Advances in Medical Education and Practice最新文献

Purpose: Artificial intelligence (AI) is rapidly transforming healthcare, with potential advancements in diagnostics, image analysis, and drug discovery. This study aimed to investigate how medical students in the Kingdom of Bahrain perceive AI and their understanding of its application.

Methods: This study used a cross-sectional electronic survey design. A total of 350 responses were collected from students at Arabian Gulf University and the Royal College of Surgeons in Ireland in Bahrain. The survey was adopted from a previously validated instrument, assessed attitudes, knowledge, and confidence regarding AI using 5-point Likert scales and dichotomous questions. Statistical analysis was performed using SPSS, with a significance level of p<0.05.

Results: We found that 86% of students believe AI will play a crucial role in future healthcare. While 37.7% were less inclined towards radiology due to AI, 46.9% believed that some specialties would be replaced. About 60.9% understood basic AI principles. About 82% agreed AI learning would benefit their careers. Only 24.6% had received AI teaching, which they found useful. Students with AI training demonstrated a stronger belief in AI's role (p=0.008) and the necessity of AI education (p=0.010) but were less likely to consider radiology (p=0.004). They also reported higher confidence in using AI tools (p=0.004).

Conclusion: Medical students in Bahrain had positive views on AI's future in healthcare and recognize the importance of AI education. Students with AI training showed greater confidence in utilizing and understanding AI tools. These findings identify the critical need to integrate AI education into medical curricula to prepare future physicians for the evolving AI-driven medical landscape.

Background: Understanding the drivers of medical students' learning enthusiasm is crucial amid concerns about the physician workforce. This study compares China's five-year and eight-year medical programs, focusing on curriculum design and the effectiveness of assignments.

Objective: To compare learning enthusiasm between the two programs and analyze how assignment design and curriculum influence active learning and critical thinking.

Methods: A cross-sectional study surveyed 504 medical students (98 eight-year, 406 five-year) using the Self-Assessment Scale for Active Learning and Critical Thinking (SSACT).

Results: Significant differences emerged between five-year and eight-year students in geographical origin (χ² = 22.11, P < 0.001, Cramer's V = 0.209) and program preference (χ² = 67.26, P < 0.001, Cramer's V = 0.366). Eight-year students were more often from provincial capitals (39.80% vs 17.98%) and had chosen their program as a first preference (88.78% vs 68.23%), with stronger clinical career commitment (57.14% vs 36.45%). Lecture engagement was higher in the eight-year cohort. The assignment evaluation showed that both groups invested more than 5 hours per week. Review writing showed differences between the two groups (χ² = 22.49, P < 0.001, Cramer's V = 0.212), but eight-year students found it more meaningful (49.49% vs 28.07%). Using the reliable SSACT (Cronbach's α = 0.892), eight-year students scored higher in active learning (managing study, P = 0.037; summarizing discussions, P = 0.025) and critical thinking (formulating questions, P = 0.034; generating solutions, P = 0.014; connecting knowledge, P = 0.018; developing hypotheses, P = 0.004).

Conclusion: Assignment overload and limited self-study time in the current model may undermine critical thinking and active learning. Reforms should balance task quality with volume to better support educational goals.

Background: Formative mock examinations are increasingly used to help medical students transition from theoretical learning to clinical application. Delivering such assessments through virtual near-peer formats may enhance accessibility and engagement, yet evidence remains limited regarding student perceptions and confidence outcomes.

Methods: A single live virtual near-peer mock single-best-answer (SBA) examination was conducted in March 2023 using an interactive polling platform. Senior medical students developed 30 SBA questions aligned with the UK Medical Licensing Assessment content map. Participants completed a post-session questionnaire containing retrospective pre- and post-ratings of confidence and anxiety, and items assessing perceived preparedness, question difficulty, time allocation, and platform usability. Data were analysed using the Wilcoxon signed-rank test and Pearson's chi-squared test.

Results: A total of 198 students participated, with 82.8% from Cardiff University. Median self-reported confidence for sitting final examinations increased from 5 (IQR 4-6) to 6 (IQR 4-7) (p < 0.001), while anxiety remained unchanged at 8 (IQR 6-9) (p = 0.054). Participants rated the mock as moderately beneficial for exam preparation (median 5 [IQR 4-6]) and judged the 90-second question limit appropriate (median 8 [IQR 7-10]). Most respondents (65.7%) preferred the live-polling platform for future mock assessments.

Conclusion: A single virtual near-peer mock SBA examination was feasible and well received, and was associated with a small but measurable gain in students' self-reported confidence without a change in anxiety. These findings highlight the value of virtual near-peer formats as accessible formative tools within undergraduate medical education. However, the generalisability of results should be interpreted cautiously given the retrospective pre-post design and sampling concentration.

Background: Neurological disorders remain a challenge in sub-Saharan Africa, with limited expertise and credible research data to guide interventions and disease prevention. Training the next generation of clinical researchers requires a focused and concerted effort to stem the growing neurological disease burden. The US National Institute of Health (NIH) research training funded through the Fogarty International Center (FIC) Global Brain Disorders Research program gave trainees an opportunity to participate in mentored neurology research and training for 1-2.5 years. We conducted a descriptive cross-sectional study among mentees of 2 FIC research programs to assess the training experience and inform program refinement.

