Several Ways Generation Z May Shape the Medical School Landscape

Learning together: a narrative review of external resources for medical education through a shared student-faculty lens

External resources, defined as commercial learning resources typically found online and not created by academic institutions, are increasingly utilized by students in medical education. As the use of external resources continues to grow, there is a need to understand their appropriate place within medical education and for faculty members to continue to integrate such resources into the existing medical curricula. A gap in the literature exists regarding the role of such resources within formal medical education.

This narrative review identifies factors contributing to the use of external resources, integrates student and faculty perspectives to highlight their unique insights, and collaboratively proposes recommendations for the future use of external resources in medical education.

Identified factors contributing to the increased use of external resources include generational affinity for technology and online learning, perceived efficiency compared to live lectures, pass-fail grading system of biomedical science courses, the pressure of board exams, and impacts of the COVID-19 pandemic. Although external resources are expensive, medical students use them to support their pre-clerkship learning and performance on national licensure exams. Faculty share the goal of student success and see potential for integration of external resources in the curriculum but raise concerns about reduced learner presence and willingness to read as well as the possibility of a universal medical curriculum. Collaborative student-faculty recommendations include the primacy of student autonomy, the benefits of classroom engagement, and the importance of cost management around third-party resources.

Although external resources should not supplant all faculty instruction, they can benefit both medical students and faculty when thoughtfully and strategically integrated within the pre-clerkship curriculum to enhance learning outcomes and board exam performance.

Revisiting the Pediatric Neurosurgical Workforce: An Update After 15 Years and Analysis of Generational Change

BACKGROUND AND OBJECTIVES

The landscape of medicine has undergone significant changes with shifting generational values. Studies are increasingly looking into factors such as work-life balance and diversity in neurosurgery, but few have considered these trends in pediatric neurosurgery. This study investigated the changes in the pediatric neurosurgical workforce over the past 15 years and highlighted generational differences in demographics, practice patterns, and values.

METHODS

Databases were compiled using neurosurgical societies to identify current pediatric neurosurgeons. A 36-question survey was administered, and responses were collected for a 6-month period ending in February 2023. Responses were compared between age groups (<45 years, 45-54 years, 55+ years). Results from this survey were compared with a previous survey performed in 2008.

RESULTS

Four hundred ninety-five pediatric neurosurgeons received the 2023 survey (response rate: 49%, 241/495). 172 pediatric neurosurgeons were identified after excluding 69 respondents whose practice was not >75% pediatric. Compared with the 2008 cohort, the 2023 cohort were more likely to be female (P < .001), have American Board of Pediatric Neurological Surgery Society certifications (P < .001), and have complete pediatric fellowships (P < .001). The 2023 cohort also had lower case volumes (P < .001), worked fewer hours per week (P < .001), were more inclined to grow their practice (P < .001) when compared with the 2008 cohort. Younger neurosurgeons (<45 years) had more frequent call schedules (P = .03) and were more likely to anticipate retiring by the age of 65 years (P < .001) compared with neurosurgeons aged older than 55 years.

CONCLUSION

These results reveal a generational shift in the pediatric neurosurgical workforce, suggesting how the field may continue to evolve in the coming decades. Understanding these changes is essential for addressing future challenges in the workforce.

Trigger warnings in medical student education: A scoping review

BACKGROUND

Medicine is recognised as a challenging course where exposure to potentially distressing content is inevitable. Some educators provide students with warnings before they encounter potentially upsetting content-trigger warnings. In this scoping review, we mapped the existing literature seeking to better understand how trigger warnings are implemented in medical schools and how they are influencing education within them.

METHODS

Bibliographic databases were searched to identify relevant literature, including searching for grey literature. Articles were included if they focussed on medical school education and were written in English. Data analysis was undertaken using both quantitative and qualitative approaches (thematic analysis).

FINDINGS

Searching generated 1284 potential records for inclusion. Articles not related to the primary research question were excluded. Abstracts of the remaining 841 articles were screened, and ultimately, 12 articles met criteria for full-text review. Of these, there were three empirical research studies. Qualitative analysis identified five main themes: purpose, implementation, student distress, responsibility and problems with terminology.

CONCLUSIONS

The use of trigger warnings within medical student education remains contentious. There is a lack of consensus as to their purpose and much diversity in how they are implemented. There was limited published empirical evidence to inform practice in this area.

