MedEdPublish (2016)最新文献

Purpose: To investigate the impacts of The Patient-centered Medicine (PCM) Scholars Program - a longitudinal curriculum designed to inculcate attitudes, values, and competencies to practice patient-centered medicine, with a special focus on underserved populations, addressing social determinants of health and health disparities, and advancing health equity and social justice - on graduates' career choices and practice behaviors.

Methods: Cross-sectional online survey of 2010-2017 program graduates (N=191) and analysis of residency placement data 2010-2024 from an institutional website. Sixty-three graduates responded to the survey, translating to a 33% response rate.

Results: Eighty-five percent of respondents reported that the program prepared them to provide patient-centered care for underserved and vulnerable patients. The most important PCM skills applied in practice included: building relationships with patients, communicating well with patients, and practicing collaborative decision-making. For residency training, 53% of graduates chose primary care settings, and 67% chose to work in underserved settings. The open-ended data revealed that students strongly valued the following aspects of the PCM Scholars Program: exposure to patient experience, dedication to serving the underserved, and building relationships with patients.

Conclusions: Our study provides evidence regarding the impacts of the PCM Scholars Program graduates' career choices and their competencies to practice patient-centered care. The PCM Scholars Program has led to meaningful contributions to training the future healthcare workforce, to address the needs of our evolving patient populations with a special focus on advancing social justice and health equity. Long term, this work will continue to focus on bridging the gap between health professions education and practice and creating transformative educational innovations responsive to the need for a highly trained healthcare workforce that can meet the challenges of the 21 ^st century.

Background: Problem-Based Learning (PBL) is increasingly used in medical education to develop critical thinking, communication, and learner autonomy. Although widely studied in developed countries, evidence from low-resource settings like Ghana, particularly involving first-year students, remains limited. This study seeks to address this gap by assessing the impact of PBL on critical thinking, communication skills, and satisfaction levels among novice medical students.

Methods: This longitudinal pre-test-post-test study will be conducted at the University for Development Studies, School of Medicine. All first-year students who meet the eligibility criteria will be enrolled. Participants will undergo baseline (pre-PBL) and follow-up (post-PBL) assessments using the Critical Thinking Questionnaire (licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0) and Interpersonal Communication Competency Skills Scale (ICCS). A 5-point Likert scale will be used to measure student satisfaction after eight months of exposure to PBL. Statistical analyses including paired t-tests, ANOVA, and regression will be performed using SPSS v26.0. to assess changes through the mean scores.

Discussion: The study will provide context-specific insights on the effectiveness of PBL in enhancing key competencies among first-year medical students. Findings will inform curriculum development, tutor training, and educational policy in Ghana and similar settings.

Clinical trial registration number: Not applicable.

Advanced Life Support (ALS) is a crucial component of medical training. Previously, a single-person OSCE-Station (Objective Structured Clinical Exam) was used to assess these skills, focusing primarily on the team leader role and emphasizing theoretical knowledge. However, students demonstrated deficiencies in key algorithm-compliant practical skills, such as cardiac massage, mask ventilation and defibrillator use, and struggled to integrate into a team-based resuscitation approach. To address this, a constructive alignment approach was used to revise the course and offer a guideline-appropriate, three-person resuscitation model. Learning outcomes and assessment targets were aligned with the course activities to increase student engagement and increase desired skill attainment. In the summer semester 2023, students and lecturers were briefed on the new structure of the course and assessment, specific skills were highlighted, and a model video was provided. The OSCE format was adjusted to assess both practical and non-technical skills. In the new setup, each student was randomly assigned one of three roles and assessed using role-specific checklists with defined criteria, focusing on non-technical and practical abilities. Course activity included training and practice in the three-person resuscitation approach. A team OSCE (tOSCE) approach for assessment was used, with one student for each role being examined. Results indicated both subjective and objective markers of satisfaction in course activities and tOSCE results. A team-based OSCE station proves effective for teaching combined practical and non-technical competencies.

Background: Mentoring for clinical faculty in academic health centers offers numerous benefits; however, structured virtual mentoring remains understudied in this context. The Mentorship Matters pilot program was established to better understand whether providing structured curricula in a virtual format can result in positive outcomes for clinical faculty.

