The Impact of Role Models on Medical Students

Comparison of Online Peer-Assisted Learning and Faculty-Led Teaching for Short Answer Questions

INTRODUCTION

Peer-assisted learning (PAL) is a well-recognised pedagogical approach in medical education; however, research on its effectiveness in online settings remains limited. Multiple-choice questions have been the predominant method for assessing PAL outcomes, despite Short Answer Questions (SAQs) being the superior tool for evaluating knowledge. This study compares online peer and faculty teaching in enhancing medical students' higher-order thinking skills and assesses students' perceptions of these methods.

METHODS

Third-year medical students undergoing surgical placements were consented and recruited for the study. Three pre-defined cohorts were randomised to the following arms: no intervention (n = 41), online PAL teaching (n = 37) and online faculty teaching (n = 35). Peer teaching was delivered by fourth-year students (n = 6) and faculty teaching by Clinical Teaching Fellows (CTFs) (n = 6). Academic outcomes were assessed using end-of-block SAQ formatives, and teaching quality was evaluated using the validated SEEQ questionnaire. Knowledge gain and self-perceived confidence were assessed through pre- and post-session tests, validated with a reference group of learners.

RESULTS

Consent for SAQ exam scores was obtained from n = 19 (no intervention), n = 29 (PAL) and n = 21 (CTF). No significant differences were seen between the groups (p = 0.650). SEEQ completion was n = 24 (PAL) and n = 30 (CTF). CTF tutors received significantly higher ratings in domains of Learning (p = 0.017) and Group Interaction (p = 0.036). Pre- and post-session tests showed no significant differences in scores (p = 0.957) or self-perceived confidence ratings (p = 0.454).

CONCLUSION

This study shows that online PAL is a viable alternative to faculty-led teaching for enhancing SAQ skills and knowledge acquisition. However, faculty-led teaching offers a superior educational experience.

Breaking the Glass Ceiling: Female Speaker Representation at the American Orthopaedic Foot & Ankle Society Annual Meetings Over Time

Background

Female representation among residents and practicing surgeons in orthopaedics remains disproportionately low at 19.3% and 7.4%, respectively. This study investigates female representation in speaker roles at American Orthopaedic Foot & Ankle Society (AOFAS) meetings over time.

Methods

The annual AOFAS meeting programs for 2012 to 2024 were reviewed by 3 independent raters. Each speaker, moderator, and panelist was classified based on gender and role; data were cross-checked using Fleiss multirater κ validation. Sessions discussing surgical or biomedical topics were categorized as "technical," and all other sessions were categorized as "nontechnical." Yearly odds ratios (ORs) and CIs evaluating gender vs session status, as well as gender vs speaker role, are provided.

Results

A total of 2396 speaking sessions were analyzed; 11.5% of sessions were led by female speakers. Over time, female speaker representation ranged from 5.61% in 2014 to 18.75% in 2022. Female speakers led only 10.8% of the 2088 technical sessions. On average, female speakers were significantly more likely than males to assume nontechnical speaking roles across all years combined (OR 1.5111, 95% CI 1.0792-2.1158, P = .0162). For individual year ORs, female speakers were significantly more likely to assume nontechnical speaking roles in 2020 (OR 12.24, 95% CI 4.082-36.67, P < .001); however, the differences were not statistically significant for other years. Females also comprised 10.10% and 12.00% of moderator and panelist roles, respectively.

Conclusion

Female speaker involvement was representative of AOFAS female membership and the national population of female orthopaedic surgeons. Additionally, our study revealed an increasing trend in female speakers, panelists, and moderators from 2012 to 2024. However, there is a need for a shift in the distribution of speaker roles to prevent professional marginalization. Continued efforts to support female representation as role models at national conferences increases visibility and may help to address the lack of women within orthopaedics.

Level of Evidence

Level III, retrospective cross-sectional study.

Qualitative Insights into Resident Perceptions of Teaching Excellence and Educational Curricula

OBJECTIVE

The objective of this study was to understand the resident perspective on what makes an excellent surgical educator and to identify gaps in a single-institution-developed "Residents as Teachers" curriculum (RaTC) following the completion of the RaTC by residents at the institution.

DESIGN

A longitudinal 8-hour RaTC was developed and administered in 1-hour sessions over 2 years. Content included interactive clinical and technical skills teaching, feedback, evaluation and assessment, and interpersonal skills. Residents who had completed the RaTC were invited to participate in interviews exploring their perceptions of the RaTC and their own clinical teaching experiences. Interview comments were coded and analyzed for thematic content.

SETTING

This study took place at the University of Nebraska Medical Center (Omaha, NE). The RaTC was delivered between 2021-2023 and interviews were held in June of 2023.

PARTICIPANTS

The eligible cohort for this study included all general surgery residents in our general surgery program who had completed the full RaTC (PGY2 and above).

RESULTS

Seven subjects participated in interviews. Subjects reported that the RaTC helped enhance their skills as surgical educators and that teaching is an important part of their job. Thematic analysis identified 3 areas in which subjects commented on both facilitators and barriers to educating in the clinical environment: educator behaviors and teaching methodologies, learner attitudes and behaviors, and systemic factors. Residents felt uncomfortable teaching procedural tasks, giving constructive criticism, and finding time to teach throughout the day.

CONCLUSIONS

The RaTC was well received by our participants, who reported that it helped improve their ability to teach. However, they often felt uncomfortable implementing these skills in real-life scenarios with learners. Our curricula will be revised, and other training programs could design curricula to provide more time to practice these skills in particular in a low-stakes setting, which may help residents feel more confident utilizing them while teaching.

Constructing psychometric measurement of a past supervised experience scale with educational roles to investigate the relationship between being instructed, being supported, and being supervised for attending physicians in teaching hospitals - a questionnaire survey

PURPOSE

Although school-based planned education has steadily been introduced, master-apprentice learning is still an indispensable part of medical education. All medical clinical teachers begin their careers as medical students, often without knowing exactly how they will learn to teach. Kilminster and Jolly identified three primary functions of clinical supervisors including clinical teaching, support and guidance, and work supervision. Therefore, we designed a study using questionnaires to assess the three factors of clinical educators for past supervised experiences, including 'being instructed,' 'being supported,' and 'being supervised,' based on Kilminster and Jolly's illustration in 2000, to see the relationship between the three factors mentioned above.

MATERIALS AND METHODS

The study started with a literature review to construct the essential items regarding past supervised experiences of physicians as clinical teachers. We invited 10 experts from fields including medical education and experienced clinical teachers to assess the content validity. One hundred physicians in teaching hospitals were sampled for the preliminary test. Another 364 physicians in teaching hospitals were sampled for the formal study of confirmatory factor analysis and pathway analysis.

RESULTS

The" Past Supervised Experiences with Educational Roles Scale" showed satisfying reliability with all Cronbach's α values exceeding .80, and three factors from supervised experiences were identified, including 'being supported,' 'being instructed,' and 'being supervised.' In our model, the 'being supported' experience could positively affect 'being supervised' with significance, directly and indirectly, by being instructed.

