Pub Date : 2024-09-16DOI: 10.1101/2024.09.16.24313727
BEATRIZ RODRIGUEZ-MARTIN, RUBEN MIRON-GONZALEZ, MARIA DEL CARMEN ZABALA-BANOS, Montserrat Pulido-Fuentes, Esmeralda Santacruz-Salas, Carlos A Castillo-Sarmiento
There is little research on teachers' perceptions of the use of Virtual Learning Environments (VLEs) in undergraduate nursing education. The aim of this study was to understand teachers' perceptions of the barriers and facilitators for the implementation of wiki- and blog-based VLEs as tools to improve collaborative learning. A qualitative action-research study in an intentional opinion-intensity sample of teachers on the Bachelor of Nursing degree course was used. The data were collected and analysed according to the SWOT approach, the constant comparison method, and the coding process. The analysis highlighted weaknesses (e.g., limited audio-visual communication and feedback, privacy concerns), threats (e.g., training, pre-planning, and time cost), strengths (e.g., being intuitive, friendly and accessible, creating shared knowledge) and opportunities (e.g., improving technological skills, teaching innovation, evaluation and peer learning) for the incorporation of VLEs to promote collaborative learning in nursing training. Although both our study and the existing literature on the subject show many advantages that encourage the implementation of VLEs in nursing training, the barriers described in this paper cannot be ignored in the context in which the university currently finds itself. These barriers and facilitators to implementing VLEs in nursing training will be of interest to educational authorities.
{"title":"Barriers and facilitators for the implementation of wiki- and blog-based Virtual Learning Environments as tools for improving collaborative learning in the Bachelor of Nursing degree.","authors":"BEATRIZ RODRIGUEZ-MARTIN, RUBEN MIRON-GONZALEZ, MARIA DEL CARMEN ZABALA-BANOS, Montserrat Pulido-Fuentes, Esmeralda Santacruz-Salas, Carlos A Castillo-Sarmiento","doi":"10.1101/2024.09.16.24313727","DOIUrl":"https://doi.org/10.1101/2024.09.16.24313727","url":null,"abstract":"There is little research on teachers' perceptions of the use of Virtual Learning Environments (VLEs) in undergraduate nursing education. The aim of this study was to understand teachers' perceptions of the barriers and facilitators for the implementation of wiki- and blog-based VLEs as tools to improve collaborative learning.\u0000A qualitative action-research study in an intentional opinion-intensity sample of teachers on the Bachelor of Nursing degree course was used. The data were collected and analysed according to the SWOT approach, the constant comparison method, and the coding process.\u0000The analysis highlighted weaknesses (e.g., limited audio-visual communication and feedback, privacy concerns), threats (e.g., training, pre-planning, and time cost), strengths (e.g., being intuitive, friendly and accessible, creating shared knowledge) and opportunities (e.g., improving technological skills, teaching innovation, evaluation and peer learning) for the incorporation of VLEs to promote collaborative learning in nursing training.\u0000Although both our study and the existing literature on the subject show many advantages that encourage the implementation of VLEs in nursing training, the barriers described in this paper cannot be ignored in the context in which the university currently finds itself.\u0000These barriers and facilitators to implementing VLEs in nursing training will be of interest to educational authorities.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-22DOI: 10.1101/2024.08.22.24312406
Alberto Rubio-Lopez, Rodrigo García Carmona, Laura Zarandieta Román, Alejandro Rubio-Navas, Ángel González Pinto, Pablo Cardinal-Fernández
Background: As medical education evolves, innovative methods like virtual reality (VR) and 3D-printed mannequins are increasingly used to simulate high-stress medical scenarios realistically. This study investigates the effectiveness of VR and 3D-printed mannequins in replicating stress levels during pericardiocentesis training, comparing their impact on the emotional and physiological responses of learners. Methods: We enrolled 108 final-year medical students who were randomized to train with both VR and 3D-printed mannequins. Heart rate variability (HRV) analysis was employed to assess stress responses. Additionally, a secondary analysis examined the influence of demographic factors, lifestyle, medication use, and academic stress on these responses. Results: Both VR and traditional mannequin-based training methods proved equally effective in simulating the stress levels encountered in real medical procedures. Our findings indicate significant interactions between stress markers and demographic factors, which highlights the complex nature of stress responses in medical education and underscores the necessity for personalized training approaches. Conclusion: The study validates the use of VR as a viable alternative to traditional mannequins, capable of simulating the technical skills and emotional pressures of medical procedures such as pericardiocentesis. Incorporating VR into medical training programs may enhance learning outcomes and accessibility, particularly in settings constrained by resources.