Methods: Mentorship Matters offered tailored, virtual mentoring for Department of Medicine faculty, covering topics such as career advancement, academic promotion, and work-life integration, through monthly virtual meetings. Participants underwent pre-, mid-, and post-engagement surveys, including the Leadership in Academic Medicine Program Survey and internal questions tailored by the Mentorship Matters team after reviewing mentorship literature for clinical faculty ^21,24.

Results: Among 23 mentees and 8 mentors, pre-engagement data showed 25% of mentees reported no previous mentoring ²³. Sixty-three percent felt inadequately supported and expressed a need for career guidance ²³. Fifty-seven percent of mentors lacked formal mentoring and 86% felt under-supported ²³. Results from the mid-point survey demonstrated that mentees (n=10) highly valued Mentorship Matters for career advancement (100%), academic promotion (89%), work-life integration (78%), and scholarship support (78%); 90% found the time commitment appropriate ^23,24. Among mentors (n=8), 88% found the time commitment suitable, all found the virtual format effective, and 63% found content on difficult conversations meaningful. In the post-engagement survey, both mentees (n=9) and mentors (n=7) found topics such as leadership development, career advancement, academic promotion, and work-life integration to be highly meaningful ^23,24. Mentees emphasized the value of networking. Post-engagement data suggested a strong positive correlation between the virtual format and appropriate time commitment for mentees ( r(7) = 1, P < 0.001) ^23,24.

Conclusions: Virtual, regularly scheduled programmatic mentorship supports clinical faculty's career growth. Programs like Mentorship Matters enhance knowledge, job satisfaction, and networking, which fosters faculty success in academic health centers.

Background: Servicing increasing healthcare demands requires a sufficient supply of general practitioners (GPs). However, heightened by pandemic conditions, critical and chronic shortages of GPs persist globally. In light of this, new and clear strategies for promoting increased general practice/family medicine specialisation across medical education targeting emerging medical graduates are urgently needed.

Aim and method: This article aims to provide evidence-informed practical tips to foster positive perceptions of general practice and increase both interest in and uptake of general practice specialisation. These tips relate to training phases in medical school through to specialty training and are targeted at medical students, trainees, supervisors, program managers and other medical educators. They are drawn from a larger body of evidence produced by the authorship team as part of a funded project in Australia that included 25 interviews with GPs who attained their specialty fellowship between 2014-2023 and 17 key medical education stakeholders who participated in 4 facilitated workshops in late 2023.

Conclusion: Through these tips, we provide a practical framework on how trainees, doctors and medical educators involved in training phases from medical school to specialty training can foster positive perceptions of and interest in general practice. These practical interventions target those from medical students, prevocational doctors and specialty registrars/residents (henceforth referred to as trainees), to their supervisors, program managers and other medical educators. These tips consider the importance of positive experiences (including language) around general practice specialisation to both encourage its uptake and to support long and successful careers in the specialty.

Aim: Due to the outbreak of the COVID-19 pandemic, the microscopy course as part of the dental medical training in Leipzig, Germany, was transformed from a classroom-only course into a purely digital and later hybrid course with reduced attendance time. Aim of this educational research study is the detailed evaluation of digital and hybrid courses regarding students' perception and learning outcome. Based on the findings current teaching should be critically scrutinised, resulting in a modern design of the histology curricula.

Methods: This is an educational research study. The students' subjective experiences are measured with the help of an evaluation survey and the learning success was objectively measured using a digital assessment course. Data was collected in two consecutive year groups of dentistry students, each after completion of the second semester. Cohort A consisted of 56 students, cohort B of 54 students. The sampling was purposive and the sample size equals the sample population (closed population of A+B = 110). A statistial analysis of the quantitative results were carried out and quantitative results were analysed using content-structuring qualitative content analysis.

Results: Students are predominantly positive about hybrid teaching approaches, although limitations such as perceived deterioration of the quality of teaching and insufficient learning success in cohort A can be identified. Hybrid teaching cohort B showed significantly better learning success than the purely digital cohort A.

Discussion: Particularly digital lecture formats and the CUVM have been valued by students. In addition, practical courses with appropriate resources (e.g. CUVM, digital identification course) can benefit from a blended approach. Regardless of the continued importance of practical training in dental studies, digital teaching formats developed as an emergency solution at the beginning of the pandemic should be evaluated in regard to their success and the existing potential should be further expanded in a targeted manner.

