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Global populations are rapidly aging, posing significant challenges. Yet, ageism among clinicians and medical students persists, undermining empathy and care quality. Traditional short-term educational efforts have limited effect; sustained, relationship-based programs hold promise but remain understudied. To address this, we implemented a year-long service-learning project, where first-year medical students visit elderly individuals at their homes to engage in light physical activities and discuss life challenges. This qualitative study examines the project's impact on first, second, and third-year medical students.From August to October 2020, we recruited, via convenience sampling, first-year medical students of three consecutive cohorts (n = 313) that completed ten home visits with older adults; of these sixty (19%) students participated in focus groups/interviews and 128 (41%) submitted reflective assignments. Data was manually analyzed using Braun and Clarke's six-phase reflexive thematic approach until saturation. We adhered to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist.Three major themes and seven sub-themes emerged. First, building trusting patient-physician relationships, characterized by empathy, trust, and effective communication, alongside a balance between physician responsibility and patient autonomy. Second, embracing uncertainty and holistic care, which involved navigating medical ambiguity and integrating psychosocial dimensions into clinical reasoning. Third, reflecting on vulnerability, aging, and mortality, encompassing the emotional impact of disability and decline; reframing aging positively; and processing experiences of death and loss. Participants described profound shifts in their perspectives on aging, care relationships, and their professional identities; changes that persisted throughout their pre-clinical training. To conclude, early and sustained engagement with older adults in their home environment through a structured service-learning project enhanced medical students' professional development, empathy, and attitudes toward aging. Incorporating similar programs into medical education curricula may provide substantial pedagogical benefits. Future research should assess long-term impacts on career choices and care quality.

Gamification is increasingly adopted in health professions education to enhance clinical reasoning, a core competency essential for safe patient care. Although many interventions report positive outcomes, the magnitude and consistency of these effects remain uncertain. This meta-analytic review synthesizes quantitative findings on the effectiveness of gamified learning on clinical reasoning in medical and allied health learners across diverse contexts. Following PRISMA 2020 guidelines, we searched MEDLINE, Scopus, and Web of Science (2010-2023) for randomized and non-randomized studies evaluating gamified interventions targeting clinical reasoning. Eligible populations included pre- and post-licensure learners, with traditional or non-gamified instruction as comparators. Quantitative measures of clinical reasoning were required. Risk of bias was assessed using RoB 2.0 and ROBINS-I, and standardized mean differences (SMDs) were pooled using a random-effects model. From 713 records, 26 studies met inclusion criteria and 10 contributed to the meta-analysis. Gamified interventions were associated with improved clinical reasoning compared with traditional instruction (SMD = 1.11; 95% CI: 0.69-1.52). Substantial heterogeneity was observed (I² = 85%). Assessment of publication bias suggested possible overestimation of effects, with an adjusted pooled estimate of 0.75 (95% CI: 0.24-1.27). The certainty of evidence was rated as low due to heterogeneity, risk of bias, and potential publication bias. Gamified learning may support the development of clinical reasoning in health professions education; however, considerable variability across studies and low certainty of evidence warrant cautious interpretation. Future research should employ theory-informed designs, validated reasoning measures, and rigorous methodologies to clarify when and how gamification is most effective.

Background: Effective disaster management requires healthcare professionals to function not only as responders but also as trainers who can disseminate knowledge and skills. In low-resource settings such as Tanzania, structured train-the-trainer (ToT) programs tailored to physicians remain limited. This study aimed to design, implement, and evaluate a trainer development program for Tanzanian emergency medicine physicians using the ADDIE instructional design framework to transparently link needs assessment to role-adapted objectives, learning activities, and evaluation.

Methods: A mixed-methods design was applied, combining pre-training surveys, post-training assessments, and thematic feedback analysis. The program, conducted on 21-22 November 2024 at the Urla International Emergency Disaster Training and Simulation Centre, followed the ADDIE model (Analysis, Design, Development, Implementation, Evaluation). Twenty Tanzanian physicians (mean age 35.9 years, 60% female, mean experience 8.2 years) participated. Participants were grouped as Emergency Medicine Specialists/Medical Officers (n=8) and General Practitioners/Resident Physicians (n=12), with tailored objectives focusing on leadership, teamwork, disaster planning, and trainer skills.

