Medical Education Online最新文献

Simulation-based learning (SBL) is effective for EKG interpretation training in the advanced cardiac life support (ACLS) context, enhancing motivation, confidence, and learning outcomes. However, research on the psychometrics of assessment rubrics for ACLS skills among pre-clinical students is limited. This study investigates the validity and reliability of assessment rubrics for ACLS skills, including EKG interpretation, scenario and pharmacological management, and teamwork. An SBL course that integrates basic EKG interpretation into ACLS Stations was conducted at Phramongkutklao College of Medicine, utilizing high-fidelity mannequins to simulate realistic scenarios, enrolling 96 medical students. The course consisted of five independent stations, and each student was assessed once by two raters using ten-item assessment rubrics. The rubrics included three domains: (1) EKG and ACLS algorithm skills, (2) management and mechanisms of action, and (3) affective domains. Validity evidence on the content was gathered, and construct validity was confirmed with confirmatory factor analysis (CFA). Inter-rater and internal consistency reliability were calculated. Generalizability theory was utilized to analyse the data. Three expert reviews yielded an item-objective congruence index of 0.67-1.00, with iterative validation through alpha and beta tests. The CFA demonstrated a good fit, but two questions with loading factors below 0.30 were removed, resulting in an eight-item assessment form. An inter-rater correlation of 0.70 (p < 0.001) and a Cronbach's alpha of 0.76 was demonstrated. To achieve a Phi-coefficient ≥0.80, three raters and at least 10 items are required in a p×i×r crossed design. With eight items, r:(p×i) nested design reliability was 0.69, 0.79, and 0.83 for one, two, and three raters, respectively. While a single rater with 10 items achieved a Phi-coefficient of 0.74. The rubrics for assessing ACLS skills among pre-clinical students demonstrated acceptable validity and reliability. A condensed eight-item rubric with acceptable reliability is proposed as a practical tool for optimizing assessment in future evaluations relevant to the pre-clinical context.

Background: Social media use in medical education has surged, with YouTube and Facebook leading before COVID-19. Recently, TikTok has drawn young learners, expanding access but often lacking alignment with formal curricula and quality standards.

Objectives: This study aims to analyze the quality of academic medical content on TikTok within the Latin American context, focusing on the most-viewed Spanish-language accounts.

Materials and methods: This cross-sectional study analyzed medical education microvideos on TikTok through a systematic search conducted on 1 March 2024, using the keywords 'medical education' and 'medical review.' The search yielded 300 microvideos, from which the 100 most-viewed were selected. The 13 most popular accounts were identified, and their top three most-viewed microvideos were analyzed, resulting in a final sample of 39 microvideos. Popularity was measured through views, likes, and the Viewability Index (VPI), while educational quality was assessed using the JAMA Benchmark Criteria, which evaluates authorship, attribution, disclosure, and validity.

Results: The majority of accounts (69.2%) were male-created, with 30.8% based in Mexico and Peru. Physicians comprised 53.8% of content creators, followed by medical students (23.1%). General medical education was the main focus (69.2%), with general medicine as the most common topic (76.9%). The dataset included 39 microvideos, averaging 1,653,677 views, and #medicina was the most frequently used hashtag. Popularity metrics strongly correlated with engagement metrics (comments, shares) but weakly with favorites. Educational quality scores were low, with only two accounts scoring 1 out of 4 points on the JAMA Benchmark.

Conclusion: TikTok's engagement metrics amplify popular medical microvideos among Spanish-speaking users but do not reliably reflect educational quality, raising concerns about misinformation. 'Favorites' may serve as a more accurate indicator of perceived informational value. Standardized assessment tools should incorporate both engagement and quality metrics to improve content reliability and accessibility to evidence-based medical information.

Enhancing clinical competence in postgraduate year (PGY) trainees is crucial for effective patient care, especially in emergency medicine. This study investigated the impact of a well-designed, group-developed, peer-assessed learning approach combined with high-fidelity simulations on clinical skills and teamwork of PGY trainees. PGY trainees participated in a one-month program featuring team development, clinical training, scenario design, simulation, peer-assisted debriefing, and post-course evaluations at one week and three months. Trainees were divided into two groups, engaged in clinical practice, group discussions, and developed critical scenarios under mentor guidance to challenge the other group. Teamwork performance was assessed using the TEAM scale, Ottawa Global Rating Scale, and reflective essays. Follow-up evaluations employed the PGY Clinical Proficiency Evaluation scale. Trainees identified deficiencies in situation monitoring and maintaining composure, noting difficulties in effectively monitoring and reassessing situations. Despite having passed ACLS training, participants recognized their lack of clinical experience in managing critically ill patients, handling dynamic situations, low self-confidence, and limited leadership opportunities in resuscitation teams. However, team morale was high, and performance in communication and leadership was relatively strong due to the similar hierarchical levels of the trainees and initial team dynamics established during their training. Follow-up questionnaires indicated significant improvements in clinical confidence, reasoning abilities, familiarity with ACLS resuscitation guidelines, and team dynamics across various subspecialty training areas. The integration of peer-assisted learning with high-fidelity simulation significantly enhanced clinical competence, teamwork, and confidence in PGY trainees. This innovative approach provides a structured, supportive learning environment that effectively prepares trainees for real-world clinical challenges. Future research should explore long-term outcomes and broader applications of this method.

