BMC Medical Education最新文献

Introduction: Urinary incontinence (UI) is a growing global health problem that affects both women and men of all ages and can seriously negatively impact quality of life. Healthcare professionals' knowledge and attitudes significantly influence UI prevention, diagnosis, and treatment. However, there is a notable lack of research exploring healthcare students' understanding and perceptions of UI. In many countries, they, as future healthcare professionals, must also have continence care competency before graduation. Therefore, the study aimed to assess the knowledge and attitudes of healthcare students toward UI.

Methods: The study was designed as an observational, analytical, and comparative cross-sectional with 378 healthcare students in Serbia during the winter semester of the 2023/2024 academic year. A general questionnaire for obtaining sociodemographic data, the Urinary Incontinence Knowledge Scale (UIKS) and the Urinary Incontinence Attitude Scale (UIAS) were used as students' report measures. Kuder-Richardson Coefficient (K-R 20) showed high reliability of the UIKS at 0.83, while Cronbach's alpha coefficient was 0.62 for the UIAS.

Results: The UIKS score was 16.6 ± 3.9/30. Healthcare students achieved the highest score in the domain of knowledge about the impact of UI on quality of life and the lowest in the domain of UI control. There is a significant difference in students' knowledge level concerning the study program and whether they had a course focusing on UI. The UIAS score was 45.1 ± 4.6/60, indicating a positive attitude to UI. A statistically significant positive but weak correlation was obtained between knowledge and student attitudes about UI.

Conclusions: The study findings highlight a concerning gap in understanding UI among healthcare students despite their pivotal role as future healthcare professionals and underscore the urgent need for comprehensive educational strategies to bridge the knowledge gap and foster more positive attitudes toward UI and their implementation in clinical practice to improve patient health outcomes.

Background/aim: Psychotherapy training for medical students and residents in China is still in development. To establish an appropriate training program, understanding medical students' and residents' current knowledge and attitudes toward psychotherapy is needed.

Methods: One hundred and forty-nine participants, including medical students, residents, and other health providers (HCPs), self-reported their understanding of 18 types of psychotherapy, negative attitude towards cognitive behavioral therapy (CBT), and their attitude towards psychological interventions and counseling in primary care (APIC-PC) through an online survey.

Results: Participants' understanding of psychotherapy was generally low (M = 26.25, SD = 22.99). Medical students' (M = 34.42, SD = 22.61) and HCPs' (M = 37.25, SD = 30.834) understanding was significantly higher than residents' (M = 20.08, SD = 19.54), F(2, 146) = 8.63, p < .001. Participants from psychiatric departments (M = 33.85, SD = 25.89) understood more psychotherapy than those from non-psychiatric departments (M = 20.98, SD = 19.20), t(147) = 3.46, p < .001. Participants with a bachelor's degree (M = 2.40, SD = 0.976) scored lower on the Negative Attitude Towards CBT Scale than participants with a graduate degree (M = 2.76, SD = 1.00), t(147) = -2.20, p = 0.029. All participants' APIC-PC scores were relatively the same and indicated a neutral to slightly positive attitude towards psychotherapy and counseling practices. However, they showed a slightly negative attitude in the "willingness to counsel" subscale (M = 2.65, SD = 0.93).

Conclusion: This study indicated a lack of knowledge of psychotherapy and a lack of psychotherapy courses for medical students and residents, especially those from non-psychiatric departments in China. Our findings suggest an urgent need for psychotherapy and relevant training for Chinese medical students and residents.

Trial registration: The study has been registered at ClinicalTrials.gov (Identifier: NCT06258460, website: httpsregister.

Clinicaltrials: gov ).

Background: Individuals often respond differently to medications, giving rise to the field of precision medicine (PM), which focuses on tailoring treatments to individual genetic, environmental, and lifestyle factors. This study examined the level of comfort healthcare professional students have with their knowledge of precision medicine, alongside their attitudes and perceptions toward precision medicine, at a tertiary institution in Nigeria.

Methods: A cross-sectional questionnaire-based study was conducted among healthcare professional students (400-600 level) at the University of Nigeria Nsukka between January and March 2024. The data were analyzed via IBM Statistical Product and Service Solutions (SPSS) for Windows version 27. Descriptive analyses (frequency, percentage, mean, and standard deviation) and chi-square tests were used to summarize and compare the variables. Statistical significance was set at p < 0.05.

