BMC Medical Education最新文献

Background: Surgical education necessitates hands-on training, which poses ethical challenges when practicing on real patients. Simulation training emerges as a pivotal solution, offering a safe and effective environment for skill acquisition. However, existing simulation models often overlook common surgical conditions like superficial skin abscesses. The National Medical Commission advocates for simulation-based training in basic surgical skills, highlighting the need for accessible and cost-effective models. Thus, this study aimed to develop and evaluate a novel Indigenous Cost-effective model for Incision & Drainage (NICA) of subcutaneous abscesses, addressing the gap in surgical education.

Methodology: Following institutional ethics clearance, the study employed Kern's Six-step approach for curriculum development. The NICA model was conceptualized and crafted using locally available, low-cost materials, validated by expert opinion, and implemented in a simulation lab setting. A total of 155 surgical interns underwent training, consisting of didactic video sessions, hands-on practice with the NICA model, and structured assessments. Pre- and post-training evaluations were conducted to measure interns' performance and feedback.

Results: Expert validation confirmed NICA model's fidelity and usefulness. Training 155 surgical interns resulted in significant skill improvements. Pre-training, 33% correctly performed pre-procedural requisites, 46% executed procedural techniques, and 48% performed post-procedural steps accurately. Post-training, these percentages surged to 95%, 97%, and 98%, respectively. Post test score showed significant skill enhancements across all domains (p < 0.05). Intern feedback highlighted increased confidence, satisfaction, and interest in learning, affirming NICA model's effectiveness.

Conclusion: The development and implementation of the NICA model offer a scalable and cost-effective solution for surgical training in resource-limited settings. The model's effectiveness in enhancing interns' skills and confidence underscores its potential to address training needs effectively. The study highlights the significance of simulation-based training in surgical education and advocates for the widespread adoption of indigenous low-cost models to improve surgical skills acquisition.

Background: Exposure to the breadth of healthcare opportunities is crucial to high-school and college students considering a career in medicine. Most programs revolve around research or subspecialties, limiting exposure to the richness within medicine.

Objective: We conducted a program evaluation of the Stanford Clinical Summer Internship (CSI) 2-week program, to understand learner viewpoints around CSI program utility, and to assess long term impact. We assess viewpoints by learner level (high school versus college) and participation mode (in-person versus virtual).

Methods: In 2016 we launched a two-week premedical internship, incorporating AAMC core competencies. In 2022 and 2023, we surveyed past participants, collecting demographic data and evaluating/comparing CSI's impact on educational and career paths, future preferences in healthcare careers, and influential factors of matriculation for high-school and college participants.

Results: Of 411 past participants, 42% responded (n = 173). We found minimal significant differences between high school and college students. The primary reason for joining was exploring a career in health professions. Notably, 82% acknowledged Stanford-CSI broadened their medical perspectives, 79% gained clarity on healthcare professionals' daily life, 79% heightened their interest in healthcare careers, 71% enhanced their resumes, and 72% learned valuable clinical skills. In-person participants reported developing more friendships (agree/strongly agree: 60% vs 35%, unpaired t-test: p = 0.01), while virtual participants reported having more interest in research careers (40% vs 68%, p = 0.01). Amongst high school matriculants (n = 133), 46% are now in college and 4% in medical or nursing school. Amongst collegiate matriculants (n = 40), 89% have graduated and 11% are now in graduate or medical school. All respondents believed Stanford-CSI was a worthwhile investment of time and resources, with nearly all reporting subsequent increased interest in medicine.

Conclusions: Stanford-CSI's summer internship gives premedical students real-world medical profession exposure and fosters meaningful connections. Our findings and teaching framework can guide similar program developments, supporting future medical education initiatives.

Background: We developed a blended training program at a tertiary pediatric center based on hospital-specific emergency guidelines, profession-specific Virtual Patients (VPs), and interprofessional team training. Using this novel approach, we addressed differing educational needs of medical and nursing staff and intrinsic cognitive overload among participants, aiming for harmonization of in-house emergency proceedings.

Methods: Self-assessments of pediatric emergency knowledge and skills were conducted before (T1) and after (T2) preparation using VPs, as well as after the team training day (T3). At T3, participants completed questionnaires on the training approach, its components, and learning impact. Ten months after the training, a follow-up survey (T4) queried perceived benefits within and beyond emergency situations.