Faculty Perceptions on the Roles of Mentoring, Advising, and Coaching in an Anesthesiology Residency Program: Mixed Methods Study

Background

Mentoring, advising, and coaching are essential components of resident education and professional development. Despite their importance, there is limited literature exploring how anesthesiology faculty perceive these practices and their role in supporting residents.

Objective

This study aims to investigate anesthesiology faculty perspectives on the significance, implantation strategies, and challenges associated with mentorship, advising, and coaching in resident education.

Methods

A comprehensive survey was administrated to 93 anesthesiology faculty members at Washington University School of Medicine. The survey incorporated quantitative Likert-scale questions and qualitative short-answer responses to assess faculty perceptions of the value, preferred formats, essential skills, and capacity for fulfilling multiple roles in these support practices. Additional areas of focus included the impact of staffing shortages, training requirements, and the potential of these practices to enhance faculty recruitment and retention.

Results

The response rate was 44% (n=41). Mentoring was identified as the most important aspect, with 88% (n=36) of faculty respondents indicating its significance, followed by coaching, which was highlighted by 78% (n=32) of respondents. The majority felt 1 faculty member can effectively hold multiple roles for a given trainee. The respondents desired additional training for roles and found roles to be rewarding. All roles were seen as facilitating recruitment and retention. Barriers included faculty burnout; confusion between roles; time constraints; and desire for specialized training, especially in coaching skills.

Conclusions

Implementing structured mentoring, advising, and coaching can profoundly impact resident education but requires role clarity, protected time, culture change, leadership buy-in, and faculty development. Targeted training and operational investments could enable programs to actualize immense benefits from high-quality resident support modalities. Respondents emphasized that resident needs evolve over time, necessitating flexibility in appropriate faculty guidance. While coaching demands unique skills, advising hinges on expertise and mentoring depends on relationship-building. Systematic frameworks of coaching, mentoring, and advising programs could unlock immense potential. However, realizing this vision demands surmounting barriers such as burnout, productivity pressures, confusion about logistics, and culture change. Ultimately, prioritizing resident support through high-quality personalized guidance can recenter graduate medical education.

Making a serious game (gamification) for generation Z medical students to learn, teach, and assess medical Physiology

The concept of serious games and gamification in medical education is gaining attention due to its nature of curiosity and to engage the student's attention by simultaneous cultivation of their higher-level thinking without the experience of boredom. Significant differences were reported among the present medical students, generations Y and Z compared to earlier generations. The advancements in serious games for medical education fit well with millennial medical students' learning styles. Till date, there are no scientific research studies available in literature majorly using solo playing gaming experience for medical Physiology teaching, learning, and assessment in medical schools. In this unsystematic (narrative) review, the development and process in gamification for medical Physiology teaching and assessment has been analyzed. Inclusion criteria: list of articles from PubMed, Medline, and Cochrane by means of manual search with the key words include; gamification on Physiology teaching, learning; serious games created/developed for medical Physiology. Exclusion criteria include the articles not involving medical Physiology teaching, gaming app application, card board games, and quiz games. This review explores the difficulties and practical challenges encountered by a medical educator/doctor professional toward the development of solo playing gamified platform. Also further necessitates the user-friendly interface or apps that involve drop and drag options for serious solo playing games development for medical education. Additionally, insists the addition of gamification elements and artificial intelligence tools application as one of the components of curriculum as electives in medical schools for undergraduate and post graduate level. These will pave the way for medical educators to familiarize the gamification designing tools for various serious solo playing games for medical subjects' teaching, learning, and assessment.

Managing assessment during curriculum change: Ottawa Consensus Statement

Curriculum change is relatively frequent in health professional education. Formal, planned curriculum review must be conducted periodically to incorporate new knowledge and skills, changing teaching and learning methods or changing roles and expectations of graduates. Unplanned curriculum evolution arguably happens continually, usually taking the form of "minor" changes that in combination over time may produce a substantially different programme. However, reviewing assessment practices is less likely to be a major consideration during curriculum change, overlooking the potential for unintended consequences for learning. This includes potentially undermining or negating the impact of even well-designed and important curriculum changes. Changes to any component of the curriculum "ecosystem "- graduate outcomes, content, delivery or assessment of learning - should trigger an automatic review of the whole ecosystem to maintain constructive alignment. Consideration of potential impact on assessment is essential to support curriculum change. Powerful contextual drivers of a curriculum include national examinations and programme accreditation, so each assessment programme sits within its own external context. Internal drivers are also important, such as adoption of new learning technologies and learning preferences of students and faculty. Achieving optimal and sustainable outcomes from a curriculum review requires strong governance and support, stakeholder engagement, curriculum and assessment expertise and internal quality assurance processes. This consensus paper provides guidance on managing assessment during curriculum change, building on evidence and the contributions of previous consensus papers.

