BMC Medical Education最新文献

Background: The quality of oral cancer resection is extremely important for patient outcomes, such as local control and survival. However, most current simulators either provide only rater-dependent feedback or are not compatible with electrosurgery. Therefore, we developed an electrosurgical simulation task for oral cancer resection that provides objective quantitative metrics and collected initial validity evidence.

Methods: We developed a soft tissue simulation task using a plant-derived model that supports electrosurgery. As quantitative measures demonstrating "ensuring appropriate margins" in oral cancer resection and "maintaining safety" during electrosurgery, we employed nine-directional margin error distance and tumor bed carbonization degree measured using a spectral colorimeter. As validity evidence of the task, 10 expert surgeons completed a questionnaire about the task. In addition, five experts and 12 novices performed the task, and quantitative data obtained from their performance was used for evaluation.

Results: The replication of oral cancer resection was highly evaluated (4.4 out of 5 points), and quantitative measures for evaluating the skills of surgeons (4.8 out of 5 points) were agreed upon by experts. The internal consistency of the measures was good (Cronbach's alpha: 0.803). Compared to novices, experts had smaller margin errors (0.79 mm vs 2.45 mm), lower carbonization (ΔE: 2.33 vs 8.70), faster resection times, and fewer grasping attempts (all P < 0.001).

Conclusion: This user-friendly plant-derived simulation task is compatible with electrosurgery and provides objective quantitative performance metrics. These findings support its use as a practical assessment tool for formative feedback in simulation-based training.

Background: Head-Mounted-Displays which have mixed reality capabilities have a range of functions which may improve medical training and address certain challenges facing universities worldwide. Devices such as the Microsoft HoloLens 2 device can facilitate provision of procedural tutorials from remote locations, provide tutors with a first-person perspective of a student's field of view, and allow the insertion of holographic artefacts which can replicate in-person tutorials and facilitate vertical integration of curriculum elements. This study aimed to evaluate the feasibility, efficacy and usability of the Microsoft HoloLens 2 device in providing tutorials to medical students on peripheral intravenous cannulation from a remote location.

Methods: Medical student volunteers were randomly allocated to an In-Person (IP) group and HoloLens (HL) group. Students in the IP group received a tutorial on intravenous cannulation in-person, the HL group received the tutorial remotely via the HoloLens. Both groups completed an initial metric- based competency assessment, received a period of metrics-based feedback which informed a period of deliberate practice, followed by a second competency assessment. Students in the HL group received a familiarisation session with the device, completed a Mental Rotations Test, provided feedback, completed a System Usability Scale (SUS) questionnaire and three students completed interviews. One additional student completed a Think Aloud session.

Results: Seventeen student volunteers were recruited. Sixteen students underwent block randomisation. One additional student completed the Think Aloud session. Baseline characteristics of the two groups were similar. Mean initial competency scores were similar for the HL and IP groups, both groups showed significant improvements in performance, and there was no significant difference between the groups' post-feedback scores, (p= 0.11). Students SUS scores were mean 79.4 (Standard Deviation 13.1). Quantitative and qualitative feedback was relatively positive, but identified several usability and technological limitations, including the development of headaches and visual fatigue.

Conclusions: This study demonstrates that tutorials on intravenous cannulation which are delivered remotely using the HoloLens 2 device are feasible, show a similar improvement in student performance to in-person tutorials, and are relatively well received by students and tutors. The ability to deliver procedural tutorials to a remote location has the potential to be a significant asset to medical educators. However, it also highlights several usability issues, including the development of "cybersickness" symptoms which may be limiting factors in its widespread adoption by educational institutions, and warrants further investigation.

Background: Effective communication, motivation, and self-efficacy are essential competencies for nursing students to deliver high-quality patient care. Educational strategies grounded in motivational theory, such as the ARCS model, may enhance these outcomes. This study aimed to examine the effects of an education program based on the ARCS motivational model on nursing students' communication skills, learning motivation, and academic self-efficacy.

Methods: A mixed-method randomized controlled trial was conducted with sixty-four first-year nursing students randomly assigned to either an experimental group (n = 34), which received six hours of ARCS-based communication training, or a control group (n = 34), which received standard instruction. Quantitative data were collected pre- and post-intervention using validated instruments measuring communication skills, learning motivation, and academic self-efficacy. Qualitative data were obtained from reflective journals written by the experimental group and analyzed through inductive descriptive content analysis.

Results: The experimental group demonstrated significant improvements in ego-supportive language, active listening, and empathy (p < 0.05), whereas no significant change was observed in the I-language subscale. Only the experimental group showed significant increases in learning motivation and academic self-efficacy (p < 0.05), while the control group remained stable. Qualitative findings generated three overarching themes-Transformation in Communication, Motivation through ARCS, and Internalization and Development-which supported the quantitative results and illustrated enhanced emotional empathy, perceived relevance, and satisfaction.

Conclusions: Education based on the ARCS motivational model significantly improved nursing students' communication skills, motivation, and self-efficacy. While affective and participatory competencies developed substantially, cognitive-reflective components may require extended or repeated interventions. The ARCS framework offers a robust pedagogical approach to fostering learner engagement and readiness in nursing education.

