Advances in Medical Education and Practice最新文献

Purpose: Simulation-based teaching is an integral part of medical training, providing the opportunity to apply clinical knowledge in a realistic yet controlled environment. The proportion of observers to active participants in the simulation is increasing, owing to the increasing number of medical students. Evidence suggests that using an observer tool can enhance learning, support debriefing and improve observer satisfaction. However, there is a lack of generalisable observer tools designed for use across different simulation scenarios, including both technical and nontechnical skills. We aimed to evaluate the acceptability and perceived usefulness of our novel observer tool and its impact on learning and peer feedback in a medical-student simulation.

Methods: We delivered a simulation series to 43 medical students in which observers of simulation completed our CARSEAT observer tool, an acronym for Communication, A-E assessment, Rapport, Situational awareness, Escalation, Application of clinical knowledge, and Teamwork. The participants completed the pre- and post-intervention questionnaires. The study used an unpaired pre-/post- intervention design, with 38 pre- and 34 post-survey respondents. Primary outcomes were perceived usefulness, engagement, and impact on learning and feedback. Descriptive statistics were used for quantitative data, and qualitative data were analysed thematically.

Results: 94% of respondents found observing simulation more useful when using the tool than without. The majority agreed that the tool improved aspects of learning and peer feedback. Thematic analysis identified six major themes: (1) impressions of observation, (2) engagement during observation, (3) enhancement of learning, (4) providing peer feedback, (5) useful aspects of the CARSEAT tool, and (6) suggested improvements for the CARSEAT tool.

Conclusion: Our novel observer tool improved engagement, enhanced learning, and supported peer feedback during the medical student simulation sessions. The tool's structure and clear domains make it easy to use and generalise across different simulation scenarios, with potential for integration into undergraduate curricula, and wider implementation across institutions.

Background: Histology and Embryology (HE) are important basic medical courses, with complex, abstract content and difficult memorization of knowledge points, which leads to a decrease in students' interest in learning. Therefore, how to improve students' learning interest is worth serious consideration by teachers. This study aims to investigate the promoting effect of interesting teaching based on flipped classrooms and game teaching on the experimental teaching of HE.

Methods: Implementing flipped classrooms and gamified teaching methods for the class of 2023 in clinical medicine. Before class, the teaching videos were uploaded to Moso Teach to guide students in self-directed learning. In class, each group discussed the experimental content on the digital platform, and the teacher supervised the classroom to guide and address queries. Later, some students were randomly selected to explain the morphological characteristics of the main structure on the podium, and the teacher recapitulated and assessed the performance of each group. Finally, the knowledge points of HE were carefully designed into classroom games to make the learning experience more engaging. The effectiveness of the flipped classroom and game-based teaching methods was assessed through surveys and comparisons of grades with those of students in the 2022 class who were taught using traditional methods.

Results: In this study, 93.62% of the students reported an enhanced teaching effect after altering the experimental teaching method. Meanwhile, the proportion of students who did not understand the observation slices declined from 12.77% to 1.06%, while those who were not very active or passive declined from 43.62% to 21.28%. Importantly, the scores of experimental and final exams for the 2023 grade of students taught by interesting teaching method were significantly higher than those of the 2022 grade of students taught by traditional teaching method (P < 0.05).

Conclusion: The application of flipped classroom and game teaching, piqued students' curiosity, kindled their interest in learning, and amplified their learning enthusiasm and self-learning ability.

Introduction: Blended e-learning guided by the First Principles of Instruction (FPI) can enhance learning outcomes while reducing costs, performing comparably to face-to-face training. However, in low- and middle-income countries, its application in health professions education remains limited, with little empirical evidence and minimal evaluation from learners' perspectives. This study was designed, implemented, and evaluated an FPI-based blended course to generate evidence and insights for future course design and to assess the teaching and learning quality (TALQ) from learners' viewpoints.

Methods: A descriptive, correlational design was employed at the Health Professional Education training program at the University of Global Health Equity in Rwanda between February and April 2025, and data were collected using the reliable Teaching and Learning Quality survey instrument. A descriptive statistic, a one-way multivariate analysis of variance and correlation analysis were conducted to analyse the collected data.