CONCLUSIONS

Our study developed a validated instrument that allows investigation of the formation of better-supervised experiences from current physicians. Our findings inspired us to focus more on supportive coaching in teaching and supervising medical trainees. Our study indicated that faculty development for skills of supporting students is crucial to effective clinical teaching and supervision.

To speak or not to speak: Factors influencing medical students' speech and silence in the operating room

PURPOSE

The surgical clerkship provides medical students with valuable hands-on experience. This study examined why medical students speak or remain silent in the OR to improve progression from novice to engaged surgical team member.

METHODS

Using Constructivist Grounded Theory 37 interviews were conducted concerning expectations and behaviors that encourage or discourage students from speaking during their clerkship. Transcripts were coded, analyzed, and triangulated to develop a conceptual model.

RESULTS

Students' decision to speak or remain silent was based on their perception of the OR as a safe learning space. Our findings suggest that better preparation, awareness of critical moments, and informal communication with team members encouraged student speech.

CONCLUSIONS

Medical students remain conflicted about their speaking in the OR and their evaluation. Key to improving students' psychological safety is establishment of interpersonal relationships, awareness of OR mood, and assignment of case-related tasks to assist with OR assimilation and improved learning.

From classroom to operating room: What attracts medical students to neurosurgery

BACKGROUND

The specialties chosen by medical students after graduation are critical to their professional trajectories. This study investigates the perceptions of medical students at Jazan University in southwestern Saudi Arabia toward neurosurgery, focusing on the factors that influence their inclination to pursue this specialty.

METHODS

An observational cross-sectional study was conducted among 342 medical students from the Faculty of Medicine at Jazan University during the 2022-2023 academic year. The participants included students ranging from second- to sixth-year levels.

RESULTS

Among the 342 students, 207 (60.5 %) were males, and 135 (39.5 %) were females, with 169 (49.4 %) expressing interest in neurosurgery. Over time, there was a trend of decreasing interest in neurosurgery. The primary reasons for choosing this specialty were market demand for neurosurgeons and potential for substantial income, while stress was the main deterrent. Multivariate analysis revealed that third-, fourth-, and fifth-year students were significantly less likely to pursue neurosurgery, with reductions of 89 % [OR=0.11, 95 % CI: (0.04-0.29), p < 0.001], 83 % [OR=0.17, 95 % CI: (0.07-0.43), p < 0.001], and 74 % [OR=0.26, 95 % CI: (0.11-0.61), p = 0.002], respectively. The strongest motivating factors for choosing neurosurgery were research opportunities [OR=2.37, p < 0.001] and the prestige associated with the specialty [OR=2.35, p < 0.001].

CONCLUSIONS

The study provides valuable insights into medical students' perceptions and career aspirations related to neurosurgery in southern Saudi Arabia. It highlights key factors such as research opportunities, prestige, and competitiveness that motivate students to consider neurosurgery as a specialty. The study also addresses common misconceptions and stereotypes about neurosurgery, promoting a more accurate understanding of the field among students. These findings have significant implications for medical education, career guidance, and healthcare policy, helping to shape initiatives that enhance patient care and support the development of neurosurgery.

Becoming a doctor: using social constructivism and situated learning to understand the clinical clerkship experiences of undergraduate medical students

BACKGROUND

Despite the emphasis on the uniqueness and educational importance of clinical clerkships in medical education, there is a lack of deep understanding of their educational process and outcomes. Especially due to an inherent trait of clinical clerkships which requires participation in the workplace outside the classroom, it is difficult to fully comprehend their educational potential using traditional learning perspectives such as imbibing outside knowledge. Accordingly, this study aims to explore the experiences of a rotation-based clerkship of medical school students from the perspective of social constructivism of learning, which can empirically examine what and how medical students learn during clinical clerkship in South Korea. By providing an insight into the workings of the clerkship process, this study contributes to a better understanding of how a learning-friendly environment can be cultivated at clinical clerkships.

METHODS

The study utilized a basic qualitative study to understand what and how medical students learn during their clinical clerkships. Semi-structured, in-depth individual interviews were conducted with eight sixth-graders who had experienced a two-year clerkship at Ajou University Medical School. Data were analyzed based on Lave and Wenger's situated learning theory and Wenger's social theory in learning.

RESULTS

We found that the medical students had developed different aspects of their professional identities such as values, functionality, career decisions, sociality, and situating during their clinical clerkships. Further, professional identity was formed through a combination of participation and reification-the processes involved in the negotiation of meaning. This combination was facilitated by the students' first experience and relationships with professors, classmates, and patients. Finally, non-learning occurred in the context of over-participation (learning anxiety and alienation) or over-reification (evaluation and e-portfolio).

CONCLUSIONS

This study revealed five sub-professional identities and their formation process from the learners' perspective, thereby uncovering the unique learning characteristics and advantages of rotated-based clerkship and contributing to a further understanding of how gradual improvements can be made to the traditional clerkship education of medical students.

The use of an educational video on forensic autopsy in curricular teaching for medical students-is it worth the effort? : A field report from lecturers and a survey among students

PURPOSE

The purpose of this work is to share our experience with an educational video on forensic autopsy. Using questionnaires, we attempted to answer the following questions: Does watching the video trigger emotions in students? Does the autopsy meet the expectations that they had before? Does the video help to prepare them for their subsequent autopsy participation?

METHODS

A total of 365 medical students who attended their classes during the COVID-19 pandemic measures were provided with the video on an online platform. Links leading to questionnaires were positioned before and after the video. One hundred seventy-six students returned to face-to-face teaching during their course in forensic medicine. Those among them who chose to participate in an autopsy at our institute were given the link to a third questionnaire after their autopsy participation. The data was analyzed using IBM SPSS 27.0 and Microsoft Excel.

RESULTS

One hundred seventy-two students completed a questionnaire before watching the educational video, 85 also completed one afterwards, and 28 completed the third questionnaire. The most intense feelings while watching the video were "curiosity" and "surprise". Out of twelve students (14.1%) who had imagined the autopsy differently in advance, five perceived the autopsy shown in the video as rougher or more brutal than expected. All autopsy participants who had previously viewed the video felt adequately prepared.

CONCLUSION

Teaching should include an introduction to the handling of the corpse and the general procedures in the dissecting room. Although a video cannot substitute for personal interaction, it is useful to prepare students for their autopsy participation.

