Advances in Medical Education and Practice最新文献

Background: Compulsory education of communication skills has begun to develop in Poland over the past several years. The aim of this study was to explore perception of preparation by the universities and self-assessment in communication skills among Polish doctors, nurses and midwives.

Methods: The research was based on an online survey examining 22 communication skills. A list of communication skills was created based on the recommendations for teaching medical communication described in the Calgary-Cambridge model. Data collection took place from March to July 2022. The sample consisted of a variety of health professions, including physicians, nurses and midwives.

Results: The results show that medical school graduates who took part in the survey rated their preparation in communication skills as low and the number of hours dedicated to communication training as insufficient. The most challenging aspects of communication skills include dealing with patient aggression, handling patients who express complaints, grievances, or expectations and discussing non-medical treatments with patients. The surveyed nurses and midwives rated their overall preparation significantly higher than physicians and felt strong in showing empathy. Doctors in turn assessed their task-oriented communication skills as much better.

Conclusion: The respondents emphasized the importance of communication skills training. Our findings underscore the urgent need for structured, longitudinal communication training within medical education, supported by systemic changes at the levels of policy, curriculum design, and faculty development. Communication skills must be prioritized as core clinical competencies across all health professions, not treated as peripheral elements of medical education and ideally should be continued throughout one's medical career and postgraduate education. Particular emphasis should be placed on teaching how to manage patient aggression, address complaints, and communicate with patients who pursue alternative medicine and not evidence based treatment. These results may also assist universities in other countries, where medical curricula are being implemented.

Purpose: We conducted a quality improvement study to gain insight into how the COVID-19 pandemic affected the education of trainees in pulmonary and critical care medicine (PCCM). We also sought to understand the experiences of fellows to better prepare for future pandemics.

Methods: We sent an electronic survey to fellows of an academic PCCM program and used data from the electronic survey to design semi-structured interviews for a qualitative study.

Results: Three themes were generated, centred on the emotional burden and physical demand, friendship, and education. Favourable aspects included the organizational response to the pandemic, particularly in terms of communication, personal protective equipment, and an emphasis on teamwork. Fellows became proficient in critical care procedures. The need for a trainees' respite area was emphasized. Other areas of concern included the lack of leadership to facilitate assistance from various services in the ICU and ensuring adequate education in pulmonary medicine, despite the extended demands of critical care.

Conclusion: Participants were dismayed at the lack of support from other services. The shift to virtual lectures resulted in a loss of personal contact and connections, as fellows much preferred in-person sessions. Our results highlight opportunities for learning, fulfillment, and challenges encountered while navigating a pandemic.

Background: Virtual patients (VPs) have traditionally been utilized in clinical education rather than in preclinical instruction. However, limited research has evaluated the effectiveness of VP-based sessions in enhancing early clinical exposure (ECE) during the preclinical years.

Aim: To assess the impact of VP-based tutorials in supplementing the Clinical Skills module for second-year medical students.

Methods: In this prospective study, the effectiveness of VP-based tutorials was compared to conventional lecture-based teaching within the Clinical Skills module. All second-year medical students enrolled during the 2022/2023 and 2023/2024 academic years were included. The 2022/2023 cohort (Group 1) received traditional lectures, while the 2023/2024 cohort (Group 2) participated in VP-based tutorials. Student performance was evaluated using pre- and post-module tests and formative Objective Structured Clinical Examination (OSCE) scores.

Results: Baseline performance showed no significant difference in pre-module test scores between Group 1 (26.55 ± 22.45%) and Group 2 (27.13 ± 26.21%) (p = 0.681). Both groups demonstrated significant improvements in post-module scores (Group 1: 73.88 ± 15.11%; Group 2: 75.01 ± 10.09%, p<0.0001 for both), with no significant difference between the two (p = 0.129). However, Group 2 achieved significantly higher OSCE scores compared to Group 1 (82.62 ± 11.03% vs 75.80 ± 14.38%, p<0.0001).

Conclusion: This study highlights the value of incorporating virtual patients into preclinical education. VP-based tutorials significantly enhance clinical skill development and facilitate early clinical exposure, offering a promising adjunct to traditional teaching methods in preclinical curricula.

Introduction: Medical education standards influence the academic performance and clinical competencies of medical students as career practitioners. With the rising demand for teaching innovation and technological advancement in medical education, clinical teaching in China has faced many challenges, which necessitate a re-evaluation of traditional educational approaches. To overcome these challenges, the tertiary hospital in Guangzhou and the medical school in Macau have initiated the reform of clinical teaching in an undergraduate teaching program with a specific project for Macau medical students to perform clinical placement in anaesthesia at the tertiary hospital in Guangzhou. The project was co-led and co-chaired by both institutions and coordinated by the Anaesthetic Department, International Office, and Medical Education Department at the tertiary hospital in Guangzhou. This project aimed to analyse students' anaesthetic placement experiences to illustrate the effectiveness of collaborative teaching and the development of a student-co-designed curriculum.