Results: This study, involving 38 postgraduate certificate-level learners (79.1% response rate) from four types of institutions, found strong support for the integration of FPI elements in a blended e-learning module. Learners frequently engaged in problem-solving activities, reported significant learning progress, and rated the course quality as outstanding with high satisfaction. Furthermore, strong correlations were observed among teaching and learning quality measures, while no significant associations were found between demographic variables and teaching and learning quality scores.

Conclusion: The blended eLearning lesson design-structured around a central problem, activation of prior knowledge, multimedia-based explanations, collaborative discussions, and opportunities for reflection and application-demonstrated effective integration of the first principles of instruction. This integration of FPI within a blended e-learning framework was a key factor in promoting student engagement, learning progress, and satisfaction, thereby contributing to the overall enhancement of teaching and learning quality.

Purpose: Maternal and neonatal health remains a major challenge in Ethiopia. Despite midwives' potential to prevent over 80% of related deaths, shortages and competence gaps persist due to theory-focused preservice curricula. In 2013, Debre Tabor University introduced a competency-based midwifery curriculum. This study evaluated whether this curriculum reform improved the quality of labor and delivery care provided by midwives.

Methods: A comparative cross-sectional study was conducted among 68 BSc midwifery graduates from ten third-generation Ethiopian universities (32 trained under a competency-based curriculum; thirty-six under a conventional curriculum). Labor and delivery care quality was assessed through direct observation using a validated checklist. Additional data on birth outcomes were collected through record reviews, and facility inventories were used to evaluate the availability of essential supplies. Mean percentage scores were compared using independent t-tests and effect sizes (Cohen's d) were visualized with Gardner-Altman plots.

Results: On average, midwives performed 75.3% of the tasks required for quality labor and delivery care, with competency-based curriculum graduates (CBCGs) scoring higher (83.3%) than conventional curriculum graduates (CCGs) (68.2%), which was consistent across all components of labor and delivery care. This difference was statistically significant (t (61.77) = 5.29, p < .001), with a large effect size (Cohen's d = 1.26; Δ = 15%). During the initial client assessment, CBCGs more frequently inquired about vaginal bleeding and practiced hand hygiene. CBCGs also demonstrated higher performance in delivery preparation, neonatal resuscitation readiness, administering uterotonics, early breastfeeding support, and skin-to-skin contact.

Conclusion: Midwives trained under a competency-based curriculum provided higher quality labor and delivery care than the conventionally trained control group, with a large effect size, suggesting clinical relevance. However, the overall performance revealed persistent gaps, highlighting the need for further research to examine long-term outcomes to inform curriculum development and policy.

Purpose: Simulated patients (SPs) are critical to simulation-based education (SBE) in developing learners' clinical, communication, and professional skills. However, limited research has examined the factors influencing SP performance and consequent learning outcomes.

Patients and methods: We conducted a systematic review (2013-2025) using six databases, focusing on human SPs in healthcare education. Nineteen studies met the inclusion criteria and were analyzed using inductive thematic analysis. Study quality was assessed using the QATSDD tool.

Results: Inductive thematic analysis identified three key domains influencing SP performance: emotional (anxiety, fulfillment), cognitive (task complexity, improvisation), and logistical (training, scheduling). SP involvement enhanced educational outcomes (empathy, communication, clinical reasoning) but was sometimes limited by SP fatigue, stress, or cognitive overload. Among the reviewed studies, 7 were high and 12 were of medium quality (no low-quality studies).

Conclusion: Authentic SP portrayals enhance student learning, but factors such as emotional strain and cognitive load can limit effectiveness. We recommend structured SP training, robust feedback mechanisms, and attention to SP cognitive and cultural challenges. Future research should prioritize long-term SP outcomes, measurement of SP cognitive load, and exploration of ethical and cultural dimensions of SP engagement.

