Advances in Medical Education and Practice最新文献

Purpose: Course evaluations are critical for improving educational practices; however, their results can be influenced by various unexpected factors, including cultural values. Despite several studies on cultural dimensions in course evaluations, Japanese students were rarely the focus of evaluation in the Asian context. Data on Japanese students' evaluation practices may reveal diverse behavioral patterns in Asian countries, highlighting the value of country-specific studies to uncover unique educational contexts. This study explores, through a cultural lens, how Japanese medical students perceive course evaluations and the factors influencing their participation.

Methods: Four Focus Groups were created with 23 third- and fourth-year medical students. The recorded discussion data were analyzed using a thematic analysis approach by applying Hofstede's model of six cultural dimensions as a theoretical framework.

Results: This study identified three main themes influencing student participation in course evaluations: their emotions, insufficient understanding of the evaluations' significance, and logistics impacting student motivation. Gratitude positively influenced their decision to participate in course evaluations, whereas anger, anxiety about presumptuousness, fear and indifference had a negative impact. Additionally, their willingness to participate was positively influenced by the perceived benefits for future students. Logistics, including the timing of evaluations and the design of the online evaluation form, also contributed to either encouraging or discouraging their participation.

Conclusion: This study has illuminated factors shaping medical students' perceptions and motivations regarding course evaluation through Hofstede's model. These include "perfectionism" associated with decisiveness, "the attitude of accepting the status" linked to restraint, "teacher-centered education" and "respect for authority" related to power distance, "peer pressure" reflecting collectivism, and "risk avoidance" tied to uncertainty avoidance. Understanding these cultural nuances is crucial for the effective implementation of course evaluations in medical schools, as they offer valuable insights into how cultural contexts influence perceptions and motivations across diverse educational environments.

Aim: The study aims to compare traditional interviews with Multiple Mini Interviews (MMIs) to assess their reliability in evaluating applicants across racial and socioeconomic backgrounds.

Background: In the 2019-2020 admissions cycle, The University of Texas Medical Branch John Sealy School of Medicine (JSSOM) admissions committee observed inconsistencies in interview scoring, topics discussed during interviews, and interviewer comments using an unstructured interview format. Additionally, the recent Supreme Court decisions in Students for Fair Admissions, Inc. (SFFA) v. the University of North Carolina and SFFA v. President & Fellows of Harvard College, which ended race-conscious admissions, or affirmative action, and upheld holistic admissions practices, encouraged medical school admissions committee to reevaluate their approach to admissions.

Methods: Data from six admissions cycles (2018-2022), totaling 5799 interviewees, were analyzed to assess potential biases and the effectiveness of the admissions process. Spearman correlation examined relationships between Casper scores and both traditional interview and MMI outcomes. T-tests and Cohen's d explored demographic differences across URM, African American, Hispanic, and disadvantaged applicants in interview and academic metrics to evaluate fairness.

Results: When comparing MMIs and traditional interviews, both appear equal in reducing group differences (Underrepresented in Medicine(URM) versus non-URM, African American to non-URM, Hispanic to non-URM, and disadvantaged to non-disadvantaged). MMIs decreased demographic differences compared with traditional interviews for African-American candidates and slightly increased for URM, Hispanic, and disadvantaged candidates, but the effect size was small.

Conclusion: Future work includes conducting rigorous data analysis to better assess the MMI's utility, exploring the correlations between MMI scores, clinical evaluations, and objective structured clinical examination (OSCE) results. This multifaceted approach will provide a comprehensive view of how MMI performance aligns with real-world clinical assessments and standardized evaluation metrics, offering valuable insights into its effectiveness as a predictor of future medical proficiency.

Preceptors play an indispensable role in shaping the future of healthcare. They bridge theoretical learning and practical clinical expertise in a rapidly evolving medical education landscape. Their influence extends beyond knowledge transfer, embodying the values, attitudes, and professionalism essential to competent medical practice. Bandura's Social Learning Theory posits that individuals learn through observation and modelling. Applying this theory supports the assumption that trainees acquire skills and professional norms by observing preceptor behaviour, a process known as vicarious learning. They transmit clinical competencies, ethical standards, and interpersonal skills critical for patient-centred care. Despite their significance, challenges such as increasing workloads, diverse trainee needs, and the complexities of modern healthcare often impede their ability to mentor effectively. Preceptors shape trainees' professional identities and ethical standards, which are significantly influenced by the hidden curriculum, the set of unspoken or implicit lessons conveyed outside the formal curriculum. Globally, there is growing recognition of the need to support and enhance the role of preceptors in medical education. Due to several challenges, some factors might prevent preceptors from maintaining their role model status, including the need for experience, continuous learning, and adaptation to diverse trainee needs. Strategies such as engaging in reflective practices and implementing effective stress management techniques are crucial for preceptors to navigate these barriers and uphold their status. However, few studies have synthesised the various dimensions of preceptor influence, including role modelling, communication skills, and the hidden curriculum. This review aims to fill this gap by exploring the variable role of preceptors in shaping medical trainees' professional development. It highlights the theoretical underpinnings of preceptorship, discusses the challenges preceptors face, and proposes evidence-based strategies to enhance their impact on future healthcare professionals.