Twelve tips for implementing trigger or content warnings in healthcare professions education

Trigger warnings are statements offering prior notification of sensitive content, allowing recipients to prepare for and avoid ensuing distress. Students are increasingly reporting expectations for warnings in classrooms and learning contexts. Discussions regarding use of warnings have clear relevance to healthcare education, which regularly explores sensitive content. Their use has been positioned as a measure for inclusive education and as a means to enhance trauma awareness and empathy. Expectations for warnings need to be considered in the context of preparedness for professional practice. This Twelve Tips paper explores the evidence in relation to warnings and its applicability to social learning contexts. These tips highlight considerations and strategies for the use of warnings in the context of healthcare education, balancing issues of inclusivity, learner and educator wellbeing, and professional preparedness. These discussions are situated within the context of current classroom-based healthcare education.

Applying simulation learning theory to identify instructional strategies for Generation Z emergency medicine residency education

Introduction

Generation Z learners are entering emergency medicine (EM) residency training, bringing unique learning preferences that influence their engagement with residency education. To optimally teach and motivate this incoming generation of learners, EM educators must understand and adapt to the changing instructional landscape.

Methodology

The Simulation Leaders Advancing the Next Generation in Emergency Medicine (SLANG-EM) Workgroup was created to identify effective educational strategies for Generation Z learners entering EM. Members were faculty in the Society for Academic Emergency Medicine (SAEM) Simulation Academy, well versed in learning theory supporting simulation-based education (SBE) and actively involved in EM residency education.

Unique treatment/analysis

Through primary and secondary literature searches, the SLANG-EM Workgroup identified four distinctive learning preferences of Generation Z learners: (1) individualized and self-paced learning, (2) engaging and visual learning environments, (3) immediate and actionable feedback, and (4) combined personal and academic support. Workgroup members evaluated these learning preferences using a novel conceptual framework informed by the theoretical principles underpinning SBE, recommending instructional strategies for Generation Z EM residency learners across multiple educational environments.

Implications for educators

Instructional strategies were described for the didactic, simulation, and clinical learning environments. In the didactic environment, identified instructional strategies included meaningful asynchronous education, interactive small-group learning, and improved multimedia design. In the simulation environment, educational innovations particularly suitable for Generation Z learners included learner-centered debriefing, rapid-cycle deliberate practice, and virtual simulation. In the clinical environment, described instructional strategies involved setting learner-centered goals and delivering facilitative feedback in the context of an educational alliance. Overall, these instructional strategies were clustered around themes of student-centered education and the educator as facilitator, which align well with Generation Z learning preferences. These findings were synthesized and presented as an advanced workshop, "Delivering Effective Education to the Next Generation," at the 2023 SAEM Annual Meeting.

Corona Virus Disease (COVID-19): Lessons Learned Impact on the Education of Health Professionals

The coronavirus disease (COVID-19) had a tremendous impact on the education of health professionals globally because of the lack of continuity in the medical education process. After it was declared a pandemic, stay-at-home orders forced students to learn virtually, to mitigate the spread of infection. While didactic courses transitioned easily to a virtual format, using platforms like Webex, Zoom, Google Classroom, etc. preclinical and clinical teaching suffered immensely. Patient care was halted for the safety of the patients, students and faculty, and staff involved. Uncertainty about clinical care and isolation during quarantine due to infections caused poor mental health among students. Most health professions innovated their teaching with simulations, role-play, educational videos, etc. but dental education suffered due to the need for psychomotor skill development. As the COVID-19 protocols evolved, and vaccinations became available, the teaching slowly transformed to Flipped Classrooms, Blended Learning, and Hybrid formats, and patient care was allowed with screening, triaging, and testing before scheduling for aerosol-causing procedures in dentistry. This new normal was accepted and silver linings in the pedagogies were appreciated by faculty and institutions alike as outcomes were analyzed. This chapter examines lessons learned on pandemic awareness, effective teaching pedagogies, and challenges of health professionals. An analysis of the lessons based on the framework of the Community of Inquiry is provided as guidelines to educate Gen Z for the future.