背景：随着医学教育的发展，虚拟现实（VR）和三维打印人体模型等创新方法越来越多地被用于真实模拟高压力医学场景。本研究调查了 VR 和 3D 打印人体模型在复制心包穿刺术培训过程中的压力水平方面的有效性，比较了它们对学习者情绪和生理反应的影响。培训方法我们招募了 108 名应届医科学生，随机让他们使用 VR 和 3D 打印人体模型进行培训。采用心率变异性（HRV）分析评估压力反应。此外，我们还对人口统计因素、生活方式、药物使用和学习压力对这些反应的影响进行了二次分析。研究结果在模拟真实医疗过程中遇到的压力水平方面，VR 和传统人体模型培训方法证明同样有效。我们的研究结果表明，压力标记与人口统计学因素之间存在明显的相互作用，这突出了医学教育中压力反应的复杂性，并强调了个性化培训方法的必要性。结论这项研究证实了使用 VR 替代传统人体模型是可行的，它能够模拟心包穿刺术等医疗程序中的技术技能和情绪压力。将虚拟现实技术融入医学培训项目可提高学习效果和可及性，尤其是在资源有限的情况下。
{"title":"Comparative Analysis of Stress Responses in Medical Students Using Virtual Reality Versus Traditional 3D-Printed Mannequins for Pericardiocentesis Training","authors":"Alberto Rubio-Lopez, Rodrigo García Carmona, Laura Zarandieta Román, Alejandro Rubio-Navas, Ángel González Pinto, Pablo Cardinal-Fernández","doi":"10.1101/2024.08.22.24312406","DOIUrl":"https://doi.org/10.1101/2024.08.22.24312406","url":null,"abstract":"Background: As medical education evolves, innovative methods like virtual reality (VR) and 3D-printed mannequins are increasingly used to simulate high-stress medical scenarios realistically. This study investigates the effectiveness of VR and 3D-printed mannequins in replicating stress levels during pericardiocentesis training, comparing their impact on the emotional and physiological responses of learners. Methods: We enrolled 108 final-year medical students who were randomized to train with both VR and 3D-printed mannequins. Heart rate variability (HRV) analysis was employed to assess stress responses. Additionally, a secondary analysis examined the influence of demographic factors, lifestyle, medication use, and academic stress on these responses. Results: Both VR and traditional mannequin-based training methods proved equally effective in simulating the stress levels encountered in real medical procedures. Our findings indicate significant interactions between stress markers and demographic factors, which highlights the complex nature of stress responses in medical education and underscores the necessity for personalized training approaches. Conclusion: The study validates the use of VR as a viable alternative to traditional mannequins, capable of simulating the technical skills and emotional pressures of medical procedures such as pericardiocentesis. Incorporating VR into medical training programs may enhance learning outcomes and accessibility, particularly in settings constrained by resources.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1101/2024.07.25.24311022
Duha Alkurdi, Shiva Rasouli, Bochen Jia
The integration of Artificial Intelligence (AI) into medical education has emerged as a transformative element in the modern healthcare educational system. With the exponential growth of medical knowledge and the increasing complexity of healthcare systems, AI offers innovative solutions to enhance learning outcomes, facilitate personalized education pathways, and improve clinical decision-making skills among medical professionals. This literature review explores the transformative role of AI in the training of healthcare providers, focusing on advancements in medical education, medical diagnostics, and emergency care training. Additionally, it addresses the readiness of healthcare professionals to employ AI technologies, analyzing their current knowledge, attitudes, and the training provided. By synthesizing findings from multiple studies, we aim to highlight AI's potential to enhance medical education, address challenges, and propose future directions for integrating AI into healthcare training.
