Advances in Medical Education and Practice最新文献

The Productive Failure (PF) technique is an educational strategy that uses collaborative problem-solving to facilitate resident physicians' understanding of new concepts. A novel implementation of this approach is PF simulation, in which they engage in simulation before receiving comprehensive teaching on the involved aspects. PF commences with the generation and consolidation phases, where resident physicians develop and analyze the advantages and constraints of various Representations and Solution Methods. These are followed by the knowledge assembly phases, respectively. Wherein physicians gain essential concepts by organizing their representations and thoughts in alignment with established responses. PF is deliberately designed to induce failure in problem-solving; however, in the following review, this process of failure can help resident physicians better acquire target ideas. The crucial aspect of PF design is that throughout the problem-solving phase, physicians receive no instructional support or scaffolding. Explicit failure-driven scaffolding is an alternative method for enhancing the efficacy of preparatory problem-solving. This narrative review examines the theoretical foundation of PF and its role in collaboration, clinical reasoning development, stress management, and knowledge retention among resident physicians. Using cognitive psychology, clinical reasoning theories, and reflective practice, we examined how PF helps people learn from failure, shift from traditional teaching to retain knowledge long-term, and develop flexible skills in complex clinical settings. Highlighting these components underscores the significance of practical simulations, varied information sources, and systematic feedback in cultivating these competencies. The role of PF in medical education policy suggests ways to integrate it into future training models to address current curriculum gaps. Future directions for PF in medical education include individualized learning, interdisciplinary collaboration, and the integration of future technologies such as virtual reality (VR). PF constitutes a viable educational approach for augmenting the clinical and cognitive competencies of resident physicians, equipping them with the intricacies of contemporary medical practices.

Background: Electrocardiography (ECG) is a pivotal diagnostic tool. However, the accuracy of ECGs interpretation by resident varies from region to region, but overall interpretation ability is poor. The aim to assess whether the low competency described worldwide are also prevalent in the Chinese residents.

Methods: This pilot study was a cross-sectional, questionnaire-based assessment of ECG interpretation skills of residents (n=165). We selected eight 12-lead ECGs. Each ECG was provided with a brief clinical scenario, consisted of age, gender, and chief complaint.

Results: The Cronbach's Alpha for Likert scale used item questionnaire was 0.75. In the university learning situation, only a small number of students considered they were proficient in ECG (n=3, 1.82%). More than half of residents (n=102, 61.82%) relearned the ECG knowledge during their clinical clerkships. The overall ECG interpretation ability is poor, as ECG test scores were 6(4,8). Just 17 residents (10.3%) scored more than 10 points. The non-internal medicine residents had a better performance in the interpretation of supraventricular tachycardia compared with internal medicine residents (median score 2 versus 0, p<0.05). The highest competency was observed in the ST elevated myocardial infarction (correct rate 54.55%). The poorest ability to misread ECG was long QT and left bundle branch block (correct rate 0.61% and 0.00%). Few participants reported complete confidence about their diagnosis (less than 10%).

Conclusion: Our research reveals that residents do not appear to be prepared to interpret ECG abnormalities, including common emergencies and common abnormalities, even the normal ECG strip.

Background: Clinical reasoning is a critical skill for physical therapy (PT) students to provide effective care. This study aimed to assess the reliability, internal consistency, and construct validity of the Arabic version of the Self-Assessment of Clinical Reflection and Reasoning (SACRR) questionnaire in physical therapy students at Majmaah University.

Materials and methods: A quasi-experimental, non-randomized design was employed, with 76 students divided into three groups: intern (n = 19), pre-clinical (n = 21), and post-clinical (n = 36). Pretest and posttest assessments were conducted. Internal consistency of the Arabic version of the SACRR was analyzed using Cronbach's alpha coefficient. Statistical analyses were performed using SPSS 19.0.

Results: The mean age was 22.8 ± 1.3 years, 58 (76.3%) were females, and 18 (23.7%) were males. Significant differences were found between pretest and posttest SACRR scores for Items 7-11 and 14-26 (P<0.05), with mean score increasing from 109.36 ± 11.41 to 116.95 ± 7.40 (P<0.0001). Cronbach's alpha values indicated strong internal consistency: pretest α = 0.915 and posttest α = 0.860.

Conclusion: Clinical exposure improved clinical reasoning skills among physical therapy students, highlighting the importance of clinical education in healthcare curricula. The Arabic version of the SACRR questionnaire demonstrated good reliability for assessing clinical reasoning skills in this population. Further studies are warranted to validate the SACRR questionnaire in diverse cultural and linguistic contexts, as well as to validate the tool across different cultures and healthcare disciplines.

Purpose: To explore the effectiveness and pedagogical significance of a teaching model that integrates case-based learning (CBL) with standardized patient (SP) for posterior fossa meningiomas, compared to using CBL alone teaching.

