Advances in Medical Education and Practice最新文献

Purpose: A PhD degree involves both structured and independent learning. It will allow the student to gain expertise and research skills. The supervisor is critical to this educational journey and can ultimately serve as a deciding factor as to whether the process is successful. There are a lack of studies synthesising evidence on what contributes to success. The aim of this narrative review was to identify and summarise the key elements contribute to successful doctoral supervision.

Methods: A comprehensive but non-systematic search was undertaken to identify relevant studies across all disciplines, with a focus on medical and health sciences. Search terms included (but were not limited to) `PhD´, ´success´ and ´supervision´. Findings have been presented in a narrative format in three main sections: student-specific factors, supervisor-specific factors and shared themes.

Results: Key student attributes that influenced successful supervision included intrinsic motivation, commitment to the research topic, self-management, and adaptation to cultural and personal change. Supervisory influences encompassed supervision style, level of training, institutional support, and research culture. Shared elements of the relationship involved the establishment of mutual expectations, open and regular communication, appropriate contact frequency, professional conduct, and respect.

Conclusion: PhD supervision is a complex and evolving partnership requiring mutual engagement and reflection. Early clarification of roles and expectations, coupled with ongoing dialogue and professionalism, is essential to creating a positive supervisory environment and promoting doctoral success.

Background: The flipped classroom (FC) is increasingly used in medical education, but the impact of a continuous FC strategy on anesthesiology learning and career choice in eight-year medical program students remains unclear.

Methods: In a randomized trial, 200 students received either continuous FC (n=100) or traditional (n=100) anesthesiology instruction. Outcomes included final exam scores, survey-assessed satisfaction, active learning, critical thinking, and post-course specialty selection. Mediation analysis evaluated how a weighted composite of these scores influenced anesthesiology major selection.

Results: The continuous FC group demonstrated significantly higher final exam scores, satisfaction, and active learning levels (all P < 0.05). Most importantly, students in the FC group were 21.77 times more likely to choose anesthesiology as their specialty than those in the control group (OR = 21.77, 95% CI: 1.79-264.83, P = 0.016). Mediation analysis indicated that 44.13% of the total effect of the FC intervention on specialty choice was mediated by improvements in the weighted composite score (indirect effect: β = 0.059, 95% CI: 0.024-0.102, P = 0.005).

Conclusion: The continuous FC approach enhances learning outcomes, fosters essential skills, and significantly increases the selection of anesthesiology as a specialty. This demonstrates its substantial positive impact and potential value in addressing specialty shortages in medical education.

Medical education has undergone significant transformations, driven by rapid technological advancements. This systematic review aims to map and analyze educational technology trends from the late 1970s to 2024, tracing their evolution and their Impacts on competency development. Following PRISMA guidelines, a comprehensive search was conducted across seven databases in August 2024, yielding 18 studies published between 1978 and 2024 for qualitative, thematic synthesis. The findings indicate that technology integration has evolved through distinct trends. While simulation-based approaches were most frequently reported to enhance clinical reasoning and psychomotor skills, blended learning was highlighted for enabling flexible delivery, and other technologies, such as e-learning platforms and Web 2.0 tools, also played significant roles in supporting knowledge acquisition and collaborative learning. Despite these benefits, high costs, infrastructure limitations, and the need for specialized faculty training were identified as persistent barriers to adoption. In conclusion, the literature review indicates that technological trends have enriched medical education by fostering interactive, accessible, and flexible learning environments. Future strategies must therefore focus on developing scalable, cost-effective solutions. A dedicated systematic review of AI's trajectory and impact is strongly recommended as a critical next step, building upon the historical foundation laid by this study.

Purpose: Emergency Medical Technicians (EMTs) provide lifesaving care to sick and injured patients. After completing a state-approved course with cognitive and psychomotor training, EMT certification requires passing the National Registry computer-based adaptive exam. This study examined whether delays in taking the exam are associated with failure and provides context on the EMT role and certification process in the United States.

Methodology: Data included pass/fail results from 714 students who completed EMT courses between January 2013 and June 2025 at a large public university in Los Angeles County, California. All courses used similar curricula, equipment, facilities, instructors, and competencies. The study analyzed first-attempt exam outcomes relative to the time elapsed between course completion and testing.

Findings: Students who tested within 15-45 days had comparable pass rates, with the highest success among those testing within 30 days. Passage rates declined significantly after 45 days, and delays beyond 60 days were strongly associated with failure. These results indicate that the best chance of passing occurs when the exam is taken within 1-45 days of course completion.

Originality: This study demonstrates that delaying the National Registry EMT exam increases the likelihood of failure, particularly after 60 days. The findings can guide administrators and instructors in advising students to minimize delays and may inform curriculum adjustments to support long-term knowledge retention.

Background: Medical students typically must pass an end-of-placement supervisor evaluation for each clinical rotation to progress to the next level of the course. However, evidence suggests these evaluations show weak correlation with other reliable educational assessments. This study aims to determine supervisor perceptions of the sign-off process to inform possible improvements.