Results: A total of 56 medical staff and 56 nursing staff members participated in the pilot phase. Of these, N = 55 (98%) and N = 48 (85%), respectively, returned self-assessments; questionnaires were completed by N = 55 (98%) and N = 51 (91%), respectively. In both groups, 57 participants (50.9%) completed the follow-up survey. After team training (T3), both groups had statistically significant increased knowledge and skill scores compared with those at T1. Regarding the blended approach and its components, medical and nursing staff alike rated the entire course and its guidelines, the preparatory VPs, and the team training very highly. Participants felt being better prepared for pediatric emergencies. Perceived strengths of the training approach were in the triangulation of teaching methods and its interprofessionalism. More training scenarios were requested, as well as recurrent training. In the follow-up, participants reported improved confidence and calmness, as well as improved communication and collaboration when involved in an emergency. Beyond emergencies, benefits were reported in daily routines.

Conclusions: Our blended approach was perceived as being effective in improving preparedness among medical and nursing house staff. This approach permits customization of content and deliberate practice to improve pediatric critical care.

Background: Clinical decision-making (CDM) refers to physicians' ability to gather, evaluate, and interpret relevant diagnostic information. An integral component of CDM is the medical history conversation, traditionally practiced on real or simulated patients. In this study, we explored the potential of using Large Language Models (LLM) to simulate patient-doctor interactions and provide structured feedback.

Methods: We developed AI prompts to simulate patients with different symptoms, engaging in realistic medical history conversations. In our double-blind randomized design, the control group participated in simulated medical history conversations with AI patients (control group), while the intervention group, in addition to simulated conversations, also received AI-generated feedback on their performances (feedback group). We examined the influence of feedback based on their CDM performance, which was evaluated by two raters (ICC = 0.924) using the Clinical Reasoning Indicator - History Taking Inventory (CRI-HTI). The data was analyzed using an ANOVA for repeated measures.

Results: Our final sample included 21 medical students (age_mean = 22.10 years, semester_mean = 4, 14 females). At baseline, the feedback group (mean = 3.28 ± 0.09 [standard deviation]) and the control group (3.21 ± 0.08) achieved similar CRI-HTI scores, indicating successful randomization. After only four training sessions, the feedback group (3.60 ± 0.13) outperformed the control group (3.02 ± 0.12), F (1,18) = 4.44, p = .049 with a strong effect size, partial η² = 0.198. Specifically, the feedback group showed improvements in the subdomains of CDM of creating context (p = .046) and securing information (p = .018), while their ability to focus questions did not improve significantly (p = .265).

Conclusion: The results suggest that AI-simulated medical history conversations can support CDM training, especially when combined with structured feedback. Such training format may serve as a cost-effective supplement to existing training methods, better preparing students for real medical history conversations.

Introduction: Computer-based tests (CBT) have been noted as a stellar alternative for examinations, having been expected to address the deficiencies of traditional examination model. This study assessed the perceptions, challenges and strategies for improving the Nursing and Midwifery Council of Nigeria computer-based final qualifying examination.

Methods: The study was a cross-sectional descriptive survey using all the 214 year 2023 graduates of the Department of Nursing Sciences, University of Nigeria, Enugu Campus. Data was collected using a researcher-developed questionnaire.

Results: Majority had a positive perception towards CBT (74.3%). Their was a preference for CBT compared to traditional pen and paper examination (2.96 ± 0.96), Respondents experienced challenges answering long story-like question amidst limited time (74.3%) among others. It was suggested that use of good CBT environment to prevent time wastage, (3.32 ± 0.83), and fixing of malfunctioning computer systems prior to examination (3.32 ± 0.85) will help ameliorate challenges. There were no significant association between perception and sex (p = .308) as well as between the challenges experienced and age (p = .322).

Conclusion: The perception of candidates on the use of CBT for final qualifying nursing examinations was positive. Addressing the challenges experienced will ensure a sustained positive and seamless experience for candidates.