{"title":"The Role of Artificial Intelligence in Modern Medical Education and Practice: A Systematic Literature Review","authors":"Duha Alkurdi, Shiva Rasouli, Bochen Jia","doi":"10.1101/2024.07.25.24311022","DOIUrl":"https://doi.org/10.1101/2024.07.25.24311022","url":null,"abstract":"The integration of Artificial Intelligence (AI) into medical education has emerged as a transformative element in the modern healthcare educational system. With the exponential growth of medical knowledge and the increasing complexity of healthcare systems, AI offers innovative solutions to enhance learning outcomes, facilitate personalized education pathways, and improve clinical decision-making skills among medical professionals. This literature review explores the transformative role of AI in the training of healthcare providers, focusing on advancements in medical education, medical diagnostics, and emergency care training. Additionally, it addresses the readiness of healthcare professionals to employ AI technologies, analyzing their current knowledge, attitudes, and the training provided. By synthesizing findings from multiple studies, we aim to highlight AI's potential to enhance medical education, address challenges, and propose future directions for integrating AI into healthcare training.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141778358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-24DOI: 10.1101/2024.07.23.24310890
Alexander Fidel, Mark V. Mai, Naveen Muthu, Adam C. Dziorny
Background Exposure to patients and clinical diagnoses drives learning in graduate medical education (GME). Measuring practice data, how trainees each experience that exposure, is critical to planned learning processes including assessment of trainee needs. We previously developed and validated an automated system to accurately identify resident provider-patient interactions (rPPIs). In this follow-up study, we employ user-centered design methods to meet two objectives: 1) understand trainees' planned learning needs; 2) design, build, and assess a usable, useful, and effective tool based on our automated rPPI system to meet these needs. Methods We collected data at two institutions new to the American Medical Association's "Advancing Change" initiative, using a mixed-methods approach with purposive sampling. First, interviews and formative prototype testing yielded qualitative data which we analyzed with several coding cycles. These qualitative methods illuminated the work domain, broke it into learning use cases, and identified design requirements. Two theoretical models-the Systems Engineering Initiative for Patient Safety (SEIPS) and Master-Adaptive Learner (MAL)-structured coding efforts. Feature-prioritization matrix analysis then transformed qualitative analysis outputs into actionable prototype elements that were refined through formative usability methods. Lastly, qualitative data from a summative usability test validated the final prototype with measures of usefulness, usability, and intent to use. Quantitative methods measured time on task and task completion rate. Results We represent GME work domain learnings through process-map-design artifacts which provide target opportunities for intervention. Of the identified decision-making opportunities, trainee-mentor meetings stood out as optimal for delivering reliable practice-area information. We designed a "mid-point" report for the use case of such meetings, integrating features from qualitative analysis and formative prototype testing into iterations of the prototype. A final version showed five essential visualizations. Usability testing resulted in high performance in subjective and objective metrics. Compared to currently available resources, our tool scored 50% higher in terms of Perceived Usability and 60% higher on Perceived Ease of Use. Conclusions We describe the multi-site development of a tool providing visualizations of log level electronic health record data, using human-centered design methods. Delivered at an identified point in graduate medical education, the tool is ideal for fostering the development of master adaptive learners. The resulting prototype is validated with high performance on a summative usability test. Additionally, the design, development, and assessment process may be applied to other tools and topics within medical education informatics.
{"title":"Precision Education Tools for Pediatrics Trainees: A Mixed-Methods Multi-Site Usability Assessment","authors":"Alexander Fidel, Mark V. Mai, Naveen Muthu, Adam C. Dziorny","doi":"10.1101/2024.07.23.24310890","DOIUrl":"https://doi.org/10.1101/2024.07.23.24310890","url":null,"abstract":"Background\u0000Exposure to patients and clinical diagnoses drives learning in graduate medical education (GME). Measuring practice data, how trainees each experience that exposure, is critical to planned learning processes including assessment of trainee needs. We previously developed and validated an automated system to accurately identify resident provider-patient interactions (rPPIs). In this follow-up study, we employ user-centered design methods to meet two objectives: 1) understand trainees' planned learning needs; 2) design, build, and assess a usable, useful, and effective tool based on our automated rPPI system to meet these needs.\u0000Methods\u0000We collected data at two institutions new to the American Medical Association's \"Advancing Change\" initiative, using a mixed-methods approach with purposive sampling. First, interviews and formative prototype testing yielded qualitative data which we analyzed with several coding cycles. These qualitative methods illuminated the work domain, broke it into learning use cases, and identified design requirements. Two theoretical models-the Systems Engineering Initiative for Patient Safety (SEIPS) and Master-Adaptive Learner (MAL)-structured coding efforts. Feature-prioritization matrix analysis then transformed qualitative analysis outputs into actionable prototype elements that were refined through formative usability methods. Lastly, qualitative data from a summative usability test validated the final prototype with measures of usefulness, usability, and intent to use. Quantitative methods measured time on task and task completion rate. Results\u0000We represent GME work domain learnings through process-map-design artifacts which provide target opportunities for intervention. Of the identified decision-making opportunities, trainee-mentor meetings stood out as optimal for delivering reliable practice-area information. We designed a \"mid-point\" report for the use case of such meetings, integrating features from qualitative analysis and formative prototype testing into iterations of the prototype. A final version showed five essential visualizations. Usability testing resulted in high performance in subjective and objective metrics. Compared to currently available resources, our tool scored 50% higher in terms of Perceived Usability and 60% higher on Perceived Ease of Use.