Student support services: Perceptions and recommendations for the next generation

PURPOSE

Student support services/student affairs are central to the student academic experience and success at US and Canadian dental schools. This manuscript evaluates student and administrator perceptions of support services and offers recommendations for best practices in student services in predoctoral dental education to help institutions improve the student experience.

METHODS

A survey of administrators and dental students found perceptions of student support services vary between these groups.

RESULTS

Seventeen student services administrators and 263 students started the survey, and 12 administrators and 156 students completed the full survey. Survey comments indicated access to student support services is a concern. Results of the student survey, in conjunction with current literature, were utilized to develop recommendations for dental student support services.

CONCLUSION

Recommendations for student support services in dental schools include accessibility of student services, and ensuring students have access to support in the domains of wellness, academic support, and peer support as well as implementation of humanistic practices. Wellness supports should include behavioral health services, physical health services, and access to mindfulness interventions. Academic support services should include study skills, time management training, and academic supports such as tutoring. Structured peer support programs should also be implemented. Dental schools should also be mindful of the changing support needs of incoming dental students.

Incorporating ABC in physiology education: Active learning, blended learning and curricular changes

Physiology is of central importance in medicine. Teaching the complex physiological frameworks to the current generation of students with the implementation of competency-based medical education (CBME) has become a challenging task. Development of digital technology in educational field during Covid-19 pandemic has made medical educators modify their teaching learning strategies from traditional to blended mode. We offer tips to embrace the three major challenges namely, generational diversity with active learning strategies, technological growth with blended learning, and strategies to implement curricular changes in physiology education. Adult learning principles involve active learning as a crux component. Various simple active teaching strategies that can be adapted for large and small group teaching are highlighted. Blended learning is characterized by self-paced learning, and face-to-face training sessions with online collaborative learning. Simple ways to incorporate the blended mode of teaching strategies with the use of virtual platforms and learning management system (LMS) are described. Further, we discuss the nuances that help to adapt the various curriculum changes brought about by the implementation of CBME. Teaching physiology is an ever-challenging task. With an appropriate mindset, medical educators can turn these challenges into opportunities and make teaching learning a better experience.

The gross anatomy course: SARS-CoV-2 pandemic-related effects on students' learning, interest in peer-teaching, and students' perception of its importance

The COVID-19 pandemic required adjustments and limitations in university teaching, thereby challenging teaching concepts in anatomy requiring in-person contact, including the gross anatomy course. Therefore, the present study investigates the impact of COVID-19-associated adjustments on students' perception of the gross anatomy course's importance and quality, students' preferred learning setting and outcome, and their motivation to involve themselves in academic activities, including becoming a future peer-teacher of the course. Using paper-based questionnaires in Ulm, Germany, 397 (response rate: 82.3%) students of the winter term of 2020/2021 were surveyed using quantitative and qualitative items, which were compared with cohorts prior to the pandemic. Students reported a higher global rating on course quality during COVID-19 (pre-COVID-19: 5.3 ± 0.9, during-COVID-19: 5.6 ± 0.7, p < 0.001; 1 = very bad, 6 = very good). Students' perceived importance of the gross anatomy course showed a small but significant increase (pre-COVID-19: 4.2 ± 0.6, during-COVID-19: 4.3 ± 0.6, p < 0.001; 1 = strongly disagree, 6 = strongly agree). Students' motivation to apply as a peer-teacher remained stable, nevertheless, they reported less interest in transferring their knowledge to junior students. Finally, students reported that they spent significantly more learning time alone and their examination grades remained unchanged during the pandemic. Astonishingly, despite radical changes of the teaching environment due to COVID-19, students appreciate the offered teaching and highly valued the gross anatomy course.