Background: Education was affected during the COVID-19 pandemic, and there was a need to adapt the learning approaches to the situation. At the University of Gadjah Mada, many essential soft skills of healthcare professionals are taught using the interprofessional education (IPE) approach on-site. Our university responded to this crisis by offering online classes and similar types of training. Post-administration of the course, a peer-assessment was conducted, and it was used to provide feedback on the work or performance of peers among students. Peer assessment was done using paper-based and a mobile application during COVID-19. This study aimed to share a best practice for the implementation of a rank-based peer-assessment application for longitudinal interprofessional education in the community setting and to compare the score distribution of a rank-based peer-assessment before and after using mobile application.

Methods: Quantitative research design was used by processing secondary data on student peer assessment scores from 3 bachelor programs (medicine, nursing, nutritionist) Community and Family Health Care with Interprofessional Education (CFHC-IPE) in Faculty of Medicine, Nursing, and Public Health, Universitas Gadjah Mada. 4,790 students from 2018 to 2022 (5 years) were tracked before, during, and after the COVID-19 pandemic. The assessments carried out were offline, online, and blended learning, respectively. The assessment was carried out using a paper-based method before and during the pandemic, online-based with a mobile application was used. Thus, the peer-assessment was conducted manually or using paper-based method using a 5-rank scoring system. In 2019, the peer assessment was carried out using a mobile application and applied a 10-rank scoring system.

Results: The rank-based peer assessment can be well implemented to make students assess their friends more objectively, with an average score 82.02 ± 8.68. The rightward shift in the distribution of scores indicates that the average score has improved after using the mobile application compared to before its use. (82.02 ± 8.68 vs. 62.39 ± 11.13, p < 0.05).

Conclusion: The implementation of rank-based peer-assessment using a mobile application was well received during and after the pandemic by interprofessional undergraduate students. The online system made the assessment more objective and the average grades were seen to be better.

Background: There is an increasing range of mind-body medicine (MBM) courses in Germany to support university students in dealing with stress. The evaluation of these varies and often only has a small number of participants due to the limited group size of the courses. The aim of this project was the development of a quantitative basic evaluation that can be used across all sites that conduct MBM courses.

Methods: In a consensus-based and systematic decision-making process, the learning objectives and various questionnaires for the evaluation of MBM courses were discussed and evaluated by experts according to defined criteria. The process was iterative, in which the reflection and definition of the learning objectives and the questionnaires were conditional and adapted if necessary. The recommendations for the basic evaluation of students' MBM courses were developed by consensus among the experts.

Results: For the experts, the most important learning objectives of the MBM courses were stress reduction and self-experience with the exercises. A total of 21 questionnaires were evaluated from nine topics: mindfulness, empathy, self-reflection, self-efficacy, resilience, stress, sense of coherence, quality of life, and well-being. Finally, eight questionnaires were recommended by the expert group for use in a basic evaluation: stress (PSS-10), quality of life (WHOQOL-Bref), mindfulness (MAAS), self-efficacy (GSE), self-compassion (SCS), empathy (SPF), self-reflection (GRAS) and sense of coherence (SOC-13). Further questionnaires were recommended as "optional". An additional qualitative evaluation is recommended for a broader and deeper understanding of the quantitative results.

Conclusions: The proposed basic evaluation is the central result of the iterative consensus-based decision-making process, which reflects the learning objectives of the underlying MBM courses. We hope that the basic evaluation will be integrated into other MBM courses so that results of various courses can be pooled and compared across sites in the future. This could increase the informative value of the evaluations. Furthermore, researchers could consider the use of the basic evaluation in clinically controlled trials on MBM.

Trial registration: The project was not registered in a clinical trial registry because no results from health care interventions on human participants have been analyzed or reported.

Background: Impoverished students constitute a group that cannot be overlooked in higher education. It is crucial for pharmaceutical universities worldwide to implement financial assistance programs that promote the development and success of students from poor families. Chinese universities have carried out active exploration of subsidized education, and made important achievements, but there are also problems, which are worth learning from. This study proposed a strategy to improve the core literacy of impoverished pharmaceutical students under the development-oriented funding system.

Methods: The study centers on clinical pharmacy students from a pharmaceutical college as the research subjects. A sequential explanatory mixed-methods approach was employed, with quantitative data collected through a survey questionnaire, supplemented by qualitative data collected through in-depth interviews. Data gathered from these two levels were integrated and subjected to statistical analysis.

