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Sanz-Martos S, Álvarez-García C, Álvarez-Nieto C, López-Medina IM, López-Franco MD, Fernandez-Martinez ME, Ortega-Donaire L. Effectiveness of gamification in nursing degree education. PeerJ 2024; 12:e17167. [PMID: 38638160 PMCID: PMC11025539 DOI: 10.7717/peerj.17167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/06/2024] [Indexed: 04/20/2024] Open
Abstract
Background Previous research in nursing has found favorable results from the use of teaching methodologies alternative to lectures. One of the complementary methodologies used for university teaching is gamification, or the inclusion of game elements, creating a dynamic learning environment that allows the acquisition of knowledge and the development of other skills necessary for nursing students. The purpose of this study was to evaluate the effect of a gamification session on student satisfaction and knowledge scores in nursing students in simulated laboratory practice. Methods A pre-post quasi-experimental study was conducted with 122 students from the nursing degree program who participated in the research. The evaluation consisted of four sessions of three hours each. In two sessions, participants were trained through a vertical methodology, by means of theoretical training provided by teaching staff, and two hours of clinical simulation, where the students were able to practice the techniques on professional simulators. At the other two sessions, participants received an explanation of the theoretical aspects of the session, one hour of clinical simulation, and one hour of gamification, in which they had to pass tests based on the performance of practical activities on the subject of the session. At the end of the gamification session, all the participants received a certificate as winners of the "nursing game". Results There was an improvement in the satisfaction and the knowledge level in the gamification sessions. Both were statistically significant (P < 0.001). There was an improvement in the items related to the development of critical thinking and the mobilizing concepts from theory to practice in the gamification sessions. Conclusion The intervention was effective in improving the satisfaction of the sessions received and in knowledge development.
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Comrie CE, Coe TM, Moses J, Dageforde LA. Evaluating Medical Students' Perceptions of Patient-Led Transplant Surgery Education 1-2 Years Later. J Surg Res 2024; 296:149-154. [PMID: 38277951 DOI: 10.1016/j.jss.2023.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/16/2023] [Accepted: 12/28/2023] [Indexed: 01/28/2024]
Abstract
INTRODUCTION Medical students value the opportunity to learn from patients as a supplement to traditional faculty-led education; however, long-term follow-up to understand the educational impact of these experiences is lacking. We surveyed medical students who conducted non-medical virtual encounters with transplant recipients or living donors to understand the impact on students' patient care approach after 1-2 y. METHODS Students who completed their surgery clerkship from July 2020 to September 2021 were surveyed about this nonmedical patient encounter in January 2023. Quantitative and qualitative survey data were analyzed using descriptive statistics and inductive thematic analysis, respectively. RESULTS Of the 27 respondents (46% response rate), 44.4% completed the experience 1 y ago and 55.6% completed the experience 2 y ago. Nearly all respondents (96.3%) agreed that this experience was an effective way to learn about organ donation and transplantation and that learning from patients was beneficial to their development as a doctor. Over 50% felt this experience changed how they provide care to patients. Qualitatively, students reported that this activity cultivated their empathy for patients, provided unique insight into patients' illness experiences, and enhanced their understanding of the longitudinal patient-surgeon relationship. CONCLUSIONS Utilizing patients as teachers in transplant surgery not only taught medical students more about organ donation and transplantation but also built empathy and highlighted unique, non-clinical aspects of the patient experience that persisted over time. This is one of the first studies to evaluate patient-led teaching of this type over a year later and assess its unique influence on medical student development.
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Affiliation(s)
| | - Taylor M Coe
- Harvard Medical School, Boston, Massachusetts; Surgery Department, Massachusetts General Hospital, Boston, Massachusetts
| | - Joy Moses
- Surgery Department, Massachusetts General Hospital, Boston, Massachusetts
| | - Leigh Anne Dageforde
- Harvard Medical School, Boston, Massachusetts; Surgery Department, Massachusetts General Hospital, Boston, Massachusetts.