\u0000Conclusions\u0000We describe the multi-site development of a tool providing visualizations of log level electronic health record data, using human-centered design methods. Delivered at an identified point in graduate medical education, the tool is ideal for fostering the development of master adaptive learners. The resulting prototype is validated with high performance on a summative usability test. Additionally, the design, development, and assessment process may be applied to other tools and topics within medical education informatics.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"133 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141778361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-11DOI: 10.1101/2024.07.10.24310250
Martina Ann Kelly, Stefanie Rivera, Caitlin McClurg, Catherine Sweeney, Stephen Mosca, Ellen McLeod, Deirdre Bennett, Megan Brown
Objective The objective of this review is to map, describe and conceptualize how silence is discussed within literature on interactions between physicians and patients, in clinical settings. Methods We will use the methodological framework of Arksey & O’Malley, adapted by Levac et al and Joanna Briggs Institute. Empirical studies including quantitative, qualitative, mixed methods, observational studies and reviews will be included. Commentaries, editorials, and grey literature will also be examined. The databases MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus and Web of Science will be searched. A two-part study selection strategy will be applied. First, reviewers will follow inclusion and exclusion criteria based on ‘Population-Concept-Context’ framework to independently screen titles and abstracts. Next, full texts will be screened. Data will be extracted, collated, and charted to summarize methods, outcomes and key findings from the articles included. Expected results and implications This scoping review will provide an extensive description of how physicians engage with silence in clinical settings. Findings will identify how silence is perceived in physician patient interactions, the roles it plays, what factors influence use of silence and guide development of educational initiatives on use of silence in clinical settings.
目的本综述旨在描绘、描述和概念化有关临床环境中医患互动的文献中如何讨论沉默的问题。方法我们将使用 Arksey & O'Malley 的方法论框架，该框架由 Levac 等人和 Joanna Briggs 研究所改编。实证研究包括定量、定性、混合方法、观察研究和综述。此外，还将研究评论、社论和灰色文献。将检索 MEDLINE、Cumulative Index to Nursing and Allied Health Literature、PsycINFO、Scopus 和 Web of Science 等数据库。将采用由两部分组成的研究筛选策略。首先，审稿人将按照基于 "人群-概念-背景 "框架的纳入和排除标准独立筛选标题和摘要。其次，将筛选全文。将对数据进行提取、整理和制图，以总结纳入文章的方法、结果和主要发现。预期结果和影响本范围界定综述将广泛描述医生在临床环境中如何对待沉默。研究结果将确定在医患互动中如何看待沉默、沉默所起的作用、哪些因素会影响沉默的使用，并为制定在临床环境中使用沉默的教育计划提供指导。
{"title":"Silence in physician clinical practice: a scoping review protocol","authors":"Martina Ann Kelly, Stefanie Rivera, Caitlin McClurg, Catherine Sweeney, Stephen Mosca, Ellen McLeod, Deirdre Bennett, Megan Brown","doi":"10.1101/2024.07.10.24310250","DOIUrl":"https://doi.org/10.1101/2024.07.10.24310250","url":null,"abstract":"Objective\u0000The objective of this review is to map, describe and conceptualize how silence is discussed within literature on interactions between physicians and patients, in clinical settings. Methods\u0000We will use the methodological framework of Arksey & O’Malley, adapted by Levac et al and Joanna Briggs Institute. Empirical studies including quantitative, qualitative, mixed methods, observational studies and reviews will be included. Commentaries, editorials, and grey literature will also be examined. The databases MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus and Web of Science will be searched. A two-part study selection strategy will be applied. First, reviewers will follow inclusion and exclusion criteria based on ‘Population-Concept-Context’ framework to independently screen titles and abstracts. Next, full texts will be screened. Data will be extracted, collated, and charted to summarize methods, outcomes and key findings from the articles included. Expected results and implications\u0000This scoping review will provide an extensive description of how physicians engage with silence in clinical settings. Findings will identify how silence is perceived in physician patient interactions, the roles it plays, what factors influence use of silence and guide development of educational initiatives on use of silence in clinical settings.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141612476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-10DOI: 10.1101/2024.07.09.24310166
Jude Amechi Nnaka, Victor Udochukwu Ezeike, Kristjan Thompson, Izuchukwu Azuka Okafor
Objective This study examined the relationship between students′ perceptions of cadaver dissection (CD) and some learning conditions during CD. Methods This is a cross–sectional study involving 2968 medical students and graduates exposed to CD at nine countries systematically and proportionally selected from Sub–Saharan African countries based on their ranking on the four World Bank indices of development and education: population, literacy, human capital index (HCI), and human development index (HDI). A self–administered questionnaire was used to collect relevant data on learning conditions during CD experience of the participants, using online channels, including email, Whatsapp, Facebook, Instagram, and Twitter. Results About half (48.76%) of the participants perceived CD as stressful, while 51.24% thought otherwise. However, 57% of participants from institutions where a CD session lasts three hours described their experience as stressful, whereas 69.67% of participants whose institution spent one hour in a single CD session agreed that CD is not stressful. Similarly, 60.63% of participants from institutions with a student-donor ratio between 5 to 10 students per cadaver described their experience as ′not stressful′. In comparison, 57.51% of participants from institutions with a student-donor ratio of 10–20 students per donor and 53.80% of participants from institutions with over 20 students per donor described their experience as stressful. Conclusions Students from institutions with CD instructors, shorter CD sessions, and a smaller student-donor ratio are more likely to perceive CD as stress–free. Providing more support for students during CD and reducing time for CD may be an antidote to CD-related stress.
