BMC Medical Education最新文献

Background and objectives: Medical students face significant test anxiety due to academic pressure and limited mental health support. Peer led interventions offer a promising alternative, but evidence in medical education is limited. This study was aimed to develop a validated mental health intervention module and evaluate the impact of peer-led mentoring program on test anxiety among undergraduate MBBS students in India.

Methods: A structured, evidence-based peer-led mentoring module was developed using ADDIE model and validated by experts (Content Validity Index > 0.78). Study employed single-arm, pre-post intervention design involving 100 s-year MBBS students of a public medical college. Peer mentors, trained using a validated module, provided group and individual mentoring before high-stakes examinations (Mock Boards). The primary outcome was test anxiety scores measured using Westside Test Anxiety (WTA) Scale. Secondary outcomes included academic performance and qualitative assessments of acceptability and feasibility through focus group discussions.

Results: At baseline, 40% of students had test anxiety (WTA ≥ 3) (32% moderate-high, 8% severe), with a median WTA score of 2.7 (IQR: 2.25-3.25). Post-intervention, median WTA scores significantly decreased to 2.35 (difference: -0.35; 95% CI: -0.5 to -0.2; P < 0.001). The proportion of students with normal/high-normal anxiety (WTA score <3) increased from 60% to 79%, and no students had severe anxiety post-intervention (P = 0.002). Students with moderate-high anxiety showed ~22% reduction, while those with severe anxiety showed ~30% reduction in median WTA scores. Academic performance showed no significant differences among anxiety groups. Students reported high satisfaction (median score: 7/10), and the intervention was deemed highly acceptable and feasible.

Conclusions: The peer-led mentoring program effectively reduced test anxiety among medical students during high stakes examination. While academic performance did not significantly improve, integration of such programs into formal support systems could enhance sustainability and impact in medical education settings.

Background: Paediatric Cardiopulmonary resuscitation (CPR) is critical for saving children who experience cardiac arrest, but traditional teaching is often ineffective at improving clinical competence and teamwork. This study evaluates an innovative, understudied model: integrated simulation combined with Team-Based Learning (TBL) in CPR training among paediatric postgraduates.

Methods: This multi-methods observational study involved twenty-four paediatric postgraduates. The teaching method consisted of integrated simulation combined with TBL. Learning performance was measured before and after the course. Semi-structured interviews were conducted and recorded to collect data until data saturation was achieved, with the resulting data analyzed using inductive thematic analysis within a constructivist paradigm. Two researchers independently coded transcripts using NVivo 12.0, identified themes iteratively, and ensured rigour through member checking.

Results: The integrated simulation with TBL approach produced significant improvements in clinical operation scores: hands-on CPR (80.95 ± 5.81 vs. 88.46 ± 7.35), endotracheal intubation (76.03 ± 6.51 vs. 81.89 ± 9.72), defibrillation (79.96 ± 4.37 vs. 89.84 ± 3.98), and teamwork (28.33 ± 2.46 vs. 32.99 ± 2.85) (P < 0.05). For the qualitative component, semi-structured interviews were conducted with 11 participants, and analysis identified 10 core themes grouped into four clusters: "reflection and feedback," "highly simulated clinical scenario," "improving clinical thinking," and "teamwork and communication."

Conclusion: The integrated simulation with TBL improves instructional effectiveness and overall clinical emergency response capabilities among paediatric postgraduates, thereby offering an innovative structured small-group learning method for paediatric CPR training.

Background: Perioperative clinical reasoning is a pivotal competency in anaesthesiology, yet it remains underdeveloped in many residency curricula, including in China. We implemented a longitudinal elective course based on script and dual-process theories, featuring a "tripartite framework" (integrating patient-, surgery-, and anaesthetic-related factors) to enhance reasoning skills among junior residents.

Methods: A quasi-experimental study enrolled 82 first-year residents (2018-2021 cohorts) from a tertiary academic hospital. Participants in the experimental group (n = 45) voluntarily enrolled in a supplementary 56-hour course (organ-system modules, small-group case discussions), while the control group (n = 37) received conventional training. Facilitators (≥ 15 years' clinical experience, AMEE-certified) guided script development, analytical reasoning, and application of a tripartite framework (patient-, surgery-, and anaesthetic factors). A blended assessment strategy-incorporating MCQs, structured oral examinations, and anaesthesia planning tasks-was employed at 3-4 months and approximately 16 months post-intervention to evaluate short-term pedagogical impact and medium-term competency development. Questionnaires were distributed to evaluate course satisfaction and perceived clinical utility. Effect sizes (Cohen's d) were calculated to assess educational impact.