Syrian crises effect on specialty choice and the decision to work in the country among residents of six major hospitals in Syria, Damascus

Assessing the impact of war on medical residents' specialty choices and migration decisions is critical to ensure the sustainability of healthcare systems worldwide. This study aimed to evaluate the effect of the Syrian crisis on specialty choices, related factors, and decisions to work in Syria among residents of six major university hospitals in Damascus. A cross-sectional study was conducted using a validated questionnaire from 20/4/2022 to 20/5/2022, including all eligible residents with no missing data. The questionnaire was comprised of 68 items, and residents were divided into two groups: group 1 included residents who made their specialty choice after the end of the military war in Damascus 2018, while group 2 included residents who made their specialty choice (the point of submitting their lists and applying for residency) during the war. A total of 370 residents were included, with 38.4% females and 61.6% males. Our findings revealed that 30% of residents preferred working in Syria, while 43.5% preferred working abroad. The factor of a "safer and more stable life" was significantly higher in Group 1 than in Group 2 (3.86>3.5, p-value = 0.026). Additionally, Group 1 residents were more likely to choose radiology, pathology, laboratory, and psychiatry specialization as their specialties, while choosing surgical specializations and hematology decreased compared to Group 2 (p-value<0.05). Factors related to social life were rated higher by group 1 (mean = 3.31) than by group 2 (mean = 2.27, Standard deviation = 0.19, p-value = 0.002). Moreover, the factor of "a specialization to facilitate traveling abroad" was significantly higher in Group 1 (2.69>2.21, Standard deviation = 0.22, p-value = 0.033). The Syrian crisis and its economic aftermath have influenced residents' specialty choices and practice locations. Even after the war's end, the high level of migration intentions could negatively affect the quality of provided healthcare services.

Underrepresentation of African Americans in Plastic Surgery: Examining Demographics, Specialty Factors, and Medical School Experiences

BACKGROUND

Racial representation among medical trainees translates into physicians that are able to communicate with diverse patient populations and are perceptive to health disparities. This is important within plastic surgery where an optimal physicianpatient relationship is essential to health outcomes.

OBJECTIVE

The purpose of this study is to address underrepresentation of African Americans (AA) in plastic surgery through improving understanding of factors that may contribute to AA medical student interest in plastic surgery.

DESIGN

This was a voluntary, cross-sectional survey. An online survey was designed to collect information on demographics, specialty factor importance, medical school experiences, and plastic surgery interest among medical students. The survey was distributed to medical students within three national medical organizations between August 2018 and February 2019. The following groups of respondents were statistically COMPARED: AAs interested vs. AAs not interested in plastic surgery and AA vs. Caucasian medical students both interested in plastic surgery.

SETTING

Online survey for medical students in the United States.

PARTICIPANTS

All 428 participants were medical students that belonged to at least 1 of the 3 national medical organizations between August 2018 and February 2019.

RESULTS

The survey was completed by 428 participants of which 142 were excluded for incomplete surveys, leaving 286 (66.8%) participants to be included in the study. Among AA medical students, 128 (75.3%) were not interested in Plastic Surgery and 42 (24.7%) were interested. The 2 groups were similar demographically but differed significantly across multiple specialty factors and medical school experiences (p < 0.05). When compared to interested Caucasian medical students (n = 30), interested AA medical students differed significantly in demographics, specialty factors, and medical school experiences (p < 0.05).

CONCLUSIONS

This study supports the implementation of medical school interventions emphasizing specialty factors and medical school experiences unique to AA medical students interested in plastic surgery to promote their application into the specialty.

An Ophthalmology Virtual Externship during the COVID-19 Pandemic: A Pilot Study

Background  The evolution of medical school curricula, characterized by truncated preclinical periods and reduced emphasis on ophthalmology, presents formidable obstacles to early exposure for aspiring medical students. The constraints imposed by the coronavirus disease 2019 pandemic further exacerbated the limitations on opportunities, compelling the implementation of innovative initiatives aimed at augmenting students' ophthalmology education through virtual means. Purpose  This article assesses the impact of an Ophthalmology Virtual Externship (OVE) on medical students' knowledge, interest, confidence, and seeking mentorship in ophthalmology. Materials and Methods  A total of 76 students voluntarily participated in the program. The OVE encompassed four virtual sessions, facilitated by 4th year medical students employing a near-peer mentorship framework. The initiative was tailored for 2nd and 3rd year medical students and was conducted under the supervision of a faculty member. All participating students completed both pre- and postexternship surveys utilizing a 7-point Likert scale to gauge their levels of interest, confidence, and inclination toward mentorship opportunities in the field of ophthalmology. Furthermore, assessments of ophthalmology knowledge were administered prior to and subsequent to the externship participation. The degree of satisfaction derived from the OVE experience was also evaluated. Results  Participation in the OVE significantly elevated confidence in knowledge ( p  < 0.001) and mentorship interest ( p  = 0.029). Ophthalmology knowledge test scores also notably improved post-OVE across all participants, irrespective of prior experience ( p  < 0.001), with the most significant increase observed among 2nd and 3rd year students ( p  < 0.0001). After OVE participation, 73% of students expressed intent to pursue ophthalmology opportunities, including mentorship or research. The OVE received an average Likert score of 6.35 out of 7 for student satisfaction. Conclusion  The OVE serves as a virtual learning instrument beneficial for 2nd and 3rd year students with a proclivity for ophthalmology, offering a means to circumvent curriculum-related constraints. Moreover, given the decline in formal ophthalmic education, our study contributes to future research assessing the effectiveness of an OVE in addressing ophthalmic knowledge gaps among all medical students.

'A role model is like a mosaic': reimagining URiM students' role models in medical school

BACKGROUND

Role modelling is a widely acknowledged element of medical education and it is associated with a range of beneficial outcomes for medical students, such as contributing to professional identity development and a sense of belonging. However, for students who are racially and ethnically underrepresented in medicine (URiM), identification with clinical role models may not be self-evident, as they have no shared ethnic background as a basis for social comparison. This study aims to learn more about the role models of URiM students during medical school and about the added value of representative role models.

METHODS

In this qualitative study we used a concept-guided approach to explore URiM alumni's experiences with role models during medical school. We conducted semi-structured interviews with ten URiM alumni about their perception of role models, who their own role models were during medical school and why they considered these figures as role models. Sensitizing concepts guided the topic list, interview questions and finally served as deductive codes in the first round of coding.

RESULTS

The participants needed time to think about what a role model is and who their own role models are. Having role models was not self-evident as they had never thought about it before, and participants appeared hesitant and uncomfortable discussing representative role models. Eventually, all participants identified not one, but multiple people as their role model. These role models served different functions: role models from outside medical school, such as parents, motivated them to work hard. Clinical role models were fewer and functioned primarily as examples of professional behaviour. The participants experienced a lack of representation rather than a lack of role models.

CONCLUSIONS

This study presents us with three ways to reimagine role models in medical education. First, as culturally embedded: having a role model is not as self-evident as it appears in existing role model literature, which is largely based on research conducted in the U.S. Second, as cognitive constructs: the participants engaged in selective imitation, where they did not have one archetypical clinical role model, but rather approach role models as a mosaic of elements from different people. Third, role models carry not only a behavioural but also a symbolical value, the latter of which is particularly important for URiM students because it relies heavier on social comparison.

Perception of newly graduated physicians toward ethical education in medical schools: a Brazilian cross-sectional nationwide study

OBJECTIVE

The objective of this study was to evaluate fresh medical graduates' perceptions regarding the general aspects of ethics teaching in Brazilian medical schools.

