Advances in Medical Education and Practice最新文献

Background: In professional health education, it is common to align teaching strategies with students' preferred learning and thinking styles. However, the evidence supporting this "meshing" approach is weak. To address this gap, this study aimed to investigate the learning and thinking styles of first-year female pharmacy students and compare them to their performance in an anatomy course.

Material and methods: This cross-sectional study evaluated first-year female Doctor of Pharmacy students enrolled in an anatomy course over two consecutive academic years. Two validated inventory tools were used to assess students' learning and thinking styles: the Visual, Aural, Read/Write, and Kinesthetic Learning Styles Inventory (VARK) and the Thinking Style Indicator (TSI). The students' final course grades were compared with their thinking and learning styles.

Results: 259 students (98% of both cohorts) provided complete data on both instruments. The kinesthetic (58%) and concrete-sequential learners (32%) had the highest grades among the studied population. Neither learning style (P = 0.959) nor thinking style (P = 0.918) predicted the performance of students in the anatomy course. On the other hand, students with multimodal learning and thinking styles tended to have better scores than those who were unimodal.

Conclusion: The results of the study demonstrate that learning and thinking styles do not have a significant role in the performance of pharmacy students in an anatomy course, which led us to reject the null hypothesis. Thus, anatomy educators should make full use of multiple active blended learning modalities available to accommodate the full range of individualized learning preferences.

Background: Case-based learning (CBL) is a student-centered pedagogy that introduces students to real-life scenarios by presenting an authentic case, mirroring situations encountered in clinical practice. It serves as a bridge between theoretical knowledge and practical applications in nursing practice, fostering development of critical thinking skills in clinical decision-making by providing practical and immersive learning experiences to students. This study examined the impact of CBL on critical thinking in clinical decision-making among student nurses at Kampala International University (KIU), Uganda.

Methodology: -The study used descriptive design with criterion purposive sampling. 28 students nurses consented and participated in the study. The procedure involved CBL pedagogy, implemented using framework for teaching that was adopted and adapted by researchers and prepared instructional content on "Anemia in Pregnancy". The instrument for data collection was the California Critical Thinking Skills Test (CCTST) questionnaire (34-point scale). Collected data were analyzed using percentages, descriptive statistics and ANOVA for sub-scale scores with a significance P-value of <0.05.

Results: Very few (7.1%) participants had strong, whereas majority (92.9%) had superior overall CCTST scores. Participants' CCTST total mean score was 27.39, sub-scale analysis 5.79, evaluation 3.96, inference 5.64, deductive reasoning 5.54, and inductive reasoning 6.46 as their mean scores. CBL was a statistically significant factor influencing participants' scores in analysis (P =0.016), evaluation (P =0.007), and deductive reasoning (P =0.025) but did not have a statistically significant effect on inference (P =0.932) or inductive reasoning (P =0.670) sub-scale scores.

Conclusion: As a pedagogy, CBL has an excellent impact on KIU student nurses' critical thinking in clinical decision-making, as shown by study findings. However, there is a need to use more than one student-centered pedagogy to transfer adequate knowledge in curriculum to student nurses and strengthen clinical teaching to enhance their clinical management skills were recommended.

Purpose: Maternal Advanced Cardiovascular Life Support (ACLS) training is crucial for effective maternal cardiopulmonary resuscitation education. Traditional lecture-based approach for maternal cardiopulmonary resuscitation falls short in providing opportunities for adequate practice and active participating. Peyton's four-step teaching method shows advantages in the acquisition of procedural skills. Its effectiveness is constrained in group settings due to the 1:1 teacher-student ratio requirement. This study aims to evaluate the effectiveness of a modified Peyton's four-step teaching method in maternal ACLS training, with the objective of optimizing clinical training strategies.

Methods: Sixty physicians participating in ACLS training at our hospital from October 2023 to December 2024 were enrolled and randomly divided into an experimental group (n = 30) and a control group (n = 30). The experimental group received the modified Peyton's four-step teaching method, while the control group underwent traditional lecture-based training. Teaching effectiveness was compared through knowledge assessments, skill evaluations, and feedback questionnaires.

Results: No significant difference was observed in knowledge scores between the two groups (experimental group: 94.6 ± 4.1 vs control group: 94.3 ± 3.9, P > 0.05). However, the experimental group demonstrated significantly higher accuracy in skill operations, including uterine displacement maneuvers, peripartum cesarean section decision-making, defibrillation, and resuscitation drug administration (P < 0.05). Teamwork performance and adherence to maternal cardiac arrest (CA) protocols were also superior in the experimental group (P < 0.05). Questionnaire results indicated higher satisfaction (4.5 ± 0.7 vs 4.1 ± 0.5, P < 0.05) and greater learning engagement (4.5±0.6 vs 4.0±0.6, P < 0.05) in the experimental group.

Conclusion: The modified Peyton's four-step teaching method significantly enhances physicians' mastery of maternal ACLS skills, improves teamwork capabilities, and elevates both teaching quality and learner satisfaction.