Results: The quantitative survey yielded a total of 397 valid samples, most of whom were females (73.8%), mainly at undergraduate level (89.67%), and from non-urban area (73.81%). Five of them participated in further qualitative interviews. The combined data identified: (a) financial aid-most students were highly satisfied with the financial support; (b) psychological support-most of the students interviewed reported that the scholarship significantly improved their self-confidence and motivation; (c) academic guidance-funded students had clear expectations for career development and academic guidance, demonstrating a strong need for further professional study; and (d) employment assistance-most students wanted career guidance and career planning support.

Conclusions: The financial assistance in pharmaceutical colleges and universities should be enriched to resolve the worries of impoverished clinical pharmacy students through economic assistance, improve the moral cultivation with psychological assistance, strengthen their cultural and scientific literacy, and improve their knowledge and practical ability through academic assistance. Through the integration of pharmacy education, the vocational competence of clinical pharmacy students can be improved by employment assistance, and the reform of higher pharmacy education can be further promoted to improve the training quality of pharmaceutical talents.

Background: Acquiring sufficient knowledge and understanding the importance of intestinal microbiota and probiotics in health and disease, as well as their potential for interactions with concurrently administered drugs, can significantly influence future pharmacotherapeutic practices among health science students.

Objective: This study aimed to assess the knowledge, factors influencing knowledge, attitudes, and practices regarding intestinal microbiota and probiotics and their interactions with drugs among students of the Faculty of Medicine in Novi Sad.

Materials and methods: This cross-sectional study was conducted in the form of an anonymous questionnaire among first- and final-year medical and pharmacy students. Predictors of knowledge scores were analyzed using a negative binomial regression model.

Results: The questionnaire was completed by 263 medical and pharmacy students (44.58% first-year and 55.5% final-year students). Approximately half of the students (53.2%) demonstrated fair knowledge, 34.2% had poor knowledge, and only 12.5% had good knowledge about the intestinal microbiota and probiotics. Study year and self-assessment of knowledge were statistically significant predictors of knowledge scores, while the presence of chronic diseases, previous education, and lifestyle were not. The most common indications for probiotic use among respondents were antibiotic use (75.4%) and gastrointestinal symptoms (69.9%). A large number of respondents reported not paying attention to the concurrent use of probiotics with drugs or food, nor to the choice of specific probiotic strains. Most students expressed that they receive insufficient information on this topic at the university.

Conclusion: Most students demonstrate inadequate knowledge about the gut microbiota and probiotics, which affects their practical use of these supplements. The primary reasons for this are insufficient information and unreliable sources of information. Therefore, enhancing education on this topic could significantly improve the knowledge and pharmacotherapeutic practices of future healthcare professionals.

Background: Medication management is a critical aspect of nursing, in particular with respect to paediatric patients, in whom medication errors are prevalent. Enhancing competence in this area requires not only general nursing skills but also targeted educational interventions and emotional support. This study aims to examine the relationship between nursing students' levels of liking children and their self-efficacy in paediatric medication administration, thereby exploring the impact of emotional factors on clinical competence.

Methods: This descriptive study was conducted with 308 nursing students in their second, third and fourth years of study at a state university in eastern Turkey between December 2022 and February 2023. Data were collected using the Student Descriptive Information Form, the Barnett Liking of Children Scale and the Medication Administration Self-Efficacy Scale. Statistical analysis included the Mann-Whitney U test, the Kruskal-Wallis H test, Dunn's test for multiple comparisons and Spearman's rho correlation coefficient.

Results: The mean age of the participants was 21.82 ± 1.94 years, and 68.8% were female. The mean Medication Administration Self-Efficacy Scale score was 52.97 ± 15.27, and the mean Liking of Children Scale score was 66.65 ± 15.8. No significant relationship was found between the total score on the Liking of Children Scale and the score on the drug preparation subdimension (p > 0.05). However, a positive but weak correlation was found between the total score on the Liking of Children Scale and the score on the drug administration subdimension (r = 0.137; p < 0.05). Similarly, a positive but weak relationship was identified between the total score on the Liking of Children Scale and the score on the Medication Administration Self-Efficacy Scale (r = 0.123; p < 0.05).

Conclusions: Nursing students' liking of children is positively, although weakly, associated with their self-efficacy in paediatric medication administration. This result suggests that emotional factors, such as affinity for children, may be relevant when designing nursing education programmes, particularly in paediatric care settings .