Results: A total of 431 healthcare professional students participated in this study. Fewer than half (n = 200, 46.4%) were pharmacy students, and the majority were within the age range of 21-25 years (n = 288, 66.8%). Nearly half (n = 206, 47.8%) reported having information about precision medicine from the internet, and the majority (n = 341, 79.1%) expressed having an interest in a career involving research in precision medicine. More than half of the students (n = 240, 55.7%) were comfortable with their knowledge of precision medicine and had favourable attitudes (n = 236, 54.8%). Additionally, more than half had positive perceptions of ethical concerns (n = 216, 50.1%) and education in precision medicine (n = 239, 55.5%). Gender, age, department, level of study, awareness of PM, and interest in a career involving research were significantly associated with students' knowledge, attitudes, and perceptions of precision medicine (p < 0.001).

Conclusion: Healthcare professional students were comfortable with their knowledge of PM and, in addition, had favourable attitudes and positive perceptions toward the use of precision medicine.

Background: Academic accreditation is a pivotal process in nursing education, ensuring program quality, consistency, and graduate readiness for professional practice. Despite its significance, limited research explores the lived experiences and perspectives of stakeholders, including academic nurse educators, administrators, students, and alumni-engaged in accreditation.

Purpose: This study aimed to explore the lived experiences, perceptions, and insights of nursing education stakeholders regarding the accreditation process, focusing on its impact on educational quality, program reputation, and professional preparation.

Methods: A qualitative phenomenological approach was employed, using purposive sampling to recruit 54 participants from a Saudi nursing college, including academic nurse educators and administrators (n = 24), students (n = 20), and alumni (n = 10). Data were collected through semi-structured interviews.Thematic analysis identified key themes and subthemes associated with participants' experiences of accreditation.

Findings: Six main themes emerged: (1) knowledge and experience of accreditation; (2) importance and benefits of accreditation; (3) impact of accreditation; (4) preparation for professional practice; (5) challenges of accreditation; and (6) suggestions for improvement. Stakeholders across all groups recognized accreditation as essential for program quality and career readiness. Faculty and alumni emphasized the role of accreditation in enhancing program reputation and credibility, while students highlighted its influence on their learning experiences, though they expressed a desire for more engagement and transparency in the process. Faculty and administrators reported significant challenges, including administrative demands, time management, and resource allocation in maintaining accreditation standards.

Conclusion: This study offers a comprehensive view of accreditation's multi-dimensional impact from multiple stakeholder perspectives and experiences, reinforcing accreditation's importance in promoting nursing education quality and alignment with healthcare standards. However, findings suggest a need for institutional support to manage accreditation demands effectively. Future research should investigate accreditation's long-term impact through longitudinal and multi-site studies to broaden understanding and enhance the generalizability of findings in nursing education contexts worldwide.

Background: Reflection fosters self-regulated learning by enabling learners to critically evaluate their performance, identify gaps, and make plans to improve. Feedback, in turn, provides external insights that complement reflection, helping learners recognize their strengths and weaknesses, adjust their learning strategies, and enhance clinical reasoning and decision-making skills. However, reflection alone may not produce the desirable effects unless coupled with feedback. This study aimed to investigate the impact of feedback integrated reflection on meaningful learning and higher order MCQ score among under-grade medical students.

Objective: To evaluate the impact of feedback-integrated reflection versus reflection alone on higher-order MCQ scores among undergraduate medical students in a gynecology clinical setting.

Methods: A randomized controlled trial was conducted with 68 final-year medical students randomly assigned to a study group (feedback-integrated reflection) and a control group (reflection alone). Both groups completed a pre-test, followed by six daily teaching sessions on gynecology topics. Participants engaged in written reflections after each session, and the study group additionally received individualized feedback. Independent sample t-tests were used to compare pre and post-test scores between the groups, while paired t-tests assessed within-group improvements.

Results: Pre-test scores were comparable between the study group (11.68 ± 2.60, 38.93%) and the control group (11.29 ± 2.38, 37.15%; P = 0.52). Post-test scores showed a significant improvement in the study group (20.88 ± 2.98, 69.32%) compared to the control group (15.29 ± 2.66, 51.00%; P = 0.0001). The percentage gain in learning was 35.43% for the control group (reflection alone) and 78.77% for the study group (feedback-integrated reflection). The normalized learning gain (NLG) was calculated to compare the effectiveness of the intervention (feedback-integrated reflection) with that of the control (reflection alone). The study group demonstrated a mean normalized learning gain of 69.07%, compared to 29.18% in the control group. The net learning gain, calculated as the difference in normalized learning gains between the study and control groups, was found to be 39.89%.

