BMC Medical Education最新文献

Background: Trauma surgery is characterized by high-acuity, low-frequency events. While trauma remains a leading cause of death and disability worldwide, surgical residents experience reduced trauma operative volumes during training. This paper highlights an important innovation for improvement of trauma surgery training: use of camera systems to record high fidelity video footage of open trauma cases.

Methods: This paper describes the systematic approach of integrating video camera recording of open trauma surgical cases at the Sotero del Rio Hospital in Santiago, Chile. Recording devices include both hand-held and head-mounted action cameras. We describe surgical team roles and responsibilities as well as workflow for patient consent, maintenance and management of recording equipment, and video storage and editing.

Results: Our system of open trauma video recording has resulted in the largest video repository of emergent, high-fidelity trauma cases. Our video library contains over 1000 hours of video featuring over 250 independent operations and a broad variety of trauma cases.

Conclusions: Successful implementation of an open trauma video recording program requires clearly stated roles and responsibilities, a shift in work culture, and full integration of video recording into a trauma system's existing workflow. Use of the appropriate handheld and head-mounted cameras offers the opportunity to seamlessly collect high quality video footage with minimal impact to the operating team. A large and diverse open trauma video repository allows surgical trainees to review novel cases, attending surgeons to review previous cases, and overall improvement of educational conferences and didactics. Surgical trauma video recording and postoperative review represents a viable, inexpensive, and highly transportable solution to the recent reductions in overall trauma caseloads for surgical trainees across the globe.

Background: It is critical to evaluate competence and learning outcomes in nursing education. The purpose of the study was to adapt the Nursing Student Competency Scale (NSCS) into Turkish and to determine its validity and reliability.

Methods: This methodological study was conducted between March 2023 and May 2023 with 2nd, 3rd, and 4th-year students enrolled in the nursing program at a university. The data were collected using the "Student Identification Form" and the "Turkish version of NSCS (NSCS-T)". Content, face and construct validity were evaluated. Reliability was examined with internal consistency and test-retest.

Results: A total of 316 nursing students voluntarily participated in the study. The item-level content validity index of the scale ranged between 0.80 and 1.00. According to confirmatory factor analysis, the six-factor model consisting of 30 items (medical-related knowledge, basic nursing skills, communication and cooperation, life-long learning, global vision, and critical thinking) had a good fit index (χ2/df = 2.54; GFI = 0.852; CFI = 0.943; RMSEA = 0.063; TLI = 0.936; SRMR = 0.038). The factor loadings of the scale are greater than 0.30, explained 75.8% of the total variance. The Cronbach's alpha of the scale was 0.97 across the scale and 0.86-0.93 among the subscales; item-total correlations were between 0.55 and 0.83. Intraclass correlation coefficient ranged between 0.95 and 0.98.

Conclusions: The results indicated that the NSCS-T is a sufficiently valid and reliable instrument to measure the competency level of Turkish nursing students.

Trial registration: Not applicable.

Background: The flipped classroom (FC) approach has demonstrated efficacy in enhancing the learning process, including within higher education contexts such as medical education. Recently, FC has emerged as potential alternative to traditional teaching models across various disciplines, particularly due to its more engaging nature. However, there is limited data available regarding its impact on student performance, particularly in the context of long-term knowledge retention in pharmacology. In this study, our objective was to assess the short- and long-term impact of FC on student performance in Hungarian pharmacology teaching at medical faculty in Semmelweis University (Budapest, Hungary).

Methods and results: 161 medical students and 10 teachers were involved in this study. We flipped four seminars, then we assessed the academic performance by using multiple choice tests immediately and two weeks after the flipped class. A follow-up assessment was conducted six months after the initial two FC sessions. Our findings indicated that the FC approach enhanced both short- and long-term knowledge retention across most topics. Notably, this long-term improvement was evident even six months after the original seminars on specific subjects. However, despite these topic-specific benefits, the overall performance, including exam grades, did not show significant improvement when compared to the conventional teaching approach. Additionally, we assessed student and teacher perceptions using two questionnaires immediately after practice and at the end of the year. According to the questionnaire responses, students perceived positively the FC approach, emphasizing its interactive and thought-provoking aspects. However, they identified the time-consuming nature of preparation as a significant concern. Teachers also viewed the FC approach favorably, particularly appreciating its interactivity and potential for greater effectiveness. Interestingly, more experienced teachers were less receptive to the FC method, and their perceptions of it were less favorable compared to those of their younger colleagues.

Conclusions: The flipped classroom approach presents a viable strategy for teaching pharmacology, with the potential to enhance student performance and engagement. However, student occupation and faculty resistance may pose significant challenges to the implementation of such alternative teaching methods.

Background: The ever-expanding field of surgery requires novel tools to teach surgical pathologies and their management. Basic knowledge must already be acquired on a pre-graduate level at medical school. The SARS-CoV-19 pandemic has pushed students to explore digital online platforms to complement their medical education. This study aimed to assess the utility of short educational videos and the importance of digital learning methods to teach abdominal surgery.