Trial registration: Registered at ClinicalTrials.gov (NCT07004205 Registration date: 12.05.2025).

Background: VR simulation has been suggested as a resource-efficient tool in the education and training of doctors. Few studies have been conducted on what motivates different groups to use VR simulation, particularly during the transition from undergraduate to postgraduate learning. A deeper understanding of first-year residents' experiences and attitudes may improve the development of VR simulation as an effective learning tool during this transitional phase. Therefore, the aim of this study was to explore the attitudes of Norwegian first-year residents towards this well-established yet rapidly evolving technology and their experiences of using it.

Methods: First-year residents at Levanger Hospital, Norway were offered VR-based simulation from October 2022 to August 2023. Data were collected using semi-structured focus group discussions and in-depth individual interviews. Eleven first-year residents were interviewed. Data were analyzed using reflexive thematic analysis. Our results were interpreted in the light of Self-determination theory to better understand the influence of motivational factors on actual usage of VR simulation.

Results: Three themes were generated from the data: (1) The playground of emergency medicine: Learning in a safe environment, (2) Barriers to be overcome and (3) Recognizing one's reality in a virtual world. The findings showed that the participants considered VR simulation to be a safe and flexible learning tool for training in emergency care. The data also revealed various physical and psychological factors as barriers to using the tool. Variation, adaptation to individual needs and realistic experiences in VR simulations appeared to be important factors relevant to the clinical work of first-year residents.

Conclusions: Our findings suggest that facilitating the use of VR simulation and offering content relevant to the target group may increase motivation. In this study, the perceived transferability from VR simulation to clinical practice appeared to influence its successful implementation and use. Future research should further explore applicability, the effect of incorporating learning theory into VR simulation software development, and the role of VR simulation in soft skills training.

Introduction: Integrating artificial intelligence (AI) into medical education poses barriers and opportunities for medical educators. One of those opportunities is content creation for medical ethics assessment. Assessing the performance of AI in generating multiple choice questions (MCQs) in ethics that aligns with United States Medical Licensing Examination (USMLE) is important. The present study evaluates the performance of eight AI models-GPT-4 Turbo, GPT-3.5 Turbo 0125, o1 Mini, o1 Preview, GPT-4, Claude 3.5 Sonnet, Claude 3 Opus, and Gemini-in regard to the relevance, clarity, and accuracy of generated ethics-based MCQs.

Methods: Each of the eight models was tasked with generating two sets of question, answer, and explanation for each of 13 selected USMLE-aligned student learning outcomes related to medical ethics. Responses were rated by four independent experts in medical ethics on relevance, clarity, and accuracy. Performance metrics were assessed using mean, median, range, and total scores, with an overall percentage score computed for each model. Qualitative responses noting strengths and weaknesses were collected.

Results: Claude 3.5 Sonnet had the highest overall performance (86.28%), accuracy (85.57%), and clarity (91.73%). o1 Mini followed closely with an overall score of 85.19%, while GPT-4 had the highest rating for relevance (88.65%) and a total score of 84.87%. GPT-4 Turbo and o1 Preview had the lowest overall score at 76.79%. Identified weaknesses included incorrect answer selection, best answer not available, and the question was not ethics-based.

Conclusion: The findings indicate clear potential for medical educators tasked with designing medical ethics MCQs for teaching and assessment. However, expert oversight is needed to ensure proper utilization.

Data availability statement: Data supporting the findings of this study are available from the corresponding author on request.

Background: Recent literature has reported declining attendance among certain medical student cohorts. The limited existing studies primarily explore attendance at lectures but not attendance on clinical attachments, which are mandatory for satisfactory student progression. This study aimed to investigate the factors influencing medical students' decision to attend learning activities on clinical attachments, to optimise attendance and to formulate recommedations with respect to educational outcomes and the student experience.

Methods: Nine focus groups with clinical year medical students were conducted at a UK medical school, based at three different hospital sites (n = 39). Thematic analysis of transcripts was performed (NVivo Software V14.23.2).

Results: Key factors which influenced medical students' decision to attend clinical attachments were grouped into 6 main themes: (1) student factors, (2) learning activity factors, (3) assessment pressure, (4) organisational factors, (5) tutor factors, and (6) attendance monitoring. Fourteen sub-themes were then identified under these key themes. Specific factors that encouraged attendance included clustered learning activities that maximised student time efficiency and high tutor interactivity with an awareness of student-specific learning outcomes. Factors that discouraged attendance included a prioritisation of students for self-directed learning largely driven by exam pressure and a belief amongst some students that attendance on clinical attachments may not correlate with exam performance. Attendance may be optimised through clustering timetabled learning activities, transparently balancing self-study and timetabled activities, increased faculty development initiatives and further optimising university assessments to emphasise the skills acquired through patient exposure.

Conclusions: This study highlights the heterogenous decision-making relating to attendance among medical students on clinical attachments. The data presented may help to explain the declining attendance trends on clinical attachments observed in certain cohorts. Future research could quantitatively investigate the effect of specific recommendations to optimise both attendance and the student experience.