BMC Medical Education最新文献

Background: Revitalizing primary health care requires that the health workforce, especially doctors, must appreciate the significance of the socio-cultural environment in health. To achieve this objective, training of medical students must emphasize greater understanding of the community and its role in health through community engagement using community-engaged learning. However, research on this learning method applied in a purely community engagement context is lacking. A medical school in Ghana adapted its fourth-year junior clerkship curriculum in Community Health to include a community-engagement programme. This study reports students' perceptions of the said programme as a way of evaluating it and helping to improve upon its implementation.

Methods: A cross-sectional survey using a Google form-based questionnaire with open- and closed-ended questions was conducted from May 2022 to December 2023 among 303 current and past medical students of the University of Health and Allied Sciences, Ghana who had experienced the said programme. Based on the first three levels of the Kirkpatrick's four-level model of training evaluation, data was collected on participants' socio-demographics, their assessment of the programme content and delivery, subsequent attitudinal changes and their application to practice. Descriptive statistics were performed on quantitative data and thematic content analysis done for responses to the open-ended questions.

Results: More than half of participants were males (188/303). The mean (SD) participant age was 23.9 years (2.4). Over 90% indicated the programme was valuable to their training (277/297) and were satisfied with the facilitators (283/297) despite some anxieties expressed at the start of their clerkship. Participants noted that they acquired other skills including teamwork and leadership aside the reinforced academic content. At least 99% of participants noted they could conduct the processes of community entry and engagement with or without assistance.

Conclusion: Although there is room for improvement, the students' community engagement programme may have some utility in the training of medical students to enable them better appreciate community interactions that influence health. Further research incorporating objective assessments of learning and behaviour change is needed to comprehensively assess the programme.

Background: The assessment of undergraduate medical students consists of a written component and an advanced clinical competency test that evaluates the students' skills. The Objective Structured Clinical Examinations (OSCE) were only implemented in most medical schools in the last ten years, similar in many developing countries. It was first used with other clinical assessment methods. This study was designed to investigate how medical students in the fourth and sixth grades and examiners perceived the unique format, features, and quality of the Grand Objective Structured Clinical Examinations (GOSCE), a novel method for assessing students. The aim was to understand how this innovative method, distinct from traditional assessment methods, prepares students for real-world scenarios where they encounter different specialty cases. Additionally, the study aimed to understand the significant role and challenges faced by the Faculty of General Medicine at Koya University in implementing this type of OSCE and to identify potential improvements to enhance the quality of the assessment process.

Methods: Following the administration of two distinct GOSCE examinations for the fourth and sixth stages, feedback forms were created using Google Forms and distributed to students and examiners. The feedback forms covered all aspects of the examination process. The responses were then rigorously analyzed using the scientific tool SPSS, allowing for a comparison between students from both stages and the faculty and external examiners.

Results: In the survey of 104 undergraduate students (78% of attendants), the majority (84n,80%) rated the fairness of the assessment as good, which is the primary goal of GOSCE. A large percentage (89n,85.6%) agreed that the examination covered a wide range of clinical skills. Eighty students (76.85%) believed the patients cooperated and found the findings precise; on the other hand, The obtained responses from 24 out of 33 faculty staff members (75%) and 29 out of 35 external examiners (82%) strongly agreed that the examination adequately covered a wide variety of clinical abilities. Only two of 68 examiners (2.9%) believed the examination needed more to provide a learning opportunity.

Conclusion: With the insightful suggestions for improvement provided by the participants, GOSCE has a promising potential to evolve into a fair, objective clinical tool for assessing medical students, instilling a sense of optimism for its future development.

Background: Reflection is a critical component of learning which plays a significant role in improving knowledge and skills. It is a metacognitive process that aims to create a deeper understanding of the situation. This study sought to explore the perspectives of medical students concerning the role of reflection in their professional development.

Methodology: This qualitative content analysis study was undertaken with 20 medical students across different year levels in 2023. Participants entered the study by purposive sampling. Data was collected through individual semi-structured interviews. Interviews were audio recorded and transcribed verbatim. Collected data was analyzed based on the steps proposed by Graneheim and Lundman. Data analysis was performed using MAXQDA-10 software.

Results: A total of 168 primary codes were extracted. After removing duplicate codes and merging similar codes, finally 54 codes were extracted, which were placed in 3 main themes and 7 subthemes. They encompassed: self-awareness (self-acceptance, metacognitive self-exploration, semantic perception); professional competence (self-directed learning, professional commitment); and reflection culture (organizational climate, educational structure).

