Advances in Medical Education and Practice最新文献

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.

Introduction: Research is a vital component of surgical training, enhancing academic skills and career opportunities. This study aimed to assess the research involvement of surgical residents in Saudi Arabia and identify key predictors, barriers, and motivations.

Methodology: A cross-sectional study was conducted among 297 surgical residents between December 2021 and September 2023 using a structured online questionnaire. Data were analyzed with SPSS.

Results: Overall, 51.2% of residents published at least one paper during residency. Prior research experience in medical school significantly predicted publication during residency (P = 0.012). In logistic regression, residents in gynecology had lower odds of publication compared to general surgery (OR 0.58, P < 0.05). The main motivation for research was fellowship acquisition (63.3%). The leading barriers were lack of time (67.0%) and work-related stress (50.0%).

Conclusion: Early research engagement in medical school strongly predicts future productivity during residency, while time constraints and stress remain major obstacles. Our findings suggest that residency programs could enhance research output by providing structured mentorship, allocating protected research time, and encouraging early exposure to research activities.

The integration of ultrasound into undergraduate medical education (UGME) has garnered increasing attention due to its potential to enhance clinical training; however, a standardized framework for its implementation and curricular standards has yet to be established. This study aims to review how medical schools have implemented ultrasound training, evaluate its benefits in helping students develop clinical decision-making skills, and identify barriers that limit its broader adoption. A literature review was conducted using PubMed, MEDLINE, and Google Scholar databases to identify peer-reviewed studies published between 1993 and 2025, focusing on curricula design, implementation strategies, educational outcomes, and challenges. Results show that early and longitudinal exposure to ultrasound improves students' understanding of anatomy, strengthens clinical reasoning, and increases preparedness for residency; however, curricular time constraints, faculty training gaps, and financial barriers continue to deter some programs from introducing ultrasound curriculum early. While growing evidence supports the value of ultrasound in UGME, adoption remains inconsistent, underscoring the need for standardized, evidence-based frameworks to ensure equitable access and skill development across institutions. Future efforts should focus on developing and implementing national standards that promote consistent and uniform integration of ultrasound training into UGME.

Purpose: Research integrity is a critical component of medical education and ethical research practice. However, evidence suggests that medical professionals often demonstrate inadequate awareness of its core principles. This study examines the awareness of research integrity and corresponding training preferences among medical staff at a large tertiary hospital, with implications for continuing medical education curriculum development.

Methods: A cross-sectional survey of 517 physicians, nurses, pharmacists, and technicians measured knowledge of guidelines, perceptions of misconduct consequences, and training preferences. The instrument validity and reliability were confirmed (I-CVI: 0.857-1.000; S-CVI/Ave: ≥0.976; Cronbach's α: 0.881-0.937). Data analysis employed descriptive statistics, correlation, and multivariate regression.

Results: Overall awareness was limited (median awareness rate: 31.1-32.7%), with significant structural disparities: higher familiarity with publication-related norms such as duplicate submission (score: 1594) and authorship (1567), but poorer understanding of research ethics (1486) and institutional policies (1506). Training demand was modest (median demand rate: 13.0%), with highest preference for applied topics including statistical application (1203) and ethics regulations (1215). Case-based and online formats were most desired. Research ability (evaluation), which depends on research experience, was an independent factor influencing both awareness (β = 0.462-0.473, p < 0.001) and training demand (β = 0.411, p < 0.001).

Conclusion: This study identifies a clear structural imbalance in research integrity awareness among medical staff: technical proficiency in research methods is not matched by foundational ethical reasoning. Moreover, staff preferences for training are diverse, favoring tiered, digital, and case‑based formats. To address this gap, an integrated, innovative, and layered educational approach is needed-one that blends ethics with methodological training through scenario‑driven modules and flexible online platforms. Such a model will enhance continuing professional development in academic integrity, provide evidence for institutional ethics policies, and contribute to global efforts to strengthen research governance in medical practice.

Introduction: Autologous Fat Transfer (AFT) for total breast reconstruction is a novel, minimally invasive technique recently introduced into the Dutch healthcare system. Although plastic surgeons are experienced with AFT for aesthetic and partial reconstructive procedures, its application for total breast reconstruction presents unique challenges, necessitating standardized training.

Methods: A multidisciplinary team developed an e-learning module on The Huddle platform, guided by adult learning theory, context-specific instruction, visual learning aids, and key insights from a clinical research program (BREAST trial). The module included text, videos, illustrations, and case-based learning. Nine Dutch plastic surgeons with varying experience levels pilot-tested the module. Semi-structured interviews assessed clarity, relevance, and usability.

Results: Feedback was predominantly positive. Participants appreciated the structured format, permanent accessibility, and visual materials that supported procedural understanding. Several surgeons reported intended changes to their surgical approach, such as modifications in fat harvesting. Suggested improvements included patient selection criteria, radiological aspects, and information on common complications. The absence of narrated videos was perceived as a limitation.

