main influencers of medication response", in comparison to 45.3% of the students at the baseline (p < 0.001). The belief that gene variants are correlated with the susceptibility to the side effects of drugs was one of the lessons that benefited the most, with an improvement from 45.3% to 72.6% (p < 0.001). At the end of the intervention, 75.8% of students approved PGx execution being pharmacists' job, whereas 44.2% voted for it at the baseline (p < 0.001). Following the intervention, 75.8% of students strongly agreed that PGx testing should be part of pharmacy education, up from 61.1% (p = 0.016). The number of students that strongly agreed that genetic testing would make drug selection significantly improves from 55.8% to 78.9% (p = 0.002). Focus group interviews confirmed these findings. Students valued talking about tailored medication and promoted PGx to their future employers. According to several students, the PGx course should be mandatory for PharmD students and offered earlier for better practical use.

Conclusion: The PGx educational intervention improved students' PGx knowledge and attitudes. The study underscores the need to integrate PGx into pharmacy courses to educate students about personalized medicine in clinical practice.

Purpose: The evolution of health promotion has greatly served as an essential function for equitable health improvement aimed at addressing social determinants to improve health outcomes. This study seeks to determine the perspectives of eye health professionals on the use of health promotion interventions for the prevention and early diagnosis of eye diseases, with a specific focus on their views regarding the integration of health promotion into optometry education in South Africa.

Methods: A quantitative cross-sectional study was conducted among 68 respondents employing a convenience sample. A self-administered questionnaire was distributed electronically to all respondents. Descriptive frequencies and percentages summarized categorical data, with bivariate comparisons using the chi-square test.

Results: The findings reveal a considerable disagreement among respondents regarding the integration and emphasis of health promotion within optometry education, with minimal agreement highlighting a perceived lack of opportunities to explore health promotion as a core component of the curriculum.

Conclusion: Integrating health promotion into optometry education is not only relevant but necessary for addressing the increasing opportunity to integrate health promotion to reduce preventable vision loss in South Africa, where public health needs are pressing. The lack of early and consistent exposure to health promotion, as well as the insufficient focus on policy-related education, highlights the need for a more integrated approach.

This study protocol outlines the test evaluation of the design of a comprehensive Nordic hospital at home (HaH) digital education program entitled "the Nordic Digital Health and Education" program (NorDigHE). The NorDigHE program aims to prepare healthcare professionals for healthcare provision in a HaH context. The program, developed by a Nordic consortium, spans five modules over 3.5 weeks of full-time study, equivalent to 5 ECTS, and employs various learning tools, eg, text, videos, learning games, and simulations. The design evaluation will involve 120 healthcare students and professionals across Denmark, Norway, and Sweden, focusing on their perceptions and experiences with the different educational tools utilized in the education. To be included in the study, the participants need to have completed at least four semesters of bachelor level studies in medicine, nursing or other registered healthcare professions. Each of the participants will test two of the five modules at their own pace during the design evaluation. Evaluation data will be collected through established instruments measuring student motivation, quiz functionality, videos' effectiveness, and the educational platform's usability assessments. The outcomes of this study will be used to refine the education and the learning tools employed. Ultimately, the results will help optimize the structure and contents of the NorDigHE education program, to better prepare healthcare professionals and students with essential skills to navigate the evolving landscape of digital health and remote patient healthcare effectively.

Background: Medical education directly impacts patient care, yet the predictive validity of pre-clinical academic performance for licensure exam outcomes remains debated. This national, multi-institutional study (2019-2021) assessed the relationship between university course grades, cumulative grade point average (GPA), and Comprehensive Basic Science Examination (CBSE) scores in Iranian medical students.

Methods: Course grades and GPAs of 23 medical schools were linked to CBSE outcomes of 51 medical schools across five consecutive exam periods via student national ID. Pearson's correlation, paired t-tests, ANOVA, and chi-square assessed trends. Hierarchical cluster analysis (dendrogram) examined course grade correlations. Independent CBSE total score predictors were found using multiple linear regression.

Results: Of the 25,757 individual records, 9,359 (45.2% female) had complete academic and CBSE data, making them eligible for primary analyses (84.5% passed CBSE on the first attempt). The GPA was 15.11±1.74, and the CBSE score was 101.68±24.61. All course grades correlated significantly with CBSE subtests (r=0.055-0.544, P<0.001). A significant moderate association (r=0.492, P<0.001) exists between overall GPA and CBSE. Repeat examinees had considerably lower GPAs and CBSE scores (P<0.001). GPA (β=0.318), Anatomy (β=0.158), Physiology (β=0.135), Epidemiology (β=0.043), and Virology (β=0.043) were the most significant predictors in regression modeling (R²=0.426). Cluster analysis showed that academic grades in anatomy, physiology, and biochemistry were strongly correlated with CBSE subtests.

Conclusion: This study represents the first large-scale national dataset in Iran pertaining to medical education. Pre-clinical GPA and course grades exhibit overall and subject-specific, notable predictive validity for CBSE performance. To enhance medical education and licensure results, it is advisable to implement standardized, cross-institutional comparisons alongside dynamic curriculum reviews. The regression model and clustering insights provide a framework for targeted educational interventions.

Background: Compulsory education of communication skills has begun to develop in Poland over the past several years. The aim of this study was to explore perception of preparation by the universities and self-assessment in communication skills among Polish doctors, nurses and midwives.

Methods: The research was based on an online survey examining 22 communication skills. A list of communication skills was created based on the recommendations for teaching medical communication described in the Calgary-Cambridge model. Data collection took place from March to July 2022. The sample consisted of a variety of health professions, including physicians, nurses and midwives.

Results: The results show that medical school graduates who took part in the survey rated their preparation in communication skills as low and the number of hours dedicated to communication training as insufficient. The most challenging aspects of communication skills include dealing with patient aggression, handling patients who express complaints, grievances, or expectations and discussing non-medical treatments with patients. The surveyed nurses and midwives rated their overall preparation significantly higher than physicians and felt strong in showing empathy. Doctors in turn assessed their task-oriented communication skills as much better.

Conclusion: The respondents emphasized the importance of communication skills training. Our findings underscore the urgent need for structured, longitudinal communication training within medical education, supported by systemic changes at the levels of policy, curriculum design, and faculty development. Communication skills must be prioritized as core clinical competencies across all health professions, not treated as peripheral elements of medical education and ideally should be continued throughout one's medical career and postgraduate education. Particular emphasis should be placed on teaching how to manage patient aggression, address complaints, and communicate with patients who pursue alternative medicine and not evidence based treatment. These results may also assist universities in other countries, where medical curricula are being implemented.