Methods: The participating medical students attended the anaesthetic placement at the tertiary hospital in Guangzhou, which is scheduled to spend one day in operating theatres, recovery rooms, and central theatre pharmacies under supervision. All participating students provided post-placement feedback by answering a pre-designed enquiry questionnaire to develop a co-designed curriculum. Post-placement feedback, including written reflections in response to the enquiry questionnaires, was collected and semantically analysed.

Results: Post-placement feedback in response to the enquiry questionnaires was presented as themes, which formed the core elements of the student-co-designedanaesthetic placement curriculum.

Conclusion: This study demonstrates the effective implementation of collaborative teaching and curriculum co-designed in anaesthesia education at a tertiary hospital in the "Greater Bay Innovative Zones of China". This curricular design model facilitates the development of a student-centred anaesthetic curriculum for better clinical teaching and learning.

Interprofessional education (IPE) is an important concept in healthcare education. Evaluating IPE implementation is essential for identifying challenges, exploring opportunities, and strengthening integration. This study evaluated the available evidence on IPE in Saudi Arabia, focusing on its outcomes, barriers, and A scoping review methodology was employed to analyse research from four databases covering the period from 2000 to 2024. The search used keywords such as "IPE" and "Saudi Arabia" and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for scoping reviews. In total, 5,174 records were identified. After removing duplicates and screening for relevance, 21 articles were included in the final review. Most studies followed a cross-sectional design, used the Readiness for Interprofessional Learning Scale (RIPLS), and were conducted in Central Saudi Arabia. This review highlights the growing evidence for the implementation of IPE in Saudi Arabia. Although the findings indicate a positive attitude towards IPE, challenges remain in the implications for the educational system. Addressing this gap and ensuring a more structured and widespread implementation can enhance IPE and patient outcomes.

Background: The Organ-System-Based Curriculum (OSC) has emerged as a transformative approach to medical education, gradually replacing traditional subject-based teaching. However, the existing literature on OSC has not been comprehensively evaluated.

Methods: Following the Joanna Briggs Institute (JBI) guidelines for scoping reviews, we systematically searched five databases-Medline (PubMed), Embase, ERIC, CINAHL, and Web of Science-for studies published in English between 2010 and 2024. We aimed to answer three key questions regarding OSC implementation strategies, effectiveness in medical education, and challenges in promotion. Two reviewers independently screened articles and extracted data based on predefined inclusion and exclusion criteria, with a third reviewer resolving disagreements.

Results: From an initial 1206 records, six studies met the inclusion criteria. Thematic analysis revealed: (1) Interdisciplinary team-based teaching with variable integration of basic sciences and clinical medicine, exemplified by improved student satisfaction and exam performance in integrated modules; (2) Effectiveness of academic interventions, including tutoring and problem-based learning, which enhanced clinical reasoning and examination outcomes; (3) Challenges, such as insufficient curriculum integration, limited student engagement in clinical practice, and difficulties integrating surgical education, highlighting areas needing improvement.

Conclusion: This scoping review synthesizes current evidence on OSC, demonstrating its potential to enhance multidimensional competencies in healthcare professionals. Addressing identified design and implementation challenges will be crucial to optimizing OSC's impact and wider adoption.

Background: Research is vital in medical education, fostering evidence-based practice and professional growth. However, medical students in low- and middle-income countries, such as Uganda, face significant barriers to research participation, including limited mentorship and resources. At Makerere University, these challenges impede surgical research output among students. Near-peer mentorship programs (NPMPs) offer a promising solution by leveraging senior students and residents to guide peers, enhancing research skills and productivity. This study implements and evaluates an NPMP within the Makerere University Surgery Society (MUSS) to boost student-led surgical research.

Methods: A mixed-methods implementation research design, guided by the RE-AIM Framework, will assess the NPMP over 12 months at Makerere University College of Health Sciences. The program involves 120 participants: 15 surgical residents mentoring 30 senior students (Years 3-5), who mentor 75 junior students (Years 1-5). Convenience and purposive sampling will recruit participants. Quantitative data (surveys, logs) will measure reach, effectiveness (research output, competency), adoption, implementation, and maintenance. Qualitative interviews with 25 participants will explore feasibility, acceptability, and sustainability. Data analysis includes descriptive/inferential statistics and thematic analysis. This protocol has been approved by the Mulago Hospital Research and Ethics Committee (Protocol Approval Number MHREC 2931).