Background: With the growing demand for medical services worldwide, especially during public health emergencies, medical students, as a special group of future medical workers, are important for the development of health services, and they therefore experience more stress than ordinary college students do. The mental health of medical students plays a vital role in their training, and interpersonal relationships are an important factor affecting their stress levels.

Purpose: This study aims to investigate the network structure of stress and interpersonal relationships among Chinese medical students and identify bridge variables to prevent and relieve this stress.

Patients and methods: A self-report measurement taken from the Sociodemographic Questionnaire, Stress Scale for College Students and Interpersonal Relationship Synthetic Diagnosis Test was administered to 322 Chinese medical students from January to April 2022. Network analysis was used to determine the network structure, and the bridge expected influence (BEI) was identified as the bridge variable.

Results: A total of 6.83% of the medical students experienced high levels of stress, and 31.06% of the medical students experienced various degrees of interpersonal distress. The edges across the community associated with stress and interpersonal relationships were all positive. The edges between S1 "personal hassle" and R3 "dealing with people", S2 "academic hassle" and R2 "socializing", and S3 "negative life event" and R4 "dating someone of the opposite sex" were the strongest. S1 "personal hassle" had the greatest BEI of the stress community (0.44), and R3 "dealing with people" had the greatest BEI of the interpersonal relationship community (0.19).

Conclusion: This study used network analysis to investigate the relationship between stress and interpersonal relationships in Chinese medical students at the component level for the first time and highlight that the critical bridge variables "personal hassle" and "dealing with people" may contribute to preventing and relieving stress in Chinese medical students.

Background: Emergency Medical Services (EMS) is pivotal in the healthcare system, particularly in Emergency Medicine (EM) education. This study focuses on the current state and structure of the EMS rotation within Saudi Emergency Medicine Programs.

Objective: The aim is to evaluate the availability and implementation of the EMS rotation curriculum in Saudi Emergency Medicine Programs concerning the Saudi Commission for Health Specialties (SCHS) requirements, identify gaps in its delivery, and propose areas for improvement to enhance standardization and effectiveness.

Methods: A cross-sectional survey was conducted among emergency medicine program directors and residents in Saudi Arabia. Inclusion criteria were physicians who had completed EMS rotations after 2018. The survey collected data on participant backgrounds, available activities, evaluation-related services, and field experience. SPSS version 24 was used for data analysis, employing Chi-square tests to determine statistical significance.

Results: The study included 68 participants, 51.5% current EM residents and 42.6% graduated EM residents. The majority were from the Central EM residency program (51.5%). Education of prehospital healthcare providers was the most reported activity (78%), followed by ride-along (Ground) (75%) and dispatch observation (66.1%). Significant differences in activity availability and evaluation services were observed based on respondents' positions and locations. For instance, ride-along (Air) was available in 7.1% of Eastern Region programs compared to 0% in Western programs. The most meaningful component of EMS rotation, as reported by 41.5% of participants, was ride-along.

Conclusion: This study highlights the variability in EMS rotation activities and evaluation services across Saudi emergency medicine programs and underscores the need for more structured and comprehensive training approaches aligned with SCHS requirements.

Background: During COVID-19 pandemic in Jordan, a number of medical students participated in voluntary work. However, barriers and facilitators were unclear. Therefore, we aimed to evaluate their experience and attitudes towards volunteering during a pandemic and the factors affecting that.

Methods: A cross-sectional questionnaire-based study, using paper and online questionnaire which were distributed to final-year medical students at the University of Jordan from August 2021 to October 2021, about their experience and attitudes towards voluntary work during pandemics.

Results: A total of 375 of final year medical students responded to the questionnaire. The number of male and female respondents were equal. Past voluntary work experience prior to COVID-19 pandemic in 44.8% of students, while 79.2% of them did not volunteer during the COVID-19 pandemic. Around 60% of students were willing to participate in future voluntary work that does not involve patients infected with COVID-19, while 29.3% of them were willing to do so depending on the type of pandemic and the availability of vaccines. There were 86.1% of students who thought that participating in voluntary work involving infected patients during pandemics, should be optional; where 10.1% suggested that it should be compulsory if vaccines were available.

Conclusion: The majority of medical students did not volunteer during the COVID 19 pandemic. However, many of them expressed willingness to take part in future pandemics. Providing sufficient protection aids and adequate training, would affect positively the willingness of medical students to participate in voluntary work during a pandemic.

