Advances in Medical Education and Practice最新文献

Purpose: This study aimed to explore the perspectives of residency program directors in Japan regarding overtime duty hours and the balance between clinical training and self-improvement activities. This study explores the impact of work-hour regulations on resident well-being and training quality, contributing to global discourse on medical education reform.

Participants and methods: A cross-sectional survey was distributed to 701 residency training hospitals across Japan to investigate their readiness for new duty-hour limits under the Medical Care Act, which categorizes working hours into Level A (960 hours/year), Level B (1440 hours/year), and Level C-1 (1920 hours/year). The survey, conducted from October 18 to December 15, 2023, achieved a 36.2% response rate (n=254). Key questions included: "Considering the balance between clinical skills development and mental well-being, what do you think is the optimal number of overtime duty hours per month for resident physicians?" Statistical analysis included descriptive statistics and Chi-square tests to compare responses across hospital types.

Results: Most directors favored a conservative overtime limit of 40 hours per month (mean ± standard deviation: 40 ± 21 h), with 24.0% expressing this preference. These findings reveal a significant evidence-practice gap, suggesting that current practices often exceed recommended limits, highlighting a need for alignment between policy and implementation.

Conclusion: This study provides insights into the complex interplay between resident training demands and well-being under Japan's new duty-hour reforms. It offers valuable insights for policymakers and educators aiming to optimize training environments and enhance resident well-being globally.

Purpose: Ophthalmology poses challenges for general practitioners, who have been identified globally as receiving inadequate training. Family medicine (FM) trainees often lack sufficient ophthalmology training; however, this issue is not unique to Saudi Arabia. Studies from Australia, the United States of America, New Zealand, and the United Kingdom have revealed the same concerns. Patient consultations offer opportunities for applying skills gained through structured education, yet the extent of FM trainees' clinical exposure to ophthalmology remains unclear. Effective workshops designed to enhance primary healthcare providers' ophthalmic skills exist internationally, but similar initiatives are lacking in Saudi Arabia.

Patients and methods: This one-year, cross-sectional study distributed a self-administered online questionnaire among family physicians and residents in a university hospital and the hospital's medical services center in Jeddah, Saudi Arabia. Data were inspected and cleaned in Excel and analyzed using IBM SPSS 29.

Results: The ophthalmology knowledge of family physicians averaged 5.1 on a scale of 1-10, suggesting moderate proficiency. Exposure to ophthalmology cases varied, indicating potential knowledge gaps and necessitating targeted educational interventions. Notably, 82.5% of the physicians believed that family physicians should lead the primary eye care by assuming responsibility for ensuring high levels of training and practice. Our study identified predictors influencing knowledge and confidence, including the effects of experience, training duration, and recognition of the necessity of continuous professional development courses. However, none of these associations were found to be statistically significant.

Conclusion: The physicians in our study exhibited a moderate level of ophthalmology knowledge (mean score = 5.1), revealing potential knowledge gaps. Despite their varied exposure to ophthalmology, 82.5% of the family physicians in this study advocated leading the medical profession in primary eye care. Experience and training duration were found to be non-significant predictors of knowledge and confidence.

Objective: This study aimed to assess the quality of the educational environments within which an orthopedic residency training program is being conducted throughout Saudi Arabia and to identify the areas of weaknesses so that the necessary improvements can be made to build a healthy and supportive environment.

Methods: This cross-sectional study included all orthopedic residents in Saudi Arabia and was surveyed using the validated Postgraduate Health Educational Environment Measure (PHEEM). We used Google Forms to Email the online survey to Saudi trainees in the orthopedic residency program from January 1 through September 30, 2022.

Results: The majority of participants were between 26 and 30 years; 15.6% were women. Among the subscales of PHEEM, perception of role autonomy scores were statistically significantly associated with participants' regions and their level of training (p = 0.026 and p = 0.019, respectively). The association of perception of teaching and participants' regions was also statistically significant (p = 0.004). The mean score for the perception of social support subscale was 25.99, which indicates that residents are generally satisfied with the level of support they receive in the training program. However, there is still room for improvement in this area.

Conclusion: The overall PHEEM score was positive but highlighted areas for improvement. Role autonomy and instructional subscales were perceived positively, yet still have room for growth. Social support showed more advantages than disadvantages. Despite the generally favorable environment, enhancements are needed in workloads, working hours, clarity of clinical protocols, and teaching supervision quality.

Background: Medical school graduates are faced with the difficult decision of choosing a specialty training program. Understanding the decision criteria as well as the intracurricular factors-which have been studied less frequently and thus lack clarity-may help to prevent an impending shortage of certain specialists and to ensure the recruitment of young doctors into supposedly less popular specialties. Evidence-based changes to the medical curriculum are needed to support the balanced development of health care systems with demand-driven staffing of all specialties, especially in the outpatient sector and in rural areas. The aim of this systematic review was to identify the intracurricular factors that influence medical students' choice of specialty that have been described in the international literature.

Methods: A systematic review was conducted by searching Medline. After applying the inclusion and exclusion criteria to the 2537 primary results and 19 hits from an additional manual search, data were extracted from 334 studies. In addition, a quality assessment of all included studies was performed.