METHODS

A structured questionnaire was applied to 4,601 participants among the 16,323 physicians who registered in one of the 27 Regional Medical Councils of Brazil in 2015. Answers to four questions regarding general aspects of ethics education in medical school were analyzed. Sampling procedures involved two stratification variables: legal nature (public vs. private) of medical schools and monthly household income higher than 10 minimum wages.

RESULTS

A large percentage of the participants had witnessed unethical behaviors during contact with patients (62.0%), toward coworkers (51.5%), and in relationships with patients' families (34.4%) over the course of their medical training. Even though most of the responders (72.0%) totally agreed that patient-physician relationship and humanities education were part of their medical school curriculum, important topics such as conflicts of interest and end-of-life education were not satisfactorily addressed in the participants' medical training. Statistically significant differences were found between the answers of public and private school graduates.

CONCLUSION

Despite great efforts to improve medical ethics education, our findings suggest the persistence of deficits and inadequacies in the ethics training currently given in medical schools in Brazil. Further modifications in ethics training must be made to address the deficiencies shown in this study. This process should be accompanied by continuous evaluation.

Mentors and Role Models: the Role Female Medical Educators Serve for Female Medical Students

Discussion of diversity, equity, and inclusion (DEI) has moved to the forefront in medical education, and in particular, efforts toward gender equity have emphasized the need for more women faculty and physicians. Gender parity was recently achieved for medical students matriculating into US allopathic schools during the 2017-2018 academic year1. However, this documented increase in women attending medical school as students is not matched by an increase in women teaching in the undergraduate medical education (UME) curriculum. In 2020, the faculty employed by medical schools across the USA (totaling 186,311) includes 43% women; this percentage drops significantly when considering the rank of full professor, of which only 26% are women [1]. For faculty representing graduate programs in science, technology, engineering, and math (STEM), many of which teach in the pre-clerkship phase of UME, less than 25% are women [2], according to the 2019 AAMC statement of gender equity.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01776-1.

Prosocial modelling matters: the association between parent and faculty involvement in fighting COVID-19 with medical students' career commitment

BACKGROUND

Role models are essential in medical education, yet empirical research is relatively insufficient on the influence of prosocial modelling on medical students' career commitment. The prosocial behaviour of medical staff involved in the fight against the novel coronavirus disease 2019 (COVID-19) at the beginning of 2020 presents an opportunity to fill the research gap. We explored and compared the different associations of the two most important role models for medical students - parents and faculty- with medical students' career commitment.

METHODS

The cross-sectional study was conducted with 99,559 undergraduate students majoring in clinical medicine in mainland China. Questions were asked to collect information about participants in the battle against COVID-19, medical students' determination to practice medicine after graduation, as well as students' socio-demographic characteristics. Chi-square tests and hierarchical regressions were performed to examine the associations between parent and faculty involvement and students' career commitment.

RESULTS

The results showed statistically significant associations between prosocial modelling during the COVID-19 pandemic in China and students' intention to pursue medical careers. The association of faculty involvement (OR = 1.165, p < .001) with students' career commitment was greater than that of parents (OR = 0.970, p > .05). For faculty involvement, the association was stronger among male students (OR = 1.323, p < .001) and students who were already determined to be doctors (OR = 1.219, p < .001) before the pandemic.

CONCLUSIONS

Our study provides new evidence on the potential roles of parents and faculty in shaping medical students' career commitment. Encouraging faculty to act as positive role models could help medical students increase their intention to become doctors.KEY MESSAGESProsocial modelling could enhance students' intention to pursue medical careers.The association of prosocial behaviour of faculty is larger than that of parents on medical students.Those who have prior medical career commitment are much more likely to persist in the medical profession, and prosocial modelling of faculty is positively associated with their medical career commitment.

Outstanding qualities of a successful role model in medical education: Students and professors' points of view

Introduction

Role models play a crucial role in determining the professional development of medical trainees. The purpose of this study was to gain in-depth understanding of the outstanding qualities of successful role models.

Material and methods

In this qualitative-descriptive study, data were collected through conducting interviews, and the inductive content analysis was performed. The study was done at the school of medicine of Tehran University of Medical Sciences in Iran. Twenty-five medical students, medical graduates, and faculty members participated in 25 interviews from April to December 2019. The participants were recruited via purposive sampling.

Results

five categories and 13 subcategories were extracted from the data. The results of this study illustrated five crucial qualities of a good clinical role model including an excellent character, effective coach and mentor, inspiring medical leader, expert clinical teacher, and a professional physician. Our results also highlighted the lasting effects of positive role modeling of clinical teachers on medical trainees' professional careers. Another category in the present study was connected to future consequences of being a role model in a clinical setting.

Conclusion

The result of this study illustrated crucial qualities of a good medical role model. This result can assist the leaders to engage with medical educators to better understand the process of role modeling and design the best plan for development of role modeling in medical education.

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Medical role models can play an essential role in gradually helping medical trainees mature professionally.

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Role models can undoubtedly motivate medical students to stay on track, focus on life decisions, instill determination, and have perseverance in work.

Awareness, perceptions, and characteristics of internal medicine residents as role models

BACKGROUND

Role modelling is an essential component of medical education in which trainees incorporate observed characteristics into their personal behaviour and practice style. Data on residents as role models is limited. There are no previous quantitative studies addressing residents as role models from the resident's perspective.

OBJECTIVE

This study aimed to dissect the awareness, perception, and positive characteristics of internal medicine (IM) residents as role models.

METHODS

This was a cross sectional study, in which 59 medical students (MS) and 64 IM residents from Medstar Georgetown University Hospital completed a questionnaire on role modelling. Descriptive and comparative analyses between both groups were conducted.

FINDINGS

Most participants perceived IM residents as role models, but MS were more likely to report that IM residents lack awareness of their role model status. While MS perceived spending more hours with residents, the residents perceived dedicating more of the time spent together to teaching. Most participants denied previous training in role modelling but expressed interest in receiving formal role modelling training. Most participants reported MS behaviours were modified based on their observations of IM residents; however, while most of these behaviours were positive, there were also negative behaviours reported.

CONCLUSION

There was a discrepancy between perception and awareness of residents as role models. This characterisation of IM residents as role models sets the ground for the design of interventions to increase awareness and create educational interventions aimed to support residents in their teaching role.

The impact of role modelling on the future general practitioner workforce: a systematic review

Role modelling has been identified as an important phenomenon in medical education. Key reports have highlighted the ability of role modelling to support medical students towards careers in family medicine although the literature of specific relevance to role modelling in speciality has not been systematically explored. This systematic review aimed to fill this evidence gap by assimilating the worldwide literature on the impact of role modelling on the future general practitioner (GP) workforce. A systematic search was conducted in Medline, Embase, Scopus, Web of Science, Cochrane, ERIC and CINAHL, and all authors were involved in the article screening process. A review protocol determined those articles selected for inclusion, which were then quality assessed, coded and thematically analysed. Forty-six articles were included which generated four broad themes: the identity of role models in general practice, role modelling and becoming a doctor, the impact of role modelling on attitudes towards the speciality, and the subsequent influence on behaviours/career choice. Our systematic review confirmed that role modelling in both primary and secondary care has a crucial impact on the future GP workforce, with the potential to shape perceptions, to attract and deter individuals from the career, and to support their development as professionals. Role modelling must be consciously employed and supported as an educational strategy to facilitate the training of future GPs.

