BMC Medical Education最新文献

Background: Skill training in medical education poses significant challenges. The traditional "see one, do one " approach is increasingly seen as outdated and inconsistent with modern adult learning principles. The 2019 Medical Council of India (MCI) skill training module recommends Peyton's four-step method for psychomotor skill training is designed for a 1:1 teacher-to-student ratio. However, this ratio is often impractical due to faculty shortages. Peer-assisted learning (PAL) has emerged as a potential solution, yet its effectiveness in teaching suturing skills using Peyton's method remains underexplored in our context.

Objectives: To compare the effectiveness of PAL using Peyton's method with faculty-assisted learning (FAL) for surgical skill training and to evaluate students' perceptions of their learning experiences through validated feedback forms.

Materials and methods: Sixty second-year MBBS students were randomized into two groups: one trained in basic suturing techniques (interrupted, vertical mattress, and continuous suturing) by peer tutors (PAL group) and the other by faculty members (FAL group). Peer tutors, trained by senior faculty members, used Peyton's four-step method to teach suturing techniques in a skill lab using manikins. Post-training, proficiency was assessed using a 15-point OSCE checklist, and students' perceptions were evaluated through a questionnaire.

Results: Both groups achieved mean proficiency scores exceeding 80% (> 12/15) across all techniques, with no statistically significant difference between groups. Students in both groups reported high satisfaction with their training experience. Notably, the PAL group demonstrated significantly higher confidence in performing suturing both in the skill lab and on real patients (p < 0.05).

Conclusion: Peer-assisted learning is as effective as faculty-assisted learning for surgical skill training using Peyton's method. PAL can be recommended as a viable adjunct to traditional teaching methods for skill instruction.

Clinical trial number: Not applicable.

Background: The biopsychosocial and spiritual model (BPSM), commonly referred to as body-mind unity, complements the biological model by expanding health professionals' understanding through the integration of psychological and eco-social elements as influential factors in health and disease. Clerkships are a phase of medical education where students transition from theoretical learning to practical application under the supervision of experienced health practitioners. This study investigates the knowledge, attitudes, and practices (KAP) of clerkship supervisors at the University of Botswana's Faculty of Medicine (UB-FOM) regarding the BPSM.

Methods: We conducted a quantitative cross-sectional survey, distributing online (via Microsoft 365 Forms) and self-administered paper-based questionnaires to clerkship supervisors. KAP information was gathered using a five-point Likert scale and an open-ended question section that asked respondents to elaborate on factors they perceived as limitations to applying the BPSM.

Results: Only 34.3% of approximately 140 clerkship supervisors invited to participate in the study responded. Forty-eight supervisors completed the questionnaire. Most participants (n = 38, 79.2%) reported receiving training on the BPSM during their undergraduate or postgraduate education. Most UB-FOM clerkship supervisors appreciated the importance of considering all four dimensions of health in healthcare activities (mean score = 4.14 > weighted mean score of 4.04). They felt less comfortable instructing medical students on the model during clinical rotations (mean score = 3.98 < weighted mean score of 4.04), and they expressed less agreement about the ability of psychosocial processes and treatments to alter medical illnesses. Additionally, they less recognised the importance of incorporating spiritual evaluation into medical practice (mean score = 3.82 < weighted mean score of 4.04). Obstacles to implementing the BPSM included time constraints during consultations, a negative attitude towards the BPSM, a lack of updated training, and an absence of defined guidelines for the BPSM.

Conclusion: While most UB-FOM clerkship supervisors who participated to the study acknowledged the importance of considering all four dimensions of health in healthcare activities, they felt less comfortable instructing medical students on the BPSM during clinical rotations and expressed less agreement about the efficacy of psychosocial processes in medical treatment. We recommend implementing research that specifically targets the beliefs and attitudes of clerkship supervisors.

Precision Medicine (PM) is revolutionizing patient care by integrating biomedical data, lifestyle factors, and environmental influences to guide treatment plans, particularly in the field of oncology. With its growing utility, there is a pressing need to ensure that recent medical graduates are competent in this field. This study examines the impact that involvement in a Precision Medicine Clinic (PMC) has on medical students' education and career plans. Surveys were distributed to medical students who presented at PMC meetings with the goal of assessing comfort, confidence, and perceived benefit of involvement, along with qualitative feedback. Results indicated increased comfort and confidence in PM and in the interpretation of Next Generation Sequencing (NGS) following involvement in PMC and a positive influence on future career plans. Qualitative responses highlighted enhanced critical thinking skills and career exploration. These findings underscore the significance of integrating hands-on PM experiences into medical education to effectively prepare future healthcare professionals for the medical landscape in which they will be working. Limitations include potential biases from retrospective survey responses, revealing an opportunity for future prospective surveys. This study offers a valuable framework for institutions seeking to incorporate PM into medical education curricula.