Methods: In this randomized comparative study, we enrolled 72 interns and standardized residency trainees from the neurosurgery department of our hospital between July 2023 and September 2025. Participants were randomly divided into an experimental group (CBL+SP) and a control group (CBL-only), with 36 individuals in each group. After completing the study plans, teaching effectiveness was assessed through evaluations of theoretical knowledge and clinical skills, while participant satisfaction and teaching approach evaluation were measured using questionnaires. Furthermore, a survey was conducted among the CBL-only group to gather their opinions on the primary drawbacks of using this teaching approach exclusively.

Results: The experimental group demonstrated significantly higher theoretical test scores (88.71 ± 7.43 vs 79.47 ± 8.43, p < 0.001) and clinical skill scores (81.36 ± 5.68 vs 71.11 ± 7.22, p < 0.001) compared to the control group. Furthermore, the experimental group showed notable advantages over the control group in novelty, enhancing learning interest, self-study ability, integration of theory and practice, communication skills, clinical thinking, satisfaction rates, and teaching promotion (p < 0.05). The major drawback of the CBL-only teaching was the lack of clinical atmosphere and doctor-patient communication.

Conclusion: The SP-CBL integrated teaching model significantly improves clinical teaching outcomes compared to the CBL alone and is worthy of promotion in clinical education for posterior fossa meningiomas.

Background: Mastery of foundational sciences namely, anatomy, physiology and biochemistry is essential for nursing competence, yet many undergraduate nursing students struggle with these courses.

Objective: To investigate institutional factors influencing academic achievement in biomedical sciences among undergraduate nursing students in Uganda.

Methods: A cross-sectional study, guided by the philosophy of critical realism, Input-Transformation-Output framework, and constructivist learning theory, was conducted at four purposively selected public universities in Uganda between April and June 2024. A total of 208 undergraduate nursing students were enrolled using the census approach. This study examined the influence of institutional factors on academic achievement in biomedical sciences, measured by the Grade Point Average (GPA). Data were collected using a self-administered questionnaire with excellent internal consistency (α = 0.9366) and analysed using Welch's analysis of variance and linear mixed-effects model.

Results: Lower ratings of lecturer's teaching quality (β = -0.25, 95% CI: -0.46, -0.03, p = 0.03), online only teaching (β = -0.41, 95% CI: -0.75 - -0.07, p = 0.02) and lack of constructive feedback (β = -0.47, 95% CI: -0.90, -0.03, p = 0.046) were associated with lower GPA scores, while Problem Based Learning (β = 0.48, 95% CI: -0.05-1.91, p = 0.04) and good lecturer-student relationship (β = 0.34, 95% CI: -0.06 to 0.62, p = 0.03) predicted higher GPA scores.

Conclusion and recommendations: Lower teaching quality, lack of feedback, and online only instruction were linked to lower GPA scores, while problem-based learning and good lecturer-student relationships predicted higher achievement. Therefore, nursing programs should prioritize strengthening lecturer's teaching skills, providing constructive feedback, fostering positive lecturer-student relationship, and integrating Problem Based and blended teaching approaches to improve students' academic outcomes.

Intuitive medicine is a skill based on experience and pattern recognition, involving a process with subconscious reasoning that plays a significant role in clinical decision-making. Its application can enhance physicians' speed, creativity, and diagnostic accuracy while reducing treatment costs. Despite its importance, the concept, application, and learning strategies of intuition remain unclear to many young physicians and medical students. Furthermore, the dominance of guideline-based systems and the emphasis on strict adherence in medical education have limited creativity in clinical practice. This study explores the role of intuition in clinical decision-making, emphasizing its integration with evidence-based medicine and the potential of artificial intelligence (AI) as a tool to teach and strengthen intuitive skills. Integrating intuition with evidence-based medicine can foster a more creative and adaptive medical practice. The strategic use of AI in medical education offers a promising approach to formalize and enhance the teaching of intuitive clinical reasoning. Further specialized research is recommended to optimize these approaches and validate their impact on clinical performance.

Introduction: Simulation-based training is increasingly being adopted in cardiac surgery to train future surgeons. Although low- and high-fidelity cardiac surgical simulations have been described previously, simulation fidelity or the degree to which a simulation replicates reality is poorly defined and not well established. This study examines the literature on the themes of fidelity using a novel multidimensional surgical framework.

Methods: A keyword-based literature review was conducted to retrieve published cardiac surgical simulation studies using MEDLINE and EMBASE, from January 2000 to February 2020. The search was limited to the date of publication and not by type. Within predefined dimensions, the included articles were thematically analyzed using a hybrid coding approach to identify fidelity themes and subthemes.

Results: Twenty-six articles were included in the thematic analysis after duplicate removal, screening, and eligibility assessment based on the inclusion and exclusion criteria. Seven themes were identified within physical, surgical, and interactional dimensions. They were derived from environmental, equipment, anatomical, physiological, procedural, perceptual, and psychological simulation components. Subthemes for three levels of realism were generated for each theme by using an iterative process.