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Ortega-Donaire L, Bailén-Expósito J, Álvarez-García C, López-Medina IM, Álvarez-Nieto C, Sanz-Martos S. Satisfaction of Online University Education during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:healthcare11101421. [PMID: 37239706 DOI: 10.3390/healthcare11101421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/18/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
The rapid global spread of the coronavirus disease affected the education sector, which had to adapt its teaching methodology to an online scenario to curb the increase in infections. This study aimed to determine the satisfaction level of university students regarding the online education they received during the COVID-19 pandemic. A descriptive cross-sectional study was carried out with nursing degree students. Convenience sampling was used because of the accessibility of the sample, estimating 168 as the minimum sample size needed. The satisfaction level was measured using the "Questionnaire on Satisfaction of University Students with Online Training" (CUSAUF). The sample consisted of 215 participants. The overall level of satisfaction was high. Subject content and teaching methodology were the most highly rated aspects, while aspects related to lecturer-student communication and communication among students were rated the worst. The Cronbach's α for the satisfaction scale was 0.94, showing high internal consistency and reliability of the sample. Online education could be considered an alternative methodology for teaching learning modules or complementing face-to-face training in future training programs.
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Affiliation(s)
- Lucía Ortega-Donaire
- Department of Nursing, Faculty of Health Sciences, University of Jaen, 23071 Jaén, Spain
| | | | | | - Isabel M López-Medina
- Department of Nursing, Faculty of Health Sciences, University of Jaen, 23071 Jaén, Spain
| | - Carmen Álvarez-Nieto
- Department of Nursing, Faculty of Health Sciences, University of Jaen, 23071 Jaén, Spain
| | - Sebastián Sanz-Martos
- Department of Nursing, Faculty of Health Sciences, University of Jaen, 23071 Jaén, Spain
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Harkins P, Burke E, Conway R. Musculoskeletal education in undergraduate medical curricula-A systematic review. Int J Rheum Dis 2023; 26:210-224. [PMID: 36502533 PMCID: PMC10107471 DOI: 10.1111/1756-185x.14508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/04/2022] [Accepted: 11/20/2022] [Indexed: 12/14/2022]
Abstract
Rheumatic and musculoskeletal diseases encompass a vast spectrum of up to 200 conditions that are increasingly prevalent, with significant associated disability and socioeconomic burden. Their impact is pervasive, with musculoskeletal conditions being the second leading cause of years lived with disability worldwide, in addition to the 9th most common cause of disability-adjusted life years. It is therefore imperative that all graduating medical physicians are competent in their management, and that the quality of undergraduate musculoskeletal education is commensurate with patient and societal needs. A systematic literature review was conducted between April 1, 2021 and June 1, 2021 assessing the quality of undergraduate musculoskeletal education in medical schools. Educational interventions in musculoskeletal medicine were also included. Quality assessment appraisal of the studies was done using a Mixed Methods Appraisal Tool. One thousand and thirty-three titles were screened, and 44 studies were included in the final analysis. Our analysis of these studies showed that the quality of undergraduate musculoskeletal education, as determined by the cognitive mastery and clinical confidence of undergraduate medical students remains inadequate. Multiple educational interventions were assessed with mixed results. Despite the prevalence, and burden associated with rheumatic and musculoskeletal diseases, the musculoskeletal education of undergraduate medical students remains inadequate. Urgent international collaboration is required to devise teaching strategies and curriculum initiatives that are globally and reproducibly applicable and effective. Further research into educational interventions and teaching strategies is also required.
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Affiliation(s)
- Patricia Harkins
- Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Eoghan Burke
- Royal College of Surgeons, Dublin, Ireland, Dublin, Ireland
| | - Richard Conway
- Trinity College Dublin, The University of Dublin, Dublin, Ireland
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Shokrollahi S, Ashrafi F, Iraj B, Omid A, Mansouri V. A comparative study of the effects of multimedia training materials on mini CEX scores of internal medicine residents in Isfahan University of Medical Sciences. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:322. [PMID: 36568003 PMCID: PMC9768699 DOI: 10.4103/jehp.jehp_867_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 12/27/2021] [Indexed: 06/17/2023]
Abstract
BACKGROUND Role of multimedia training materials on Mini-CEX scores of internal medicine residents. We aimed to assess the effect of multi multimedia training materials on Mini-CEX scores of internal medicine residents of Isfahan University of Medical Sciences. SETTINGS AND DESIGN A quasi-experimental action research study on 1st, 2nd, and 3rd-year internal medicine residents were implemented. MATERIALS AND METHODS The Mini-CEX test measures students' performance in six core skills necessary for medical practice. Mini-CEX scores of 135 internal medicine residents in 2017-2018 were compared before and after the training with prepared multimedia materials. We used repeated measured ANOVA and Mann-Whitney U test to compare the distribution of Mini-CEX scores across corresponding groups. Analysis was done using the SPSS software version 23 (IBM SPSS Statistics for Windows. Armonk, NY, USA: IBM Corp). RESULTS The median Mini-CEX score (IQR) of students in preintervention and postintervention groups were 16.14 (5.19) and 19.62 (3.13), respectively. Findings of this study showed a significant increase in mini-CEX scores of the groups who used the multimedia learning material compared to those who did not use it (P < 0.001). CONCLUSIONS Multimedia learning resources demonstrated a promising influence on internal residents' mini-CEX scores in this study. They demonstrate significantly greater performance after using multimedia learning materials compared to their same-year residents who did not benefit from it. This demonstrates the favorable effect of multimedia on the acquisition of practical skills such as obtaining a history or performing a physical examination.