Conclusions: Findings revealed that the most important aspect of reflection is the recognition and acceptance of individual identity, along with the metacognitive awareness of how to know, especially in the early years, and understanding the meaning of behaviors and relationships over time. Students explained the undeniable impact of reflection on individual and self-directed learning and the development of professional commitment during their studies. The findings of this study, specifically major themes from reflection culture narratives, provide us with a better understanding of the lack of a positive organizational atmosphere, inappropriate educational structure and intensive clinical rotations, as well as lack of trust between students and medical teachers, which negatively impact on or hinder professional development. It seems that by faculty development initiatives, mentoring, group reflection sessions, reflective practices can turn into an opportunity to improve the quality of education.

Background: Traditional dental anatomy education, reliant on cadaver dissections and lectures, faces challenges such as high costs, ethical concerns, and difficulty conveying complex 3D dental structures. Virtual reality (VR) offers a solution by providing immersive, interactive learning environments that can enhance students' understanding. This study systematically reviews the effectiveness of VR in dental anatomy education compared to traditional methods, focusing on its potential to improve learning outcomes.

Methods: A comprehensive search was conducted across Web of Science (WoS), PubMed, and Scopus databases until May 2024. Data were extracted, summarized, and analyzed for qualitative synthesis. The following keywords and their combinations were used: " dental OR dentistry", "education OR teaching", "virtual AND reality OR VR", and "anatomy OR dental AND anatomy". Studies were included if they met the following criteria: Investigated the use of VR in anatomy education. Compared VR-based learning to other methods such as lecture-based teaching, 3D printed or natural models, or non-interactive 3D models. Quantitative synthesis was performed using standardized mean differences (SMD) with Hedges'd and 95% confidence intervals (CI).

Results: Out of 178 records screened, seven studies were included in the meta-analysis and eight in the personal evaluation analysis. The analysis indicates a moderately positive effect of VR on dental anatomy education (SMD = 0.74, p = 0.05) compared to lecture-based education using X-ray, CBCT, or 3D models. However, at the same time, VR falls short compared to clinical experience, training with physical teeth, or quality printed models. Studies reported rare cases of discomfort, disorientation, diplopic image, and VR sickness.

Conclusions: The use of VR-based learning moderately positively affects educational outcomes, and enhances knowledge retention, especially before clinical experience. The personal evaluation of students showed a strong interest in VR, with positive feedback on its ease of use, accuracy, and educational value.

Medical educators face wicked (complex) problems. Few faculty development (FD) programs exist specifically designed for rural physicians. Memorial University created the 6for6 program, a longitudinal FD program in foundational research skills for rural physicians. This work explores the use of the Adaptive Action Method in tackling wicked problems in rural faculty development.

As of July 1st, 2021, the US Hispanic/Latinx community is estimated at 62.6 million, making up 18.9% of the population. Despite federal regulations requiring access to medical interpreters, clinicians often resort to alternative translation methods, increasing the risk of errors. Medical Spanish education lacks standardization in US medical schools, and information on curricula provided by International Medical Schools (IMGs) is limited. We aimed to demonstrate the effectiveness of virtual, peer-led Medical Spanish education for an international medical school cohort. The course consisted of 10 weekly one-hour lectures via Zoom. From 2022 to 2023, three cohorts successfully completed the course. Through realistic clinical scenarios, students practiced and reinforced their clinical knowledge in Spanish. The final exam involved a 20-minute patient encounter on Zoom, with the instructor acting as the patient and the student as the physician. Performance evaluation followed a standardized checklist. Each question was worth 3 points, with a total of 63 potential points. The passing score ratio was set at 2, equivalent to 66.7%, calculated by dividing the score by 21 (the number of questions). Student's self-reported comfort in obtaining a history and physical exam in Spanish, obtained before and after completion of the course post-comfort scores (median, 3), increased significantly compared to pre-course comfort scores (median, 0.5) - increased by an average of 2.5. This Online Spanish Medical Course (OSMC) requires no prior Spanish background or exposure, providing a notable advantage. Most students praised the convenient and effective online format. Despite its short duration, the course yielded significant benefits.

Background: Advancement in medical education has led to the adoption of online learning platforms in the development and execution of learning modules. Online learning platforms are appraised and accessed regarding their capability of ensuring a seamless experience and enhancing satisfaction in users, especially students. In this study, the satisfaction and learning experience of medical students were studied with emphasis on their sociodemographic features.

Method: Data were collected using a structured questionnaires distributed to a group of medical students in a medical college in Eastern Nigeria. 300 undergraduate students from Enugu State University of Science and Technology participated in this survey from four departments: anatomy, medical laboratory, nursing, and medicine. The questionnaires included closed-ended questions divided into sociodemographic information, learning experience, and satisfaction with online learning.

Result: Results from the survey indicate that sociodemographic factors like the course of study and sex of respondents show a noticeable relationship to the learning experience and satisfaction with online learning platforms while other factors have no impact. The majority of respondents (63.1%) strong agreed that online learning platform effectively delivers medical course content with a mean value of user learning experience of online learning platform as 4.15.