Classroom Instruction: Medical Students' Attitudes Toward LGBTQI+ Patients

The Association of American Medical Colleges declared it essential that medical students receive instruction on the health needs of lesbian, gay, bisexual, transgender, questioning, and intersex (LGBTQI+) individuals. The integration of LGBTQI+ health and instruction in medical curricula, however, is scant. A pre-post confidential survey study was completed by first-year medical students (N = 103; 85% response rate) in the context of classroom instruction. The California State University Northbridge instrument assessed students' perspectives on LGBTQI+ Patient-Care, Comfort with LGBTQI+ Patient Interactions, Gender and Sexuality, Civil Rights, and LGBTQI+ Education. Post-instruction, students reported a significant increase in understanding of bisexuality (p = .02), being transgender (p = .006), and LGBTQI+ couples' adoption rights (p = .003). The findings support the incorporation of LGBTQI+ instruction into medical curricula and suggest that educators may consider consulting pre-intervention data before teaching LGBTQI+ health content, which would allow material to be tailored toward learner-specific needs.

Medical students' views on the value of trigger warnings in education: A qualitative study

BACKGROUND

Trigger warnings-advance notification of content so recipients may prepare for ensuing distress-feature in discussions in higher education. Students' expectations for warnings in some circumstances are recognised, and some educators and institutions have adopted use. Medical education necessitates engagement with potentially distressing topics. Little is known about medical students' expectations regarding warnings in education.

METHODS

All students from a 4-year graduate-entry UK medical degree programme were contacted via digital message outlining study details and were openly sampled. Qualitative methodology was chosen to explore participant expectations, experiences and meanings derived from experiences. Students participated in semi-structured interviews exploring perspectives on functions, benefits and drawbacks of trigger warnings in classroom-based medical education. We analysed interview transcripts using thematic analysis.

RESULTS

Thirteen semi-structured, qualitative interviews were undertaken. Themes in the following areas were identified: (1) students' experiences influence understanding of trauma and trigger warnings, (2) warnings as mediators of learning experiences, (3) professional responsibilities in learning, (4) exposure to content, (5) professional ethos in medical education and (6) how to issue trigger warnings. Students recognised the term 'trigger warning', and that warnings are an accommodation for those affected by trauma. Students' conceptualisation of warnings was influenced by personal experiences and peer interactions both within and outside education. Students expressed both support and concerns about use of warnings and their ability to influence learning, assuming of responsibility and professional development.

DISCUSSION

Diverse student opinions regarding warnings were identified. Most students suggested that warnings be used prior to topics concerning recognised traumas. Incremental exposure to distressing content was recommended. Students should be supported in managing own vulnerabilities and needs, while also experiencing sufficient formative exposure to develop resilience. Greater understanding of trauma prevalence and impacts and underpinnings of warnings amongst students and educators are recommended to optimise education environments and professional development.

What factors motivate male and female Generation Z students to become engaged as peer teachers? A mixed-method study among medical and dental students in the gross anatomy course

Peer-teaching is widely established in anatomy teaching and offers well-described advantages. Nevertheless, at Ulm University, Germany, a reduction in the number of peer teacher applicants for the dissection course was observed. This study examined factors related to the attractiveness of a position as a peer teacher for Generation Z students. Participants of the gross anatomy course were asked to evaluate factors influencing the attractiveness of a peer teacher position using a six-point Likert scale. Additionally, open-ended questions were analyzed qualitatively. Sex-specific subgroup analysis was performed comparing students of low and high motivation to apply for a tutorship. Of the 374 students who participated in this study (response rate 53%), 38% stated that they were intending to apply as peer teachers. Data indicated that students displayed intrinsic motivation to apply for a tutorship because of the opportunity to improve their anatomy knowledge and/or their pleasure in teaching. In contrast, extrinsic factors like remuneration of the tutorship and its relevance for their curriculum vitae were least important. Anatomy educators underestimated the demotivating factor of the workload associated with the tutorship and encouraged students less frequently to apply than peer teachers. Only minor sex-specific differences could be identified. Nevertheless, female students were encouraged less frequently to apply than their male peers. In summary, Generation Z students apply as peer teachers because they are enthusiastic about the task. To motivate students to commit to extracurricular activities like a tutorship, anatomy educators should actively encourage students-particularly females-more frequently to apply.