目的：本研究探讨了学生对尸体解剖（CD）的看法与尸体解剖过程中一些学习条件之间的关系。方法这是一项横断面研究，根据人口、识字率、人力资本指数（HCI）和人类发展指数（HDI）这四项世界银行发展和教育指数的排名，从撒哈拉以南非洲国家中按比例系统地选取了九个国家的 2968 名医科学生和毕业生参与研究。通过电子邮件、Whatsapp、Facebook、Instagram 和 Twitter 等在线渠道，采用自填式问卷调查法收集参与者在 CD 体验期间学习条件的相关数据。结果约一半（48.76%）的参与者认为 CD 有压力，而 51.24% 的参与者持相反意见。然而，57%的来自机构的参与者认为他们的经历是有压力的，而69.67%的来自机构的参与者认为他们的经历是没有压力的。同样，60.63%来自学生与捐献者比例为 5 至 10 人/尸体的院校的参与者认为他们的经历 "没有压力"。相比之下，57.51%来自学生与捐献者比例为 10-20 名学生/每具遗体的院校的参与者和 53.80%来自学生与捐献者比例超过 20 名学生/每具遗体的院校的参与者认为他们的经历是有压力的。结论有 CD 指导教师、CD 课时较短、学生与捐赠者比例较小的院校的学生更有可能认为 CD 没有压力。在 CD 期间为学生提供更多支持并缩短 CD 时间可能是缓解 CD 相关压力的良方。
{"title":"Stress from Cadaver Dissection Linked to Learning Conditions: Evidence from Sub-Saharan Africa","authors":"Jude Amechi Nnaka, Victor Udochukwu Ezeike, Kristjan Thompson, Izuchukwu Azuka Okafor","doi":"10.1101/2024.07.09.24310166","DOIUrl":"https://doi.org/10.1101/2024.07.09.24310166","url":null,"abstract":"Objective\u0000This study examined the relationship between students′ perceptions of cadaver dissection (CD) and some learning conditions during CD. Methods\u0000This is a cross–sectional study involving 2968 medical students and graduates exposed to CD at nine countries systematically and proportionally selected from Sub–Saharan African countries based on their ranking on the four World Bank indices of development and education: population, literacy, human capital index (HCI), and human development index (HDI). A self–administered questionnaire was used to collect relevant data on learning conditions during CD experience of the participants, using online channels, including email, Whatsapp, Facebook, Instagram, and Twitter. Results\u0000About half (48.76%) of the participants perceived CD as stressful, while 51.24% thought otherwise. However, 57% of participants from institutions where a CD session lasts three hours described their experience as stressful, whereas 69.67% of participants whose institution spent one hour in a single CD session agreed that CD is not stressful. Similarly, 60.63% of participants from institutions with a student-donor ratio between 5 to 10 students per cadaver described their experience as ′not stressful′. In comparison, 57.51% of participants from institutions with a student-donor ratio of 10–20 students per donor and 53.80% of participants from institutions with over 20 students per donor described their experience as stressful. Conclusions\u0000Students from institutions with CD instructors, shorter CD sessions, and a smaller student-donor ratio are more likely to perceive CD as stress–free. Providing more support for students during CD and reducing time for CD may be an antidote to CD-related stress.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141586768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-10DOI: 10.1101/2024.07.09.24310170
Rahma Menshawey, Esraa Menshawey
Abstract Background: Sexual harassment of medical students is a growing concern. Sexual harassment is an unethical and illegal conduct. Yet, medical students are at a unique disadvantage to be victimized to due organizational failures, fear of retaliation, and unique power dynamics. As more women, minorities, and vulnerable groups enter the medical field, the time is ripe for proactive measures to ensure their empowerment and protect in light of such heinous and harmful acts. Main body of the abstract: Original research studies, which examined the sexual harassment of medical students were identified on the PubMed database using the key terms, sexual harassment, and medical students. A total of 36 studies were identified. The purpose of this review is to highlight the key findings in the original research literature on the sexual harassment of medical students, and to identify themes in hopes to inspire progressive solutions to embolden student safety. Short conclusion: There is a growing global body of literature that has examined the sexual harassment experiences of medical students. Themes across the studies reveal a wide array of experiences. Medical students, especially females, are faced with harassment from professors, colleagues, and patients. The impact of harassment is far reaching, and includes depression, post-traumatic stress disorder, loss of concentration and academic interests, changing specialty of interest and relocation. There is a number of barriers to reporting these events, notably including a lack of institutional response, lack of time to go forward with a complaint, fear of retaliation and career impact. Proactive measures are needed to protect the students and embolden them and provide them with safe and accessible means to reporting these events, as well as ensuring adequate responses to reports on the institutional level, and continued emotional and career support are needed.
