MedEdPublish (2016)最新文献

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.

Social media has revolutionized how society receives and transmits information in the digital age, including healthcare. While the future of social media platforms remains uncertain, the benefits of social media for healthcare organizations, departments, and divisions are clear when compared to traditional communication methods, including improved recruitment efforts, increased promotion of faculty work, rapid dissemination of information and education innovations, and accelerated professional networking. Consequently, preferred platforms may shift but the benefits of social media likely cement it, in one form or another, in medical education and society at large. The strategic development of a social media presence at the department level can be opaque and overwhelming amidst varying mediums, yet the benefits of use have never been more important. Here, we present 12 tips for developing a successful social media presence as a healthcare department, addressing the creation of a purposeful social media strategy and crucial considerations for any platform, current or future, at all levels of development.

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 persons with disability (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.

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.

Introduction: In Syria, specialist dentists undergo five years of undergraduate education and four years of postgraduate education. In the latter, students engage in treating complex cases as part of their professional training. This study aimed to obtain in-depth qualitative understanding of the clinical learning environment at Damascus University Faculty of Dental Medicine, Syria.

Methods: Semi-structured interviews were held with eight postgraduate dental students at Damascus University Faculty of Dental Medicine. The faculty has eight clinical departments; therefore, a single participant was purposively sampled from each department. The male-female ratio of the eight interviewed participants was 1:1. All interviews were conducted between 26 ^th April 2020 and 8 ^th January 2021. Data were analyzed inductively using reflective thematic analysis. Pragmatic saturation was discussed during the analysis and the authors made an interpretative judgement to stop data collection at the eighth interview.

Results: Major themes which emerged covered different aspects of the clinical learning environment such as clinical training, social interaction and assessment procedures. Faculty's negligence of their teaching duties was one of the most recurrent themes. In clinical training and due to faculty inaccessibility, students had to rely on themselves or their senior peers in training. The social climate was perceived negatively and assessment was described as unfair and biased.

Discussion: This study employed Gruppen's conceptual framework to conduct a theory informed analysis of the clinical learning environment in a dental school with limited resources. The findings highlight important areas of improvement that needs addressing, including the unavailability of teaching staff, neglect of student needs, a competitive social atmosphere, and inconsistent assessment practices. Future research ought to focus on understanding the perspectives of teaching faculty and decision makers regarding the obstacles to implementing substantial reforms aimed at enhancing the clinical learning experience.

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.