Methods: Clinical supervisors were recruited to provide feedback on their perceptions of the end-of-placement sign-off process. Responses were received from 59 of the 161 (36.6%) Year 3 clinical placement supervisors in hospitals and General Practitioner (GP) practices affiliated with Imperial College School of Medicine. A mixed methods approach was used, combining statistical and thematic analyses.

Results: Perceived positives of the single supervisor sign-off model included accountability, feasibility and continuity of supervision. Reported negatives were inflexibility, limited contact time, psychometric concerns and altered student learning behaviours with different staff. GP supervisors reported significantly more contact time with students than hospital-based supervisors (p<0.001), and were more likely to feel they had adequate supervision time to make informed ratings of student knowledge (p<0.001) and skills (p<0.001). Significantly more supervisors in Medicine (62%) and Surgery (64%) desired a change in the single supervisor sign-off model than GP supervisors (27%) (p=0.04).

Conclusion: This study provides novel and rich qualitative data on supervisor perceptions of the clinical sign-off process which have implications for undergraduate medical education curriculum reform. Hospital-based supervisors were less positive towards the sign-off process, likely due to modern working practices of shared patient loads, shorter rotations, and reduced contact time with students. Different sign-off requirements should be considered for GP supervisors versus those in hospital settings; possible alterations include multi-source feedback, embedded in-placement assessment, optimisation of the sign-off form, and additional formalised supervision time in supervisors' work schedules.

Objective: This study seeks to offer medical educators, researchers, and clinical practitioners a novel, comprehensive, and visually engaging perspective on the field. It accomplishes this by analyzing the research trends, frontier topics, and pressing issues related to Health Professions Education Model (HPEM) over the past two decades from 2005 to 2024.

Methods: This study employed CiteSpace 6.4.R1 and R-tool (version 4.5.1) software to conduct an analysis of articles pertaining to the Health Professions Education Model within the Web of Science Core Collection (WoSCC) database. The analysis encompassed various aspects, including keywords, disciplines, countries, institutions, authors, and references.

Results: A total of 2,953 articles were incorporated into this study. The predominant research topics within this domain encompassed "interprofessional education (IPE)", "competency-based continuing professional development (CPD)", and "student-led professional experiences (SLEs)." The five countries with the highest number of publications related to Health Professions Education Model (HPEM) were the United States, Australia, Canada, England, and China. Notable authors in this field included Olle ten Cate, Frank Jason R. Eric S. Holmboe, and Carol Carraccio. Additionally, the journals that emerged as the leading publications in this discipline were Academic Medicine, Medical Education, and Medical Teacher.

Conclusion: This study emphasizes the critical importance of international cooperation and exchange, particularly highlighting the necessity to strengthen collaboration among relevant institutions and prominent scholars in Europe, the United States of America, and China. Furthermore, it underscores current trends in the development of HPEM, specifically interprofessional education and competency-based continuing professional development. The research offers valuable insights for medical educators, scholars, and clinicians, enhancing their understanding of prevailing research trends and future directions within Health Professions Education Model.

Background: The development of Malawi's first National Oral Health Policy (MNOHP) in 2022 marked a milestone in strengthening the country's oral health system. However, the extent to which future oral health professionals are aware of and prepared to implement this policy remains unclear. This study explored the knowledge, perspectives, and interest of dental surgery students in Malawi regarding the MNOHP, with the aim of identifying educational and policy engagement gaps.

Methods: A descriptive cross-sectional exploratory survey was conducted among all willing clinical-year dental students enrolled in Malawi's sole Bachelor of Dental Surgery (BDS) program at Kamuzu University of Health Sciences. Data were collected using a structured, self-administered questionnaire developed from validated tools and refined through expert review and piloting. Descriptive analyses summarized participants' demographic characteristics, policy knowledge, exposure, and perspectives on curriculum integration. Ethical approval was obtained from the College of Medicine Research and Ethics Committee (P.11/24-1270).

Results: A total of 43 students participated (response rate 95.6%). Most participants were male (60.5%) and enrolled in Year 3 or 4. Awareness of the MNOHP was limited: only 27.9% correctly identified its launch year (2022) and 9.8% knew it had seven priority areas. Although 85.0% had never read the policy and 97.6% reported not being taught about it, all respondents expressed strong interest in learning more and participating in policy development. A majority (88.4%) believed oral health policy education should be compulsory, and over half (51.2%) preferred that it be introduced during the clinical years.

Conclusion: Malawian dental students exhibit enthusiasm to engage in oral health policy but lack foundational knowledge of the MNOHP. Integrating structured policy education within the dental curriculum covering the policy's seven priority areas of leadership, prevention, access, workforce, financing, infrastructure, and research could bridge this gap. Building policy literacy among future dentists is essential for effective policy implementation and long-term improvement of oral health outcomes in Malawi.