Clinical Teaching Competencies in Physical Therapist Education: A Modified Delphi Study

OBJECTIVE

Clinical instructors play a key role in physical therapist professional education but may serve with minimal preparation and without clearly defined expectations for their teaching performance. The objective of this study was to utilize a consensus-building process to establish core competencies of clinical teaching within physical therapist education.

METHODS

A modified Delphi approach was used to identify core competencies of clinical teaching. An expert panel consisted of clinical instructors, site coordinators of clinical education, and directors of clinical education, representing multiple geographic regions in the United States. The panel assessed the relevance of 30 original competencies. Criteria for consensus included 75% of participants perceiving the competency as very or extremely relevant and a median score of 2 (very relevant) on a 5-point Likert scale. Consistent with a Modified Delphi approach, quantitative and qualitative data analysis were completed for each of the 3 rounds. Revised surveys were used in Rounds 2 and 3 based on the results from previous data analysis.

RESULTS

Twenty-four competencies achieved final consensus. The competencies were categorized within 3 domains: learner-centered educator (n = 8), assessor/evaluator (n = 7), and professional role model (n = 9).

CONCLUSION

The 24 competencies and 3 domains provide the foundation for a competency framework for clinical teaching in physical therapy. This framework provides clarity for the expected knowledge, skills, and attitudes of clinical instructors in physical therapist professional education.

IMPACT

This is the first study, to our knowledge, to utilize a consensus-building strategy to clearly define competencies of clinical teaching in physical therapist professional education. Like efforts in nursing and medical education, adoption of these competencies could promote consistency in clinical instructor teaching behaviors and contribute to the creation of assessment and professional development mechanisms for clinical instructors, positively impacting the preparation of the next generation of excellent physical therapist clinicians.

Interest in Infectious Diseases specialty among Japanese medical students amidst the COVID-19 pandemic: A web-based, cross-sectional study

Introduction

The emergence of the novel coronavirus disease of 2019 (COVID-19) has led to huge disruptions in the medical field and society. The significance of training and education for experts has been increasingly acknowledged in Japan, where the number of infectious disease (ID) specialists is reportedly insufficient. In this paper, we report the results of a web-based survey that was conducted to reveal the ways in which the COVID-19 pandemic has influenced medical students’ awareness of ID specialists and future career choices.

Method

This cross-sectional descriptive study was conducted in March 2021 and targeted 717 medical students belonging to Medical School of Okayama University, Japan. The questionnaire consisted of four questions meant to assess students’ knowledge and future intentions of becoming ID specialists.

Results

We obtained 328 eligible questionnaires (response rate: 45.7%). Of 227 (69.2%) students who were aware of ID specialists, 99 (43.6%) answered that they came to know about them only after the pandemic, 12 (3.7%) answered that their interest in being an ID specialist arose during the pandemic, while 36 (11.0%) responded that they would rather not become ID specialists. At the time of the survey, 5 students (1.5%) were aiming to become ID specialists.

Conclusion

We observed a very low rate of interest to be an ID specialist among medical students. The experience of the pandemic does not seem to have influenced Japanese medical students to choose ID as a specialty for their careers. Continuous efforts to increase the number of ID specialists are necessary in Japan as a countermeasure against the coming pandemic.

Twelve tips for students who wish to write and publish

Stepping into the world of research can be an overwhelming task, especially for those with relatively little experience, such as medical students. This article aims to provide students with tips for writing and publishing in all fields. The 12 tips are as follows: (1) find your why; (2) play to your strengths and be realistic; (3) be well read; (4) revisit missed opportunities; (5) talk to the doctors around you; (6) broaden your horizons; (7) get to grips with the submission process early; (8) pay attention to the details; (9) remember that submission is not the end; (10) the process can't be rushed; (11) consider the alternative paths to presenting research; (12) start writing. This writing is derived from personal experience with supporting evidence and is not designed to be encyclopaedic, simply a reference to help students alleviate any concerns and begin their own journey into the world of research.

Role models as a factor influencing career choice among female surgical residents in Saudi Arabia: a cross-sectional study

BACKGROUND AND PURPOSE

Role models in the medical field are professional and experienced persons whose actions unconsciously inspire juniors to strive to be like them. To our knowledge, no studies have examined whether having a female surgical role model has influenced women to pursue a surgical career in Saudi Arabia. Hence, we sought to evaluate whether identifying role models in surgery influences career choice and defined the ideal qualities of a surgical role model as perceived by newly qualified doctors.

METHODS

We employed a cross-sectional, survey- based study design, conducted between June 2020 and January 2021, in which female surgical residents completed a questionnaire about their perceptions and influence of role models in general surgery specialty at the time they pursue a career in surgery.

RESULTS

A total of 51 respondents completed the questionnaire. The majority of them (78.4%) had a role model and (19.6%) indicated that their role model was a female. Of those who had a role model, (67.5%) agreed that they experienced a positive influence on their surgical career choice. Clinical and operation skills were reported as the most remarkable factor to be considered in their role models. Working directly with a male surgical consultant and female surgical residents imprinted a positive influence but this did not reach a statistical significance.

CONCLUSION

The findings of this article contribute empirically to the strong effects of the same-sex role models and highlight the curial role of surgical residents in influencing female's career choices in general surgery as an achievable and attainable domain. Which encourage the creation of national mentorship programs and exploring more in barriers for pursuing a surgical career.

Factors Influencing Career Decisions and Satisfaction Among Newly Practicing Ophthalmologists

PURPOSE

To describe the career choices of newly practicing ophthalmologists and explore factors influencing career decisions and satisfaction.

METHODS

A cross-sectional study was conducted using data from an electronic survey of ophthalmologists who completed training within the prior 5 years. The survey included questions about demographic information, medical education, current practice, factors affecting career choices, and career satisfaction. Statistical comparisons were made based on gender, type of practice, subspecialty training, and practice area.

RESULTS

Surveys were completed by 696 (32%) newly practicing ophthalmologists, including 276 (40%) women, 179 (29%) academicians, and 465 (67%) subspecialists. A higher proportion of female respondents entered academics than male respondents (36% vs 26%, P = .009). Female and male respondents pursued fellowship training with similar frequency (64% vs 68%, P = .32), but men were more likely to seek vitreoretinal fellowships (30% vs 11%, P < .001) and women were more likely to undertake fellowships in pediatric ophthalmology (21% vs 8%, P < .001), uveitis (10% vs 2%, P = .002), and neuro-ophthalmology (6% vs 2%, P = .042). A total of 514 (83%) respondents reported being happy with work life.

