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Huang Q, Yan SY, Huang J, Guo Y, Zeng XT, Jin YH. Effectiveness of simulation-based clinical research curriculum for undergraduate medical students - a pre-post intervention study with external control. BMC MEDICAL EDUCATION 2024; 24:542. [PMID: 38750452 PMCID: PMC11097530 DOI: 10.1186/s12909-024-05455-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Simulation is widely utilized in medical education. Exploring the effectiveness of high-fidelity simulation of clinical research within medical education may inform its integration into clinical research training curricula, finally cultivating physician-scientist development. METHODS Standard teaching scripts for both clinical trial and cross-sectional study simulation were designed. We recruited undergraduates majoring in clinical medicine at 3th grade into a pre-post intervention study. Additionally, a cross-sectional survey randomly selected medical undergraduates at 4th or 5th grade, medical students in master and doctor degree as external controls. Self-assessment scores of knowledge and practice were collected using a 5-point Likert scale. Changes in scores were tested by Wilcoxon signed-rank test and group comparisons were conducted by Dunn's tests with multiple corrections. Multivariable quantile regressions were used to explore factors influencing the changes from baseline. RESULTS Seventy-eight undergraduates involved the clinical trial simulation and reported improvement of 1.60 (95% CI, 1.48, 1.80, P < 0.001) in knowledge and 1.82 (95% CI, 1.64, 2.00, P < 0.001) in practice score. 83 undergraduates involved in the observational study simulation and reported improvement of 0.96 (95% CI, 0.79, 1.18, P < 0.001) in knowledge and 1.00 (95% CI, 0.79, 1.21, P < 0.001) in practice. All post-intervention scores were significantly higher than those of the three external control groups, P < 0.001. Higher agreement on the importance of clinical research were correlated with greater improvements in scores. Undergraduates in pre-post study showed high confidence in doing a future clinical research. CONCLUSION Our study provides evidence supporting the integration of simulation into clinical research curriculum for medical students. The importance of clinical research can be emphasized during training to enhance learning effect.
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Affiliation(s)
- Qiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, #169, East Lake Road, Wuchang District, Wuhan City, Hubei Province, China
- Department of Evidence-Based Medicine and Clinical Epidemiology, Second School of Clinical Medicine, Wuhan University, Wuhan, 430071, China
| | - Si-Yu Yan
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, #169, East Lake Road, Wuchang District, Wuhan City, Hubei Province, China
- Department of Evidence-Based Medicine and Clinical Epidemiology, Second School of Clinical Medicine, Wuhan University, Wuhan, 430071, China
| | - Jiao Huang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, #169, East Lake Road, Wuchang District, Wuhan City, Hubei Province, China
- Department of Evidence-Based Medicine and Clinical Epidemiology, Second School of Clinical Medicine, Wuhan University, Wuhan, 430071, China
| | - Yi Guo
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, #169, East Lake Road, Wuchang District, Wuhan City, Hubei Province, China
- Department of Evidence-Based Medicine and Clinical Epidemiology, Second School of Clinical Medicine, Wuhan University, Wuhan, 430071, China
| | - Xian-Tao Zeng
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, #169, East Lake Road, Wuchang District, Wuhan City, Hubei Province, China.
- Department of Evidence-Based Medicine and Clinical Epidemiology, Second School of Clinical Medicine, Wuhan University, Wuhan, 430071, China.
| | - Ying-Hui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, #169, East Lake Road, Wuchang District, Wuhan City, Hubei Province, China.
- Department of Evidence-Based Medicine and Clinical Epidemiology, Second School of Clinical Medicine, Wuhan University, Wuhan, 430071, China.
- Department of Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
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den Bakker CR, Ommering BWC, de Beaufort AJ, Dekker FW, Bustraan J. The bumpy ride to a medical PhD degree: a qualitative study on factors influencing motivation. BMC MEDICAL EDUCATION 2024; 24:159. [PMID: 38373938 PMCID: PMC10875841 DOI: 10.1186/s12909-023-04973-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 12/13/2023] [Indexed: 02/21/2024]
Abstract
INTRODUCTION In parallel with a tremendous increase in medical PhD enrolments, concerns have risen about PhD candidates' poor well-being, increasing attrition rates for PhD programmes, and, eventually, a decline in clinician-scientists. According to the Self-Determination Theory, autonomous motivation is strongly linked to positive aspects of well-being and other positive outcomes such as study completion and success. In this way, motivation has a pivotal role in successful completion of medical doctoral programmes. In this study we explored factors affecting motivation during the PhD journey and aimed to contribute to engaging doctoral education environments, and, eventually, a sustainable clinician-scientist workforce. METHODS This constructivist qualitative interview study was conducted among ten medical PhD candidates in the final phase of their PhD. We used timeline assisted interviews to identify meaningful experiences throughout their PhD journey. Thematic analyses as an iterative process resulted in overarching themes. RESULTS We identified six themes influencing autonomous and controlled motivation along the challenging PhD journey: (1) Initial motivation to start a PhD matters; (2) Autonomy as a matter of the right dose at the right time; (3) PhD as proof of competence and/or learning trajectory?; (4) It takes two to tango; (5) Peers can make or break your PhD; (6) Strategies to stay or get back on track. CONCLUSION This study revealed factors that contribute positively and/or negatively to autonomous and controlled motivation. Some factors impacted motivation differently depending on the PhD phase and individual strategies. Additionally, some factors could coincide and change from positive to negative and vice versa, showing that a successful journey cannot simply be reduced to an absence of negative experiences.
