Advances in Medical Education and Practice最新文献

Purpose: To determine the level of uptake of telemedicine among postgraduate obstetrics and gynaecology (O&G) trainees in London, and how they perceive its impact on their training.

Methods: A mixed-methods survey aimed at exploring trainee perspectives of telemedicine use in clinical practice and its implications for training. Study participants were O&G specialist doctors on the London (UK) training programme. The survey was distributed to the 2022 cohort via Email communication facilitated by Health Education England.

Results: The response rate was 46.3% (118/255). Of respondents, 96% (113/118) had experience of telemedicine, in a range of clinical environments; 91% (106/117) felt telemedicine should become embedded in O&G practice (the most frequent reported advantage was time-saving and a barrier was language translation); 43% of trainees (50/116) stated that they were unable to attain effective clinical training during telemedicine appointments; and 70% (81/116) indicated a preference for remote online teaching. The majority of trainees (75%) had some level of experience in the use of technology in clinical training, encompassing various modalities including surgical and ultrasound simulation, remote real-time training and virtual reality patient consultations. Trainee responses, on the whole, reflected a lack of confidence in their ultrasound skills; 79.5% (74/93) of trainees responsible for acute gynaecology admissions reported that at least 25% of admissions were for deferred ultrasound scanning investigation. Most trainees anticipated that real-time remote supervision for both USS and laparoscopy would enhance training opportunities and expedite time to patient diagnosis and management. Anticipated barriers included concerns regarding the uptake of technology and connectivity issues.

Conclusion: Telemedicine for clinical care has been demonstrated to be well-received by most O&G trainees. However, it is necessary to consider effective O&G training when delivering telemedicine. Technology gives rise to a number of training opportunities, with the development of online teaching, telementoring and simulation. Trainees report both advantages and disadvantages which should be carefully considered to optimise postgraduate O&G training.

Purpose: Multiple choice questions (MCQs) are the mainstay in examinations for medical education, physician licensing, and board certification. Traditionally, MCQs tend to test rote recall of memorized facts. Their utility in assessing higher cognitive functions has been more problematic to determine. This work evaluates and compares the difficulty and long-term retention of factual versus conceptual knowledge using multiple-choice questions in a longitudinal study.

Patients and methods: We classified a series of MCQs into two groups to test recall/verbatim and conceptual/inferential thinking, respectively. We used the MCQs to test a two-part hypothesis: 1) scores for recall/verbatim questions would be significantly higher than for concept/inference questions, and 2) memory loss over time would be more significant for factual knowledge than conceptual understanding compared with a loss in the ability to reason about concepts critically. We first used the MCQs with pre-clinical medical students on a summative exam in 2020, which served as a retrospective benchmark of their performance characteristics. After two years, the same questions were re-administered to volunteers from the same cohort of students in 2020.

Results: Retrospective analysis revealed that recall/verbatim questions were answered correctly more frequently (82.0% vs 60.9%, P = 0.002). Performance on concept/inference questions showed a significant decline, but a larger decline was observed for recall/verbatim questions after two years. Performance on concept/inference questions showed a slight decline across quartiles, while two years later, recall/verbatim questions experienced substantial performance loss. Subgroup analysis indicated convergence in performance on both question types, suggesting that the clinical relevance of the MCQ content may have influenced a regression toward a baseline mean.

Conclusion: These findings suggest conceptual/inferential thinking is more complex than rote memorization. However, the knowledge acquired is more durable in a longitudinal fashion, especially if it is reinforced in clinical settings.

Objective: This study evaluates the adoption of blended teaching models by faculty and students at Hubei University of Medicine. It aims to assess their willingness to adopt hybrid learning and identify the factors influencing their choices. The goal is to provide a theoretical foundation for reforming teaching models.

Methods: We distributed questionnaires to 235 faculty members and 1501 students at Hubei Medical College to assess their preferences for various teaching models. We analyzed the results using multiple logistic regression analysis.

Results: Among the participants, 34.5% of teachers and 33.7% of students preferred the hybrid teaching model. Influential factors for selecting this model included the quality of online teaching (OR=1.601, 95% CI: 1.221-2.100) and teacher-student interaction (OR=2.568, 95% CI: 1.230-5.361) for teachers. For students, significant factors included online learning tools (OR=1.894, 95% CI: 1.002-3.580), a single teaching method (OR=1.390, 95% CI: 1.042-1.856), low learning efficiency (OR=2.154, 95% CI: 1.673-2.774), and the effectiveness of online learning (OR=1.257, 95% CI: 1.181-1.339).

Conclusion: The blended teaching model has gained popularity among faculty and students in higher education. Universities should leverage advancements in information technology to address challenges in hybrid teaching. Maximizing students' sense of academic achievement and satisfaction is recommended to enhance and support the blended teaching approach.

Purpose: The primary objective of this study was to assess the various coping strategies that medical students at Alfaisal College of Medicine use to adapt to stressors and adversities faced in a medical school environment.