Methods: The data were collected via an online questionnaire created using Google Forms. All participants who had participated in the prior brain health research training programs received an online survey form. The form included a brief instruction with review guidance on the methodology to be used in training, and its objectives were provided. We used a descriptive analytical approach where we assessed the perceived interest in medical research, barriers to mentorship, satisfaction with the current mentorship and barriers to the current training program.

Results: About half of the trainees are male, and the majority, 62/72, reported that they had participated in research studies before enrolling for their training and few (11.1%) had a research experience of more than 3 years. Overall, 97.2% (70/72) reported that they were interested in conducting medical/neurology research as part of their career as a clinician, with 80.5% indicating that they were very interested. There were no significant differences across the several areas of interest regarding the level of satisfaction based on age groups and gender.

Conclusion: Barriers still exist for brain health research training in sub-Saharan Africa (SSA) and efforts to improve more protected time for research, mentorship growth and tailored research training courses are still needed to increase support for young research scientists in SSA.

Purpose: Following the recent change to pass-fail scoring in the United States Medical Licensing Examination Step 1 exam, medical students pursuing careers in surgery must focus on alternative areas to distinguish themselves. In particular, preparation and success in surgical clerkships have both become critical. However, the optimal pre-clinical preparation to enhance medical students' surgical skills prior to active clinical involvement currently remains unclear. We tested the hypothesis that a student-driven, mixed-modality surgical skills program would increase surgical skills, promoting readiness for clerkships and interest in surgery.

Patients and methods: This study assessed the efficacy of a student-led interest group which organized weekly in-person morning longitudinal skills sessions and in-person quarterly long-form evening skills workshops for pre-clinical students in their first and second years of schooling. Fifty-five participants were prospectively recruited and engaged in these skills events over an 18-month period. Students were surveyed anonymously using Likert scale qualitative instruments to assess the effectiveness of skills training, interest in surgery, and clerkship readiness.

Results: Confidence in hand skills increased significantly (suturing: p = 0.0046; knot-tying: p < 0.001) after engaging in the interest group, with responders reporting that skills acquisition motivated attendance. All students reported improved clerkship readiness and either "slightly" or "greatly" increased interest in Surgery. Furthermore, 90.4% of participants considered the sessions "very important".

Conclusion: This student-led, mixed-modality curriculum improved skill confidence, anticipated clerkship readiness, and career interest in surgery. The model may guide other student groups preparing trainees for surgical careers.

Background: The disjunction between basic sciences and clinical teaching impairs knowledge retention and application. Contextual vertical integration (CVI) embeds basic-science explanations within clinical instruction and may optimize cognitive load by lowering intrinsic cognitive load (ICL) and extraneous cognitive load (ECL), which impede learning and enhance germane cognitive load (GCL) that facilitates learning. The Contextual Vertical Integration in Clinical Education in Obstetrics and Gynecology (CONVINCED-OG) trial evaluates the role of CVI in optimizing the cognitive load.

Methods: This cluster-randomized crossover study involved three year-3 undergraduate medical student cohorts from Newcastle University at two teaching units. Each cohort was taught eight topics (four obstetrics, four gynecology). A computer-generated Latin-square schedule assigned two cohorts to CVI and one to standard teaching for each topic, then rotated the pattern, so every cohort received four CVI and four standard sessions. The same teacher delivered all sessions with identical materials at both sites, with students remaining unaware of their randomization status. Perceived cognitive loads (ICL, ECL and GCL) were self-reported using the validated Klepsch's Cognitive Load Questionnaire. Topic-level differences (integrated vs standard) were analyzed with independent t-tests and pooled within-student differences were assessed with paired t-tests.

Results: Across all eight topics, CVI reduced ICL and ECL, alongside significantly increasing GCL (except one topic where ICL differences were insignificant). Pooled within-subject analyses corroborated these findings, demonstrating consistent cognitive load optimisation with CVI.

Conclusion: By demonstrating the role of CVI in optimizing cognitive load across diverse topics within undergraduate clinical obstetrics and gynecology education, CONVINCED-OG trial supports the adoption of CVI in clinical teaching.

Background: Male nursing students face distinctive challenges in obstetrics and gynecology (OB-GYN) nursing education, influenced by social perceptions and the specialty's gender dynamics.

Objective: This study aimed to develop effective instructional strategies addressing male students' learning challenges in OB-GYN.

Methods: Using a mixed-method design (qualitative interviews, focus groups, expert workshops, Delphi survey), the prototype of instructional strategies was created based on design thinking and the Medical Research Council (MRC) framework. A non-randomized trial (n = 56) tested the 10-week intervention in a 2025 OB-GYN undergraduates' course at Wuxi Taihu University, assessing academic performance, knowledge application/transfer (teacher-rated), and competency (self-reported).

