MedEdPublish (2016)最新文献

Background: Most studies on palliative medicine (PM) undergraduate education have focused on contents and organizational issues but not the outcome. Students' learning outcomes should be studied to improve teaching in medical schools.

Methods: A questionnaire about perceived PM education and attitudes on palliative care (PC) was sent to 543 last year students in all five Finnish medical schools in 2018-2019. In total, 175 (32 %) responses were received from four universities. The students evaluated both the quantity and quality of their PM teaching, implementation of European Association for Palliative Care (EAPC) guidelines and their satisfaction to the training. There were two palliative case scenarios, and the students were asked to find the best treatment option. In addition, students´ attitudes towards end-of-life (EOL) care issues were examined.

Results: In the Finnish universities, PM education was available mainly integrated with oncology, geriatrics, and general medicine. A total of two universities also offered a specific PM course. In average, 50-70% of the EAPC curriculum was covered by lectures, small-group teaching, seminars, and bedside teaching with significant differences between faculties. Only 30-60 % of students were satisfied with the education received. The highest rankings were given in the universities with a special PM course. Students from these universities expressed less anxiety in facing EOL issues.

Conclusions: In Finland, the coverage of EAPC curriculum is satisfactory, but the PM education is mainly given integrated with other specialties. The dedicated course on PM was associated with increased perceived knowledge and satisfaction of PM education. However, PM training was not associated with students' attitudes on PC.

Background: The Occupational English Test (OET) is a globally recognized test for healthcare professionals who speak English as a foreign language (EFL). Although its speaking sub-test criteria are publicly accessible, practical application demands specialized assessor training. The aim of the study was to create a physician-friendly rubric for assessing the English history-taking skills of EFL medical undergraduates inspired by the OET speaking sub-test.

Methods: Informed by the OET criteria, a rubric was tailor-made to assess the English history-taking skills of EFL medical undergraduates studying in Japan. Using this rubric, 14 physicians assessed the English history-taking skills of 134 sixth-year medical undergraduates. We used exploratory factor analysis to ascertain its construct validity, evaluated the instrument's reliability through Cronbach's α and inter-rater reliability with chi-squared tests, and conducted a multiple regression analysis, ensuring adherence to key regression assumptions.

Results: Three key factors were found: linguistic-clinical distinction, communication dynamics, and medical comprehension. The rubric's internal consistency was verified, achieving a Cronbach's α of 0.799. Discrepancies in assessor scores highlighted the need for calibration. Four criteria emerged as vital in assessing the students' performance.

Conclusions: The tailored rubric effectively assesses the English history-taking skills of EFL medical undergraduates.

Introduction: Feedback is an essential component of medical education, enhancing the quality of students' knowledge and skills. However, providing effective feedback, particularly in clinical skills assessments like Objective Structured Clinical Examinations [OSCEs], often poses challenges. This study aimed to evaluate the content of OSCE feedback given to undergraduate medical students over five years.

Methods: A retrospective analysis of 1034 anonymised medical students' OSCE performance was conducted, focusing on written feedback. The written feedback data were randomly selected from OSCE sessions, collected from university assessment records and anonymised for ethical considerations. R software was used to identify the most frequently repeated words in the examiners' feedback text, and word cloud charts were created to visualise the responses.

Results: Word clouds generated from the top 200 most frequently used terms provided visual insights into common descriptive words in feedback comments. The most frequently repeated word over five years was "good," indicative of potentially non-specific feedback.

Discussion: The high frequency of non-specific terms like "good" suggests a need for more specific, constructive feedback. However, such generic terms can offer some positive reinforcement, more than they may be needed to foster significant improvement. As previously proposed in the literature, adopting structured feedback forms may facilitate the delivery of more specific, actionable feedback.

Conclusion: This study emphasises the importance of providing specific, actionable feedback in medical education to facilitate meaningful student development. As medical education continues to evolve, refining feedback processes is crucial for effectively guiding students' growth and skill enhancement. Using structured feedback forms can be a beneficial strategy for improving feedback quality.

Background: Learning outcomes are essential in education, guiding both educators and learners towards desired knowledge, skills, and competencies. The backward design process offers a structured approach to curriculum planning, but its integration with actionable, SMART (Specific, Measurable, Achievable, Relevant, Time-bound) learning outcomes needs further exploration.

Goal: This guide aims to introduce the concept of "A-SMART" learning outcomes and demonstrate their integration into the backward design process, focusing on outcomes that begin with action verbs.

Methods: The guide outlines a three-stage curriculum planning approach: (i) define desired results, (ii) determine acceptable evidence of learning, and (iii) plan learning activities. It emphasizes the importance of starting with action verbs in formulating learning outcomes, aligning with Stage 1 of backward design and facilitating the transition to Stage 2 (assessment development).

Results: By following this guide, educators will acquire tools to develop effective "A-SMART" learning outcomes. This approach immediately advances to Stage 2 of backward design, improving educational practices and ensuring alignment with assessment methods. The guide provides strategies for formulating outcomes that are Action-oriented, Specific, Measurable, Achievable, Relevant, and Time-based.

Conclusions: The integration of A-SMART learning outcomes into the backward design process offers a more cohesive and effective educational framework. This approach enhances clarity for learners, provides guidance for instructors, enables more effective assessments, and improves overall learning experiences. The guide also addresses potential challenges in formulating A-SMART outcomes and suggests solutions, including the use of AI tools for inspiration and critical review.