Conclusion: This fidelity framework provides educators with actionable guidance for designing cost-effective cardiac surgical simulation for competency-based training by enabling selective fidelity utilization. Educators can apply this framework through aligning learning objectives, fidelity dimensions and levels accordingly. The framework facilitates optimal resource allocation by designing effective and fit for learner simulations.

Objective: To examine five-year trends in academic performance across four final-year clinical subjects and evaluate the relationship between pre-admission scores and university academic outcomes. It also assessed the variability in grading practices across four clinical departments.

Methods: A record-based cross-sectional study was conducted among 1584 medical graduate students (cohorts 2020-2024) at Mutah University, Jordan. Data included General Secondary School Examination (Tawjihi) scores, grades in four core clinical subjects (Internal Medicine, Surgery, Pediatrics, and Obstetrics-Gynecology) and cumulative Grade Point Average (GPA). Analysis used descriptive statistics, Pearson correlation coefficients, analysis of variance and regression models.

Results: Tawjihi scores showed a weak but statistically significant correlation with GPA (r = 0.257; p < 0.001). Subject grades correlated significantly with GPA (Pediatrics r = 0.810), Obstetrics-Gynecology r = 0.786, Internal Medicine r = 0.779, Surgery r = 0.628; all p < 0.001). Year-to-year differences were significant across all subjects (F = 6.84-42.44, all p < 0.001). Regression analysis revealed that the practical component (β = 0.602; p < 0.001) slightly outweighed written exams (β = 0.547; p < 0.001) in predicting final course grades.

Conclusion: Grading variability across departments highlight the importance of standardization in clinical evaluation. These findings emphasize the need for unified assessment frameworks to enhance equity and reliability in medical education.

Purpose: Two internet-based learning tools have been developed at the Faculty of Veterinary Medicine at the University of Helsinki. One of the tools offers interactive cases related to veterinary epidemiology, the other offers interactive cases related to veterinary bacteriology. This study aimed to investigate the effect of these learning tools on learning outcomes of veterinary students for the cognitive and generic academic skills.

Methods: Over several academic years, when second-year students solved bacteriology cases or third-year veterinary students solved epidemiology cases, they filled in a learning survey. The survey consisted of a cognitive skills assessment and a self-evaluation questionnaire related to generic skills. The cognitive assessment was divided into pre- and post-exercise sections, each comprising a logical organization test and a narrative question. The data derived from the narrative responses of the learning surveys were evaluated using the Structure of the Observed Learning Outcome (SOLO) method. A Wilcoxon signed rank test for paired groups was used for statistical analysis.

Results: Between 2015 and 2018, 104 students that used the epidemiology learning tool, and between 2016 and 2020, 191 students that used the bacteriology learning tool were included in the study. Both learning tools enhanced the students' cognitive and generic skills. Both logical reasoning and the SOLO-based evaluation of the narrative responses showed a slight but statistically significant (p from 0.001 to 0.01) improvement in cognitive skills. Of the generic skills, reasoning, problem-solving and information-processing skills improved in particular. Most students also noted an improvement in their critical thinking, creativity and continuous learning skills. Most of the students also felt that the epidemiology learning tool had taught them ethical practice skills.

Conclusion: This study provides evidence that internet-based interactive cases have beneficial effects on learning outcomes in veterinary education and its results can help further develop these learning tools.

Objective: Due the concept of medical immunology is abstract and difficult to align with the "holism and balance of Yin and Yang" in traditional Chinese medicine (TCM), students feel intimidated and have weak identification with it. This study has constructed a "holism-based blended teaching model" and verified its promoting effect on knowledge, grades, and professional identification.

Methods: A cross-sectional study design was adopted. A blended teaching method based on the Zhihuishu platform was used to survey 201 students majoring in TCM. The data were collected through the Wenjuanxing scale and analyzed using descriptive statistical methods. Additionally, an independent t-test was used to compare the academic performance of the blended learning group (Grades 2019-2022) and the traditional learning group (Grades 2018).

Results: More than 85% of the students were able to integrate knowledge such as T cell dual signals and complement modulation within the framework of balance between Yin and Yang. In the experimental group, 16.29% scored above 90 points, 41.63% scored between 80 and 89 points, which were significantly better than those of the control group (3.57% and 20.41%). Moreover, 92.04% approved of the model, and 76.61% believed it enhanced professional qualities. 76.6% deepened their understanding of the overall perspective, and 82.4% were willing to adopt a combination of traditional and modern medicine thinking.

Conclusion: The research results indicate that this blended teaching method helps students better integrate the holism of TCM to understand immunology knowledge. Moreover, the students' self-study abilities and academic performance have also significantly improved. These findings enable the basic knowledge of immunology to better serve the training of professionals in TCM.