Conclusion: Feature perception, learning experience, and satisfaction level of medical students were dependent on their course of study and sex, thus independent course curriculum was relevant in determining satisfaction of students. The findings of this study add to the empirical and practical understanding of students' satisfaction with using online learning platforms as a success in medical education and its use is recommended by other medical institutions.

Background: The healthcare sector is rapidly evolving with the rise of digital technology and data-driven decision-making. However, traditional medical education has yet to fully integrate training on managing health-related information, resulting in a significant skills gap among medical and research professionals. This gap is pronounced in low- and middle-income countries (LMICs), where data privacy concerns and inadequate infrastructure hinder efforts to utilise and share health data.

Aims: To address this gap, we developed an online, modular course aimed at providing foundational skills on capturing, storing and sharing health data.

Methods: The course was developed using the ADDIE(Analyze, Design, Develop, Implement, Evaluate) instructional design model. A needs assessment workshop involving 25 global health proffesionals identified key training gaps which informed the curriculum's development. A multidisciplinary team from six institutions developed the modules. The course was piloted in a face-to-face setting with 37 participants and later adapted for online delivery via the Global Health Network platform. We evaluated the course using Level 1 of Kirkpatrick's model for training evaluation.

Results: Six foundational modules were developed: Introduction to Data Management, Data Quality, Data Repositories, Ethics of Data Sharing, Data Governance, and Costing for Data Management. Between December 2020 and April 2024, 6,384 individuals from 90 countries completed the course. Of these, 32% were from Africa, 15% from Asia, 16% from South/Central America and the Caribbean, and 24% from Europe. Summative evaluations, based on voluntary post-module surveys, demonstrated high relevance to participants' learning needs (96.6%) and strong intentions to apply the skills gained (88.3%). Key motivators for enrollment included the course's free access, relevance to professional or academic needs, and trust in the organizations and authors behind the content.

Conclusions: The high enrolment and broad geographical reach demonstrates the potential of online training as a cost-effective tool to equip health practitioners and researchers with data literacy skills. Future evaluations will assess its impact on participants' knowledge, behavior, and data-sharing and reuse practices.

Background: Maldistribution of medical professionals presents a significant challenge globally and leads to inequitable healthcare access, particularly in remote areas. Longitudinal integrated clerkships (LICs) in rural areas can improve workforce distribution and may be an innovative contributor to solving maldistribution issues. However, to align with healthcare needs, LICs must be sustainable in small communities, which often have a limited medical workforce. This study investigates the key elements underpinning LIC sustainability in small communities.

Methods: This study adopted a constructivist research paradigm in which participants' constructions of their experiences supporting LICs in small rural communities were explored. Participants were conveniently sampled from the LIC community of practice attending the 2021 virtual annual conference of the Consortium of Longitudinal Integrated Clerkships. Data were collected through video recording and thematically analysed to identify barriers and enablers to running sustainable LIC programmes.

Results: Eleven participants fulfilling key roles within LICs, including clinical school directors, program coordinators, and clinical educators, were recruited for the study. Thematic analysis indicated that it is Connectivity, expressed through three subthemes, Fostering Links, Building Trust, and Facilitating Change, which underpins sustainable LICs in small communities.

Conclusions: Connectivity is a strong mediator for sustainability of LICs and may be the central defining theme of LICs. Increasing connectivity through prioritizing community engagement, trust-building, and strategic investment enhances the sustainability of rural LICs, ensuring their continued positive contribution to medical workforce distribution in underserved areas.

Background: The current objective of preventive medicine reform is to guarantee that clinical medical students possess a comprehensive understanding of preventive medicine concepts, knowledge, and skills. Previously, case-based learning (CBL) was mostly employed to reform the clinical medicine curriculum, but there was a lack of reform in preventive medicine for clinical students in Sino-foreign joint training programs. The aim of this study was to investigate the impact of case-based learning in the Sino-foreign joint program of preventive medicine.

Methods: A total of 79 clinical medical students from the Sino-foreign joint program at Wenzhou Medical University were selected as participants to engage in 10 case-based learning sessions. The effectiveness of the instruction was assessed by analyzing the final exam scores and questionnaire responses, which encompassed instructor evaluation, self-assessment, and course learning effectiveness evaluation (CLEE).

Results: In contrast to the traditional approach, which yielded a final score of 69.2, the case-based students achieved an average of 77.62. The results of instructor evaluation showed that students' academic performance, problem-solving capabilities, research cooperation and communication, and learning attitude all improved significantly following case-based learning (P < 0.05). The self-assessment scores for all five case discussion courses exceeded 75 points, suggesting that students believed their overall competence had increased significantly. The CLEE demonstrated that CBL had a positive impact on students' learning and was highly advantageous for students.

Conclusions: It is deserving of active promotion in medical education reform that case-based learning can enhance students' comprehensive quality and classroom participation. Further research is required to ascertain whether it can replace traditional teaching methods.

Trial registration: Not clinical trial.