The metaverse is based on immersive technologies such as virtual and augmented reality, body tracking, tactile sensation, etc. A growing number of studies are demonstrating the potential of the metaverse as an attractive resource for learning medicine. However, in practice, medical teachers and students often encounter significant challenges when utilizing the underlying technologies, potentially leading to frustrating learning experiences. A significant part of the teaching time is often devoted to troubleshooting technical issues with the metaverse, and the medical content itself taking a backseat until students become proficient in navigating the metaverse environment. Therefore, it is essential to fit the metaverse's underlying technologies specifically for medical education, minimizing technical hurdles for both teachers and students. In this paper, we deal with this challenge and we present a collection of practical tips that serves as a guide for medical educators making decisions in this emerging field, where they may lack prior experience. Drawing on our observation with a cohort of 776 medical students, we conclude how to effectively identify, design, or implement educational applications tailored for efficient medical learning through the metaverse. Our work may support teachers considering metaverse learning platforms for their classrooms and it is a beneficial reference for the medical education community during the initial stages of implementing the metaverse for teaching.

Purpose: There is a pressing need to address all forms of anti-oppression in medicine, given systemic harm and inequities in care and outcomes for patients and health care professionals from equity-deserving groups. Revising definitions of professionalism used in competency-based education can incorporate new professional competencies for physicians to identify and eliminate the root causes of these inequities. This study redefined the CanMEDS Professionalism definition to centre perspectives of equity-deserving groups.

Methods: In this qualitative study there were two phases. The authors conducted individual semi-structured interviews with participants representing equity-deserving population groups to understand their perspectives on and iteratively build a definition of medical professionalism. Then, the authors undertook a consensus-building process, a modified nominal group technique, using focus groups with community members from equity-deserving groups and healthcare providers to verify findings and arrive at an updated definition of medical professionalism.

Results: Four main themes were identified: 1) healthcare at the margins; 2) equity-oriented domains of professionalism; 3) structural professionalism; and 4) supporting improved professionalism. These themes were incorporated into a consensus-based definition of medical professionalism, with a focus on anti-oppression, anti-racism, accountability, safety, and equity.

Conclusions: The authors propose a new definition of medical professionalism that embeds anti-oppression, including anti-racism, as critical competencies in clinical practice and education.

Virtual reality simulation (VRS) has the potential to disrupt and transform current understandings and practices in simulation-based education in health professions curricula. Recent technological developments, including AI applications, give the learner high levels of immersion into a virtual environment that even more closely mimic the real world than heretofore. At the same time, there are significant obstacles facing educators who strive to integrate VRS into their simulation curricula. We have written a VRS handbook for nurse educators, developed VR scenarios and delivered VRS workshops to undergraduate nursing students. Our twelve tips are aimed at undergraduate curriculum developers and simulation leaders, guiding them on how to support educators in integrating VRS into their curricula. The tips describe key considerations to be addressed in the development and integration of VRS into curricula. The tips are timely, as health professions education is on the cusp of entering technology-enhanced simulation, of which VRS will be a key player.

Despite the Supreme Court's decision on race-based admissions, academic medical centers, medical societies, and accreditation bodies remain committed to recruiting a diverse workforce. Many medical schools and graduate medical education programs created initiatives to expand their census of underrepresented in medicine (UIM) as the key to addressing health care disparities. As a result, an influx of an UIM physician workforce has entered clinical learning environments, often without consideration of the inclusivity of these settings. To create inclusive, safe, and comfortable CLEs, we must first recognize the challenges faced by UIM trainees, students, and faculty and the complex ways in which discrimination manifests. Ultimately, having inclusive CLEs allows all learners, especially those from historically excluded identities, to thrive in their training and working environment, making it essential to retain the diverse workforce necessary. Using case examples, we discuss strategies of inclusivity and ways in which we can maintain clinical learning environments where learners feel safe and supported through their training.

Background: Despite advocacy from the Association of American Medical Colleges (AAMC) and The Lancet Commission on medicine, Nazism, and the Holocaust, Holocaust education is lacking in medical education. To address this gap, students at Geisinger Commonwealth School of Medicine (GCSOM) viewed an Association of American Medical College (AAMC) webinar about medicine during the Holocaust as part of the required curriculum for first year medical students introduced in 2022.

Methods: As part of their doctoring course, Physician and Patient Centered Care (PPCC), students viewed the AAMC webinar "The legacy of the role of medicine during the Holocaust and its contemporary relevance" and participated in two structured reflections: a written reflection on how webinar topics inform students' professional development and a verbal reflection on learning from the Holocaust to develop a sense of moral courage, advocacy, and activism in medicine. Researchers conducted qualitative analysis of written reflections and analyzed session surveys to determine key themes and impact of the session.

Results: Of the 108 enrolled in PPCC, 59 (54.6%) completed a post session Likert scale survey assessing the impact of the webinar on their personal and professional development. As an average, respondents moderately agreed that the webinar impacted their personal and professional development, with 91% slightly, moderately, or strongly agreeing. Additionally, thematic analysis of required written reflections indicated a majority of students (62.5%) identified the need for additional medical humanities education about the Holocaust and its relevance to medicine.

Conclusion: Holocaust education encourages medical students to bear witness to past medical atrocities and critically assess the profession and their personal-professional growth. Continued structured integration of the Holocaust in medical education supports critical self-reflection and the development of morally courageous physicians who endorse and practice social accountability in medicine.

Disability is extremely common, and there is a need for high quality medical school curricula on working with persons with disabilities. The goal of disability training is to provide the proper knowledge and skills to address the unique needs of PWD, mitigate health disparities, and help shape more compassionate and informed physicians. This article presents 12 tips to incorporate disability training into undergraduate medical education. These tips emphasize the inclusion of PWD in all stages of the curriculum, interprofessional education, experiential learning, and exposure to a range of disability types. By leveraging these tips, educators will be able to create effective learning opportunities and improve the future healthcare of PWD.