MedEdPublish (2016)最新文献

Point of care ultrasound (POCUS) has increasingly been used by midwives worldwide. In 2018, the scope of midwifery care in Ontario was expanded to include POCUS to allow practitioners to provide more comprehensive care. In response to the scope expansion, a new continuing POCUS education course was created in collaboration with faculty and clinicians from obstetrics, midwifery, and medical radiation sciences. The continuing education sonography course focused on fostering the knowledge, skills and judgment Ontario midwives required to safely perform these new POCUS skills. The course included online modules, a two-day hands-on bootcamp workshop, and a clinical practicum under the supervision of a sonographer to confirm competency across the three trimesters of pregnancy. This paper outlines the process for POCUS curriculum development and implementation in pregnancy care following course completion. The first cohort of 17 learners completed the course in 2019. The new curriculum was well received by learners for learning and applying bedside sonography in clinical care. The indications to use POCUS most frequently reported by learners after course completion included assessment of pregnancy viability and fetal presentation. Challenges identified by participants with the course included learning new content such as physics and struggling to complete the clinical practicum due to the coronavirus pandemic. The success of this course is indicated by the completion of the objective structured clinical exams for all learners and meeting the competencies for beginning their practicum. The POCUS continuing education course plays an important role in providing the knowledge, skills and ability to perform point of care pregnancy scans among midwives.

Background: ChatGPT is a large language model that uses deep learning techniques to generate human-like texts. ChatGPT has the potential to revolutionize medical education as it acts as an interactive virtual tutor and personalized learning assistant. We assessed the use of ChatGPT and other Artificial Intelligence (AI) tools among medical faculty in Uganda.

Methods: We conducted a descriptive cross-sectional study among medical faculty at four public universities in Uganda from November to December 2023. Participants were recruited consecutively. We used a semi-structured questionnaire to collect data on participants' socio-demographics and the use of AI tools such as ChatGPT. Our outcome variable was the use of ChatGPT and other AI tools. Data were analyzed in Stata version 17.0.

Results: We recruited 224 medical faculty, majority [75% (167/224)] were male. The median age (interquartile range) was 41 years (34-50). Almost all medical faculty [90% (202/224)] had ever heard of AI tools such as ChatGPT. Over 63% (120/224) of faculty had ever used AI tools. The most commonly used AI tools were ChatGPT (56.3%) and Quill Bot (7.1%). Fifty-six faculty use AI tools for research writing, 37 for summarizing information, 28 for proofreading work, and 28 for setting exams or assignments. Forty faculty use AI tools for non-academic purposes like recreation and learning new skills. Faculty older than 50 years were 40% less likely to use AI tools compared to those aged 24 to 35 years (Adjusted Prevalence Ratio (aPR):0.60; 95% Confidence Interval (CI): [0.45, 0.80]).

Conclusion: The use of ChatGPT and other AI tools was high among medical faculty in Uganda. Older faculty (>50 years) were less likely to use AI tools compared to younger faculty. Training on AI use in education, formal policies, and guidelines are needed to adequately prepare medical faculty for the integration of AI in medical education.

Introduction: Residents report limited end-of-life care training, resulting in negative socio-emotional impacts, burnout, and inadequate patient care. An academic urban county hospital adopted the Death Rounds (DR) conference for residents in the medical intensive care unit as a monthly free-form discussion to help residents cope with the emotional aspects of caring for dying patients. Our goal was to implement and evaluate a newly structured DR curriculum to help residents further reflect on experiences of caring for dying patients, reduce emotional burnout, and improve physician well-being.

Methods: Using a mixed-methods design, we conducted a qualitative needs assessment using interviews of residents. DR conference modifications based on the needs assessment include shorter, more frequent sessions; breakout groups; prompts for facilitating discussion; and multidisciplinary facilitators. A pre-post modification survey using the Likert scale was administered to all residents to assess the programmatic changes.

Results: Pre- and post-modification data were received from 30 and 50 of 116 residents, respectively. A greater proportion of post-test DR attendees reported that DR helped them feel less distressed when caring for dying patients (p=0.018). Among residents who did not attend DR, there was greater agreement in feeling emotionally supported by their team when caring for dying patients (p=0.046). Overall, 81% of post-test respondents agreed DR was worthwhile of their time, and almost all respondents agreed discussing the emotional impacts of patient death is important.

Conclusion: Death Rounds is a replicable and impactful curriculum that helps residents process the challenges of caring for dying patients and may improve emotional distress and team support.

Background: According to the Association of American Medical Colleges (AAMC) Year 2 questionnaire, the percentage of students using online medical education videos (Boards and Beyond®Sketchy Medical®, Youtube) at least once per week increased from 47.7% (2015) to 70.1% (2022). Transition to virtual learning in 2020 fostered a greater reliance on these online third-party resources (i.e., educational tools distinct from formal medical curriculum), yet existing literature have rarely evaluated their efficacy. As students in this landscape, we aimed to review the usage, efficacy, and drawbacks of third-party resources and their financial burden on students.

Methods: Four authors searched PubMed from June-July 2023 using the search terms "prevalence," "efficacy," and "disparities introduced by third-party board preparation resources." All peer-reviewed articles in English were evaluated. No inclusion or exclusion criteria were implemented. References were mined for additional results, per the discretion of each reviewer.