Medical and allied health training programs are inherently demanding, often compromising trainees' mental health through prolonged workloads, emotional exhaustion, and systemic pressures. This narrative review explores evidence-based strategies and institutional frameworks aimed at safeguarding mental health among medical and allied health trainees. The review seeks to identify effective interventions that balance professional rigor with psychological well-being. A targeted literature search of PubMed, Scopus, PsycINFO, and Google Scholar (2000-2025) was conducted using keywords such as mental health, burnout, medical education, wellness, and resilience. Eligible publications addressing psychological stress, mental health interventions, and systemic reforms in trainee education were analyzed thematically to synthesize protective strategies and best practices. Findings reveal that mental health challenges-including anxiety, depression, and burnout-affect over one-third of health trainees globally. Protective measures identified include structured mentorship, mindfulness-based resilience programs, time management training, and confidential psychological support services. Institutional strategies such as curriculum flexibility, rest-hour regulations, and leadership-driven wellness policies were shown to reduce stress and improve academic satisfaction. The inclusion of peer support systems and integration of wellness education further enhance psychological safety and engagement. Safeguarding trainee mental health requires a balanced approach combining personal resilience-building with organizational reform. Embedding wellness curricula, promoting mental health literacy, and ensuring access to support systems can mitigate burnout and improve patient care outcomes. Future efforts should focus on implementing evidence-based mental health frameworks and fostering a culture of openness within training institutions.

Purpose: Patient confidentiality and privacy are foundational ethical principles in clinical practice. Evaluating how well future physicians understand and uphold these principles is critical for effective ethics education. This study assessed knowledge and self-reported practices regarding patient confidentiality and privacy among medical students in a Jordanian medical school, providing insights into broader regional trends.

Material and methods: A cross-sectional survey was conducted among 297 medical students (Years 4-6) using a structured questionnaire. A convenience sampling approach was used to invite all accessible students through class WhatsApp groups. The final sample exceeded the precision-based minimum of 273 participants. The instrument included demographics items and 17 questions across knowledge (10 questions) and practice (7 questions) domains, measured on a 5-point Likert scale. Descriptive statistics, t-tests, ANOVA, and multiple linear regression were applied to identify predictors of practice behavior.

Results: Participants demonstrated good theoretical knowledge (Mean=4.18, SD=0.36) and reported good practices (Mean=4.06, SD=0.56). Reliability was moderate for knowledge (α=0.624) and good for practice (α=0.767) domains after reverse-scoring. Female students reported significantly better practices than males (p = 0.001). Practice scores also differed across academic years (p < 0.001), with 5th- and 6th-year students outperforming 4th-year students. In multivariate analysis, higher knowledge (β = 0.828, p < 0.001), female sex (β = -0.167, p = 0.001), and senior academic level (p < 0.05) independently predicted better practices.

Conclusion: Despite promising knowledge levels, practical challenges remain in upholding patient confidentiality and privacy among Jordanian medical students. Findings should be interpreted in light of the cross-sectional design and reliance on self-reported data. Targeted educational interventions that strengthen knowledge, address sex-specific needs and ensure early, continuous ethics education are essential to bridge the knowledge-practice gap and foster a culture of confidentiality in medical training.

Objective: This study explores the reasons and methods by which medical students use Medical Educational Commercial Off-the-Shelf (MedED-COTS) learning platforms for exam preparation. It also compares student use of these platforms with institutional resources and identifies their benefits and limitations.

Methods: A qualitative cross-sectional study was conducted at the University of Birmingham, UK, involving semi-structured focus groups with 5 medical students and 6 clinical teaching fellows (early career clinical instructors). Transcripts were analysed thematically using a deductive approach, with supplementary inductive coding to capture emerging themes.

Results: Students reported that MedED-COTS were integral for exam preparation, often perceived as essential for success. Platforms were valued for accessibility, gamified features, and continuity with familiar strategies, such as working through past papers. Peer influence strongly shaped platform selection and use. Students highlighted the benefits of identifying knowledge gaps and flexible, self-directed learning opportunities. However, concerns were raised about subscription costs, equity of access, and the need to purchase multiple platforms. Clinical teaching fellows acknowledged the appeal of MedED-COTS but cautioned that oversimplification of complex topics risked undermining the development of deeper clinical reasoning skills.

Conclusion: MedED-COTS play a prominent role in student learning but require careful integration with institutional resources to ensure balance between exam preparation and clinical reasoning development. Medical schools should provide guidance on appropriate use, address barriers of cost and equity, and consider how validated elements of these platforms could be incorporated into curricula. Given the small, exploratory sample from a single institution, findings should be interpreted as preliminary but highlight important directions for future, larger-scale research on the role of commercial learning platforms in medical education.