Purpose: Learning basic sciences divorced from clinical practices is suboptimal. Several student-centered learning strategies were introduced to enhance self-regulated learning while adopting learning techniques centered on assessment receives much less attention. This study aimed to explore the perception and efficacy of engaging early-phase preclinical medical students in generating scenario-based Multiple-choice questions (MCQs) targeting high cognitive levels.

Methods: This study is a quasi-experimental mixed-method study conducted among preclinical second-year medical students. An intervention group involved students who participated in item creation, and a control group included those who did not. The two groups were exposed to mock exams and were asked to complete a self-administered questionnaire and participate in focused group discussions on their perceptions.

Results: Out of 135 students, 48.9% created from 1 to 10 items. Item creators had significantly higher formative scores (34.3 ±10.5) than non-creators (29.6 ±10.6) (p = 0.010), and their GPA was also significantly better (B+ grade: 42.4% vs 21.7%; p = 0.015). Despite these academic variations, above 75% of the two groups were satisfied or very satisfied with non-significant variations. Formative assessment positively correlated with GPAs (rs = 0.74) and the number of developed items (rs = 0.39). The adopted strategy imposed a positive effect on the learning process and fostered procedural soft skills and student values. It allowed students to experience positive emotions and feelings of entertainment during learning and changed their perception of scenario-based MCQs. Students prefer generating such items in other subjects.

Conclusion: The student-led approach to generating clinical scenario-based MCQs demonstrates significant promise as an innovative pedagogical approach in medical education. Involving preclinical students in developing high cognitive levels of MCQs is not merely a tool for evaluation but a versatile pedagogical strategy that can be adapted to various disciplines to enhance learning and engagement and help students transition to the clinical years.

Objective: This study explores the effectiveness of the cognitive apprenticeship teaching model in fostering critical thinking and clinical reasoning and decision-making skills among medical residents during their rotations in the critical care medicine department.

Methods: We selected medical residents undergoing standardized training during their rotations in the critical care medicine department at the First Affiliated Hospital of Chengdu Medical College as the study participants. We conducted a two-month clinical practice course using the cognitive apprenticeship teaching model and evaluated its outcomes.

Results: Prior to the teaching intervention, there were no significant statistical differences (P > 0.05) in the general information and pre-teaching assessment scores related to critical thinking and clinical reasoning and decision-making skills between the two groups of students. However, after the training, the experimental group demonstrated significant improvements in four dimensions: truth-seeking, systematic skills, confidence in critical thinking, and curiosity, compared to the control group. Furthermore, in the Mini-CEX assessment, the experimental group scored higher in six dimensions: medical history inquiry, humane care, communication skills, clinical judgment, organizational efficiency, and overall clinical competency, with statistically significant differences (P < 0.05) compared to the control group.

Conclusion: The cognitive apprenticeship teaching model enhances the critical thinking and clinical reasoning and decision-making skills of resident physicians, thereby improving the effectiveness of medical education.

Introduction: Understanding the perceptions of medical students and faculty members regarding unprofessional behavior is crucial to appropriately guide medical students' behavior. This study aimed to clarify the differences in perceptions of unprofessional behavior in clinical settings among Japanese medical students and faculty members.

Methods: This single-center, cross-sectional survey was conducted at the Faculty of Medicine, Saga University. Participants were faculty members who participated in a faculty development program on medical students' unprofessional behaviors in December 2024 and fourth-year medical students who attended a similar lecture in January 2025. The survey items were determined through identifying common unprofessional behaviors based on previous reports and following a discussion with faculty members responsible for pre-graduate education. Participants were divided into faculty and student groups, and differences in perceptions were analyzed using logistic regression analysis.

Results: Participants comprised 40 (response rate 22%) faculty and 65 (64%) students. The faculty group showed significantly lower perceptions of being unprofessional in the following behaviors than the student group: violation of privacy or confidentiality obligations (odds ratio 0.089, 95% confidence interval 0.010-0.766); false statements or misrepresentation (0.180, 0.034-0.940); inappropriate use of social networking services (0.150, 0.029-0.762); fabrication or falsification of data (0.228, 0.005-0.941); bullying, discrimination, and sexual harassment (0.047, 0.006-0.383). Multivariate logistic regression analysis identified "bullying, discrimination, and sexual harassment (0.058, 0.007-0.487)" as the only factor on which their perceptions differed significantly.

Conclusion: Both faculty members and medical students perceived the unprofessional behaviors of medical students similarly, except in the cases of bullying, discrimination, and sexual harassment. However, since faculty members considered five behaviors to be less unprofessional, their perceptions regarding unprofessional behaviors need to be realigned so that they can better guide medical students toward becoming better professionals in the future, thereby improving patient outcomes.

Background: General practice (GP) placement teaching can be challenging because of time constraints, ineffective teaching models, and a lack of consensus approaches. GP clinics are more frequently used for undergraduate students' learning to translate theoretical knowledge into clinical practice. Evidence suggests that a learner-centred approach is essential for facilitating deeper learning. "Student-led consultation under supervision" is one such learner-centred teaching model applied during GP placement, engaging both trainers and trainees in applying the core values of clinical thinking. This qualitative study intends to explore students' learning outcomes when implementing the innovative teaching model "Student-led consultation under supervision during GP clinical placement" for potential quantitative introduction as a formal GP placement curriculum.