{"title":"The Sexual Harassment of Medical Students: Victims, Experiences, Impact, and Barriers to Reporting","authors":"Rahma Menshawey, Esraa Menshawey","doi":"10.1101/2024.07.09.24310170","DOIUrl":"https://doi.org/10.1101/2024.07.09.24310170","url":null,"abstract":"Abstract\u0000Background: Sexual harassment of medical students is a growing concern. Sexual harassment is an unethical and illegal conduct. Yet, medical students are at a unique disadvantage to be victimized to due organizational failures, fear of retaliation, and unique power dynamics. As more women, minorities, and vulnerable groups enter the medical field, the time is ripe for proactive measures to ensure their empowerment and protect in light of such heinous and harmful acts. Main body of the abstract: Original research studies, which examined the sexual harassment of medical students were identified on the PubMed database using the key terms, sexual harassment, and medical students. A total of 36 studies were identified. The purpose of this review is to highlight the key findings in the original research literature on the sexual harassment of medical students, and to identify themes in hopes to inspire progressive solutions to embolden student safety. Short conclusion: There is a growing global body of literature that has examined the sexual harassment experiences of medical students. Themes across the studies reveal a wide array of experiences. Medical students, especially females, are faced with harassment from professors, colleagues, and patients. The impact of harassment is far reaching, and includes depression, post-traumatic stress disorder, loss of concentration and academic interests, changing specialty of interest and relocation. There is a number of barriers to reporting these events, notably including a lack of institutional response, lack of time to go forward with a complaint, fear of retaliation and career impact. Proactive measures are needed to protect the students and embolden them and provide them with safe and accessible means to reporting these events, as well as ensuring adequate responses to reports on the institutional level, and continued emotional and career support are needed.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"195 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141588454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Study aims and objectives This study aims to evaluate the accuracy of medical knowledge in the most advanced LLMs (GPT-4o, GPT-4, Gemini 1.5 Pro, and Claude 3 Opus) as of 2024. It is the first to evaluate these LLMs using a non-English medical licensing exam. The insights from this study will guide educators, policymakers, and technical experts in the effective use of AI in medical education and clinical diagnosis. Method Authors inputted 790 questions from Japanese National Medical Examination into the chat windows of the LLMs to obtain responses. Two authors independently assessed the correctness. Authors analyzed the overall accuracy rates of the LLMs and compared their performance on image and non-image questions, questions of varying difficulty levels, general and clinical questions, and questions from different medical specialties. Additionally, authors examined the correlation between the number of publications and LLMs' performance in different medical specialties. Results GPT-4o achieved highest accuracy rate of 89.2% and outperformed the other LLMs in overall performance and each specific category. All four LLMs performed better on non-image questions than image questions, with a 10% accuracy gap. They also performed better on easy questions compared to normal and difficult ones. GPT-4o achieved a 95.0% accuracy rate on easy questions, marking it as an effective knowledge source for medical education. Four LLMs performed worst on "Gastroenterology and Hepatology" specialty. There was a positive correlation between the number of publications and LLM performance in different specialties. Conclusions GPT-4o achieved an overall accuracy rate close to 90%, with 95.0% on easy questions, significantly outperforming the other LLMs. This indicates GPT-4o's potential as a knowledge source for easy questions. Image-based questions and question difficulty significantly impact LLM accuracy. "Gastroenterology and Hepatology" is the specialty with the lowest performance. The LLMs' performance across medical specialties correlates positively with the number of related publications.