Results: The experimental group demonstrated significantly better knowledge application/transfer skills (t = 2.206, P = 0.034) and higher overall competency levels (t = 2.207-4.359, P < 0.05) compared to controls. Regression analysis confirmed the instructional strategies (β = 0.298, P < 0.001), academic performance (β = -1.062, P = 0.001), and knowledge application skills (β = 1.674, P < 0.001) as significant predictors of self-reported competency, explaining 68.5% of variance.

Conclusion: The evidence-based instructional strategies effectively enhance practical skills and professional competencies in OB-GYN nursing education. While promising, further multi-center trials with larger samples are recommended to validate these findings and assess long-term impacts on professional development.

Background: The Mbarara University of Science and Technology (MUST)'s First Mile Community Health Program (FMCH) has facilitated community placement of clinical residents at Primary Healthcare (PHC) facilities within the MUST catchment area in southwestern Uganda. While community-based training of medical residents is common in sub-Saharan Africa, little is known about how PHC facility leaders perceive its effect on service delivery in Uganda. This assessment aimed to describe the perspectives of PHC facility leaders on the impact of clinical residents' community placements on PHC services in southwestern Uganda between 2018 and 2023.

Methods: From July 2018 to December 2023, 152 clinical residents from ten specialties were placed at PHC facilities in southwestern Uganda. This was a cross-sectional study based on qualitative data-collection techniques. This study focused on MUST clinical residents and PHC facilities in the MUST catchment in southwestern Uganda. We conducted KIIs with 15 health facility leaders until no new ideas emerged. Data were deductively analyzed using WHO's five strategic directions. Transcripts were transcribed verbatim, repeatedly reviewed, and coded into predefined categories. Interviewers bracketed their own experiences to ensure facility leaders' perspectives were accurately captured.

Results: Of the 15 facility leaders interviewed, most were male and from government HC IVs. Leaders reported that resident placements improved health service delivery through community engagement, enhancing care models through training, mentorship and low-cost innovations, and improving service coordination, including establishing specialized clinics and promoting better use of equipment. Residents also supported advocacy and resource mobilization. However, short placements, inconsistent outreach, staff shortages and lack of specialists limited continuity and sustainability.

Conclusion: Facility leaders reported perceived improvement in strengthening PHC services by the clinical residents. Sustaining these gains will require institutionalized partnerships and evaluation of long-term impact. This could contribute to the advancement of primary healthcare services.

Objective: This study aims to explore the experience of using ChatGPT in academics by occupational therapy students in Saudi Arabia.

Methods: A qualitative study design was used to collect data via semi-structured individual interviews with undergraduate occupational therapy students at a Saudi Arabian University. Thematic analysis was used to process data into semantic themes and sub-themes.

Results: The total number of students who participated in the study was eight, comprised of five males and three females. The study revealed ChatGPT's strengths, such as learning enhancement, efficiency, academic support, and generalizability. The weaknesses reported included inaccuracy, ethical problems, and out-of-context responses. Students highlighted academic opportunities like ChatGPT's potential as a learning support, a self-assessment tool, and an assistant for educators. The study findings validate academic research on the educational benefits and risks that ChatGPT presents. The system provides better learning alongside increased efficiency and research assistance, although it faces significant problems with misinformation in addition to users depending too heavily on the system and the ethical risks.

Conclusion: The benefits and limitations of ChatGPT use as experienced by occupational therapy students in their learning and education were explored. Policymakers, academic institutions and educators need to take action toward effective ChatGPT implementation in educational settings. Future integration of artificial intelligence should focus on structured artificial intelligence literacy programs and institutional guidelines to maximize benefits while mitigating risks.

Purpose: Medical schools and healthcare institutions are increasingly committing to social accountability, the reorientation and prioritization of addressing local community health needs. Now, as part of this commitment, schools and institutions are called upon to demonstrate evidence of their progress towards social accountability to governments, accreditors, funders, and communities. This study aimed to understand what social accountability means to diverse interest holders, particularly with regard to demonstrating local evidence, to provide contextual insight for the development of an "impact framework" for one Canadian medical school.

Methods: One-on-one semi-structured key informant interviews were conducted with three diverse groups: academic, health services, and community interest holders to understand multiple perspectives on social accountability in health professional education. Respondents were asked how they perceive, actualize, and measure social accountability at different levels (societal, school, individual). Interviews were transcribed and thematically analyzed.

Results: Eighteen interviews were conducted, with eight academic representatives, six health care professionals, and four community leaders. The researchers identified three high-level themes in their analysis: the definition of social accountability, enacting and embodying social accountability, and measuring social accountability. There were distinct differences in terms of defining, executing, and evaluating being socially accountable and doing social accountability.

Conclusion: Respondents emphasized that defining what social accountability means for a specific context is critical to advancing the movement. Acknowledging that there are similarities and differences between being socially accountable and doing social accountability is important for evaluating an individual's or a group's accountability to society in health care, health professional education, and research. While the actual indicators and outcomes used to assess the progress toward social accountability are likely geographically bound; meaningful engagement, shared governance and power structures, and integrated data and analytic capacities are important enablers to move social accountability measurement forward.