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Affiliation(s)
- C R den Bakker
- Center for Innovation in Medical Education, Leiden University Medical Center, Hippocratespad 23, Zone V7-P, PO Box 9600, 2333 ZD, Leiden, The Netherlands.
| | - B W C Ommering
- Research Centre for Learning and Innovation, Research Group On Research Competence, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - A J de Beaufort
- Center for Innovation in Medical Education, Leiden University Medical Center, Hippocratespad 23, Zone V7-P, PO Box 9600, 2333 ZD, Leiden, The Netherlands
| | - F W Dekker
- Center for Innovation in Medical Education, Leiden University Medical Center, Hippocratespad 23, Zone V7-P, PO Box 9600, 2333 ZD, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - J Bustraan
- Center for Innovation in Medical Education, Leiden University Medical Center, Hippocratespad 23, Zone V7-P, PO Box 9600, 2333 ZD, Leiden, The Netherlands
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Hendriks B, Reinhart M. What are the chances? Clinician scientist` career pathways in Germany. BMC MEDICAL EDUCATION 2023; 23:642. [PMID: 37679714 PMCID: PMC10486072 DOI: 10.1186/s12909-023-04584-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/11/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Germany faces a lack of clinician scientists. This problem is widely acknowledged, not just in Germany, as clinician scientists are crucial for medical translation and innovation: trained in medical practice and research they are capable of translating scientific problems into clinical application and vice versa, clinical problems into research. The implementation of nationwide clinician scientist programs (CSPs) in Germany is supposed to solve the lack of trained clinician scientists and, as consequence, to improve the translational relationship between biomedical research and clinical practice. Against the backdrop of an increasing number of CSPs, our study provides early insights into their effectiveness with a focus on what it means to become a clinician scientist and to establish a subsequent career path as a clinician scientist in Germany. METHODS During a research project that was conducted from 2020 to 2023 and funded by the German Federal Ministry of Education and Research, we studied thirteen CSPs. We developed a qualitative questionnaire and interviewed 36 clinician scientists in training, their program supervisors, as well as policy stakeholders. The goal of the interviews was to identify the key obstacles in establishing a career path for clinician scientists in Germany. RESULTS We found three types of challenges for establishing and ensuring long term career paths for clinician scientists: First, local working conditions need to allow for clinician scientists to create and perform tasks that combine research, teaching, patient care and translation synergistically. Protection from the urgency of patient care and from metrics-based performance measures both in the clinic and in research seem key here. Second, a stable career path requires new target positions besides clinic management and senior residency. Third, there is a need for cultural change within university medicine that recognizes and rewards new translation-focused practices. CONCLUSION We find that CSPs improve working conditions for the duration of the program and provide protected time for doing research. After the programs, however, the career paths remain unstable, mainly due to a lack of target positions for clinician scientists. CSPs support the initial development of the clinician scientist' role, but not in a sustainable way, because the separation of research and patient care is stabilized on an institutional and systemic level. The tasks clinician scientists perform in research remain separate from patient care and teaching, thus, limiting their translational potential. In order to remain a clinician scientist within this differentiated system of university medicine, clinician scientists have to do a significant amount of extra work.
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Affiliation(s)
- Barbara Hendriks
- Robert K. Merton Center for Science Studies (RMZ) at Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Martin Reinhart
- Robert K. Merton Center for Science Studies (RMZ) at Humboldt-Universität zu Berlin, Berlin, Germany
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Burke E, Misstear K, Hennessy M. An exploration of the professional identity of clinical academics using repertory grid technique. PLoS One 2022; 17:e0277361. [PMID: 36395251 PMCID: PMC9671447 DOI: 10.1371/journal.pone.0277361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Clinicians who divide their time between clinical work and research have contributed to some of the most fundamental breakthroughs in medicine in recent history, yet their role is not always well-understood or valued. Understanding the factors which contribute to career success for clinical academics is critical for supporting this workforce. Social Cognitive Career Theory (SCCT) provides a conceptual framework for career success, incorporating personal and environmental factors. PURPOSE The aim of this study is to explore clinical academics' construal of successful clinical academic practice and to contribute to a holistic view of the professional identity of the clinical academic. METHODOLOGY Using a constructivist technique, repertory grid, the authors interviewed ten clinical academics at different career stages in one-to-one structured interviews conducted virtually between November 2020 and April 2021. Data from the interviews were analysed qualitatively and quantitatively. Common themes were identified, analysed, and ranked according to importance with respect to successful clinical academic practice. Using SCCT as a framework, constructs were categorised as personal factors, organisational factors, competencies and person-environment fit. A differential analysis between established/trainee and female/male participants was carried out. SUMMARY OF RESULTS One hundred and thirty-three constructs were elicited and categorised into 20 themes (constructs). There was consensus among participants that 6 were of high importance with respect to successful clinical academic practice, 8 of intermediate and 4 of low importance, with no consensus on 2 constructs. Personal factors of high importance include innovation and integrity. Competencies including research and teaching skills are highly important, and ability to collaborate is also considered central to successful clinical academic practice. Female participants expressed greater concerns about the impact of familial responsibilities on career progression. DISCUSSION AND CONCLUSIONS This study highlights the importance of interactions between the person and environment, and characterises the important attributes of successful clinical academics including personal factors such as integrity and innovation.
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Affiliation(s)
- Elaine Burke
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- * E-mail:
| | - Karen Misstear
- Wellcome/Health Research Board Irish Clinical Academic Training Programme, Dublin, Ireland
| | - Martina Hennessy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Wellcome/Health Research Board Irish Clinical Academic Training Programme, Dublin, Ireland
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