Advances in Medical Education and Practice最新文献

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.

Background: Overseas study is believed to enhance health professionals' research capacity. This positive impact has been passed down through generations of medical students via their tutors. This study aims to quantify and compare the benefits of tutors' overseas study experience for basic and clinical medical students.

Methods: A structured questionnaire was administered to medical students in Harbin Medical University (HMU) and its affiliated hospitals, whose tutors have overseas study experience. The study included 263 basic students from HMU basic medicine (Group A) and 263 age-matched clinical students from the affiliated hospitals (Group B). Data were analyzed using SPSS software.

Results: Most students believed that their tutors' overseas study experience greatly enhanced their abilities. The total IF (Impact Factor) of articles published during their PhD study by Group A and Group B was, respectively, 4.639 and 3.791 (P < 0.05). The number of SCI papers during their PhD study and foreign language skills improvement scores by Group A and Group B was, respectively, 1.14 and 1.06 (P > 0.05). Significant differences were found between Group A and B in the mean scores for improvement in learning ability, idea renewal, research ability and international academic communication skills (P < 0.05).

Conclusion: Our study revealed significant associations between tutors' overseas experience and medical students' outcomes. Basic students with overseas-experienced tutors demonstrated higher research achievements, while clinical students reported greater perceived improvements in overall abilities. Our findings suggest that study abroad policies for medical tutors may warrant consideration, given the observed associations with student outcomes.

The reduction in clinical rotation hours, particularly in high-demand pediatric subspecialties such as Neonatal Intensive Care Units (NICU) and Pediatric Emergency Rooms (ER), has highlighted the need for innovative approaches to enhance pediatric residency education. A 2019 survey of Italian pediatric residency programs revealed that most residents receive fewer than five hours of simulation-based training annually, with 66% participating in no simulation activities. Additionally, pediatric ER rotation hours have seen significant reductions-daytime rotations decreased by 29%, while nighttime rotations were reduced by 60% over the past four years at the University of Genoa. These challenges emphasize the importance of simulation-based curricula to address gaps in clinical exposure.This study presents a gamified simulation-based curriculum developed at the University of Genoa, designed to improve both technical and non-technical competencies among pediatric residents while compensating for reduced clinical exposure. The curriculum spans five years, with Year 1 focusing on foundational skills such as airway management, vascular access, and diagnostic techniques. Year 2 introduces more advanced scenarios like neonatal resuscitation, shock management, and cardiac arrest, while Years 3-5 culminate in high-fidelity simulations involving complex trauma and crisis resource management.Throughout the program, gamification elements such as badges, leaderboards, and team-based rewards enhance engagement, motivation, and participation. These elements provide feedback and foster progression, reinforcing residents' commitment to mastering technical skills and non-technical competencies like teamwork, leadership, and decision-making. By combining simulation-based training with gamification, this curriculum offers an innovative approach to residency education, preparing pediatric residents for real-world challenges and developing essential skills for high-stakes pediatric care.

Background: Artificial Intelligence (AI) is increasingly relevant tool to medical education and healthcare. Understanding the readiness of future physicians for AI integration is essential for developing effective curricula and fostering responsible use of this technology.

Methods: This cross-sectional study was conducted among 189 medical students at Taibah University using a validated, self-administered online questionnaire. The tool measured AI knowledge (7 items), attitudes (10 items), practices (7 items), and perceived barriers. Responses were captured on a 5-point Likert scale. Descriptive and inferential statistics, including one-way ANOVA, were used to analyze differences across academic years.

Results: Out of 189 respondents, 53.97% (n=102) of students reported familiarity with basic AI concepts, and 5.66% (n=11) were aware of machine learning and deep learning. Only 11.21% (n=21) had received formal AI instruction, and 21.18% (n=40) had attended dedicated courses. 74.60% (n=141) believed AI would revolutionize education, yet 41.91% (n=79) expressed concerns about AI replacing teachers. 52.02% (n=98) used AI regularly for exam preparation. In comparison, only 11.64% (n=22) used it for Objective Structured Clinical Examination (OSCE) preparation Key barriers included ethical concerns (n=44 responses), risk of plagiarism (n=56), lack of knowledge (n=46), and limited access to tools (n=28).

Conclusion: Medical students display cautious optimism about AI in education, with limited practical knowledge and concerns about ethical implications. Integrating structured AI education, training program, and ethical guideline is essential for preparing students for an AI-enhanced healthcare landscape.

Purpose: Neuroanatomy is a cornerstone of medical education, yet its complexity often leads to student apprehension, termed "neurophobia." This quantitative study evaluated the effectiveness of online Functional Neuroanatomy modules in enhancing second-year medical students' understanding of neuroanatomy at Weill Cornell Medicine-Qatar during the 2024-25 academic year.

Participants and methods: Four functional neuroanatomy modules were developed: Brainstem Anatomy, Sensory Pathway, Motor Pathway, and Cranial Nerves. Each module featured a 15 to 20-minute animated video and accompanying pre- and post-module quizzes. Each module included 5-10 multiple-choice questions and labeling exercises targeting structure, function, and clinical correlation relationships through distinct clinical scenarios. Thirty-six students participated in this study by completing one or more modules. A survey was administered at the end of the final module to assess student perceptions of the modules' effectiveness, utility, and overall satisfaction. Quantitative data were analyzed using paired samples t-tests to compare pre- and post-quiz performance and independent t-tests to compare weekly quiz scores between participants and non-participants.