CONCLUSIONS

The career choices of newly practicing ophthalmologists differ based on gender, type of practice, subspecialty training, and practice area. Many factors affect career decisions, and they have varying influence on subgroups within ophthalmology. Ophthalmologists have high levels of career satisfaction. This information may prove useful when developing workforce strategies to meet future eye care needs. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

Communication in the face of death and dying - how does the encounter with death influence the patient management competence of medical students? An outcome-evaluation

BACKGROUND INFORMATION

As part of an elective course, the Interdisciplinary Centre for Palliative Medicine at Duesseldorf University Hospital offers medical students the opportunity to personally meet and talk to a seriously ill patient on one or more occasions. The future physicians are provided with an opportunity to broaden their professional competence, i.e. their knowledge and skills in patient-centred communication at the end of life, and enhance their personal competence, for example in how to professionally handle their own emotions. A topical e-learning module helps the students to prepare for the meetings, and writing a reflection paper forms the basis for the concluding reflection seminar.

OBJECTIVES

The study's objective is a global and outcome-based evaluation of the elective blended-learning course that provides real-world patient interaction. The outcome-based evaluation or outcome assessment aims to objectively evaluate changes identified in knowledge, skills and attitude among the participants of the elective-course. Furthermore, the evaluation aims to answer the question of whether changes especially in attitude (social skills and self-competence) should be expected after the students have met with severely ill or dying patients.

METHOD

On two questionnaires specifically developed for this survey the students were able to provide a global rating of the elective course and describe their learning gains in palliative care. The students' learning gains were measured by means of 14 items reflecting the specific educational objectives of the offered elective course. Using the German school grading system as a rating scale, the students assessed their learning progress by retrospectively evaluating their skills before and after completion of the elective course (Comparative Self-Assessment, CSA).

RESULTS

In the time from April 2018 till March 2020, 62 students participated in the evaluation. Overall, learning progress among students could be observed across all areas of competence, and in 50% of all retrospective self-assessment items the learning gains were ≥ 50%. The highest learning gain (63.6%) was observed in the students' ability to meet a severely ill patient without fear. The lowest learning gain was observed when students had to confront and accept their own mortality.

CONCLUSIONS

The offered elective course supports students in achieving social and self-competence development goals. According to the obtained results, contact with real-world patients helps mould the students' attitude.

Impact of Mentorship, by Gender, on Career Trajectory in an Academic Anesthesiology Department: A Survey Study

INTRODUCTION

Mentorship has been identified as a key component of success in business and in academic medicine.

METHODS

After institutional review board approval of the study, an email survey was sent to anesthesiologists in one anesthesiology department to assess mentorship status. A survey link was sent to nonrespondents at 2 weeks and 4 weeks. All participants were deidentified. The identification of a mentor was compared by gender, academic rank, and years of practice.

RESULTS

Among 233 anesthesiologists, 103 (44.2%) responded to the survey. More than 90% of survey respondents agreed or strongly agreed that having a mentor is important to career success. Of the 103 respondents, 31 (30%) indicated they had a mentor. Overall, 84% of the identified mentors were men; however, this percentage differed significantly between men and women respondents (95% versus 60%; P = .03). Characteristics associated with having a mentor included younger age (P = .007), fewer years since finishing training (P = .004), and working full time (P = .02). For respondent age and years since finishing training, there was some evidence that the association was dependent on the gender of the respondent (age-by-gender interaction, P = .08; experience-by-gender interaction, P = .08).

DISCUSSION

Anesthesiologists in this department believed that mentorship led to more academic success. Few women mentors were reported, and women were unlikely to identify a mentor once advanced past an assistant professor rank. Most respondents believed that mentorship was important for overall career success, but only approximately one-third identified a mentor at the time of the survey.

Communication skills learning through role models in Nepal; what are medical students really learning? A qualitative study

BACKGROUND

Communication skills (CS) are important and teachable, however, many Asian medical schools' curricula do not incorporate them. Patan Academy of Health Sciences in Nepal identifies CS within its' aims and curriculum. CS are taught from commencement of medical school and re-emphasised throughout preclinical learning (first 2 years). There is no explicit CS teaching in clinical years but placements allow students to learn through observation. These 'role-modelling' interactions form part of CS learning and development.

METHODS

This study is a qualitative evaluation of CS learning in PAHS, through participants' experiences. Through purposive sampling, twenty medical students from 2nd, 4th and Intern years were selected for inclusion. Data were collected via audio recorded, semi-structured interviews, employing a piloted schedule. Transcripts were manually coded and analysed thematically. Codes were organised into themes and subthemes. This paper discusses themes related to role-modelling.

RESULTS

The majority of participants described role-modelling in CS learning, recounting both positive and negative incidents, reflected in the themes of; Positive and Negative experiences. Subthemes of Personal Qualities and Inspiring, emerged from positive experiences, describing students' desire to imitate or aspire to be like their role models. Learners reported predominantly negative experiences and interns exclusively so. From these emerged subthemes of; Good doctors but.., Contradictory messages, How not to behave, Unprofessional behaviour and Affect-Emotional Distress. Learners received conflicting messages from observing behaviour contradictory to explicit CS teaching. Many identified learning "how not to behave" from such incidents, however, several described feeling distressed.

DISCUSSION

Role-modelling is a powerful and important CS learning tool, seen as positively reinforcing or negatively contradicting explicit CS teaching. Negative modelling created internal conflict, confusion and distress amongst learners, despite its' potential for positive learning. The worldwide problem of negative role-modelling is also prevalent in Nepal. Medical educators need to ensure the explicit curriculum aligns with implicit learning. Clinical tutors must be alerted to their powerful role-model position and supported in developing intentional modelling skills. Learners' reflections upon their experiences should be facilitated, enabling them to critically evaluate observations and hence consciously adopt or reject role-modelled behaviour and attitudes.

Diversity of the physician workforce: Specialty choice decisions during medical school

Background

Despite efforts to increase the overall diversity of the medical student body, some medical specialties have a less diverse applicant pool based on both gender and race than would be expected based on medical graduate demographics.

Objectives

To identify whether women and Underrepresented in Medicine (URiM) medical students have baseline differences in their career interests or if their career plans change more during medical school when compared to men and non-URIM students.

Methods

Secondary data analyses of all medical students who applied through ERAS from 2005–2010 was conducted. Binary logistic regression models with the response being a planned career in one of four medical specialties (internal medicine, pediatrics, OB/GYN, and general surgery/surgical specialties) at medical school entry and graduation. Regression models included demographics, student attitudes, debt, academic metrics, and medical school experiences.

Results

Comparatively, women were less likely to be interested in internal medicine and surgery and more interested in pediatrics and OB/GYN at matriculation. URiM students expressed more interest in OB/GYN and surgery when starting medical school. At graduation, women were less likely to plan for internal medicine and surgery and were more interested in pursuing OB/GYN and pediatrics. URiM students were more likely to plan for a career in internal medicine and less likely to choose pediatrics.