Medical Students and the Drive for a Single Right Answer: Teaching Complexity and Uncertainty

The arrival of Generation Z, the next generation of medical learners, has been accompanied by efforts to adapt teaching practices for this new group of students. Many have identified challenges associated with addressing the needs of modern medical learners. One particular trend we have observed is that medical students are increasingly requesting an “answer key” for all aspects of their medical education. Students often expect to have the correct answers readily available to them to ensure they have reached the correct conclusion and to determine the precise knowledge they need to master. Yet, for much of medicine, and particularly in the care of critically ill patients with multisystem disease in intensive care units, answers are uncertain, and the body of knowledge is ever-growing. Students’ regular requests for solutions to be provided to them threaten to undermine their development into critically thinking, self-sufficient physicians. We outline three potential contributors to this multifactorial problem and offer corresponding pedagogical solutions. Specifically, we address how prioritizing outcomes over process, discomfort with uncertainty, and fear of faltering can cause students to seek excessive levels of support that may ultimately do more harm than good. Addressing students’ concerns in these three key areas will not only serve students well during their undergraduate medical training but will also equip them with the skills needed to succeed in the clinical realm. To produce physicians capable of navigating an increasingly uncertain world, medical educators will need to help students appreciate that finding the answer is more complex than being provided an answer key.

Exploring College Adjustment in First-Year Gen Z Medical Students and Its Contributing Factors

Background

First-year medical students need to adjust to university life to achieve optimal education. Notably, generation Z (Gen Z) students recently admitted to medical school possess unique characteristics that may affect their adjustment. However, limited studies have evaluated the adjustment of Gen Z medical students. In line with this, the present study explores the adjustment process of Gen Z medical students in their first year of study.

Methods

A qualitative phenomenological study was held from January 2020 to October 2020. The respondents comprised first-year students from two medical institutions. Maximum variation sampling was applied to select the respondents. Moreover, 11 focus group discussions (FGDs) with students and 10 in-depth interviews with lecturers were conducted. Curriculum documents were examined, and then the data were analysed thematically.

Results

Three themes were identified: i) domain; ii) process and iii) contributing factors to college adjustment. Academic, social and personal-emotional components of adjustment were included in the domain theme. The process theme consisted of transition, transition-transformation and transformation phases. Meanwhile, the contributing factors consisted of existing and supportive factors. Student characteristics, including demographics, mentality, prior educational experiences and social support, were considered the existing factors, while technology, learning system and well-being constituted the supporting factors.

Conclusion

College adjustment involves various domains, processes and contributing factors that are unique to Gen Z characteristics, technology dependence and culture. Therefore, well-prepared faculties are needed to support the adjustment of Gen Z students.

Motivation and personality factors of Generation Z high school students aspiring to study human medicine

BACKGROUND

A new generation of medical students, Generation Z (Gen Z), is becoming the predominant population in medical schools and will join the workforce in a few years' time. Medicine has undergone serious changes in high-income countries recently. Therefore, it is unclear how attractive the medical profession still is for high school students of Gen Z. The aim of this study was to investigate what motivation leads Gen Z students in their choice to study human medicine, and how they see their professional future. Our study was guided by motivation theory and the influence of personality traits and other personal factors on students' choice of university major.

METHODS

In a cross-sectional online survey, we included third- and fourth-year high school students in Northern Switzerland. We examined the importance of criteria when choosing a university major: personality traits, career motivation, life goals, and other considerations influencing the choice of human medicine versus other fields of study. Results Of 1790 high school students, 456 (25.5%) participated in the survey (72.6% women, mean age 18.4 years); 32.7% of the respondents aspired to major in medicine at university. For all respondents, the foremost criterion for selecting a field of study was 'interest in the field,' followed by 'income' and 'job security.' High school students aiming to study human medicine attached high importance to 'meaningful work' as a criterion; supported by 36.2% of those students answering that helping and healing people was a core motivation to them. They also scored high on altruism (p < 0.001 against all groups compared) and intrinsic motivation (p < 0.001) and were highly performance- (p < 0.001) and career-minded (p < 0.001). In contrast, all the other groups except the law/economics group had higher scores on extraprofessional concerns.

CONCLUSIONS

Swiss Gen Z students aspiring to study human medicine show high intrinsic motivation, altruism, and willingness to perform, sharing many values with previous generations. Adequate work-life balance and job security are important issues for Gen Z. Regarding the current working conditions, the ongoing shortage of physicians, and recent findings on physicians' well-being, the potential for improvement and optimization is high.

PERSONAL VALUES OF FUTURE DOCTORS

OBJECTIVE

The aim: To analyse the value priorities of first-year medical students and outline areas of educational work to develop a system of professional values of future doctors who are able to work in circumstances of challenges of the time, as well as military conflicts.