Conclusion: The findings highlight the effectiveness of feedback-integrated reflection versus reflection alone in fostering deeper learning by improving higher-order MCQ scores in a gynecologic setting in the undergraduate medical education.

Trial registration: This trial was registered retrospectively on 27th July 2024. Trial registration no is CTU/07/2024/010/RMU.

Background: National Medical Licensing Examination (NMLE) is the entrance exam for medical practice in China, and its general medical knowledge test (GMKT) evaluates abilities of medical students to comprehensively apply medical knowledge to clinical practice. This study aimed to identify nonacademic predictors of GMKT performance, which would benefit medical schools in designing appropriate strategies and techniques to facilitate the transition from medical students to qualified medical practitioners.

Methods: In 1202 medical students, we conducted the deletion-substitution-addition (DSA) and structural equation model (SEM) analyses to identify nonacademic predictors of GMKT performance from 98 candidate variables including early life events, physical conditions, psychological and personality assessments, cognitive abilities, and socioeconomic conditions. The candidate variables were assessed using psychometrically or cognitively validated and accepted instruments.

Results: We identified seven nonacademic predictors for GMKT performance. Body mass index (BMI) and working memory reaction time showed direct negative effects on GMKT performance. Psychological and personality features (conscientiousness, state anxiety, and openness to experience) indirectly affected GMKT performance via BMI, while socioeconomic conditions (father's education and mother's occupation) indirectly affected GMKT performance by influencing psychological and personality features and further BMI.

Conclusion: The identified nonacademic predictors for GMKT performance and their pathways may be useful for improving medical education by strengthening favorable and weakening, rectifying, or compensating unfavorable factors that are modifiable.

Background: Case-Based Learning (CBL) and Problem-Based Learning (PBL) are popular methods in medical education. However, we do not fully understand how they affect the clinical thinking skills of Assistant General Practitioner (AGP) trainees. This randomised controlled trial aimed to assess the effectiveness of combining CBL and PBL and compare their impact on the clinical thinking skills of AGP trainees with that of traditional lecture-based learning (LBL).

Methods: This randomised controlled trial involved 70 second-year AGP trainees who were randomly assigned to either the CBL-PBL group or the LBL group using a simple randomisation method. The CBL-PBL group engaged in a curriculum that integrated case-based and problem-based learning, whereas the LBL group followed a traditional lecture-based format, as described in the syllabus. To evaluate clinical thinking skills, the participants were assessed using the Clinical Thinking Skills Evaluation Scale (CTSES) and an assistant general practitioner's professional knowledge test. In addition, this study analysed various factors that influence clinical thinking skills.

Results: Compared with the LBL group, the CBL-PBL group showed significantly improved performance in all domains assessed by the CTSES in post-course tests (p < 0.001). Specifically, the mean scores for critical, systematic, and evidence-based thinking showed notable improvement in the CBL-PBL group. Additionally, the scores on the professional knowledge test reflected a substantial increase in this group. Furthermore, multiple linear regression analysis showed that both CBL-PBL curriculum performance scores and number of weekly article readings significantly influenced the development of clinical thinking skills.

Conclusion: The CBL-PBL teaching method positively influenced the clinical thinking skills of assistant general practitioner trainees, with a positive correlation between these skills and course performance in the CBL-PBL curriculum.

Trial registration: Not applicable.

Introduction: Video feedback, particularly with a head-mounted camera, has previously been described as a useful debriefing tool in well-funded health systems but has never been performed in a low-resource environment. The purpose of this randomized, intervention-controlled study is to evaluate the feasibility of using video feedback with a head-mounted camera during intestinal anastomosis simulation training in a low-resource setting.

Methodology: This study recruited 14 first-year surgery residents in Senegal, who were randomized into control and camera groups. Both groups received reading materials and video lectures before performing a manual end-to-end intestinal anastomosis using a synthetic model. The control group received oral feedback, while the camera group's first attempt was recorded, reviewed, and discussed before the second attempt. The primary outcomes were OSATS scores and completion time.