Methods: A convergent mixed-method approach was applied using validated surveys and pre-designed questionnaires for individual reflection when implementing innovative teaching models in medical students' GP placements. Thirty-five medical students from China and Australia participated in the study. Survey and reflection data were collected for descriptive and semantic analysis.

Results: "Student-led consultation under supervision in a consultant's chair with discussion" was the students' most highly rated teaching model. Students' reflections on the use of these teaching models were semantically analysed using a validated questionnaire. The students' reflections highlighted the perceived academic benefits with identifying the enablers of and barriers to developing the formal GP placement curriculum.

Conclusion: This study shows that "Student-led consultation under supervision in a consultant's chair with discussion" is innovative in GP teaching. The demonstrated innovation embraces the concept of cognitive apprenticeship for improving learning outcomes. These teaching models incorporate students' reflection in curriculum design and extend the definitions of "cognitive apprenticeship" and "transfer of learning" in modern clinical teaching to improve trainees' placement learning. The identified enablers of and barriers to implementing these innovative teaching models will pave the way for future studies to confirm the practicality of implementing them in real-life clinical practice.

Objective: The selection of medical specialties by medical students (MS) and factors shaping their decisions represent critical determinants of the medical workforce landscape, warranting in-depth exploration. In many countries, infectious diseases (ID) fail to be acknowledged as a satisfying specialty. Furthermore, the shortage of ID specialists has become a critical challenge in China's healthcare system. Therefore, we undertook a survey to investigate MS' specialty preference, especially their interests in ID, and the determinants influencing their decision-making processes.

Methods: We recruited the fifth, sixth, and seventh year MS to carry out this investigation. Initially, 10 semi-structured interviews were conducted to gather qualitative insights. Subsequently, 117 participants completed a questionnaire.

Results: In the qualitative study of 10 MS, motivations for medical school included personal interest (6/10) and a desire to help others (5/10). All planned to practice medicine post-graduation, with intended specialties mainly surgery (5/10) and internal medicine (4/10); key career choice factors were specialty interest (9/10) and job availability (4/10). All were unfamiliar with ID, with limited exposure to ID. None intended to pursue ID careers, primarily due to greater interest in other specialties (10/10), plus concerns like occupational exposure (2/10). In the quantitative study of 117 participants, the majority of MS applied for medical school based on personal interests (76.9%), and most (88.9%) intended to practice medicine after graduation. Internal Medicine (31.6%) and Surgery (24.8%) were the most popular first-choice specialties, with work-life balance (82.1%), interest in the specialty (81.2%), and expected income (70.9%) being the top factors influencing specialty choice. Notably, only 6.8% of MS expressed interest in pursuing a career in ID, while 48.7% reported no interest. The primary reasons for disinterest included concerns about occupational exposure, lack of inherent interest in ID, and limited procedural opportunities. Multivariate logistic regression analysis identified the overall evaluation of the ID curriculum as the sole factor associated with MS' lack of interest in ID (OR 0.376, 95% CI 0.188-0.754, P=0.006).

Conclusion: In our study, MS showed limited interest in becoming ID specialists. To enhance the appeal of the ID specialty, efforts could focus on training students on occupational safety and protection, improving the quality of ID-related courses, and optimizing career incentives. These strategies might help increase MS' interest in ID and contribute to a more balanced medical workforce.

Purpose: This study aimed to assess the knowledge and attitudes changes of pharmacy students in Jordan toward pharmacogenetics (PGx) education.

Patients and methods: The study has involved both quantitative and qualitative approaches. The quantities part investigates the pre- and post-test scores of 95 pharmacy students studying PGx at the University of Jordan. The surveys were administered before and after the educational intervention, which lasted 14 weeks. The qualitative aspect included focus group discussions, where the participants deeply revealed their perceptions of PGx.

Results: The study showed that 66.3% of students "strongly agreed that genes received from parents are the main influencers of medication response", in comparison to 45.3% of the students at the baseline (p < 0.001). The belief that gene variants are correlated with the susceptibility to the side effects of drugs was one of the lessons that benefited the most, with an improvement from 45.3% to 72.6% (p < 0.001). At the end of the intervention, 75.8% of students approved PGx execution being pharmacists' job, whereas 44.2% voted for it at the baseline (p < 0.001). Following the intervention, 75.8% of students strongly agreed that PGx testing should be part of pharmacy education, up from 61.1% (p = 0.016). The number of students that strongly agreed that genetic testing would make drug selection significantly improves from 55.8% to 78.9% (p = 0.002). Focus group interviews confirmed these findings. Students valued talking about tailored medication and promoted PGx to their future employers. According to several students, the PGx course should be mandatory for PharmD students and offered earlier for better practical use.

Conclusion: The PGx educational intervention improved students' PGx knowledge and attitudes. The study underscores the need to integrate PGx into pharmacy courses to educate students about personalized medicine in clinical practice.