Results: Participants achieved a mean post-training MCQ score of 17.68 out of 20, corresponding to an overall correct response rate of 88.4%. Scenario-based and interactive learning methods were highly valued, while insufficient training duration and limited technical infrastructure were identified as challenges. Emergency medicine specialists prioritized leadership and coordination skills, whereas general practitioners and residents emphasized educational strategies and program development.The program was feasible and well received, and participants achieved high immediate post-course knowledge scores and reported strong perceived value of scenario-based and trainer-focused learning activities. The findings support role-adapted ToT models for physicians; however, objective measurement of educator and leadership competencies and follow-up assessment of cascade training implementation are needed to determine sustained trainer development.

Very short answer questions (VSAQs) have gained attention for their superior psychometric properties compared to multiple-choice questions (MCQs). While VSAQs require knowledge recall, MCQs primarily involve knowledge recognition. This difference in cognitive processes may lead to varying cognitive workloads, defined as the amount of mental processing in working memory. Previous studies have not demonstrated consistent differences, likely due to reliance on self-reported measures. Eye tracking provides objective, process-level indicators of cognitive workload. This study investigated whether answering VSAQs requires a higher cognitive workload than answering MCQs. In a within-subject randomized crossover experiment, sixth-year medical students answered both VSAQs and MCQs. Cognitive workload was measured using screen-based eye tracking, focusing on the number of fixations and revisitations as objective indicators of mental effort. Data were analyzed using mixed-effects models. Thirty-four medical students participated, yielding 1,326 observations, which is the multiplication of the number of students by the number of questions (39 questions). Mixed-effects models showed a significant effect of question type on both workload indicators: VSAQs elicited more fixations and revisitations than MCQs (β_std = 0.30-0.39, p < .001). This effect remained after controlling for accuracy. Incorrect answers were associated with higher workload (β_std = -0.15--0.16, p < .01). Heatmaps confirmed these findings, showing denser fixations on key diagnostic features for VSAQs and on answer options for MCQs. Answering VSAQs imposed a higher cognitive workload than MCQs. The presence of answer options in MCQs may reduce workload by providing unintentional cues, while VSAQs require active retrieval. Eye tracking proved valuable for distinguishing cognitive workload across assessment formats.

Objectives: Despite increasing emphasis on clinical research ethics and quality assurance, Good Clinical Practice (GCP) training remains inadequately incorporated into postgraduate medical education. This qualitative study investigates postgraduate medical students' experiences with GCP education, exploring their learning outcomes, professional identity development, and suggestions for curriculum enhancement.

Methods: This qualitative study recruited twelve first-year postgraduate students participating in a newly established GCP elective course at a Chinese medical university. Semi-structured interviews were performed and analysed using Systematic Text Condensation. The data were interpretation employed a competency-based medical education (CBME) framework, specifically examining the aspects of role formation and contextual learning aspects.

Results: Five interrelated themes emerged from the analysis: (1) prior exposure to and foundational understanding of clinical trials; (2) motivations for enrolling in the GCP course enrolment, encompassing knowledge acquisition, practical application, and career planning; (3) evolving awareness of ethical, legal, and professional responsibilities through GCP training; (4) holistic professional development through GCP education; and (5) student recommendations for improving the practical relevance and key interested parties engagement in GCP courses. Participants universally acknowledged the value of GCP education for their future roles as clinician-investigators. However, fragmented prior knowledge and limited early exposure hindered their initial engagement. The course stimulated profound reflection on ethical responsibility and professional identity formation. Students consistently advocated for more competency-based, practice-oriented learning opportunities to better align theoretical knowledge with the practical demands of clinical research.

Conclusion: This study underscores the pressing need to integrate GCP education within structured, competency-based medical curriculum. By aligning course design with learners' emerging professional needs and addressing current implementation limitations, GCP training can more effectively support the development of ethically responsible physician-investigators.

While discrete choice experiments (DCE), have increasingly been used in the medical literature, little is known about the use of these methods for eliciting preferences from and about students and trainees in health professions. The objectives of this scoping review are to (1) describe the extent to which DCEs have been used in health professions' education, (2) identify which health professionals have been studied, and (3) identify thematic areas of research in which these methods have been used thematic areas. Between June and September 2024, we conducted a scoping review of the PubMed/Medline, EconLit, Web of Science, and Global Index Medicus databases to identify articles. Studies were eligible for inclusion in this review if they included a health profession training population and if conjoint analysis, DCE, or best-worst scaling studies were used. Forty-nine articles, comprising 60 studies and 21,731 health profession trainees, were included in this review. Medical and nursing students constitute the majority of the population studied. The greatest number of studies have been conducted in China (n = 11) and the United States (n = 8). The two most popular thematic areas in which these studies have been used are to identify preferences for policies and incentives to take a job in a rural area and residency training preferences for medical students. There has been a gradual increase in the use of these methods in the health profession education literature. The extent to which findings have been used for curriculum or policy design is not clear. DCEs are increasingly used to study health profession students and other trainees. More research is needed to explore the validity of preferences and whether preferences correlate with student outcomes or observed behavior.