Results: There were no significant demographic differences between the groups. Both groups showed significant improvement in OSATS scores from the first to the second attempt (control group: p = 0.002; camera group: p = 0.0021). The camera group demonstrated a significant reduction in completion time on the second attempt (p = 0.0038), unlike the control group (p = 0.17). Both groups reported increased confidence in performing the task (control group: p = 0.003; camera group: p = 0.0029) and had positive perceptions of the workshop's effectiveness.

Conclusion: This pilot study suggests that video feedback with a head-mounted camera is feasible and effective for debriefing during intestinal anastomosis simulation training in a low-resource setting, offering a low-cost, effective way to enhance technical skills. Further research with larger sample sizes is recommended to validate these findings and explore long-term impacts on surgical proficiency.

Background: The COVID-19 pandemic has led to the popularization of information and communication technology in medical education. This study aimed to compare the objective structured clinical examination (OSCE) and the virtual objective structured clinical examination (vOSCE), based on expert opinion, as tools for assessing the competencies needed under medical curriculum guidelines in Brazil.

Methods: In this multicenter study, the suitability levels of the OSCE and vOSCE for assessing the competencies needed under the Brazilian National Curriculum Guidelines (DCNs) were compared. The DCNs encompass five groups of domains, namely, health education; general; health management; public health needs; and individual health needs. Sixteen teaching experts served as judges. They responded to a questionnaire with the provided Likert scores indicating the ability of the OSCE and vOSCE to assess each type of competency. Virtual meetings were held via the Delphi method and a focus group-based approach to enable the experts to reach a consensus.

Results: A total of 200 items included in the guidelines (100 for the OSCE and 100 for the vOSCE) were evaluated across a total of 3,200 responses. Analysis via the Likert scale revealed a high proportion of positive evaluations for the use of the vOSCE, with kappa values ​​ranging from 0.4 to 0.72. The values ​​of the absolute agreement (positive view) between examiners and equivalence with the kappa statistic for the adoption of the vOSCE ranged from 0.38 to 0.72. Via the use of virtual meetings (Delphi and focus groups), consensus was reached regarding the capacity of the OSCE and vOSCE to evaluate 97% and 92% of these items, respectively.

Conclusion: The vOSCE can be employed to assess relevant competencies. However, it faces limitations regarding 8% (8/100) of the items, and some items (3%) cannot be assessed via either method. The difference in results between the two assessment methodologies (OSCE and vOSCE) is 5%. It is necessary to invest in the creation of instruments that can be used to apply the vOSCE and to conduct cost‒benefit analysis of its broader application in health education institutions. We conclude that the vOSCE is an effective tool for assessing most competencies of medical professionals and students required under Brazilian guidelines.

Background: Motivation is a variable that directly influences task orientation. Within the motivational sphere, the motivational climate determines whether a task is performed with an intrinsic or extrinsic.

Purpose: It has been observed that depending on motivational orientations, anxiety levels and task performance can be increased. Likewise, there are differences in interests depending on the gender of individuals.

Methods: This research aims (a) To elaborate and adjust a theoretical model of the causal relationship of motivational climate on anxiety and academic performance and (b) To analyse the causal relationship between the motivational climate on anxiety and the average mark of the participants. Regarding the design, a comparative, cross-sectional and descriptive study was carried out on a sample of 558 trainee physical education teachers. The sample for this study is from southern Spain. Likewise, the branch of study of the sample is related to university degrees in education sciences and physical activity and sport sciences. The Beck Anxiety Inventory (BAI), Perceived Motivational Climate in Sport-2 and an ad hoc socio-demographic questionnaire were used to collect the data.

Results: It is observed that the male sex presents a greater causal relationship of task climate (β=-0.259; p ≤ 0.05) and ego climate (β = 0.324; p ≤ 0.001) on anxiety. A stronger causal relationship of task climate (β = 0.340; p ≤ 0.001) and ego climate (β = 0.241; p ≤ 0.05) on mean score is also observed for the male population. The sample presents a negative causal relationship of anxiety on the average mark. This is higher for the male population (β=-0.126).

Conclusions: Male students show a greater causal effect of motivational climate on anxiety and grade point average. Likewise, the causal relationship of task climate on the development of anxiety is negative for the study sample. In contrast, the ego climate exerts a positive causal relationship on the development of anxiety.