Methods: A literature review was performed for a thorough understanding of educational videos. Short videos were then created covering different topics of abdominal surgery. To evaluate the utility of such videos, three consecutive cohorts of medical students were compared. The first cohort comprised students studying without the videos (V0), whereas the second and third cohorts had access to the videos (V1, V2). Between the three groups, the general demand for videos, subjective study habits, and objective examination scores were compared. In the V1 and V2 group, satisfaction and engagement regarding the videos were also assessed.

Results: This study included 746 medical students over a three-year period, with similar demographics. The demand for videos was high (90% in V0, 88% in V1 and V2 each) in all three groups. In total, 23 short videos were produced. Students recognized the benefits of videos in understanding the basics of surgical pathologies and their management. On average, 95.5% of the students found that videos were successful in summarizing the lectures' key points. Moreover, 96.5% found that the videos helped them to better recall the lecture content. A median overall improvement of 12.5% between V0 and V1 examination results was observed.

Conclusions: This study emphasizes the importance of implementing innovative teaching methods in modern medical education. Students expressed a strong demand for short educational videos. In the future, this project could expand to other surgical and non-surgical specialties.

Background: Measuring range of motion (ROM) accurately using a universal goniometer or visual estimation is challenging for physical therapy students. Self-controlled (SC) feedback, where learners decide whether to receive feedback, can enhance learning and foster self-efficacy (SE) by promoting self-regulation. However, the impact of SC feedback on skill acquisition in ROM measurement technique and SE in physical therapy students remains unclear. This study investigates the effects of SC feedback on skill acquisition in ROM measurement techniques and students' SE.

Methods: Thirty physical therapy students were quasi-randomly assigned to an SC group, which chose feedback during practice, or a Yoked (Yk) group, which received feedback based on the SC group's schedule. A goniometric measurement task, in which participants measure the ROM of left knee flexion using a universal goniometer, and a visual estimation task, in which they estimate it visually, were set as the learning tasks. After a pretest, they completed the practice (3 trials × 4 blocks) followed by short-term retention test (STRT) and LTRT (LTRT). All tests consisted of 3 trials. Measurement accuracy and time were used as test performance for both tasks. SE of ROM measurements was measured before the start of each test using a 10-point Likert scale. Feedback related to measurement errors were provided during practice in line with each group's conditions.

Results: The SC group maintained high feedback frequency (80.0 ± 30.3%) during the practice. Both groups improved measurement accuracy and reduced time for goniometric measurement and visual estimation tasks, but no significant group differences were found. Goniometric accuracy exceeded visual estimation in both groups. SE before the pretest did not correlate with pretest accuracy. However, SE before the STRT correlated with accuracy at that time in both groups. In the SC group, SE before the LTRT test was related to the accuracy at the STRT.

Conclusion: SC feedback did not demonstrate superior effectiveness, but external feedback improved ROM measurement accuracy and reduced measurement time. Moreover, SE after the practice was temporarily associated with accuracy, suggesting a potential link between SE and performance in skill acquisition.

Background: Medical education in Poland consists of a six-year course, a 13-month postgraduate internship, and a Final Medical Examination. The possible further career path is to specialise in a particular field of medicine, and the choice of speciality is one of the most important decisions made by young doctors. Therefore, the decision-making process creates challenges. We conducted this study to determine the factors considered during the process of choosing a medical speciality and to investigate the influence of student performance in the Final Medical Examination on this choice.

Methods: A descriptive cross-sectional survey was conducted between 4 January and 7 February 2024. The data were collected via an online survey in Polish. The survey was disseminated to doctors engaged in postgraduate internships via social networks. The Chi-square test (χ²) was used to analyse the significance of differences.

Results: The survey included 336 postgraduate trainees. Internal medicine subspecialties, surgical specialities, and paediatrics were of most interest to the respondents. The average age of respondents was 26 years. In the multiple-choice question, most people (86.6%) marked their individual interests as a key factor influencing their choice of specialisation, followed by earning opportunities in the private sector (58%) and work-life balance (54.2%). The Final Medical Examination score is a significant factor in the selection of a speciality, as indicated by 68% of respondents.

Conclusions: The process of selecting a medical speciality involves overcoming numerous limitations. The outcome of the Final Medical Examination is a significant factor influencing the choice of future specialisation. Furthermore, the decision-making process is affected by several different factors and the distinctive complexities of practising a specific speciality within the Polish healthcare system.

Background: Near-peer teaching has been shown to provide diverse benefits for both tutees and tutors in senior medical student and junior trainee settings. However, junior trainees may face more obstacles in teaching including competing clinical priorities and time management. We sought to investigate the challenges and benefits of engaging in near-peer teaching for junior trainees within our local context. Our Near-Peer Medical Teaching (NPMT) teaching program is designed and facilitated by junior doctors for medical students at the Central Coast Clinical School (University of Newcastle) of the Joint Medical Program.

Methods: Current and past NPMT tutors participated in an online survey from October 2022 to April 2023. Tutors were asked about feasibility of teaching within a work environment, perceived benefits from their experience and attitudes towards medical education.