As health systems science has become the third pillar of medical education (along with basic and clinical sciences), Thailand has been developing medical curricula to focus more on its health systems. Despite primary care being the driving force of Thailand's health systems, their integration into the curricula remains a challenge, resulting in medical students having limited exposure and understanding. To address this, a course was co-created by stakeholders to provide students with early exposure to and understanding of primary care mechanisms. Forty-one first- and second-year medical students designed their learning experience with faculty staff and hospital directors based on excursions at four community hospitals. The course included interactive lectures, a one-week excursion and knowledge-sharing sessions. The authors assessed the course's effectiveness using mixed methods: pre- and post-tests on health system concepts and reflective writings after completion of the course. The authors analysed the test scores through descriptive statistics and the writings through thematic analysis. The co-creation process was evaluated with focus group discussions among all stakeholders and visualised using a casual loop diagram (CLD). The test results showed an increase in the knowledge and understanding of primary care in health systems after the course. The reflective writings on encountering contextualised health challenges revealed an understanding of the importance of primary care and community engagement strategies; the emerging themes were the students' learning motivation as future physicians, interest in systems thinking and understanding of leadership in healthcare. The CLD revealed how co-creation, real-world exposure, reflective practice and faculty facilitation interacted to build student ownership, transformative learning and self-efficacy through reinforcing feedback loops. This study reveals how health systems, especially on a primary care level, can be effectively taught through engaging students in course co-creation. Fostering transformative learning is a starting point towards a socially accountable medical school.

Background: Orthopaedics is a highly specialized discipline characterized by complex theoretical frameworks and extensive knowledge, posing challenges for postgraduate teaching. With the advancement of educational technology, micro-lectures have been increasingly adopted in medical education. However, their isolated use may be insufficient to sustain student engagement or ensure effective learning. The bridge-in, learning objective, pre-test, participatory learning, post-assessment, and summary (BOPPPS) teaching model, which emphasizes the closed-loop management of student participation and teaching feedback, may address these limitations.

Objective: This study aims to develop and evaluate a BOPPPS-based micro-lecture teaching system for orthopaedic postgraduates, to improve teaching quality, enhance students' clinical competencies, and provide evidence-based insights for teaching reform.

Methods: Forty-eight first-year surgical postgraduates in a residency program were randomly divided into experimental and control groups (n = 24 per group). The experimental group received micro-lecture instruction integrated within the BOPPPS framework, while the control group received ordinary teaching. Both groups were assessed using the Mini-Clinical Evaluation Exercise and Direct Observation of Procedural Skills after clinical training. A questionnaire survey was conducted to gauge students' satisfaction with the BOPPPS-based micro-lectures.

Results: The experimental group showed significantly better clinical diagnostic and treatment abilities than the control group across most domains (p < 0.007). No significant differences were identified in humanistic care (p = 0.015), providing detailed information and informed consent (p = 0.190), or communication skills with patients (p = 0.209) after Bonferroni correction. Performance in preoperative preparation reached the threshold of significance (p = 0.005). The experimental group outperformed the control group in eight other clinical practice indicators (p < 0.005).

The Single Accreditation System (SAS) unified graduate medical education (GME) accreditation for allopathic (MD) and osteopathic (DO) programs under the Accreditation Council for Graduate Medical Education (ACGME). Implemented between 2015 and 2020, it aimed to expand access and standardize residency training across degree types. While the SAS succeeded in expanding opportunities for DO graduates in certain specialties, particularly family medicine and pathology, persistent disparities remain across competitive medical and surgical fields. Specialty-specific analyses reveal that DO applicants continue to face significant barriers in dermatology, ophthalmology, plastic surgery, neurosurgery, and orthopedic surgery, with disproportionately lower match rates and limited representation in top-tier residency programs. Structural challenges including the closure of many osteopathic-led programs, limited access to research mentorship, and degree-based bias among residency programs have exacerbated these disparities. Although Osteopathic Recognition and initiatives such as the Pathologist Pipeline have helped support osteopathic participation in select areas, broader reforms are needed to fulfill the original goals of the SAS. Enhancing academic partnerships, expanding research infrastructure, addressing implicit biases, and fostering DO leadership within academic medicine are critical steps toward ensuring equitable residency access for all graduates. Continued monitoring of match trends and specialty-specific outcomes will be essential to assessing the SAS's long-term impact on healthcare workforce diversity and equity.