Results: A total of 14 influencing factors were identified from the reviewed literature, of which "clinical-practical experience", "clinical role models", and "voluntary offerings" were mentioned most frequently. We sorted the factors into four main categories: "Teaching"; "Teaching environment, influence and interaction"; "Curriculum"; and "Voluntary work". The studies were highly heterogeneous regarding research methods and the quality of reporting.

Conclusion: Involving students in the planning and structuring of clinical phases, active feedback, voluntary offerings, seminars/simulations, and involvement in the clinical team can increase a specialty preference. Conversely, discrimination, prejudice and poor quality of teaching and clinical exposure may act as a deterrent. It is necessary to sensitize medical staff regarding their role and influence in the decision-making process. Further prospective and qualitative research is needed to address this issue adequately.

As awareness increases of the fundamental role of the arts and humanities in medical education, teachers must expand their skills to include arts-based pedagogical methods. With strong evidence to support its use with medical learners, Visual Thinking Strategies (VTS) is an arts-based method increasingly being adopted in medical education. VTS provides a structured way of leading interpretative discussions prompted by works of art. However, the simplicity of its structure can be deceiving. As with other teaching skills, faculty development is needed to train educators in VTS facilitation. This is essential not only to optimize VTS' benefits to participants, but - when VTS is implemented in research studies - to prevent doubts being cast on its impact on medical learners. Educators can apply the twelve tips on facilitating VTS described in this article to guide fruitful facilitation of VTS among medical learners, as well as to enhance discussion-based teaching in general.

Purpose: To evaluate medical students' perceptions about using peer teaching (PT) in the online Clinical PBL (C-PBL).

Materials and methods: The C-PBL used in the Primary care Unit (PCU) of the medical course of the Ribeirao Preto University was adapted to the virtual environment. A PT session was included to enhance students' intrinsic motivation. This cross-sectional study applied a 14-item survey to evaluate the perceptions of 378 medical students from the first to the seventh semester about the use of PT in this context.

Results: According to participants' perceptions, the use of PT in the online C-PBL allowed the interactive participation of students and produced satisfactory knowledge acquisition. Preparing and presenting a slideshow and being taught by peers contributed significantly to their learning. The survey used to collect information presented a high internal consistency measured by Cronbach's alpha.

Conclusion: From the students' perspectives, the use of PT in the online C-PBL was satisfactory and improved learning for peer teachers and learners. This study contributes additional evidence suggesting that PT is an effective teaching strategy in online learning and can be associated with PBL. This finding has implications for curriculum development and the health system.

Clinical reasoning skills are crucial for physicians. In clinical reasoning conferences using real cases, medical students, residents, and senior residents can follow experts' clinical reasoning processes. However, supervisors may struggle to clearly articulate their clinical reasoning process. It is necessary to demonstrate this process concretely and systematically for educational purposes. This study introduces the method of clinical reasoning case conferences using semantic qualifiers and the dual-process theory designed for outpatient cases to improve clinical reasoning education methods for beginners. In these conferences, participants assume the roles of a moderator, learner, presenter, and commentator. The presenter sets the first semantic qualifier from the chief complaint and pre-examination information, presents the present illness history, and then sets the second semantic qualifier. After the learners propose a snap diagnosis, the presenter provides additional information, and the learners develop a comprehensive differential diagnosis. Finally, the presenter shares the examination results, and the group discusses the results, determines the final diagnosis, and decides the future diagnostic strategy. This method helps expert physicians articulate their clinical reasoning process, aiding in the education of learners at all levels and enhancing supervisors' metacognition of their medical practice.

Purpose: This paper aimed to define and characterize the nursing student-faculty (NS-F) relationship in clinical practice.

Methods: An integrated literature review was conducted in PubMed, Scopus, and CINAHL from December 6th to 25th, 2023. The final review included 15 articles. The analysis employed the concept analysis method by Walker and Avant to identify antecedents, attributes, and outcomes of the NS-F relationship.

Results: The common attributes were caring, interpersonal connectedness, motivation, and constructive communication. A clinical learning environment and contact between nursing students and faculty are the antecedents whilst positive consequences are but not limited to a positive learning environment, motivation, well-being, and empowerment.

Conclusion: The findings from this analysis can be applied in practice to improve clinical education by guiding nurse faculty and students to implement effective interactions that promote the professional and academic development of nursing students. The findings offer practical implications for enhancing student-faculty relationships, leading to better learning outcomes in clinical settings.

Introduction: The COVID-19 pandemic forced educational institutions worldwide to shift to online learning as a means to continue education during lockdowns and social distancing measures. This study investigates the effectiveness of online learning in comparison to traditional on-campus learning, specifically within the context of medical education.

Methods: Two hundred and three first- and second-year medical students at King Saud University participated in this randomized experimental study. The research employed written exams to evaluate learning outcomes, with a focus on the understanding of lecture content. Data analysis was performed using the Statistical Package for Social Studies (SPSS 22).

Results: The findings reveal that while online learning attained similar learning outcomes to on-campus learning for content related to the early parts of the lecture, significantly lower outcomes were achieved by the online learners as the lecture progressed. Moreover, a smaller percentage of online students demonstrated a full understanding of the lecture material compared to on-campus students.

Conclusion: This study emphasizes the importance of assessing the effectiveness of online learning methods, particularly in medical education, to address students' needs better and improve the quality of online learning systems.