{"title":"Performance of Advanced Large Language Models (GPT-4o, GPT-4, Gemini 1.5 Pro, Claude 3 Opus) on Japanese Medical Licensing Examination: A Comparative Study","authors":"Mingxin Liu, Tsuyoshi Okuhara, Zhehao Dai, Wenbo Huang, Hiroko Okada, Furukawa Emi, Takahiro Kiuchi","doi":"10.1101/2024.07.09.24310129","DOIUrl":"https://doi.org/10.1101/2024.07.09.24310129","url":null,"abstract":"Study aims and objectives\u0000This study aims to evaluate the accuracy of medical knowledge in the most advanced LLMs (GPT-4o, GPT-4, Gemini 1.5 Pro, and Claude 3 Opus) as of 2024. It is the first to evaluate these LLMs using a non-English medical licensing exam. The insights from this study will guide educators, policymakers, and technical experts in the effective use of AI in medical education and clinical diagnosis.\u0000Method\u0000Authors inputted 790 questions from Japanese National Medical Examination into the chat windows of the LLMs to obtain responses. Two authors independently assessed the correctness. Authors analyzed the overall accuracy rates of the LLMs and compared their performance on image and non-image questions, questions of varying difficulty levels, general and clinical questions, and questions from different medical specialties. Additionally, authors examined the correlation between the number of publications and LLMs' performance in different medical specialties.\u0000Results\u0000GPT-4o achieved highest accuracy rate of 89.2% and outperformed the other LLMs in overall performance and each specific category. All four LLMs performed better on non-image questions than image questions, with a 10% accuracy gap. They also performed better on easy questions compared to normal and difficult ones. GPT-4o achieved a 95.0% accuracy rate on easy questions, marking it as an effective knowledge source for medical education. Four LLMs performed worst on \"Gastroenterology and Hepatology\" specialty. There was a positive correlation between the number of publications and LLM performance in different specialties.\u0000Conclusions\u0000GPT-4o achieved an overall accuracy rate close to 90%, with 95.0% on easy questions, significantly outperforming the other LLMs. This indicates GPT-4o's potential as a knowledge source for easy questions. Image-based questions and question difficulty significantly impact LLM accuracy. \"Gastroenterology and Hepatology\" is the specialty with the lowest performance. The LLMs' performance across medical specialties correlates positively with the number of related publications.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141577421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-02DOI: 10.1101/2024.06.29.24309595
Phil Newton, Chris J Summers, Uzman Zaheer, Maira Xiromeriti, Jemima R Stokes, Jaskaran Singh Bhangu, Elis G Roome, Alanna Roberts-Phillips, Darius Mazaheri-Asadi, Cameron D Jones, Stuart Hughes, Dominic Gilbert, Ewan Jones, Keioni Essex, Emily C Rees, Ross Davey, Adrienne A Cox, Jessica A Bassett
ChatGPT apparently shows excellent performance on high level professional exams such as those involved in medical assessment and licensing. This has raised concerns that ChatGPT could be used for academic misconduct, especially in unproctored online exams. However, ChatGPT has also shown weaker performance on questions with pictures, and there have been concerns that ChatGPTs performance may be artificially inflated by the public nature of the sample questions tested, meaning they likely formed part of the training materials for ChatGPT. This led to suggestions that cheating could be mitigated by using novel questions for every sitting of an exam and making extensive use of picture-based questions. These approaches remain untested. Here we tested the performance of ChatGPT-4o on existing medical licensing exams in the UK and USA, and on novel questions based on those exams. ChatGPT-4o scored 94% on the United Kingdom Medical Licensing Exam Applied Knowledge Test, and 89.9% on the United States Medical Licensing Exam Step 1. Performance was not diminished when the questions were rewritten into novel versions, or on completely novel questions which were not based on any existing questions. ChatGPT did show a slightly reduced performance on questions containing images, particularly when the answer options were added to an image as text labels. These data demonstrate that the performance of ChatGPT continues to improve and that online unproctored exams are an invalid form of assessment of the foundational knowledge needed for higher order learning.