PATIENTS AND METHODS

Materials and methods: The method of questionnaires involving the students of Ternopil National Medical University from Ukraine and India was used, as well as the method of content analysis of students' creative work. At the final stage of the study, essays written by Ukrainian first-year students on the day of the beginning of the war in Ukraine on February 24, 2022 were analysed.

RESULTS

Results: The desire to help people was the motive to enter a medical university for the majority of both Ukrainian and international students. Besides, Ukrainians identified civic values that are important in wartime: unity, national consciousness, struggle. In their opinion, the first day of the war determined the splash of anti-values: panic, fear, confusion. However, a similar study conducted ten days after the start of the war showed increase of confidence in victory, the levelling of negative emotions among Ukrainians. Therefore, the issue of the dynamics of values in wartime should be studied more.

CONCLUSION

Conclusions: Institutions of higher medical education should maintain a high intrinsic motivation of students in their altruistic striving to serve people, and improve the adaptation of first-year students, especially international ones. In wartime, it is necessary to intensify the educational work regarding ethical and spiritual development for strengthening the psychological well-being of students.

Medical educators' views and experiences of trigger warnings in teaching sensitive content

BACKGROUND

Trigger warnings-prior notification of topics so recipients may prepare for ensuing distress-are encountered widely in contemporary culture. Students at some universities have expressed expectations for trigger warnings. Medical education routinely exposes students to numerous potentially distressing topics. However, this topic remains understudied in medical education. Little is understood about educators' views or practice relating to warnings in the context of medical education.

METHODS

Twenty medical educators from a medical degree programme in the UK participated in a semi-structured qualitative interview study, exploring medical educators' views and experiences of managing distressing situations and, specifically, their use of warnings. We analysed interview transcripts by thematic coding and identified themes.

RESULTS

Analysis identified themes relating to educators' conceptualisation of trigger warnings and rationale for use, concerns about the use of warnings and the critical purpose of medical school in ensuring preparedness for clinical practice. Participants shared that warnings were given to empower students in approaching distressing topics and to enable engagement with learning. Warnings acknowledged that some experiences would be distressing and normalised and signalled acceptability of emotional responses. Decisions to use warnings were influenced by the nature of content and, reactively, in response to experiences of student distress. Terminology regarding trigger warnings was interpreted varyingly by participants. A broad variety of topics were identified as potentially sensitive. A number of concerns were noted regarding the use of warnings.

DISCUSSION

Warnings alone did not fulfil educators' responsibility in supporting students' professional development, but may be a useful adjunct, signalling that self-care is valued and should be prioritised. Despite frequent use of warnings, individual educator practice was shaped by varying rationale. A framework that addresses competing tensions of preventing distress and supporting professional development is needed as part of a trauma-informed approach to medical education.

Twelve tips for interfacing with the new generation of medical students: iGen

iGen, or Generation Z, is the newest generation of health professions students to enter the classroom. This generation represents the first cohort of students in which technology has been present in all aspects of their lives. Since birth, they have been influenced by the boom of social media and wide-spread internet availability, leading to decreased face-to-face interactions and a desire for immediate access to information. Health professions educators should recognize the unique attributes of iGen students in order to foster student success and create a more positive learning environment. The following twelve tips examine the research-based distinctive characteristics of iGen students and highlight important concepts to consider when modifying current pedagogy to better support their needs. Incorporating these tips as an educator can promote lifelong learning and skill development for iGen students and empower this generation to thrive.

Generational differences in psychological wellbeing and preventative behaviours among nursing students during COVID-19: a cross-sectional study

BACKGROUND

Many nursing programmes have had to swiftly move online in response to COVID-19. Nursing students are often a heterogenous group that traverses generational boundaries. Exploring generational differences may assist in developing support systems for specific groups. This study sought to examine psychological wellbeing and preventative behaviours among nursing students from the iGeneration in comparison to older generations.

METHOD

A prospective cross-sectional study was undertaken using a convenience sample of pre-registration nursing students studying at two Australian Universities, one regional and one metropolitan. About 631 pre-registration nursing students completed an online survey.