Methods: This cross-sectional study utilized an online questionnaire distributed to medical students (aged 18+) at Alfaisal University from March 15 to April 30, 2023. Inclusion criteria focused on College of Medicine students from Years 1 to 5. The survey assessed stressors and coping strategies, with a modified Brief COPE scale for relevance. A target sample of 240-290 participants was calculated for a 95% confidence level. Data were analyzed using SPSS, applying descriptive statistics and Chi-Square tests. Ethical approval was obtained from the Institutional Review Board, ensuring confidentiality and voluntary participation.

Results: The most common stressors were high parental expectations, academic workload, frequent examinations, self-esteem issues, and sleep deprivation. The most frequently employed coping strategies included spiritual, religious beliefs and practices, stress acceptance, emotional support from family and friends, and humor. This study highlights the coping mechanisms adopted by medical students in Saudi Arabia to address academic challenges.

Conclusion: Understanding the preferred coping techniques in Alfaisal University medical students and recognizing the importance of spiritual well-being and social support can inform interventions to improve both academic performance and mental well-being in this population.

Purpose: This study aimed to explore the perspectives of residency program directors in Japan regarding overtime duty hours and the balance between clinical training and self-improvement activities. This study explores the impact of work-hour regulations on resident well-being and training quality, contributing to global discourse on medical education reform.

Participants and methods: A cross-sectional survey was distributed to 701 residency training hospitals across Japan to investigate their readiness for new duty-hour limits under the Medical Care Act, which categorizes working hours into Level A (960 hours/year), Level B (1440 hours/year), and Level C-1 (1920 hours/year). The survey, conducted from October 18 to December 15, 2023, achieved a 36.2% response rate (n=254). Key questions included: "Considering the balance between clinical skills development and mental well-being, what do you think is the optimal number of overtime duty hours per month for resident physicians?" Statistical analysis included descriptive statistics and Chi-square tests to compare responses across hospital types.

Results: Most directors favored a conservative overtime limit of 40 hours per month (mean ± standard deviation: 40 ± 21 h), with 24.0% expressing this preference. These findings reveal a significant evidence-practice gap, suggesting that current practices often exceed recommended limits, highlighting a need for alignment between policy and implementation.

Conclusion: This study provides insights into the complex interplay between resident training demands and well-being under Japan's new duty-hour reforms. It offers valuable insights for policymakers and educators aiming to optimize training environments and enhance resident well-being globally.

Purpose: Ophthalmology poses challenges for general practitioners, who have been identified globally as receiving inadequate training. Family medicine (FM) trainees often lack sufficient ophthalmology training; however, this issue is not unique to Saudi Arabia. Studies from Australia, the United States of America, New Zealand, and the United Kingdom have revealed the same concerns. Patient consultations offer opportunities for applying skills gained through structured education, yet the extent of FM trainees' clinical exposure to ophthalmology remains unclear. Effective workshops designed to enhance primary healthcare providers' ophthalmic skills exist internationally, but similar initiatives are lacking in Saudi Arabia.

Patients and methods: This one-year, cross-sectional study distributed a self-administered online questionnaire among family physicians and residents in a university hospital and the hospital's medical services center in Jeddah, Saudi Arabia. Data were inspected and cleaned in Excel and analyzed using IBM SPSS 29.

Results: The ophthalmology knowledge of family physicians averaged 5.1 on a scale of 1-10, suggesting moderate proficiency. Exposure to ophthalmology cases varied, indicating potential knowledge gaps and necessitating targeted educational interventions. Notably, 82.5% of the physicians believed that family physicians should lead the primary eye care by assuming responsibility for ensuring high levels of training and practice. Our study identified predictors influencing knowledge and confidence, including the effects of experience, training duration, and recognition of the necessity of continuous professional development courses. However, none of these associations were found to be statistically significant.

Conclusion: The physicians in our study exhibited a moderate level of ophthalmology knowledge (mean score = 5.1), revealing potential knowledge gaps. Despite their varied exposure to ophthalmology, 82.5% of the family physicians in this study advocated leading the medical profession in primary eye care. Experience and training duration were found to be non-significant predictors of knowledge and confidence.

Objective: This study aimed to assess the quality of the educational environments within which an orthopedic residency training program is being conducted throughout Saudi Arabia and to identify the areas of weaknesses so that the necessary improvements can be made to build a healthy and supportive environment.

Methods: This cross-sectional study included all orthopedic residents in Saudi Arabia and was surveyed using the validated Postgraduate Health Educational Environment Measure (PHEEM). We used Google Forms to Email the online survey to Saudi trainees in the orthopedic residency program from January 1 through September 30, 2022.

Results: The majority of participants were between 26 and 30 years; 15.6% were women. Among the subscales of PHEEM, perception of role autonomy scores were statistically significantly associated with participants' regions and their level of training (p = 0.026 and p = 0.019, respectively). The association of perception of teaching and participants' regions was also statistically significant (p = 0.004). The mean score for the perception of social support subscale was 25.99, which indicates that residents are generally satisfied with the level of support they receive in the training program. However, there is still room for improvement in this area.

Conclusion: The overall PHEEM score was positive but highlighted areas for improvement. Role autonomy and instructional subscales were perceived positively, yet still have room for growth. Social support showed more advantages than disadvantages. Despite the generally favorable environment, enhancements are needed in workloads, working hours, clarity of clinical protocols, and teaching supervision quality.