Background: Over half of the Dutch students experience burnout symptoms. In order to design effective interventions, it is important to know more about cognitions and behaviors that relate to burnout. An example of such cognitions might be inaccurate expectations of medical students regarding their study, as studies in other populations already indicated that unmet expectations can relate to burnout symptoms. Therefore, the aim of this study is to evaluate the relationship between an expectation-reality mismatch of medical students and burnout symptoms.

Methods: We performed an exploratory mixed methods study consisting of two sequential data collection methods. Firstly, individual semi-structured interviews were performed with six students to explore expectations. Secondly, we designed an anonymous questionnaire to explore presence of expectation mismatches and the relationship with burnout symptoms. Burnout was assessed using the short Burnout Assessment Tool (sBAT).

Results: 155 medical students filled in the questionnaire. Important mismatch topics were: level of supervision, feedback quality, amount of time spent on different tasks, amount of initiative needed and culture on clerkship location. We found that 21.9% of the students scored high to very high on the sBAT. Moreover, a mismatch between expectations and reality was positively correlated with burnout.

Conclusions: Students that experienced a bigger mismatch between expectations and reality also experienced more burnout symptoms. Consequently, it is important that future research further establishes this relationship, as expectation management might be an interesting avenue to reduce negative experiences and emotions during the clerkships.

Background: Educators have called for training in artificial intelligence (AI) in medical education given its certain impact on the future of healthcare. However, there is no consensus regarding how to introduce AI into medical education and little is known about how AI is viewed among medical trainees. In an effort to inform the development of medical education curricula on AI, this study explores perceptions of resident physicians regarding AI in healthcare and its possible impact on their future practice.

Methods: The authors conducted focus groups with resident physicians across multiple specialties in 2018-2019. Residents were invited to voluntarily participate during pre-existing conference times. Interview transcripts were coded iteratively, and coded data was clustered into categories and themes to capture resident perceptions on AI.

Results: Fifty-six residents from emergency medicine, internal medicine, pathology, pediatrics, and radiology participated in six separate focus groups. Conversations generated the following five overarching themes: healthcare is transforming, AI has a role at the clinical and systems level, concern for lack of agency in the development and implementation of AI, AI presents potential harms and uncertainties, and enduring roles of the physician: humanism, judgment, and responsibility.

Conclusion: Residents described humanistic roles that should not be replaced by technology and voiced concerns that physicians lack agency to influence how AI will be used in healthcare. Medical education should explore humanistic and ethical challenges related to AI, provide a foundational understanding of AI technology, and offer opportunities for participation in the development of AI technology when possible.

The X+Y scheduling model has become a widely adopted and effective approach within pediatric and internal medicine residency training programs across the United States. A closer examination of the factors contributing to its success reveals the broader societal and generational context influencing today's medical trainees-specifically, members of Generation Z (Gen Z). This model supports enhanced adaptability and personalization of learning, fosters teamwork and collaboration, integrates flexibility and wellness, and promotes diversity and inclusion-key educational priorities that align closely with Gen Z's values and learning preferences. Furthermore, the model resonates with and revitalizes foundational principles of adult learning theory. As Gen Z continues to comprise the majority of incoming medical trainees, further research is warranted to evaluate the applicability and effectiveness of the X+Y model in pediatric subspecialty fellowships and other residency programs, particularly in surgical and procedural-based specialties.

Introduction: The proportion of limited English proficiency (LEP) patients continues to rise and now represents 10% of the US population. These patients face many health care challenges and health disparities. To address the needs of educating the next generation of physicians on how to work with patients with limited English proficiency, we developed an instructional session focused on this goal.

Methods: First year medical students participated in a 90-minute session focused on best practices for working with interpreters and LEP patients. During the didactic part of the session, faculty led students in a discussion regarding best practices through use of video examples. During the interactive exercise, students obtained the HPI from a mock patient fluent in a language other than English through use of a phone interpreter.

Results: Following the session, the proportion of students that felt confident in obtaining a HPI from a LEP patient increased from 27% to 72%. The proportion of students who felt that it was unacceptable to have a family member interpret for a LEP patient increased from 50.5% to 68.5%.

Discussion: Our innovative and practical curriculum can be easily incorporated into medical school curricula, ensuring medical students are prepared to work with trained professional interpreters and meet the needs of a diverse patient population.