MedEdPublish (2016)最新文献

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.

Background: In June 2022, the Dobbs decision by the U.S. Supreme Court overturned federal abortion protections. In states with restrictive abortion laws such as Indiana, which also has the country's largest medical school and the third worst maternal mortality rate, the impact of this ruling may have a significant impact on healthcare in the state. The purpose of this study was to analyze perceptions of medical students in Indiana in their third and fourth years of education after the Dobbs decision to assess if the state's current abortion restrictions impact their career choice.

Methods: Between December 2022 and March 2023, an anonymous survey was carried out at Indiana University School of Medicine, which included questions about personal beliefs on abortion and the current abortion laws in Indiana, as well as priorities when choosing residency training and practice locations.

Results: Our survey found that four-fifths of medical students in Indiana disagreed with the Dobbs decision. While most students (71.4%) had not considered state abortion laws when selecting a medical school, since the Dobbs decision, 66.3% of third-year and 40.3% of fourth-year students indicated that they would take abortion laws into account when choosing a residency program. 47.5% of women students stated that they will be seeking residency in a state where abortion is legal and 55.3% of single students were more likely to leave Indiana to practice medicine.

Conclusion: Our research suggests that physicians who are more liberal in their views on abortion may now be much less likely to practice in conservative states which will compound the healthcare outcomes secondary to the Dobbs decision. We emphasize the role that abortion laws have in shaping the landscape of healthcare workforce and the need for a more nuanced understanding of how societal structures impact women's reproductive decisions and career paths in medicine.

The rapid growth of immersive virtual reality (VR) has gained widespread global attention in the field of education. In higher education within healthcare, VR has already been widely explored and employed. One specific form of virtual reality, 360-degree video, is regarded as a more user-friendly, realistic, and cost-effective alternative to other VR modalities, providing an immersive experience that requires less complex technology while still offering a high level of engagement in educational contexts. A 360-degree video is relatively easy to produce and can be seamlessly integrated into educational settings, serving a versatile and accessible tool for enhancing interactive learning experiences across various healthcare disciplines. We developed and integrated ten 360-degree videos, designed for viewing through head-mounted displays, to enhance educational practices in healthcare at Maastricht University, the Netherlands. In this article, we share guidelines for developing and integrating 360-degree videos into undergraduate and graduate healthcare programs, drawing on insights from our own experiences.

Background: During the COVID-19 pandemic, we developed an e-learning resource to support medical students in having effective conversations with COVID vaccine hesitant patients (an urgent challenge). Development of information and communication skills elements was underpinned by narrative learning theory; learners interact with three fictional characters whose stories run through the resource in activities and role-plays. We co-developed the resource and characters with students, colleagues and local community.

Methods: We used a mixed methods approach to evaluate the resource, including a survey of pre- and post- module self-confidence scores, and by thematic analysis of a focus group with seven final year medical students to explore their perceptions of how the story elements influenced their learning.

Results: All students surveyed reported an improvement in their confidence in having effective conversations with vaccine-hesitant patients. The focus group analysis suggests that character-based narratives can promote learning online, particularly through engagement and accessibility, relatability of characters and their stories, improved memory, and emotional connection.

Conclusions: This study suggests that character-driven stories have potential value in online learning about vaccine hesitancy conversations. Further research is needed to establish the nature of their impact on different aspects of learning including the duration of effect on students' communication skills and any patient-related outcomes.

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: Whilst debriefing literature offers valuable tools for healthcare education, there remains a gap in resources specifically designed for debriefing communication skills. Effective communication is fundamental to patient care, particularly during sensitive interactions. This article provides a specialised toolkit for educators to enhance communication skills debriefing, developed through synthesis of existing literature and the authors' extensive experience teaching communication skills through simulation.

Methods: Drawing from literature and the authors' extensive experience teaching communication skills through simulation, we present six interconnected tools: leveraging cognitive dissonance, recognising micro-ruptures in rapport, mapping communication to clinical reasoning, differentiating sincere from performative empathy, metaphor dissection (analysis of the implicit meanings in patients' figurative language), and emotional labour accounting (the work of managing displayed emotions in professional contexts). We demonstrate these concepts through a fictional case study of Dr Morton's interactions with a patient and family.

Results: The toolkit offers specific debriefing questions for each component that encourage reflective practice. Cognitive dissonance exploration helps clinicians recognise when competing professional values affect communication. Micro-rupture identification aids in preserving therapeutic relationships. Communication mapping enhances clinical decision-making. Understanding different forms of empathy guides appropriate engagement. Metaphor analysis reveals hidden meanings in patient-clinician dialogues. Emotional labour accounting acknowledges the personal cost of managing emotions professionally. Together, these elements create a framework that strengthens communication effectiveness whilst supporting clinician wellbeing.

Conclusions: Effective debriefing of communication skills requires attention to both technical and emotional dimensions of healthcare interactions. This toolkit provides practical strategies for educators to help learners navigate the complexities of healthcare communication, ultimately improving patient care whilst supporting clinician resilience.

Background: This study determined the correlation between creative thinking aptitude, measured by the Torrance Test of Creative Thinking-Figural (TTCT-F), and five-year academic achievement.

Methods: The TTCT-F was administered to 135 first-year medical students at a Tokyo-based medical school in 2018. Participants' academic records-annual GPAs over five years-were averaged, and data were analyzed in 2023. Pearson correlation coefficients examined the relationship between the TTCT-F Creativity Index and the five-year average GPA; multiple linear regression assessed the predictive value of TTCT-F components on GPA; canonical correlation analysis explored multivariate relationships.

Results: The Creativity Index demonstrated a weak, non-significant correlation with the five-year average GPA. Fluency, Originality, and Elaboration components were not significantly correlated, while Abstractness of Titles demonstrated a moderate positive correlation. Linear regression indicated that Abstractness of Titles significantly predicted GPA, accounting for approximately 8% of the variance. Canonical correlation analysis revealed a moderate multivariate association between TTCT-F components and academic performance.

Conclusions: Certain aspects of creative thinking, particularly abstract reasoning, may relate to academic success in medical education. Further research is needed to clarify the role of creative thinking in medical training and whether it warrants greater integration into curricula.

The transition from residency or fellowship to autonomous, independent consultant can be daunting, to say the least! New consultants may face a number of challenges and decision points previously unencountered in their careers. In this article, we present twelve tips for trainees transitioning to their first consultant position (with an emphasis on those in academic or hybrid positions) to help with a smooth, successful process.