Conclusions

From matriculation to graduation, women have relatively stable preferences regarding planned medical specialties. In contrast, URiM students’ specialty plans shifted over time among the four specialties, with variation in preferences occurring between matriculation and graduation.

Never Too Late to Learn: How Education Helps Female Entrepreneurs at Overcoming Barriers in the Digital Economy

The study of Entrepreneurship Framework Conditions (EFC) has found that training and education have, among other things, a positive effect on overcoming barriers when starting your own firm. Our research can be placed in this line, but with an added specificity, since it is focused firstly on women and secondly on the digital economy. Thus, we have studied the situation of women entrepreneurs in the digital economy in Spain, asking them about their personal traits, the characteristics of their ventures and the barriers they encountered. We have studied the effect of EFCs on overcoming barriers to entrepreneurship, with a special focus on training and entrepreneurship education. In addition, the effect of self-efficacy perception (the conviction of having the necessary skills to start a business) on overcoming barriers to entrepreneurship has been factored in. After the implementation of a Structural Equation Model (SEM), we show that training helps female entrepreneurs in the digital economy to overcome barriers to entrepreneurship, especially after the mediation of their self-efficacy perception, which is increased by specific entrepreneurial training. We can conclude that policy recommendations to counteract the gender gap in entrepreneurship with specific training should be promoted, specifically in such a strategic sector as the digital economy.

Exploring Careers in Medicine: Implementation and Perceived Value of a Multi-Specialty Elective

INTRODUCTION

Choosing a medical specialty is one of the most crucial and difficult decisions made during medical school. Given that specialty exposure is among the most important factors in decision-making, the Careers in Medicine (CiM) multi-specialty elective was designed to provide clerkship students an avenue to explore three or more specialties of interest during a single elective.

METHODS

A cross-sectional study was conducted at Vanderbilt University School of Medicine using anonymous surveys and de-identified written reflections submitted by students enrolled in the CiM course between August 2015 and June 2018. Data were analyzed using a mixed-methods approach.

RESULTS

The majority of students reported the elective guided them in ruling out (80%) and ruling in (65%) specialties. About half (51%) of students decided between the procedural versus critical-thinking dichotomy. Finally, 80% of students reported that they would take the course again rather than a focused elective. Major themes identified from student reflections included course attributes, specialty impacts, and student values.

DISCUSSION

Implementation of a multi-specialty elective during the clerkship year was an effective way to help students understand their career values, gain early exposure to specialties not featured in core clinical curriculums, and determine future fields of interest.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01311-0.

Clinical teachers' perceptions of role modeling: a qualitative study

BACKGROUND

Role modeling has been significantly considered in medical education in recent decades. In the clinical course, students learn necessary skills and accordingly their professional identity is formed by observing and working among clinical educators. Given the importance of the role modeling in medical education, in the present study, it was attempted to explore the clinical teachers' perceptions of being a role model for medical students using a qualitative method.

METHODS

A qualitative design, based on the content analysis approach, was used to analyze the perspectives of 15 clinical teachers. Participants were chosen by purposeful sampling. Data were collected using reflection paper writing.

RESULTS

During the data analysis, five main categories emerged: influencing others, developing different dimensions of student, situational self-awareness, feedback and continuous effort.

CONCLUSIONS

This study will be useful to form role modeling educational programs. Encouraging clinical teachers to make continuous efforts to improve role modeling and educating time management and self-control skills can help reduce the challenges of role modeling for clinical teachers.

Exploring clinical educators' perceptions of role modeling after participating in a role modeling educational program

INTRODUCTION

Role modeling significantly affects medical students' values, attitudes, and professional behaviors. Role modeling is a complex and multidimensional process that necessitates accurate perception and adequate knowledge and skills. However, most clinical educators do not have adequate awareness and knowledge about the positive and negative effects of role modeling. We aimed to explore clinical educators' perceptions of role modeling after participating in a role modeling educational program.

METHODS

This qualitative study was conducted on eighteen clinical educators who were voluntarily participated in a three-month role modeling educational program. Data were collected using reflection paper writing and were analyzed through conventional content analysis.

RESULTS

Data analysis resulted in the development of three main categories, namely closer attention to role modeling and effort for its promotion, deliberate effort to display role modeling, and creating a positive environment to increase the effectiveness of role modeling.

CONCLUSIONS

Clinical educators have limited role modeling knowledge and skills, and hence, educational programs are required to improve their role modeling knowledge, attitudes, and skills. Role modeling educational programs should aim at developing educators' awareness and knowledge about role modeling, develop their reflection and self-control abilities, and sensitize them to the importance of deliberate use of role modeling.

Diversity in Neurosurgery: Trends in Gender and Racial/Ethnic Representation Among Applicants and Residents from U.S. Neurological Surgery Residency Programs

OBJECTIVE

To assess trends in gender, racial, and ethnic diversity of applicant pools and subsequent resident cohorts in neurosurgical residency programs in the United States.

METHODS

Applicant and residency data from 2009 to 2018 were analyzed from the Electronic Residency Application Service, Journal of the American Medical Association, and National Resident Matching Program to evaluate trends in diversity.

RESULTS

There was no statistically significant difference between applicant sex from 2009 to 2013 compared with 2014 to 2018 (P > 0.05). From 2009 to 2018, the percentage of female residents saw a statistically significant increase from 12.9% to 17.5% but remained less reflective of women's representativeness in the United States (50.8%). The percentage of Black and Hispanic applicants decreased across the observed period (4% and 1%, respectively). While Black people represented 5.2% of the resident pool in 2009, this decreased to 4.95% by 2018. Hispanic residents saw a <2% net increase (5.5% to 7.2%) in resident representation but still fell behind when compared with census statistics. The application pool did not see a significant change in the percentage of White and Asian applicants; however, the percentage of residents did decrease slightly over the observed decade.

CONCLUSIONS

Current efforts to improve racial and ethnic diversity have not been sufficient in generating parity in the recruitment and retention of racially underrepresented groups in neurosurgery. Although the presence of women in applicant and resident pools has increased, not much is known about the impact on women who also identify within racially underrepresented groups. More proactive measures for recruitment and retention are needed to reach equity in the future neurosurgical workforce.

The Emotion of Disgust among Medical and Psychology Students

The emotion of disgust evolved as a way to protect oneself from illness and is associated with aspects of disease avoidance. Disgust Scale–Revised (DS-R) (Olatunji et al., 2008) measures the disgust propensity of three kinds of disgust (core, animal reminder, contamination). Contextual factors, such as academic background, might influence DS-R scoring, especially among medical students, where the notion of disease is central. We examined DS-R scoring and the choice of postgraduate studies in medical (n = 94) and psychology (n = 97) students. In an anonymous web-based survey, participants completed the DS-R and a questionnaire including plans for postgraduate studies. Females outnumbered males and scored higher in total DS-R score (p = 0.003). Psychology students scored higher in all three kinds of disgust (p < 0.001 for core disgust and animal reminder, p = 0.069 for contamination disgust), indicating a higher level of disease avoidance. Medical students willing to follow Internal Medicine scored higher in core disgust (p < 0.05), while psychology students willing to study Experimental Psychology scored lower in the animal reminder subscale (p = 0.019 and p < 0.001 for the association between these subscales and the orientation of Medical and Psychology Students, respectively). In conclusion, disgust propensity as rated by DS-R is related to academic background and orientation preferences in postgraduate studies.