Results: Statistical analysis showed significant improvement in post-module quiz scores across all modules (p < 0.001), indicating short-term learning gains. No significant difference was observed in official weekly neuroanatomy quiz scores between participants and non-participants (p > 0.05), possibly attributable to students' already strong baseline performance and access to multiple learning resources. Survey responses reflected high satisfaction, with students praising the modules' clarity, interactivity, and flexibility.

Conclusion: These findings support the effectiveness of neuroanatomy modules as a supplementary digital tool that enhances comprehension and addresses neurophobia. However, limitations, including small sample size, lack of long-term retention assessment, and reliance on quiz-based evaluation, warrant caution and suggest the need for more rigorous future studies.

Background: Currently, midwifery education is confronted with a variety of obstacles, such as inadequate resources and conventional learning methods that are less effective in enhancing the clinical skills of students. Technological advancements and the rapid evolution of maternal and neonatal health services necessitate the transformation of midwifery education to a competency-based curriculum and outcome-based assessment paradigm. Artificial intelligence (AI) and deep learning have the potential to provide adaptive, personalized, and precise learning in this context. Nevertheless, its implementation continues to encounter a variety of challenges.

Purpose: This study reviews the role of AI and deep learning algorithms in enhancing outcome-based assessments in midwifery education, focusing on improvements in objectivity, personalized learning, and students' clinical readiness.

Patients and methods: This study employed a systematic literature review from Science Direct, Semantic Scholar, Springer Nature, and Taylor and Francis databases. Rayyan's software was employed to select 15 articles from the 771 articles that were discovered, in accordance with the inclusion and exclusion criteria. To guarantee objectivity and quality, two researchers conducted an independent evaluation.

Results: Our review indicates that algorithms including Convolutional Neural Networks (CNN), Long Short-Term Memory (LSTM), Random Forest, and Support Vector Machine (SVM) are proficient in facilitating objective evaluations, delivering tailored feedback, and enhancing clinical learning simulations. Artificial intelligence has demonstrated the capacity to enhance students' communication, critical thinking, and clinical decision-making abilities. The primary challenges encompass infrastructure preparedness, digital literacy, and ethical concerns pertaining to data protection and algorithmic prejudice.

Conclusion: Artificial intelligence and deep learning possess significant promise to revolutionize achievement-based assessments in midwifery education through accurate, adaptable, and scalable evaluations. The successful implementation relies on the management of technological, pedagogical, and ethical restrictions, along with thorough integration into the curriculum to equip graduates for global maternal and neonatal health concerns.

Background: Residency training provides systematic, competency-based education for medical graduates. Although specialised knowledge and clinical skills are crucial in pediatric cardiology, training in China is often limited to 2-3 months with lecture-heavy approaches. We explored integrating clinical pathway(CP) and case-based learning (CBL) models to enhance training efficiency.

Methods: The study involved 47 second-year pediatric trainees in Guangdong Provincial People's Hospital (2021-2024), randomly divided into a traditional teaching (TT) group and a CP-CBL group. Both groups underwent a 3-month training period, with no significant baseline differences (age: 21.6 ± 1.2 vs 22.1 ± 0.8 years; eight male trainees/group). The TT group received conventional lectures and ward-based learning. In the CP-CBL group, standardized instruction for common diseases was delivered through CP, whereas atypical/complex cases were taught with CBL. Both groups covered identical syllabus and duration. Outcomes were assessed through a theoretical test, case analysis, and an anonymous trainee questionnaire with a 5-point Likert scale. Group means were compared using Welch's t-tests (α = 0.05) in R software (significance level: p < 0.05).

Results: Among 47 pediatric trainees, 24 (51.1%) were assigned to the CP-CBL group. No significant differences in age, experience, or prior CP-CBL exposure were observed between groups. All trainees completed the rotation exam. The CP-CBL group outperformed the TT group in comprehensive assessments (case analysis + theory exams), with 37.5% vs 4.3% of trainees scoring >90 points respectively. Trainees in the CP-CBL group reported higher satisfaction with learning interest (p < 0.01) and perceived skill improvement (p < 0.01), but no significant differences in course organisation (p = 0.49) or instructor performance (p = 0.79).

Conclusion: In pediatric cardiology training, CP-CBL outperformed TT in both knowledge acquisition and learner engagement.

Background: Emergency education is a critical component of medical training, enabling students to effectively respond to urgent and life-threatening situations. This study aimed to evaluate the knowledge, attitudes, and practices (KAP) of medical students regarding prehospital emergency care, and to explore the factors influencing these dimensions.

Methods: A cross-sectional survey was conducted between September 1 and October 10, 2024, at Wannan Medical College in Anhui province, southeastern China. Participants were selected using a stratified cluster sampling method. Data were analyzed using independent samples t-tests, one-way ANOVA, and Pearson correlation analysis. Structural equation modeling (SEM) was employed to examine the interrelationships among emergency knowledge, attitudes, and practices.

Results: A total of 452 medical students completed the survey, with 439 valid responses included in the final analysis. Among the participants, 213 were male (48.50%) and 226 were female (51.50%). The mean scores for emergency knowledge, attitudes, and practices were 23.17 ±4.43, 18.20 ±3.76, and 13.68 ±2.71, respectively. The SEM analysis revealed that knowledge had a significant positive effect on attitude (β=0.831, P<0.001) and on practice (β=0.477, P <0.001). Attitude also significantly influenced practice (β=0.448, P<0.001).

Conclusion: This study underscores the pivotal mediating role of attitudes in linking emergency knowledge to practice among medical students. Enhancing emergency knowledge through targeted educational interventions, alongside fostering positive attitudes, may effectively improve students' engagement and performance in real-life emergency care situations.