Introduction: Given the importance of the internship course in enhancing student capabilities, it seems necessary to employ appropriate techniques to manage and organize the training process. This research was conducted with the goal of identifying the essential data elements required for the development of an internship monitoring system in Health Information Technology.

Methods: This qualitative research was conducted in 2022 using the Delphi technique. The study population consisted of professors from the Health Information Technology departments in medical universities in Iran (n = 85), selected through a convenience sampling method. The research instrument was a researcher-developed questionnaire, designed based on the approved educational curriculum, literature review, and analysis of existing systems. Its validity was confirmed by a panel of Health Information Technology experts, and its reliability was established with a Cronbach's alpha coefficient of 0.83. The results of the Delphi rounds were analyzed and presented using descriptive statistical methods (Percent, Average, Standard deviation) with SPSS software, version 16.

Results: Twenty professors from the Health Information Technology departments across the country participated in this research. The final model of the essential data elements for developing an internship monitoring system in Health Information Technology comprises five main data sections as follows: management data elements with three data axes, user data elements section with four data axes, functional data elements section with six data axes, output data elements section with two data axes, and key performance indicators section with five data axes.

Conclusion: In this research, a comprehensive set of essential data elements for developing an internship monitoring system in Health Information Technology was compiled. The proposed framework can facilitate the integration of data collection and provide a coherent approach to student evaluation.

Introduction: This study aimed to explore the factors that contribute to sustaining the motivation of teachers in medical science universities.

Materials and methods: This qualitative content analysis study was conducted from August 2019 to May 2021. Thirty-seven in-depth semi-structured interviews were conducted with teachers from medical sciences universities in Iran, selected through purposive sampling. The conventional content analysis approach was employed to analyze the data. The process involved five steps, including identifying meaning units, condensing them, assigning codes, establishing categories and subcategories, and identifying overarching themes.

Results: The teachers' experiences were explored into 'establishing pathways to excellence in the teaching profession'. Three categories 'engagement with continuous personal and professional development', 'autonomy for exploration', and 'pleasure in the teaching profession' were explored as the factors that contribute to the sustaining of teachers' motivation. Teachers' motivation is sustained through their engagement in continuous personal and professional development, which promotes a sense of growth and mastery. Autonomy for exploration is also a critical factor, as it enables teachers to take ownership of their work, and innovate without restrictions, thereby sustaining their job motivation. Furthermore, the pleasure derived from the teaching profession, encompassing the enjoyment of teaching, sense of self-worth, and fulfillment, plays a vital role in sustaining teachers' motivation and driving their pursuit of excellence.

Conclusion: The teachers' experiences were explored into a theme of 'establishing pathways to excellence in the teaching profession'. The results revealed that engagement in exploration and continuous personal and professional development contributed to the sustained motivation of teachers. Teachers who pursued the excellence pathway reported a sense of fulfillment and pleasure in their teaching profession, which was facilitated by their involvement in the process. Moreover, collaboration with others catalyzes personal and professional growth, thereby fostering sustained motivation among educators.

Background: The integration of artificial intelligence (AI) into medical education is poised to revolutionize teaching, learning, and clinical practice. However, successful implementation of AI-based tools in medical curricula faces several challenges, particularly in resource-limited settings like Pakistan, where technological and institutional barriers remain significant. This study aimed to evaluate knowledge, attitudes, and practices of medical students and faculty regarding AI in medical education, and explore the perceptions and key barriers regarding strategies for effective AI integration.

Methods: A concurrent mixed-methods study was conducted over six months (July 2023 to January 2024) at a tertiary care medical college in Pakistan. The quantitative component utilized a cross-sectional design, with 236 participants (153 medical students and 83 faculty members) completing an online survey. Mean composite scores for knowledge, attitudes, and practices were analyzed using non-parametric tests. The qualitative component consisted of three focus group discussions with students and six in-depth interviews with faculty. Thematic analysis was performed to explore participants' perspectives on AI integration.

