Advances in Medical Education and Practice最新文献

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.

Purpose: The proliferation of predatory open-access journals poses a significant threat to scientific integrity, especially among early-career researchers unfamiliar with deceptive publishing practices. This study aimed to assess dental interns' awareness of predatory journals in Riyadh and to identify factors associated with awareness, including research interest and familiarity with journal evaluation tools.

Methods: An analytical cross-sectional survey was conducted among 155 dental interns across six institutions in Riyadh. A self-developed, psychometrically validated electronic questionnaire assessed participants' demographic profiles, research experience, and awareness of predatory journals. Statistical analyses included Cronbach's alpha, exploratory factor analysis, chi-square tests, t-tests, and logistic regression.

Results: Only 47.7% of interns recognized the term "predatory journal", and 74.8% were unfamiliar with Beall's List. Awareness was significantly associated with research interest (OR = 7.18, *p* < 0.001) and prior invitations from predatory journals (OR = 8.82). Demographic factors such as gender, marital status, and university affiliation showed no significant associations with awareness. Awareness was moderately correlated with prior publication activity (r = 0.38, p < 0.001) but was not significantly predicted by publication count in regression models.

Conclusion: The findings reveal moderate yet inconsistent awareness of predatory publishing practices among dental interns in Riyadh. While many exhibit strong research interest, gaps remain in ethical journal evaluation and identification. Targeted educational initiatives, including institutional workshops and curriculum integration, are essential to foster ethical publishing literacy among emerging dental professionals.

Objective: The objective of this review is to analyze the hidden curriculum with respect to its potential as a curriculum promotor or inhibitor of medical curricula, and to review the strategies that can help make it one of the curriculum promotors.

Data sources: We searched PubMed, Cochrane Reviews, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) library, with Google Scholar for grey literature, using specified keywords with a time limit from January 2000 to December 2023. We included original articles, review articles and meta-analyses, book chapters, and books focusing on the hidden curriculum effects on curriculum.

Data extraction and synthesis: Three different reviewers independently searched the relevant literature. The Best Evidence Medical Education (BEME) quality criteria were used to assess the quality, the Critical Appraisal Skills Program (CASP) checklists for risk of bias assessment, and the GRADE-CERQual framework for confidence of evidence in each article. Findings were synthesized by using thematic synthesis to identify promotive and inhibitory effects along with recommended strategies.

Results: A total of 23 articles were selected for full review. These articles infer that the hidden curriculum can affect the medical curriculum in both negative and positive ways. A few of the curriculum-promoting effects of hidden curriculum are soft skills (interpersonal, communication, and professional behaviors often labelled as soft skills in the literature) and practical knowledge acquisition, cultural proficiency, moral growth, and professionalism. The negative or inhibitory effects include a detrimental learning environment, learning unprofessional and unethical practices, gender inequities, stress, and burnout. Strategies that should be adopted to overcome the inhibitory effects of the hidden curriculum include raising awareness among the stakeholders regarding the hidden curriculum, aligning the hidden curriculum with the intended curriculum, institutional and administrative policies, role modelling, and mentorship.

Conclusion: Hidden Curriculum plays a very crucial role in medical education. By addressing its due importance, it can highly enhance the competence of future health professionals.

Background: Effective management of laboratory turnaround time (TAT) and adherence to sample collection protocols are essential for clinical efficiency and patient care. While WHO recommends TAT monitoring for performance evaluation, resource-limited settings such as Yemen face systemic challenges, including inconsistent training, poor infrastructure, lack of ongoing oversight, and limited use of electronic archiving systems, which can undermine compliance.

Aim: This study assessed the Knowledge, Attitudes, and Practices (KAP) of clinical laboratory workers in Dhamar, Yemen, regarding sample collection methods and TAT to identify gaps and guide interventions.

Methods: A cross-sectional study surveyed 97 laboratory workers (technicians, supervisors) across public and private hospitals using a structured questionnaire to assess their KAP regarding TAT and sample collection. Data analysis was performed using SPSS version 26.0. The association between overall KAP levels and demographic factors was assessed using chi-square tests. A p-value <0.05 was considered statistically significant. Ethical approval was obtained prior to data collection, and informed consent was obtained from all participants.

Results: A survey of 97 laboratory professionals revealed significant gaps in Turnaround Time (TAT) knowledge, with nearly half (50.5%) demonstrating poor understanding and only 23.7% correctly defining TAT; knowledge was significantly influenced by job role (p = 0.017) but not by education or gender. Despite 95.9% acknowledging TAT's importance, key challenges included high workload (67%) and equipment malfunctions (45.3%).

Conclusion: Critical gaps in TAT knowledge and inconsistent practices persist, driven by inadequate training and resource limitations. Standardized protocols, infrastructure upgrades, and targeted training are urgently needed to align practices with global standards and improve healthcare outcomes in Yemen.