Although the number of female medical school students is increasing, there is an imbalance regarding women in neurosurgery. In addition, a huge gender gap concerning leading positions as well as scientific careers exists. We performed a questionnaire-based data assessment of former and current neurosurgical residents, medical school students in their final and medical school students in their first year. The questionnaire assessed reasons for resigning from the residency program as well as possible discrimination or gender-specific disadvantages which prevent medical school students from choosing a surgical speciality. We found that significantly more (p = 0.05) female residents left neurosurgical training and indicated gender-based inequalities during the program (p < 0.001). Significantly fewer final-year students would choose a surgical career compared to first-year medical students (p < 0.001). The main reasons against neurosurgical training were poor work-life balance, psychological stress and difficulties in family/child care. Women must continue to be supported to pursue surgical and scientific careers.

The medical learning environment (MLE) exerted a profound influence on students' physical, psychological, and professional development. University prestige and ranking significantly shape students' self-perception and self-esteem. Nevertheless, the relationship between university category and MLE perception remained unexplored. Our study collected 10,901 questionnaires from 12 universities, spanning six categories. John Hopkins Learning Environment Scale (JHLES) was administrated to assess MLE perceptions. Utilizing a cross-sectional design, we categorized participants into high or low JHLES groups. Next, we conducted Chi-square and parametric or non-parametric tests to analyze the relationship between perception of MLE and university category. Subsequently, we performed a multivariate logistic regression and developed a nomogram to predict the likelihood of low JHLES scores. And the model performance was assessed through receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration curves. Our study revealed a significant association between university category and MLE perception. Specifically, students from top-tier universities were prone to negative MLE perceptions. Through multivariate logistic regression analysis, we validated university category as an influencing factor (p < 0.001). Moreover, our nomogram demonstrated reliability and consistency in predicting students' MLE perspectives. The university category emerged as a predictor for perception of MLE. Students from prestigious institutions manifested an increased likelihood of negative MLE perceptions.

In this review, we gathered information about competency-based admissions and holistic admissions related to healthcare education to understand current practices better and offer recommendations within the healthcare education field. A literature search was conducted to gather peer-reviewed articles detailing information related to competency-based admissions and holistic admissions that have been implemented in healthcare education, including medical schools, nursing schools, dental schools, and other allied health fields. After screening and the addition of articles through ancestral search, 166 articles were included in this systematic review. The articles were coded for information related to definitions of competency-based admissions and holistic admissions, specific desired competencies, procedures to evaluate these competencies, outcomes of these practices, and the success of admitting well-prepared students using these practices. Results show there is wide variation in established definitions and desired competencies. Similarly, there was some variation in methods for evaluating these competencies with some common practices identified. Lastly, little evidence demonstrates the effectiveness of admitting students who are well-prepared for their programs when competency-based or holistic admissions are employed. There is a need for future research to establish a standard definition for both competency-based admissions and holistic admissions. Desired competencies should be established based on the program's mission and vision statements for what type of students they want to admit. Lastly, future research needs to focus on the long-term outcomes of implementing these practices.

Simulation provides an environment in which students can work beyond their competence. Thus even junior medical students can 'step into the role of a doctor'; to explore and gain more insight into their future role. Role-playing as doctor in a simulated environment has shown to be of value for final-year students, but this has not been studied with third-year students, who may struggle to be active participants in the clinical environment. This research used instrumental case study methodology to explore the educational value of third-year students 'stepping into' the doctor-role in a General Practice clinic simulation. Data was gathered via twenty-four interviews with students and tutors, observations and an online student survey. The value of stepping into the role of doctor centered around the experience of responsibility and was associated with feelings of agency; thinking differently with more focus on management and decision-making; insight into, and preparation for, the role of a practitioner, including working with uncertainty. Most students took part in the exercise of adopting the 'doctor' role; student buy-in was dependent upon explicit discussion of the challenge, feelings of authenticity and negotiation of concerns. GP tutors facilitating the clinic played a key role in establishing psychological safety and negotiating student concerns. Stepping into the role of doctor is a valuable exercise for junior medical students as it can provide an authentic experience of clinical responsibility that is not available in the clinical setting; and presents an opportunity to deepen student understanding of the practitioner role.