Results: 31 studies were examined for common themes and findings to provide a snapshot of the existing literature. Studies suggest third-party resources are used in a task-dependent manner with a supplemental role to lectures during the preclinical years and a primary role for United States Medical Licensing Examination (USMLE) preparation during clinical years. Medical students access these resources to perform well on board exams, prompted by studies demonstrating their efficacy in increasing USMLE Step 1 scores. Though certain resources have been frequently cited for improving board performance (e.g., First Aid, UWorld), students combine multiple third-party resources to best serve their preparation. Subscription-pricing of most third-party resources and 12-month access prices range from $100 to $479.

Conclusion: Third-party resource use may contribute to an increased financial strain on students. This, coupled with overwhelming medical student debt, may exacerbate socioeconomic disparities in medical education. Institutions should evaluate third-party resource use among students and consider provisions to increase access to them.

Despite the importance of case-based multiple-choice question (CBMCQ) exams, medical educators rarely discuss strategies to systematically approach these questions, and literature on the topic is limited. Through trial-and-error, many students develop more refined and efficient approaches to answering CBMCQs that help them maximize the application of their knowledge base. In this article we present a structured six-step approach to answering CBMCQs, grounded in dual process theory. We provide strategies for success on CBMCQ-based exams and approaches to challenging question types. We also present tips for helping neurodiverse students. Medical educators can use this structured approach and the related tips to coach students on improving performance on CBMCQ-based exams.

Objectives: The British Medical Association announced a successful vote towards industrial action to achieve 'pay restoration' on 20 February 2023; with 11 walkout periods occurring in the following months. During industrial action, concerns arose about the role medical students would play and the pressure placed upon them to 'act up'. The objective of this study was to assess the guidance issued by medical schools and local placement sites during industrial action.

Design setting and participants: This cross-sectional study collected online survey data between 7 March 2023 and 7 April 2023 from medical students across England.

Main outcome measures: Reports about guidance issued by medical schools and hospital placements.

Results: 62% of the medical schools issued guidance stating they were not cancelling clinical placements; of these, 10% said attendance was a personal choice. 17% of medical schools cancelled all clinical placements and 7% did not issue guidance. 52% of medical schools monitored attendance on strike days. 1 medical school and 3 clinical placement sites advertised paid work for students during the industrial action.

Conclusion: The impact industrial action has on medical students has not been examined. Our results show mixed guidance from medical schools that can contradict local placement guidance. This lack of guidance is mirrored in the existing, yet limited, literature. If students feel pressured to perform tasks outside their remit, with inadequate supervision, it can impact patient safety and their license to practice. For the safeguarding of patients, and students, further work is needed to produce standardised guidance during industrial action.

Purpose: Social interactions are fundamental to effective medical practice, yet assessing these complex dynamics in educational settings remains challenging. This review critically examines the emerging use of dual eye-tracking technology as a novel method to quantify, analyze, and enhance social interactions within medical education contexts.

Materials and methods: We performed a scoping review of the literature, focusing on studies that utilized dual eye-tracking within medical education contexts. Our search included multiple databases and journals. We extracted information on technical setups, areas of application, participant characteristics, dual eye-tracking metrics, and main findings.

Results: Ten studies published between 2012 and 2021 met the inclusion criteria, with 90% utilizing dual screen-based- and 10% dual mobile eye-tracking. All studies were conducted in the context of surgical training, primarily focusing on laparoscopic surgery. We identified two main applications of dual eye-tracking: (1) as an educational intervention to improve collaboration, (2) as a diagnostic tool to identify interaction pattern that were associated with learning. Key metrics included joint visual attention, gaze delay and joint mental effort.

Conclusion: Dual eye-tracking offers a promising technology for enhancing medical education by providing high-resolution, real-time data on social interactions. However, current research is limited by small sample sizes, outdated technology, and a narrow focus on surgical contexts. We discuss the broader implications and potential for medical education research and practice.

Background: The future of rural healthcare depends on training the future rural health workforce, and on rural health research that can guide clinical and policy decisions in rural spaces. Promotion of rural healthcare careers usually focuses on clinical aspects of care, and research may be seen as a lower priority. Supporting students to be involved in rural focused research offers the opportunity to broaden the pool of potentially rural interested students, and to develop research and scholarship skills and capacity in the future rural workforce.

Aim and method: We identify twelve tips that medical schools can adopt to foster medical student participation in rural-focused research and thus promote student interest in rural healthcare and rural medical practice. These recommendations are based on a review of literature and our personal experience of conducting rural-focused research activities with medical students.

Conclusion: Through these twelve tips, we provide a practical framework for enhancing undergraduate medical student exposure to rural-focused research to foster research capacity. This has potential to inspire student interest in future rural medical practice and could contribute to alleviate workforce and research gaps in rural areas.

Background: Interdisciplinary learning is gaining popularity in higher education worldwide. Currently, knowledge about how to appropriately design interdisciplinary education is still lacking. The current study presents the iterative development, pilot, and implementation of an interdisciplinary course in healthcare communication.

Methods: We used a design-based educational research approach in four phases to construct the program. In phase 1, we conducted a narrative review of the literature and distilled several prerequisites for interdisciplinary learning. In phase 2, we implemented two pilot courses with a focus on the content and the interdisciplinary context of the course. In research phase 3, we implemented the course during three consecutive years, with yearly evaluations of the course. In phase 4, we distilled design principles based on evaluation and reflection of the previous research phases.

Results: We elaborate on the various components of the design itself. Furthermore, using data from surveys, panel discussions and interviews, we reflect on the content and outcomes of the interdisciplinary course.We propose seven evidence-informed 'crossing the line' design principles for future interdisciplinary education.

Conclusions: The developed design principles pertain to interdisciplinary education in general and transcend subject-specific boundaries. The design principles are applicable in a wide range of higher education disciplines.

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.