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This study aims to understand the perspectives of surgeons and trainees on intraoperative surgical education, identifying perceived barriers and facilitators. Surgical training is shifting towards competency-based medical education (CBME) with the goal of graduating measurably competent surgeons. Despite this, concerns remain that trainees lack the clinical exposure to develop surgical competency. Understanding surgeon and trainee perspectives on intraoperative education can help identify current issues and provide direction for improving surgical training. A systematic review and meta-synthesis of qualitative studies that assess surgeon and trainee perspectives of intraoperative education was performed. 11,287 papers were screened, and 60 met the inclusion criteria, representing the perspectives of 1592 surgeons and trainees. Three major themes emerged that emphasised (1) the importance of developing trust, (2) the key qualities of effective surgeon educators, and (3) the impact of financial incentives, medico-legal concerns and educational support in the educational environment. This review provides a framework to understand intraoperative education and identifies key facilitators and barriers for surgeons, trainees and training programs.

Students who are enrolled in MD-PhD training programs face the same stressors and adverse experiences as medical students and graduate students and, additionally, have challenges unique to the dual-degree curriculum. These future physician-scientists can benefit from tailored training to help them manage these challenges. Thus, students in the Medical Scientist Training Program (MSTP) at Virginia Commonwealth University developed and implemented a student-led, administration-supported Wellness Initiative specifically for these trainees. The initiative has four aims designed to improve students' wellbeing in all major aspects of their lives and to shift the culture of the MSTP to one with a greater focus on holistic wellness. The aims are achieved with four practical components: monthly wellness programming, a peer mentorship program, annual wellness goals for students, and a wellness resource guide. Together, these components help students build their social support network, facilitate vertical transmission of institutional and local knowledge, offer intentional check-ins that encourage students to seek help whenever needed, and encourage wellness and resiliency education that will aid students throughout their careers. Since its inception in 2019, student involvement in the wellness initiative has steadily increased, with promising annual program data suggesting that it has positively impacted our MSTP students and program culture. The success of the initiative is further reinforced by positive messaging and financial support from MSTP leadership. Student leaders within the initiative continue to innovate, ensuring the initiative remains flexible enough to meet new challenges within the MD-PhD training environment as they arise. The VCU MSTP Wellness Initiative, described herein as a framework for other institutions, is the first published model of a comprehensive wellness program specifically designed to address the unique needs of physician-scientist trainees.

Objectives: With the health impacts of climate change becoming increasingly evident, there is a pressing need to prepare and educate future physicians to address these challenges. This study therefore aims to explore in depth the perspectives of final-year medical students (FYMS) on the integration of Planetary Health Education (PHE) into medical curricula (i.e. content, methods, exams). Additionally, it seeks to understand how FYMS perceive the relevance of this topic to their future profession and their perceived responsibility.

Methods: FYMS at the Heidelberg University Hospital were invited to participate in this qualitative interview study, resulting in 10 interviews conducted between December 2021 and March 2022. Using a semi-structured guide, students' views on the role of climate change in their future profession and their preferences for integrating climate change into medical curricula were explored. Interviews were audio-recorded and transcribed verbatim. Data analysis followed a structuring qualitative content analysis approach according to Kuckartz, utilizing deductive and inductive methods. Coding was performed using MAXQDA24, with iterative revisions by the authors.

Results: Participating FYMS recognized the relevance of climate change to their future practice but expressed varying degrees of perceived responsibility in addressing it with patients, e.g. depending on their desired specialization. While often struggling to identify specific content for a PHE-curriculum, FYMS emphasized the wish for knowledge on health impacts of climate change, communication skills and interactive, practice-oriented teaching methods. FYMS also reported several reservations and perceived challenges, e.g. concerning the integration of basic climate science or the introduction of mandatory exams.

Conclusion: This study provides unique insights into FYMS' perceptions of PHE, emphasizing the importance of integrating climate change and health topics into medical curricula and revealing perceived limitations. By aligning educational approaches with students' preferences and especially their concerns, appealing curricula can ultimately foster a more climate-sensitive medical practice.

By adopting a holistic perspective that looks 'upstream' at the underlying determinants of health, physicians can develop more effective strategies for promoting wellness and reducing health inequities in an increasingly diverse and complex society. Public health focuses on disease prevention and promotion of health through organized efforts by individuals and society. Population health focuses on the health outcomes of a group of individuals. We designed the Clinical Public Health curriculum, a pedagogical framework designed at the George Washington University School of Medicine & Health Sciences that breaks down traditional silos between didactic public and population health teaching, patient care and community engagement for medical students. It aims to train socially accountable clinician-citizens through an integrated, longitudinal curriculum across the four years of medical school. In this article we describe one aspect of the curriculum - four self-contained 'summits' - which can be used as a template for others seeking to develop a curriculum focusing on social accountability and engagement with community and governmental partners. During these multi-day applied educational experiences, medical students engage with key stakeholders, community members, community-based organizations, and state and national agencies to develop innovative approaches to engage in advocacy and population health. Enhanced medical school curricula focusing on the development of socially accountable clinician-citizens is an urgent need to develop more meaningful clinical-community interventions, support professional development, put context on the impact of health-related social needs on patients and families, and transform healthcare delivery and policy through greater community connection and advocacy.