Results: Teaching experience appears to be influenced by competing clinical priorities and convenience of session times, but it does not appear to exert considerable stress on tutors likely due to self-selection of tutors with prior enjoyable teaching experience. Furthermore, this study indicates that junior doctors derived enjoyment and developed clinical skills and professional qualities, which are important factors in increasing job satisfaction and ameliorating burn-out in this cohort.

Conclusions: Junior doctors appear to benefit from engaging in near-peer programs in the Australian teaching hospital setting. Further research should include qualitative methodologies to explore the perspectives of Australian junior doctors' more deeply.

Background: Team-based learning methods enhance course achievement, student success, and student satisfaction and are frequently used in nursing curricula. However, there is no valid and reliable tool for evaluating team-based learning in Türkiye. Adapting the Team-based Learning Student Assessment (TBL-SAI) into Turkish can provide a standardized and culturally appropriate evaluation tool, supporting nursing education practice and research. This study aimed to assess the validity and reliability of the Turkish version of the assessment (TBL-SAI-TR) among nursing students.

Methods: This descriptive and psychometrics study was conducted between October and November 2022. The sample consisted of 430 nursing students. The translation-back-translation method was used to determine the language accuracy of the scale. The content validity, construct validity, item analysis, and internal consistency analysis were used as psychometrics tests of the study.

Results: The Cronbach's α value of the TBL-SAI-TR was .90. The item-total correlations of the 23-item three-factor scale, validated by confirmatory factor analysis, were between .30 and .74, and the intraclass correlations were between .88 and .90.

Conclusion: This study showed that the TBL-SAI-TR is a valid and reliable tool for assessing team-based learning among Turkish nursing students.

Background: The purpose of this study was to evaluate the performance of widely used artificial intelligence (AI) chatbots in answering prosthodontics questions from the Dentistry Specialization Residency Examination (DSRE).

Methods: A total of 126 DSRE prosthodontics questions were divided into seven subtopics (dental morphology, materials science, fixed dentures, removable partial dentures, complete dentures, occlusion/temporomandibular joint, and dental implantology). Questions were translated into English by the authors, and this version of the questions were asked to five chatbots (ChatGPT-3.5, Gemini Advanced, Claude Pro, Microsoft Copilot, and Perplexity) within a 7-day period. Statistical analyses, including chi-square and z-tests, were performed to compare accuracy rates across the chatbots and subtopics at a significance level of 0.05.

Results: The overall accuracy rates for the chatbots were as follows: Copilot (73%), Gemini (63.5%), ChatGPT-3.5 (61.1%), Claude Pro (57.9%), and Perplexity (54.8%). Copilot significantly outperformed Perplexity (P = 0.035). However, no significant differences in accuracy were found across subtopics among chatbots. Questions on dental implantology had the highest accuracy rate (75%), while questions on removable partial dentures had the lowest (50.8%).

Conclusion: Copilot showed the highest accuracy rate (73%), significantly outperforming Perplexity (54.8%). AI models demonstrate potential as educational support tools but currently face limitations in serving as reliable educational tools across all areas of prosthodontics. Future advancements in AI may lead to better integration and more effective use in dental education.

Background: The volunteer Pre-Medical Health Coach (PHC) program engages student volunteers, in team-based primary care providing self-management support to patients with chronic conditions. Both the PHCs and the patients they serve are diverse. The aims of this study are to assess the impact of the PHC program on student outcomes and patient biomarkers.

Methods: All PHCs were students recruited from local universities, interviewed, then trained in motivational interviewing and evidence-based chronic disease self-management support. The 22 PHCs were diverse - 8 (36.3%) were underrepresented in medicine and 2 (9%) were first generation in college. The study setting was a public safety-net adult medicine outpatient clinic in Oakland, California. PHCs spent 5 h weekly, for 1-3 years, volunteering alongside primary care residents and faculty. Duties included: (1) observing the doctor-patient interview, (2) on-site health coaching, and (3) telephone follow-up. An internal medicine physician and a licensed clinical social worker supervised the program. Surveys were implemented to understand program impacts and career trajectories of the 22 PHCs and health action plans were reviewed over 4 years. In addition, a focus group was conducted with the PHCs using a deductive approach.

Results: Two years after completing the program, 90.9% of the PHCs were still on the path to health professions programs, 50% had applied to medical school, and 18.2% started medical training. Qualitative impacts on coaches included significant clinical exposure, meaningful connection with patients, 'bridging' between the community and health care system and having a more holistic view on health. Patient biomarkers included a decrease in hemoglobin A1c level by 1% point in diabetic patients with diabetes-focused action plans, and smoking-focused action plans led to decreased smoking or cessation.

Conclusions: The Pre-Medical Health Coach (PHC) program may benefit both PHCs and patients. PHCs were diverse and providing chronic disease self-management support to patients in a safety-net health care system. This program could be readily adapted in health care systems nationwide to increase diverse entrants to the healthcare workforce.