Factors Associated with Quality and Adequacy of Medical Student Feedback on Core Obstetrics and Gynecology Clerkships from the Student and Clerkship Director Perspective: Secondary Analyses of a Prospective Cohort Study

OBJECTIVE

We sought to investigate factors associated with improved feedback quality during third-year obstetrics and gynecology (OBGYN) clerkships.

DESIGN

This prospective cohort study assessed relationships of student and clerkship characteristics to the quantity and quality of feedback during OBGYN clerkships according to the clerkship director and third-year medical students.

SETTING

This study took place in a university-based hospital setting in which medical students rotate for 6 weeks on core clerkships during the third year of medical school.

PARTICIPANTS

Third year medical students participating in core OBGYN clerkships during the 2018 to 2019 academic year.

RESULTS

One hundred and ten students participated. Students with better clerkship scores reported higher quality of feedback, effectiveness of teaching, and quality of the clerkship overall, but did not receive a higher quantity or quality of feedback per the clerkship director. In multivariate modeling, the only factor affecting the clerkship director's rating of feedback adequacy was the number of preceptors who had given feedback. Factors associated with better student-reported feedback quality included midclerkship feedback adequacy and attendings and residents teaching procedures.

CONCLUSIONS

Improved feedback for medical students on core OBGYN clerkships is associated with more preceptors offering feedback, midclerkship feedback adequacy, and preceptors teaching procedures.

The relationship between regional medical campus enrollment and rates of matching to family medicine residency

BACKGROUND

The Michael G. DeGroote School of Medicine expanded its medical education across three campus sites (Hamilton, Niagara Regional and Waterloo Regional) in 2007. Ensuring the efficacy and equivalency of the quality of training are important accreditation considerations in distributed medical education. In addition, given the social accountability mission implicit to distributed medical education, the proportion of learners at each campus that match to family medicine residency programs upon graduation is of particular interest.

METHODS

By way of between campus comparisons of Canadian Residency Matching Service (CaRMS) match rates, this study investigates the family medicine match proportion of medical students from McMaster's three medical education campuses. These analyses are further supported by between campus comparisons of Personal Progress Index (PPI), Objective Structured Clinical Examination (OSCE), Medical Council of Canada Qualifying Examination-Part 1 (MCCQE1) performances that offer insight into the equivalency and efficacy of the educational outcomes at each campus.

RESULTS

The Niagara Regional Campus (NRC) demonstrated a significantly greater proportion of students matched to family medicine. With respect to education equivalency, the proportion of students' PPI scores that were more than two SD below the mean was comparable across campuses. OSCE analysis yielded less than 2% differences across campuses with no differences in the last year of training. The MCCQE1 pass rates were not statistically significant between campuses and there were no differences in CaRMS match rates. With respect to education efficacy, there were no differences among the three campuses' pass rates on the MCCQE1 and CaRMS match rates with the national rates.

CONCLUSIONS

Students in all campuses received equivalent educational experiences and were efficacious when compared to national metrics, while residency matches to family medicine were greater in the NRC. The reasons for this difference may be a factor of resident and leadership role-models as well as the local hospital and community environment.

Enhancement of role modelling in clinical educators: A randomized controlled trial

Introduction: Role models have an important impact on the professional behavior of medical students. Previous investigations help us understand how to improve role modelling. However, studies aiming at enhancing role modelling among clinical educators are very limited and generally lack comprehensive evaluations of the designed programs. We intended to gather robust evidence on the effectiveness of a longitudinal program for enhancing role modelling.Methods: Clinical educators were divided into intervention and control groups. The longitudinal program, developed based on the exposure phase of the 'Positive Doctor Role Modelling' framework, was delivered during three months of onsite and online sessions. The effectiveness of the program was assessed in three levels of reaction, learning, and behavior.Results: In the intervention group (N = 18), the mean score of satisfaction was 4.7 (SD = 0.5), and the learning (awareness about role modelling) improved significantly after the program (3.33-4.34), comparing to the control group (3.53-3.63). There was no significant difference in terms of behavior improvement between the two groups, before and after the program.Conclusions: Our findings indicate that our longitudinal faculty development program on role modelling was highly appreciated by clinical educators, and improved their awareness and deliberate role modelling.

Experience adds up! Questionnaire study: attitudes of medical students towards a career in general practice

Insufficient young doctors choose careers in general practice - this may relate to cultural, personal and educational influences during medical school. University of East Anglia (UEA) medical school historically produces more GPs than most but no previous studies have aimed to quantify factors which may be leading to this. This study's aim was to improve understanding of the attitudes of students towards general practice (GP) at UEA. A questionnaire study compared views of three different years of students. GP was the most popular choice for male and female students, with women expressing higher levels of commitment. Students saw GP as intellectually stimulating and making key contributions to the NHS. The main reason for the choice of GP was interest in the speciality, with positive influences attributed to contact with GPs and general practice as a setting during their course. These results suggest course design and presence of GP faculty in core teaching have crucial influences on career choices. GP can be a popular career choice, but the perceptions which lead to that choice are course-and experience - dependent. Reforms towards community-based learning and the involvement of GPs in training are crucial levers for change if workforce needs are to be achieved.

The Influence of Mentors in Orthopedic Surgery

The importance of mentorship in medicine has been established. However, little is known regarding the influence of mentors in orthopedic surgery. This study sought to (1) determine the prevalence of mentoring relationships in orthopedic surgery, (2) assess the influence of mentors in specialty and subspecialty selection, and (3) evaluate the importance of gender in orthopedic mentoring relationships. An electronic survey was distributed to 358 orthopedic surgeons at academic residency programs. Participants were asked to report mentoring relationships and their attitudes toward mentors, including gender preferences. A total of 117 (95 males and 22 females) surveys were returned. The majority of respondents (66.7%, n=78) had at least one mentor in their career, and the majority of respondents (66.7%, n=52) were satisfied with their mentoring experience. Residency was the most common time to have a mentor, and 73.3% (n=44) of respondents indicated their mentor was influential in determining their subspecialty. Although only 50% of respondents indicated they had a mentor in medical school, 84.2% (n=32) believed their mentor was influential in selecting an orthopedic surgery residency. The majority (79.4%, n=62) of respondents did not have a preference on the gender of their mentor. Many orthopedic surgeons have a mentor at some point in their career who influenced their specialty or subspecialty decision. Mentoring experiences are less prevalent in medical school, and female medical students may lack accessibility to mentoring opportunities. Future efforts should focus on opportunities that connect medical students to orthopedic surgery faculty to further diversify the field and close the gender gap. [Orthopedics. 2020; 43(1):e37-e42.].