The remote Objective Structured Clinical Examination (OSCE) is a cornerstone of medical education, enabling structured and objective assessment of clinical skills, communication, and patient-centered care. However, its widespread adoption has introduced challenges related to cost-effectiveness and efficient use of rater resources. Traditional double scoring (DS) ensures reliability but is labor-intensive and costly, especially in large-scale assessments. To address these challenges, this study introduces Targeted Double Scoring (TDS), a novel methodology that selectively applies DS to specific score ranges, particularly those near the pass/fail threshold. The study was conducted using data from a pilot remote OSCE administered to 550 clinical medicine undergraduates in China. The OSCE consisted of three stations: Clinical Reasoning (CR), Physical Examination (PE), and Fundamental Skills (FS). Each station was scored remotely by two raters, with a cut-off score of 60 out of 100. The TDS methodology was modeled based on the OSCE's DS design and fitted with scoring data. A decision-theoretic approach identified optimal Critical Score Ranges (CSRs) for targeted double scoring, balancing reliability and cost-effectiveness. The findings show that TDS significantly reduces rater workload and costs while maintaining high reliability and fairness. For instance, TDS achieved up to 70% cost savings compared to traditional DS under certain configurations. The study also highlights the flexibility of TDS, which can be tailored to different OSCE designs and scoring rubrics. These results have broad implications for medical education, especially in resource-constrained settings where optimizing assessment efficiency is critical. This study provides a practical solution to the cost-related challenges of remote OSCEs and offers a framework for adopting TDS in assessments. By focusing raters on critical score ranges, TDS maintains rigorous and fair evaluations without overburdening faculty or exceeding budgets. Future research should explore TDS scalability and its integration with emerging technologies like artificial intelligence to enhance efficiency and reliability.

Medical school can be a difficult and emotionally turbulent experience for students. Test anxiety is very common among medical students and may impact their academic performance. However, there is a lack of qualitative studies on test anxiety and emotion regulation in relation to the academic performance of medical students. This study aims to examine the relationship between test anxiety and academic performance among medical students, exploring the role of emotion regulation and coping strategies in managing test anxiety during examinations. The study involved 22 medical students from one Saudi medical school who participated in semi-structured interviews. The interviews were recorded and transcribed verbatim. A thematic analysis was conducted on the transcribed data, resulting in the identification of four key themes. The emerging themes are test anxiety, academic performance, emotion regulation, and other coping strategies. Students' anxiety can vary from a source of motivation to a severe obstacle. It impacts their theoretical understanding, practical abilities, and the evaluation criteria used to assess academic achievement. However, some students use both adaptive and maladaptive emotion regulation strategies. Promoting emotion regulation and various coping mechanisms to address test anxiety in medical students is essential to enhance their academic performance and prepare them for future healthcare professions.

Simulation training aims to increase exposure to high-stakes low-frequency events like cardiac arrest. However, within our laboratory-based simulation program, we have observed limited buy-in from internal medicine (IM) residents due to competing patient care obligations and a limited fidelity environment. Mirroring patient data within in situ simulation may provide relevance to ongoing resident patient care obligations, increasing buy-in and confidence in management. Clinical data from presently admitted patients in our institution's medical intensive care unit (MICU) was 'mirrored' to create cardiac arrest simulations. Simulations took place in a vacant MICU patient room with resuscitation equipment, including a code cart, saline-substituted medications, and a mannequin capable of endotracheal intubation. The trainee team consisted of one post-graduate year (PGY) 3 IM resident, two PGY-1 residents, and a critical care fellow. A pre- and post-survey was administered to the PGY-3 IM resident to assess confidence in performing technical and non-technical skills. An advanced cardiac life support (ACLS) instructor evaluated PGY-3 IM resident performance using a skills checklist. Eighty-three percent of PGY 3 residents endorsed changes to their practice following the simulation. Confidence increased in skills related to flexible decision-making skills but not for fixed skills such as following ACLS protocol. Qualitative feedback highlighted realism, spontaneity, and debriefing sessions as the most valuable aspects of the program. In situ mirror simulation may be a useful adjunct for IM residency programs suffering similar concerns with learner motivation during laboratory simulation.

