MedEdPublish (2016)最新文献

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.

Background: Collaborative patient centred practice is an expectation of the Australian healthcare system, yet there is not a clear understanding of what this entails. The aim of this research was to describe collaborative practice, as understood within the context of the Australian health system.

Methods: Nineteen focus groups were conducted in 2022 with 84 participants consisting of education providers (n=62), consumers (n=10), representatives from the Health Profession's Education Standing Group (n=8), and health service practitioners (n=4). Framework analysis was undertaken to understand facilitators of, and barriers to, collaborative practice and learning within the Australian education and healthcare systems.

Results: Participants were asked to describe examples of effective collaborative practice, what they would expect to experience, and examples of when collaborative practice did not occur and the associated outcomes. Participants from all groups emphasised the importance of elevating the patient voice within a patient centred collaborative healthcare team. Patients, family and carers needed to be positioned as central team members within a collaborative healthcare team. Power and hierarchy within the healthcare team impacted on the ability to deliver collaborative practice.

Conclusions: By positioning the patient and their family and carers as members of the team, shared goals for optimal patient outcomes were experienced. By contrast when collaborative practice did not occur, or patients were omitted as central team members, poor communication and disjointed healthcare was described, leaving patients feeling disempowered and disengaged.

Introduction: Curriculum development in medical education, particularly in family medicine, is essential for preparing healthcare professionals to meet evolving patient needs. This article examines the development of a Family Medicine program in Jordan, focusing on challenges, methodologies, and outcomes.

Methods: The curriculum was developed through collaboration between Jordanian and European universities, emphasizing core family medicine principles, evidence-based practice, and local context. Two cohorts of trainees participated in the one-year program, which used a 'whole task learning model' covering communication, clinical knowledge, and community health. Feedback was gathered through focus group interviews with trainers and trainees, and pre- and post-test data were analyzed to assess effectiveness in terms of exam outcome.

Results: Feedback indicated positive perceptions among trainers and trainees. Trainees valued the transition to Arabic-led lectures, improved primary care understanding, and trainer engagement. Strengths included evidence-based guidelines and patient interaction emphasis. Areas for improvement included more face-to-face training and practical opportunities. Trainers suggested enhancing practical skills training and increasing Arabic materials. Both cohorts showed significant improvement on test scores. Challenges such as non-participation and cheating highlighted the need for regular attendance and academic integrity.

Conclusion: The research underscores the importance of feedback from trainees and trainers in curriculum development. Continuous improvement, comprehensive assessment, and prioritizing linguistic and cultural relevance are crucial for enhancing primary care delivery in Jordan.

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.