Results: Majority of participants demonstrated a positive attitude towards AI integration. Faculty had significantly higher mean attitude scores compared to students (3.95 ± 0.63 vs. 3.81 ± 0.75, p = 0.040). However, no statistically significant differences in knowledge (faculty: 3.53 ± 0.66, students: 3.55 ± 0.73, p = 0.870) or practices (faculty: 3.19 ± 0.87, students: 3.23 ± 0.89, p = 0.891) were found. Older students reported greater self-perceived knowledge (p = 0.010) and more positive attitudes (p = 0.016) towards AI, while male students exhibited higher knowledge scores than females (p = 0.025). Qualitative findings revealed key themes, including AI's potential to enhance learning and research, concerns about over-reliance on AI, ethical issues surrounding privacy and confidentiality, and the need for institutional support. Faculty emphasized the importance of training to equip educators with the necessary skills to effectively integrate AI into their teaching.

Conclusions: This study highlights both the enthusiasm for AI integration and the significant barriers that must be addressed to successfully implement AI in medical education. Addressing technological constraints, providing faculty training, and developing ethical guidelines are critical steps toward fostering the responsible use of AI in medical curricula. These findings underscore the need for context-specific strategies, particularly in resource-limited settings, to ensure that medical students and educators are well-prepared for the future of healthcare.

Introduction: Bias, privilege, microaggressions, and other forms of mistreatment negatively impact students' learning, professional development, wellness, and identity. Supporting Educational Excellence in Diversity (SEED) is an innovative faculty development curriculum co-founded and co-designed by medical students/trainees. SEED is unique given it provides vital yet practical communication tools and strategies to support cultural humility when navigating critical conversations related to diversity, inclusion, and harm.

Objective: This curriculum helps faculty to identify, redress, and prevent mistreatment within clinical and non-clinical learning environments while cultivating cultural humility.

Methods: SEED incorporated a sequential hybrid model approach through the use of interactive online modules, virtual asynchronous self-reflection assignments, followed by in-person discussions with role-play opportunities. Using novel tools, it taught faculty core knowledge and strategies to facilitate discussions in navigating harms related to diversity and inclusion. Authors measured impact via self-reported, de-identified pre-and-post questionnaires.

Results: An idependent t-test analysis pre-post-test study of 67 faculty participants revealed statistically significant (P < .001) differences from pre to post on all items with one item statistically significant at a p < .05. The overall effect size was 1.65 showing significant improvement in participants' self-perceived ability to identify and address microaggressions, privilege, sources of bias, and related harm in the clinical and learning environments. These improvements were identified within themselves, faculty peers, teaching curricula, and teaching modalities. SEED was adopted health system-wide through customized departmental faculty offerings given the statistically and practically significant change in learning, awareness, and attitudes for respondents. SEED is currently under consideration as a maintenance of certification self-assessment course by a national board.

Conclusion: The innovative SEED faculty development curriculum was co-created and designed by students/trainees. SEED shows promising results in improving participants' foundational learning in promoting inclusive change to enhance learning environments for healthcare trainees. SEED is unique in providing vital yet practical communication tools and strategies to support cultural humility when navigating critical conversations related to diversity, inclusion, and harm.

Background: Artificial Intelligence is currently being applied in healthcare for diagnosis, decision-making and education. ChatGPT-4o, with its advanced language and problem-solving capabilities, offers an innovative alternative as a virtual standardised patient in clinical training. Intern physicians are expected to develop clinical case management skills such as problem-solving, clinical reasoning and crisis management. In this study, ChatGPT-4o's served as virtual standardised patient and medical interns as physicians on clinical case management. This study aimed to evaluate intern physicians' competencies in clinical case management; problem-solving, clinical reasoning, crisis management and explore the impact and potential of ChatGPT-4o as a viable tool for assessing these competencies.

Methods: This study used a simultaneous triangulation design, integrating quantitative and qualitative data. Conducted at Aydın Adnan Menderes University, with 21 sixth-year medical students, ChatGPT-4o simulated realistic patient interactions requiring competencies in clinical case management; problem-solving, clinical reasoning, crisis management. Data were gathered through self-assessment survey, semi-structured interviews, observations of the students and ChatGPT-4o during the process. Analyses included Pearson correlation, Chi-square, and Kruskal-Wallis tests, with content analysis conducted on qualitative data using MAXQDA software for coding.