Medical educators are increasingly expected to engage in impactful scholarship. However, many struggle to progress beyond isolated studies toward developing cohesive, sustainable programs of research that establish scholarly identity and contribute meaningfully to the field. Although literature exists on faculty development and individual research projects, comprehensive guidance for building a unified research trajectory in medical education remains limited. This narrative review aimed to identify and synthesize recommendations from the professional literature on developing a program of research in medical education. Searches of PubMed, MEDLINE, and Web of Science for English-language publications from January 2005 to April 2024 used terms such as 'medical education,' 'program of research,' and 'research productivity.' Twenty-five articles meeting inclusion criteria - including empirical studies, reviews, and perspectives offering practical guidance - were reviewed and analyzed thematically. Eight key strategies emerged for building a research program: (1) defining a focused program of research around core questions; (2) aligning research with institutional priorities to leverage support and resources; (3) grounding inquiries in theoretical and conceptual frameworks to enhance rigor; (4) transitioning from isolated studies to a cohesive research agenda; (5) identifying and securing resources, including mentorship and funding; (6) disseminating work strategically to maximize impact; (7) cultivating mentorship and collaborative networks; and (8) sustaining momentum while mitigating burnout risks. Despite these insights, significant gaps remain, including the lack of empirically tested frameworks specific to building programs of research in medical education and limited understanding of how these strategies apply across diverse institutional or cultural contexts. Developing a program of research in medical education requires deliberate focus, strategic alignment, and collaborative engagement. The synthesized recommendations offer practical pathways for educators aiming to enhance scholarly identity and productivity. Future research should explore the implementation and effectiveness of these strategies across varied settings to advance faculty development and the field's scholarly impact.

In 2019, the American Board of Internal Medicine (ABIM) changed procedural requirements for internal medicine (IM) residents, emphasizing that IM residents should 'have the opportunity to develop competence in procedures which will further their development as fellows in their chosen subspecialty'. While residents need to perform procedures, 'not all residents need to perform all procedures'. We sought to identify which procedures IM fellowship directors (FD) prefer graduating residents entering their fellowships have experience with and competence to perform. A total of (N = 1,463) FDs in the fifteen subspecialties of medicine were identified through the ACGME website and reached via email with a REDCap link to access the survey. The survey was developed amongst the primary authors and included demographic questions and a list of procedures. For each procedure listed, FDs were asked to indicate whether incoming fellows should have knowledge and understanding of, some experience but not competence in, or competence to perform the procedure. The survey also included Likert scale questions aimed at understanding FD attitudes regarding the value of learning procedures during IM training and a free text response soliciting their opinion on the ABIM change in procedure requirements. A total of 424 surveys were completed by FDs from the 15 ABIM subspecialties. Most of the FDs in 8 of 15 subspecialties indicated they preferred incoming fellows have competence in 1-10 (mean 5) of 19 procedures listed and these varied by specialty. One hundred free text responses were received and assigned to one or more themes. This survey can provide guidance to IM program directors and residents applying to subspecialties to tailor their procedural training to the specialty of their choosing.

Background: The practice of evidence-based medicine (EBM) has become pivotal in enhancing medical care and patient outcomes. With the diffusion of innovation in healthcare organizations, EBM can be expected to depend on medical professionals' competences with digital health (dHealth) and artificial intelligence (AI) technologies.

Objective: We aim to investigate the effect of dHealth competences and perceptions of AI on the adoption of EBM among prospective physicians. By focusing on dHealth and AI technologies, the study seeks to inform the redesign of medical curricula to better prepare students for the demands of evidence-based medical practice.

Methods: A cross-sectional survey was administered online to students at the University of Montreal's medical school, which has approximately 1,400 enrolled students. The survey included questions on students' dHealth competences, perceptions of AI, and their practice of EBM. Using structural equation modeling (SEM), we analyzed data from 177 respondents to test our research model.

Results: Our analysis indicates that medical students possess foundational knowledge competences of dHealth technologies and perceive AI to play an important role in the future of medicine. Yet, their experiential competences with dHealth technologies are limited. Our findings reveal that experiential dHealth competences are significantly related to the practice of EBM (β = 0.42, p < 0.001), as well as students' perceptions of the role of AI in the future of medicine (β = 0.39, p < 0.001), which, in turn, also affect EBM (β = 0.19, p < 0.05).

Conclusions: The study underscores the necessity of enhancing students' competences related to dHealth and considering their perceptions of the role of AI in the medical profession. In particular, the low levels of experiential dHealth competences highlight a promising starting point for training future physicians while simultaneously strengthening their practice of EBM. Accordingly, we suggest revising medical curricula to focus on providing students with practical experiences with dHealth and AI technologies.