Systematically generating differential diagnoses facilitates a clinician's history, physical exam, and clinical evaluation. IMPASSIVE DICTATING is an acronym for pathophysiologies to consider in a differential diagnosis: immune reactions and dysregulation, metabolic, psychiatric, allergic, structural, social, infectious, vascular, endocrine/exocrine, degenerative, iatrogenic, congenital, traumatic, autoimmune, toxic, idiopathic, neoplastic, and genetic. We suggest that this mnemonic includes several improvements on previous pathophysiology-based acronyms and have informally validated this new mnemonic with two lists of common diseases. By emphasizing mechanisms of disease rather than clinical experience, IMPASSIVE DICTATING may be particularly useful in preclinical education, other teaching contexts, and complex patient presentations. We demonstrate the use of IMPASSIVE DICTATING with several common syndromes and underscore its utility and application compared to other methods of creating differential diagnoses.

Background: Public health education increasingly emphasizes experiential learning and community engagement. Peer review complements traditional staff evaluation, enhancing learning outcomes and refining teaching strategies. This study aims to investigate the perceptions and experiences of medical students with peer evaluation of community health projects. Staff evaluation for the same projects will be used for comparison.

Methods: A cross-sectional survey study involving medical students from the epidemiology and community health course at the College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU). Students assessed their peers' community health projects using a self-administered questionnaire. Staff evaluations were also compared. Data was analyzed by IBM SPSS 29.

Results: The study included 187 participants, primarily medical students (98.3%), who evaluated 20 community health projects. Three teaching staff members also rated the same projects. Medical students ranked effort expended (4.34), topic importance (4.26), and apparent participation (4.26) in descending order of value. The Staff evaluated the topic's relevance as the highest (4.43), but they rated the tools as lower (3.9). Medical students ranked tools sufficiency significantly higher, with a mean of (4.16 vs 3.90) than Staff (p <0.05). Both groups evaluated the project's level of innovation and the clarity of its target audience in a comparable manner. The analysis of the Full Project Level indicated no substantial disparity between medical students and Staff, as evidenced by the p-value of 0.920.

Conclusion: This study validates that peer evaluation of student projects is equally practical as evaluation conducted by faculty members. Consequently, allocating resources toward enhancing peer students' learning and evaluation capabilities is justifiable.

Background: Understanding alumni satisfaction and the competencies gained during university training can guide improvements in education quality, particularly in higher education institutions. This study at Mbarara University of Science and Technology (MUST) explored the factors influencing alumni decisions, their residency experiences, and their levels of satisfaction. Additionally, it provided recommendations for improving graduate training programs.

Methods: We conducted a mixed methods study from June to September 2022, employing an online survey and in-depth interviews (IDIs). The survey was distributed via Email and WhatsApp to MUST residency alumni, with 12 participants selected for IDIs. Descriptive summary statistics and thematic analysis were used to analyze the data.

Results: Ninety-five MUST alumni (34.3% response rate) participated, predominantly males (80%), aged 31-40 (69%), and Ugandans (72%). Most graduated after 2018 (83%) in surgical specialties such as obstetrics/gynecology (38%) and general surgery (19%). Factors influencing residency program choice included practice-oriented study programs (61%), fields of specialization (55%), university or departmental reputation (46%), and admission standards (32%). While 80% were satisfied with the learning and teaching, only 50% expressed satisfaction with the infrastructure. IDIs revealed satisfaction due to compassionate faculty and strong university partnerships but criticized limited study facilities, difficult adaptation for international students, insufficient hands-on training, human resource shortages, and limited technology. Recommendations included collaborative mentorship, increased hands-on training exposure, more partnerships, and enhanced infrastructure and technology support.

Conclusion: Most alumni were satisfied with their residency training despite infrastructure dissatisfaction, finding it well-aligned with their work and beneficial for their careers. Our study highlights opportunities for implementing proposed improvements to enhance residency training. It suggests that similar universities should conduct post-graduate tracers to evaluate trainee experiences and inform future directions.

Background: Measurement of medical graduates' perception of their internship program can help to improve the program to guarantee the general satisfaction of medical interns and enhance their clinical training.

Objective: To evaluate the medical interns' perceived preparedness for clinical practice and investigate the contributing elements.

Method: The study was carried out to include 109 medical interns. Assessment preparedness for hospital practice questionnaire in Hospitals was used.

Results: For clinical practice, the vast majority of participants (81.7%) were either fully or very well prepared. However, no statistically significant relationship was observed between the intern characteristics and preparedness level. It was found that the interns were not well prepared regarding handling emergencies, dealing with dying patients (44%), inserting an intravenous line (35.8%), conducting a digital-rectal examination (31.2%), as well as speaking with the social worker about the patient (29%). Males scored significantly higher than females regarding the interpersonal domain.

Conclusion & recommendations: The results revealed that most interns were adequately trained for their clinical experiences. More emphasis on training in emergencies, catheterization, insertion of intravenous lines, and dealing with dying patients is required, in addition to continuous assessment of the interns after each clinical rotation to discover the areas of weakness.