Results: Baseline characteristics were comparable between groups (p > 0.05). In the short-term assessment (3-4 months), the experimental group outperformed controls only in anaesthesia planning (64.2 ± 5.8 vs. 60.8 ± 8.5, p < 0.05, d = 0.47). Notably, by the 16-month medium-term assessment, the experimental group demonstrated significant and comprehensive superiority in all domains: MCQs (108.9 ± 8.8 vs. 99.8 ± 8.9, d = 1.02), anaesthesia planning (78.7 ± 9.1 vs. 70.5 ± 8.2, d = 0.94), and oral exams (80.5 ± 10.7 vs. 67.7 ± 9.1, d = 0.99) (all p < 0.01). While 47.7% of participants reported a notable learning burden, 95.5% expressed overall satisfaction and 97.7% perceived a positive impact on clinical practice.

Conclusion: This course effectively bridges cognitive theory and clinical practice, demonstrating measurable improvements in perioperative reasoning. The tripartite framework provides a replicable cognitive scaffold for high-acuity specialty training. Longitudinal data underscore the importance of sustained practice and blended assessments for competency maturation.

Background: Clinical competence is a core outcome of undergraduate medical education, yet traditional clerkships often lack structured observation and feedback. This study evaluated the effectiveness of a workplace-based learning program (WBLP) incorporating mini-Clinical Evaluation Exercises (mini-CEX) and Direct Observation of Procedural Skills (DOPS) into an internal medicine clerkship, and its impact on students' clinical competence and learning satisfaction.

Methods: This retrospective cohort study analyzed outcomes of fourth-year medical students who completed a 9-week internal medicine clerkship at Zhejiang University School of Medicine between September 2024 and May 2025. Students were categorized into a WBLP group (n = 39) and a control group (n = 38). The WBLP group received structured formative assessments with mini-CEX and DOPS every 1-2 weeks, followed by immediate feedback. Outcomes included knowledge acquisition (multiple-choice question [MCQ] exam), clinical performance (6-station Objective Structured Clinical Examination [OSCE]), and perceptions of the learning environment (satisfaction questionnaire).

Results: Seventy-seven students were included. The WBLP group achieved significantly higher scores in both the MCQ exam (85.3 ± 6.1 vs. 80.2 ± 6.7, p < 0.001) and OSCE (86.4 ± 5.4 vs. 80.9 ± 5.9, p < 0.001), particularly in history taking, clinical reasoning, and procedural skills. No significant difference was observed in CPR performance. Students in the WBLP group reported greater satisfaction with feedback, patient communication, and overall learning experience (p < 0.01).

Conclusion: Integrating structured workplace-based assessments into clerkship training significantly enhances students' clinical competence and improves their learning experience. These findings provide preliminary evidence to support broader implementation of WBLP in undergraduate medical curricula.

Background: Virtual Reality (VR) generates an artificial environment in which users interact with computer-generated scenarios and sounds. Using devices such as headsets and motion sensors, users are immersed in a simulated world. Augmented reality (AR) is an interactive overlay of the real environment that provides an additional wrapper over the environment, and the user experiences an immersive and interactive environment. In Mixed reality (MR), VR and AR elements are combined; computer graphics interplay with real objects, allowing users to interact with virtual and physical objects at the same time. VR and MR are effective training tools in different healthcare settings. These tools are useful for preparing emergency health personnel to respond to disasters by providing them with an immersive reality since real practices are very difficult to implement in mass casualty incidents. Given the usefulness of this approach, assessing the optimal training times associated with this method and the side effects that may influence learning is helpful. One of the most common side effects is fatigue. We developed a questionnaire to assess fatigue in terms of various dimensions, that can affect a person while training in the context of VR and MR.

Methods: We designed a questionnaire to assess the fatigue levels perceived by professionals and validated this measure after VR training experience. We analyzed ratings of visual, mental, physical, and general fatigue. This questionnaire was applied to emergency professionals (Sample size = 101).

Results: The reliability and validity of the questionnaire were assessed in terms of the following factors: general, social, emotional, visual, and motivational fatigue.

Conclusions: The results of this research suggest that fatigue is an element of VR and MR training. Educators should take these effects into account to optimize learning in the context of VR and MR. According to user feedback, the optimal length of time for mixed reality training is around 20 min, especially when the user has little or no experience.