{"title":"Can ChatGPT-4o really pass medical science exams? A pragmatic analysis using novel questions.","authors":"Phil Newton, Chris J Summers, Uzman Zaheer, Maira Xiromeriti, Jemima R Stokes, Jaskaran Singh Bhangu, Elis G Roome, Alanna Roberts-Phillips, Darius Mazaheri-Asadi, Cameron D Jones, Stuart Hughes, Dominic Gilbert, Ewan Jones, Keioni Essex, Emily C Rees, Ross Davey, Adrienne A Cox, Jessica A Bassett","doi":"10.1101/2024.06.29.24309595","DOIUrl":"https://doi.org/10.1101/2024.06.29.24309595","url":null,"abstract":"ChatGPT apparently shows excellent performance on high level professional exams such as those involved in medical assessment and licensing. This has raised concerns that ChatGPT could be used for academic misconduct, especially in unproctored online exams. However, ChatGPT has also shown weaker performance on questions with pictures, and there have been concerns that ChatGPTs performance may be artificially inflated by the public nature of the sample questions tested, meaning they likely formed part of the training materials for ChatGPT. This led to suggestions that cheating could be mitigated by using novel questions for every sitting of an exam and making extensive use of picture-based questions. These approaches remain untested. Here we tested the performance of ChatGPT-4o on existing medical licensing exams in the UK and USA, and on novel questions based on those exams. ChatGPT-4o scored 94% on the United Kingdom Medical Licensing Exam Applied Knowledge Test, and 89.9% on the United States Medical Licensing Exam Step 1. Performance was not diminished when the questions were rewritten into novel versions, or on completely novel questions which were not based on any existing questions. ChatGPT did show a slightly reduced performance on questions containing images, particularly when the answer options were added to an image as text labels.\u0000These data demonstrate that the performance of ChatGPT continues to improve and that online unproctored exams are an invalid form of assessment of the foundational knowledge needed for higher order learning.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141508484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-26DOI: 10.1101/2024.06.25.24309485
Natalie Smith
This article explores the redesign of a Physician Associate (PA) programs didactic coursework from traditional lecture-based methods to a student-centered blended learning platform incorporating Team-Based Learning (TBL). The initiative, supported by a course innovation grant, aimed to address the limitations of passive learning by integrating active learning experiences that enhance student engagement and comprehension. The redesigned Diagnostic Methods I course leverages blended learning to combine online materials with face-to-face interactions, fostering critical thinking and practical application of knowledge. TBL, a structured approach to collaborative learning, facilitates deeper understanding through readiness assurance tests and team-based problem-solving. Early findings indicate improved student outcomes and positive perceptions of the blended TBL approach, suggesting its potential as a valuable educational strategy in PA programs. The article provides practical insights and lessons learned for educators seeking to implement TBL and blended learning in similar educational settings.
本文探讨了重新设计助理医师（PA）课程的教学方法，从传统的讲授法转变为以学生为中心、结合团队学习（TBL）的混合式学习平台。这一举措得到了课程创新基金的支持，旨在通过整合主动学习体验来提高学生的参与度和理解力，从而解决被动学习的局限性。重新设计的 "诊断方法 I "课程利用混合式学习，将在线材料与面对面互动相结合，培养批判性思维和知识的实际应用。TBL 是一种结构化的协作学习方法，通过准备就绪保证测试和基于团队的问题解决，促进加深理解。早期的研究结果表明，混合式 TBL 方法提高了学生的学习成绩，并使学生对这种方法产生了积极的看法，这表明它有可能成为 PA 课程中一种有价值的教育策略。文章为寻求在类似教育环境中实施 TBL 和混合式学习的教育工作者提供了实用的见解和经验教训。
{"title":"Team-based Learning in a Blended Curriculum","authors":"Natalie Smith","doi":"10.1101/2024.06.25.24309485","DOIUrl":"https://doi.org/10.1101/2024.06.25.24309485","url":null,"abstract":"This article explores the redesign of a Physician Associate (PA) programs didactic coursework from traditional lecture-based methods to a student-centered blended learning platform incorporating Team-Based Learning (TBL). The initiative, supported by a course innovation grant, aimed to address the limitations of passive learning by integrating active learning experiences that enhance student engagement and comprehension. The redesigned Diagnostic Methods I course leverages blended learning to combine online materials with face-to-face interactions, fostering critical thinking and practical application of knowledge. TBL, a structured approach to collaborative learning, facilitates deeper understanding through readiness assurance tests and team-based problem-solving. Early findings indicate improved student outcomes and positive perceptions of the blended TBL approach, suggesting its potential as a valuable educational strategy in PA programs. The article provides practical insights and lessons learned for educators seeking to implement TBL and blended learning in similar educational settings.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141532375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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