Simulation-based education in medicine (SBME) constitutes a notable paradigm shift in teaching methodologies. Utilizing simulation involves replicating authentic patient experiences and enabling learners to develop skills and practice without putting patients at risk. Despite its growing popularity, limited data are currently available on the perceived value and impact of SBME in oncology. To bridge this gap, this paper presents a bibliometric analysis that maps the global implications and potential future directions of SBME in the field of oncology.Publication trends on SBME were retrospectively analyzed during the period from January 2010 to April 2024, using a number of bibliometric parameters based on the PubMed database and other resources (SpringerLink, Google Scholar, EM-Consulte, and ScienceDirect).A total of 428 publications related to simulation in oncology were identified and included in the bibliometric analysis. The United States of America (USA) was the clear leader, with the largest number of papers (164, 38.3%). Original articles (357, 83.4%) dominated the publications. The majority of the articles (413, 96.5%) were published in the English language. The articles were published in the fields of surgical oncology (165, 38.6%), medical oncology (130, 30.4%), and radiation oncology (77, 18.0%). Additionally, most of the publications were covered by the PubMed and Web of Science core collections. Importantly, articles were frequently published in influential journals, with 232 journals selected and a median impact factor of 2.6 [0.3-81.1]. Besides, the median H-index of authors was 10, the median i-10 index was 12, and the highest number of publications by an author was 3.SBME serves as an essential learning tool in oncology sciences across different domains, such as formation curricula, continued education, and recertification. SBME has the ability to teach technical, procedural, and communication skills. The future research prospects involve the broad incorporation of high technology and innovative simulation methods in oncology fields.

Simulation-based education has become essential for pre- and post-graduate training of healthcare professionals. However, there is no tool to help simulation educators or program managers in assessing the educational quality of simulation scenario scripts for team-based immersive simulation (IS), simulated participants (SP) and procedural simulation (PS). To that end, we developed the Quality Assessment of Simulation Scenario in Healthcare (QASSH) tool. This study aims at providing validity evidence for QASSH. We set up a francophone group of experts within the French-speaking Society for Simulation in Healthcare (SoFraSimS) network and designed this scale based on recently published best practices and our long experience in conceiving simulation scenarios. We tested it by submitting three scenarios of high, borderline and low quality for assessment to a group of experts, a third of which were involved in its development. Analysis of reliability and validity of the QASSH was done using the Standards for educational and psychological testing. Generalizability theory (GT) was used to assess the internal structure and reliability of the tool. The absolute reliability coefficients (G coefficients) calculated through GT were: 0.97 (IS), 0.96 (SP), and 0.98 (PS). G-facet analyses showed that no removal of a single item of QASSH significantly increased the G coefficient above 0.01 for any of the three variants. Cronbach's alpha coefficients were 0.94 (IS), 0.94 (SP) and 0.97 (PS). Estimating the impact of the number of raters on reliability (i.e. D-studies) showed that two raters were enough to achieve a G coefficient above 0.85. The G study shows a high generalizability coefficient (≥0.90), which demonstrates high reliability. The response process evidence for validity provides evidence that no error was associated with using the instrument and its reliability was high with two raters. The QASSH is a tool to assess the quality of healthcare simulation scenarios and will be helpful to instructors wishing to build effective IS, PS and SPs scenarios.

To determine the optimal length of video-based lectures for undergraduate medical students in a flipped classroom environment and evaluate the effect of their length on student engagement outcomes. Using an observational cohort study, 152 students (male = 38 and female = 114) viewed 173 videos focused on teaching Neurosurgery over three consecutive academic years. Each course consisted of 11 topics divided into a variable number of clips. Materials, methodology, and instructors remained constant throughout the study period. All students enrolled in the subject were invited to register on the online platform hosting the videos voluntarily. Data on course variables, video-based lecture characteristics, and six student engagement outcomes were analyzed. Videos under 5 minutes in length were associated with higher audience retention and higher response rates to embedded questions in the univariable analysis (p = 0.039 and p = 0.045, respectively). The viewing index, which can be equated to cumulative views, was also higher for videos under 5 minutes after multiple regression analysis (p = 0.049). Videos released earlier in the course and those related to a seminar session (with mandatory homework and class attendance) had significantly higher percentages of video viewing, viewing index, and response rate to embedded questions but lower non-access rates. In addition, earlier videos retained more audience (p = 0.036). This study provides new insights by analyzing the interaction between video duration and various engagement metrics, highlighting the importance of instructional design in flipped learning environments. The findings support the recommendation that video length should be under 5 minutes. However, this is not the only determining factor; the timing of the video release and the seminar structure can also play a crucial role. Other unmeasured classroom dynamics need to be considered for further studies that should explore these interactions in more depth.