RESULTS

An independent samples t-test revealed that students from the iGeneration possess higher anxiety compared to nursing students from older generations (p = .000). Compared to iGeneration participants, older generation participants had significantly higher scores for knowledge of COVID-19 (p = .015). iGeneration participants utilised social media to source information about COVID-19 far more than older generations (p = .008). iGeneration participants were significantly more concerned than older generations about the impact of COVID-19 on completing their clinical placement (p = .014). Older generations tended to have higher academic preventative behaviours, with significant mean scores for not attending university if they or others they knew had symptoms of COVID-19.

CONCLUSION

Given the differences between generation groups with regard to psychological wellbeing, knowledge about COVID-19, and concerns about studying in an altered study environment, strategies should be targeted to generational groups. Anxiety negatively impacts the quality of life, educational performance and clinical practice and is experienced more frequently in the iGeneration. Therefore it is crucial for nursing educators to reflect on how they engage this generation in the online space to provide support, stability and a sense of connection. This will contribute towards ensuring a well-prepared future nursing workforce who may encounter other pandemics and isolating events.

IMPACT STATEMENT

Compared with other generations, iGeneration students have a greater likelihood to experience mental health issues, isolation and insecurity. Nursing leaders and educators must be sensitive to such intergenerational differences, to ensure they are developing a skilled and productive workforce.

The Work Values of Portuguese Generation Z in the Higher Education-to-Work Transition Phase

The cohort of young people born with or after the Internet has been dubbed Generation Z (Gen Z, or post-millennials). They are now entering the higher education-to-work transition phase, although this is yet to be studied. Previous studies have found that work values and work preferences vary across generations and national cultures, justifying regular and localised examination. However, very little is known to date about the work values of Portuguese Gen Zs. In this study, we describe the work values of Portuguese university students in the higher education-to-work transition phase and examine their influence on salient work-related preferences. We surveyed over 3000 students attending university degrees from eight main Portuguese universities. We find that Portuguese Gen Zs value social values above all, followed by intrinsic and then extrinsic work values, potentially configuring a unique profile. Work values partially explain work preferences such as employer size and salary expectations. Gender differences mark our results, with women expressing higher work values in all three dimensions and lower entry salary expectations. These results can be useful for employers seeking to attract the best university graduates, facilitate their integration and promote their development.

Medical students' perception of what embodies an effective surgeon educator

BACKGROUND

Effective surgeon educators likely help medical students develop competency and may inspire pursuit of surgical training. We sought to determine the qualities medical students believe embody effective surgical educators.

METHODS

Mixed-methods study of nationally electronically recruited 3rd-year medical students using virtual semi-structured interviews and anonymous quantitative survey to determine the most critical and most frequently encountered qualities of effective surgical educators. Thematic analysis using grounded theory was undertaken.

RESULTS

Data saturation occurred after 9 interviews. Themes of effective surgical educators included: engagement (acknowledging student, knowing their name, talking to the student), fostering a positive learning environment (non-threatening, non-shaming questioning), inclusion (giving responsibility/appropriate autonomy), and understanding how to teach a novice (teaching the student how to learn, adapt to learner). On quantitative analysis of Likert based survey, encouraging, promoting a positive learning climate, timely constructive feedback, and questioning were ranked as most critical.

CONCLUSION

Students highly value positive learning climate and inclusion. Faculty Development to promote these traits may improve clerkship learning and experience.

Medical education in pediatric and congenital heart disease: A focus on generational learning and technology in education

Medical education is a complex interplay between teacher and trainee with the ultimate goal of producing competent physicians who provide excellent patient care. Physician education has evolved over centuries, from the apprenticeship of barber-surgeon through generations of bedside teachers and now evolving use of technology based instruction. All of these educational practices are based on expert assessment of effective techniques for imparting experience and knowledge to a new group of learners, the young doctor. In the past several decades, exponential growth in both medical innovation and technology development has occurred, leaving the current landscape of medical education with a substantial amount of medical data as well as innovative platforms for information access and distribution. These rapid changes have led to stark differences between medical educators and learners in their world views and preferences relating to teaching and learning. Therefore, understanding how the current generation of medical trainees perceives the world, accesses and retains information is imperative to effective education. The concept of generational learning can be used as a framework to identify teaching and learning preferences and help build relevant and effective educational content. This review article aims to outline our current understanding of generational characteristics, learning styles, and preferences. Using this framework, we will explore innovative educational content relevant to pediatric cardiology. Finally, we propose that a methodical approach to curriculum development will forge this generational gap and lead to even more effective and sharable educational content within our field.