Discussion: The pilot demonstrated that a flexible, visually rich e-learning format can support knowledge acquisition in a novel surgical technique. Interdisciplinary collaboration and iterative feedback were key strengths. Limitations include the small sample size and the purely qualitative design, which restrict generalizability.

Conclusion: We developed and pilot-tested an e-learning module for AFT in total breast reconstruction. The module was well received and considered clinically relevant, and could hereby fill an (inter)national gap in standardised training. Future research should evaluate learning outcomes quantitatively, compare efficacy to traditional training, and assess long-term impact on surgical practice.

Background: Multiple-choice questions (MCQs) with number right scoring (NRS) are now the most preferred assessment method in medical education, which requires program holders to ensure their fairness for profound decision-making and policy arrangements. Including certainty-based marking (CBM) in MCQ exams is suggested to help better distinguish students and thus increase the validity of assessments. This study aims to integrate CBM into MCQ assessments using a relatively new scoring matrix to assess pass/fail rates and exam scores.

Methods: Students in their second year of medical school participated in ten different CBM-MCQ exams. Questions were scored twice: first, traditionally using the NRS, and second, using the CBM (based on correctness and a self-report certainty scale), yielding two different final scores for each student. Exam scores and pass/fail rates were compared using paired t-tests and McNemar tests, respectively.

Results: A total of 935 students in 10 different exams were included in the study. CBM scores were significantly lower than NRS scores (0.82 points; P<0.001). There was a significant shift in the pass/fail classifications (P<0.001). Overall, 34 out of 141 NRS failures (24.1%) passed under CBM, while 85 (10.7%) of the 794 students who passed under NRS failed under CBM. This significant shift was also reported in 5 of 10 exams (P<0.05). Additionally, there was a trend towards worsening scores in CBM compared to NRS. Students with "A" grades decreased from 8.4% to 4.7% while students with "D" grades increased from 15.1% to 20.5%.

Conclusion: CBM yields significantly different scores compared to NRS, as evidenced by distinct pass/fail rates, suggesting the potential for a better assessment tool. Further studies with different types of assessments are needed to validate this method in terms of reducing cheating and guesswork. However, replacing CBM with conventional scoring methods requires further evidence and consideration.

Background: Most surveys today show a marked decline in traditional beside teaching rounds (BTR) in medical education. The online-to-offline (O2O) teaching mode has been associated with improvement of academic performance of learners. This study aimed to compare the O2O teaching rounds (O2OTR) with BTR on a nephrology inpatient service and assess efficiency and satisfaction among residents.

Methods: A total of 79 trainees who participated in the nephrology residency training, were randomized either to the O2OTR group or the BTR group (control). Theoretical knowledge tests, clinical case scenarios, and questionnaires were integrated to systematically assess the teaching efficacy.

Results: Thirty-eight residents were assigned to the O2OTR group, while the other 41 were assigned to the BTR group. Baseline demographics and performance were comparable between groups. Residents in the O2OTR group demonstrated superior performance in clinical case scenarios compared to those in the BTR group (P < 0.001) at 2 months after teaching. Moreover, O2OTR residents expressed more positive attitudes toward their clinical thinking proficiency (P < 0.001), and exhibited higher satisfaction with their teaching rounding style (P = 0.004) than their BTR counterparts.

Conclusion: This study suggests that the O2OTR mode serves as an effective and alternative approach in the nephrology residency training.

Introduction: In light of the limitations of traditional internship evaluation methods, it is necessary to explore the application of a cpmpetency-oriented approach to internship assessment. The study aims to explore a new assessment method of internship learning that more meets the requirements of competence, and evaluate its impact on the effect of internship process in Department of Urology.

Methods: The study participants comprised interns from the eight-year program at Peking Union Medical College (PUMC) who participated in the 1-month internship rotation in Department of Urology and participated in the after-department examination. The evaluation methodology was revised to implement a competency-oriented assessment utilizing standardized patients (SP). Participants were allocated into two groups: a control group unaware of the evaluation method prior to assessment (20 students), and an observation group informed of the updated evaluation methodology before internship (21 students). Both groups were evaluated and compared based on after-department examination performance, work engagement, and self-assessed ability improvement. The study lasted from March 1^st, 2024 to October 31^st, 2024.

Results: The observation group demonstrated significantly higher scores than the control group (P<0.05) across the components of the after-department examination, including "decision-making", "communication and informed consent", "surgical detail", "postoperative management" and "total score". Similarly, the observation group achieved higher scores (P<0.05) in work engagement metrics, including "engagement in ward work", "engagement in communication", "engagement in surgery" and "total score". In self-assessed ability improvement, the observation group scored higher (P<0.05) in "surgical skill", "colleague cooperation ability", "communication ability" and "total score".

Conclusion: The competency-oriented SP-based assessment method implemented in the Department of Urology internship demonstrates potential promotion for after-department examination performance, work engagement and self-evaluation of ability improvement. However, this conclusion is valid only for a single institution and department. Its application requires further evidence from higher-level studies involving multiple departments and centers.