Results: According to the findings, observation and self-assessment survey scores of intern physicians' clinical case management skills were positively correlated. There was a significant gap between participants' self-assessment and actual performance, indicating discrepancies in self-perceived versus real clinical competence. Participants reported feeling inadequate in their problem-solving and clinical reasoning competencies and experienced time pressure. They were satisfied with the Artificial Intelligence-powered standardised patient process and were willing to continue similar practices. Participants engaged with a uniform patient experience. Although participants were satisfied, the application process was sometimes negatively affected due to disconnection problems and language processing challenges.

Conclusions: ChatGPT-4o successfully simulated patient interactions, providing a controlled environment without risking harm to real patients for practicing clinical case management. Although some of the technological challenges limited effectiveness, it was useful, cost-effective and accessible. It is thought that intern physicians will be better supported in acquiring clinical management skills through varied clinical scenarios using this method.

Clinical trial number: Not applicable.

Background: High-quality care is a significant factor in reducing maternal and neonatal mortality. There are known barriers affecting midwives' ability to provide quality care in low- and middle-income countries. The presence of qualified and competent midwives, coupled with the elimination of barriers, is essential for enhancing care quality, especially in education program clinical practice settings.

Aim: To explore factors that affect Ghanaian midwifery students' provision of high-quality care while on clinical rotation.

Method: Six focus-group discussions were conducted with a total of 36 midwifery students in Accra, Ghana. Data were analyzed using deductive content analysis applying a conceptual framework identifying social, economic and professional factors influencing the provision of high-quality care.

Results: Social factors identified patient resistance to student midwives, class-based discrimination, traditional practices being preferred over evidence-based care, communication barriers, and poor security. Economic factors were unexpected expenses and inadequate compensation. Professional factors were lack of necessary materials, insufficient number of staff, and a theory-practice gap between classroom learning and hands-on experiences.

Conclusion: Factors impacting Ghanaian midwifery students' ability to provide high-quality care in clinical settings were summarized, highlighting social, economic, and professional challenges. Key issues include patient resistance, class-based discrimination, inadequate compensation, theory-practice gaps, and lack of materials. The findings emphasize the need for improved support, resources, and quality clinical learning environments. There needs to be investment in infrastructure and prioritization of pedagogy in clinical settings to enhance midwifery education and care quality in Ghana and more broadly in low- and middle-income countries.

Clinical trial number: Not applicable.

Introduction: Emotions and feelings are crucial components of our lives. However, their role in medical education scholarship, including in neuroscience education, has been overlooked. Moreover, their impact has been understudied in academia, especially across career stages. We explored emotions and feelings in the context of neuroscience education and across different career stages.

Methods: This work is based on a project exploring the value of learning in postgraduate education, drawing on data from nineteen semi-structured interviews with university alumni and academics. Eight alumni (six females and two males) and eleven academics from a UK-based STEM-intensive institution participated in the study. Alumni refers to former students who have completed the MSc in neuroscience at a STEM-intense institution within the last six years. Lecturers and Senior Lecturers in neuroscience have been labelled as junior academics, whereas Readers and Professors have been labelled senior academics.

Results: The alumni recognised their master experience was intense and challenging, yet acknowledged that enjoyment and stress are two faces of the same coin. Many cited their peers as an inspiration to go beyond the limits but only one student mentioned gratitude, which was never mentioned by the academics. At least one alumnus and one junior academic mentioned trust and confidence, but not the senior academics. Anxiety and confidence (and lack of) dominated the interviews with junior academics, who used intense words when discussing the pleasures of science. Conversely, the senior academics dedicated few words to emotions and feelings, never talked about anxiety, trust or gratitude, and very briefly mentioned the reward linked to sharing their knowledge with the next generations.

Discussion: This work epitomises the importance of exploring emotions and feelings in neuroscience education. Talking more openly about emotions and reducing the pervasive narration of 'success stories' might be directions to follow, along with stressing the importance of cultivating self-efficacy, trust and gratitude since the early stages. Meetings between students and supervisors can play a key role in developing self-trust among the students. More focus should be placed on supporting the transition process between postgraduate studies and the subsequent steps of the academic ladder.