Discussion: The NPMP aims to increase surgical research output, improve skills, and establish a sustainable mentorship culture within MUSS. By addressing mentorship gaps, it could enhance student engagement and offer a scalable model for resource-limited settings. Limitations include the lack of a control group and potential selection bias. This implementation research aims to establish a scalable model rather than prove direct causality in this initial phase.

Purpose: Entrustable professional activities (EPAs), essential for competent and safe clinical practice, serve as milestones to assess trainees' readiness for independent patient care. This study aimed to develop a context-specific EPA framework for hematology residency training in China.

Methods: We employed a modified Delphi method involving 35 experts from 8 academic hospitals to establish China's inaugural hematology-specific EPA framework. The development process comprised three key components: (1) a systematic literature review integrating international EPA models with China's the Standardized Training System for Residents (STSR) requirements; (2) structural validation through the EQual rubric (cut-off: 4.07); and (3) a two-round Delphi consultations evaluating importance, observability, evaluability, repeatability, feasibility and entrustment-supervision levels. Expert engagement metrics and inter-rater agreement evaluated consensus quality.

Results: The preliminary 14-item framework was ultimately refined to 12 EPAs following the exclusion of "Public Health Emergency Response" (EPA 14; mean score=3.23) and "Imparting Bad News" (EPA 13; 57.1% experts advocated removing). Key revisions involved expanding the hematopoietic stem cell transplantation (HSCT) competency domain to include donor selection (EPA 7) and the provisional addition then subsequent removal of "Cellular Immunotherapy Complications Management" due to insufficient standardization of assessment criteria. The final EPAs achieved unanimous EQual compliance (≥4.07) and strong Delphi consensus (Kendall's W: Round 1 = 0.271, Round 2 = 0.529, p<0.001). Clinical entrustment-supervision levels were systematically stratified by training phase and expected competency at graduation.

Conclusion: This study has established China's first hematology-specific EPA framework by addressing gaps in global EPA models through integration of integrating local clinical demands (high patient volume, resource constraints) and multidisciplinary coordination. The framework provides a validated tool for competency-based assessment, with future steps focusing on digital implementation and nationwide validation.

Introduction: Blood exposure accidents (BEA) represent a significant risk for healthcare workers. To enhance safety awareness, particularly among medical students, the "Room of Errors" may offer an innovative and effective educational approach.

Objective: To assess the impact of the "Room of Errors" simulation on medical students' knowledge regarding BEA management.

Methods: A pre-experimental study was conducted at the simulation center of the Faculty of Medicine of Sousse, including 63 students in the third level of the Second cycle of medical studies (SCMS3) who completed an internship in the occupational medicine department during the academic year2023/2024. Participants attended a simulation session of "room of errors" including seven intentional errors.An "error collection" sheet was used to identify these errors. A pre-test and post-test, each comprising 5 questions, evaluated participants' knowledge. Answers were classified as correct or incorrect.

Results: All 63 students (100%) who participated to the simulation session were included in the study. Totally, 55.6% of participants were female, with a median age of 24 years. Participants have correctly identified an average of 5.8 errors (range: 3-7) with a median of 6 [IQR: 5-7]. Following the simulation, students demonstrated significant improvements in their knowledge compared to the median pre-simulation scores (4 [IQR: 4-5] vs 2 [IQR: 1-3]; p<10^-3). The overall assessment of the tool indicated that all participants enjoyed and appreciate the error room: 64% found this learning method excellent and 22% found it good. The majority of the participants indicated that the debriefing was helpful, as it clarified specific elements, provided constructive feedback, and allowed a review of demonstrated technical skills, attitudes and behaviors.

Conclusion: The "Room of Errors" promotes reflective learning and enhances BEA prevention awareness. As an engaging and effective pedagogical tool, it may contribute to improving patient and professional safety.

The Joint PhD Degree Program (JDP) between Nagoya University (NU) and the University of Adelaide (UoA), launched in 2015, was the first such initiative of its type in Japan. Evolving from a student exchange, it required the Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT) accreditation and alignment of differing PhD admission criteria. Challenges included degree naming and eligibility requirements, which NU and UoA addressed through mutual recognition agreements. Since inception, the JDP has maintained steady enrolment, with doctoral degree students engaging in joint research and publishing over 30 peer-reviewed articles. Future developments include postdoctoral pathways and industry internships, reinforcing the Program's role in fostering and enhancing global medical research collaboration.