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Affiliation(s)
- Soheila Shokrollahi
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzaneh Ashrafi
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bijan Iraj
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Athar Omid
- Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vahid Mansouri
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Shehata MH, Prabu Kumar A, Al Ansari AM, Deifalla A, Atwa HS. Best Practices of the World Health Organization Collaborating Centres (WHOCCs) in the Eastern Mediterranean Region. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:1199-1205. [PMID: 36212703 PMCID: PMC9532253 DOI: 10.2147/amep.s367834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND World Health Organization Collaborating Centres (WHOCCs) cooperate with the WHO on a range of strategic areas such as nursing, nutrition, mental health, chronic diseases, education, and health technologies, depending on their speciality areas. As of 2021, WHO has 47 CCs in the Eastern Mediterranean Region (EMR) collaborating on diverse areas. Four CCs in the EMR located in Egypt, Kingdom of Bahrain, Sudan, and Pakistan focus primarily on medical education (ME). OBJECTIVE The objective of this review of the literature is to describe the best practices in ME based on published research from the four WHOCCs in EMR. The secondary objective is to classify them based on the level of Kirkpatrick's model (KM) of educational outcomes. METHODS The contributions of WHOCCs are categorised in to five domains namely "Curriculum Development and Course Design", "Student Assessment", "Quality, Accreditation, and Program Evaluation", "Teaching and Learning" and "Innovation in Medical Education". Initial extraction yielded 96 articles for review, while the second level of analysis reduced the number of publications to 37 based on the date of publication within the last 5 years. Numerous best practices in ME emerged from the recently published works of these WHOCCs in the areas of learning and teaching, curriculum development, innovations in medical education, quality, and assessments in medical education. Literature from the WHOCCs on assessment and curriculum design are limited, possibly indicating opportunities for additional research. CONCLUSION The researchers conclude that the WHOCCs in the EMR show transformational impact on all principal areas of research and at multiple levels.
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Affiliation(s)
- Mohamed Hany Shehata
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Helwan University Faculty of Medicine, Cairo, Egypt
| | - Archana Prabu Kumar
- Medical Education Unit, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ahmed Mohammed Al Ansari
- Medical Education Unit, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Abdelhalim Deifalla
- Department of Anatomy, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Faculty of Medicine, Suez Canal, University, Ismailia, Egypt
| | - Hani Salem Atwa
- Medical Education Unit, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Faculty of Medicine, Suez Canal, University, Ismailia, Egypt
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Utilizing educational technology in enhancing undergraduate nursing students' engagement and motivation: A scoping review. J Prof Nurs 2022; 42:262-275. [DOI: 10.1016/j.profnurs.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/17/2022] [Accepted: 07/21/2022] [Indexed: 11/19/2022]
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Flugelman MY, Glueck RM, Aronson D, Shiran A. The two envelopes method for active learning. GMS JOURNAL FOR MEDICAL EDUCATION 2022; 39:Doc30. [PMID: 36119147 PMCID: PMC9469574 DOI: 10.3205/zma001551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 08/26/2021] [Accepted: 03/03/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Active learning improves knowledge acquisition and provides medical students with learning habits that become an integral part of their behavior. As an integral element of our institution's transition from a lecture hall teaching culture to active learning, the current project, conducted with fourth year students, aimed to examine the effects of the two envelopes method of teaching on students' knowledge. METHOD The class of 120 students was divided into 12 groups of 10 students each. Six experienced senior cardiologists were assigned to teach the 12 groups. When the students arrived at the classroom, they received two envelopes. Students were instructed to open the first envelope and answer a 10-question test in 15 minutes. After completing the test, they returned the tests to the envelope, sealed it, and then opened the second envelope which included the same test and relevant patient information. They then spent the next 30 minutes discussing the test as a group and familiarizing themselves with the patients' case histories and clinical data. After completion of the group discussion, the tutor entered the room for a two-hour discussion of the patients' disease entities including the anatomy, physiology, pathology, clinical presentation, diagnostic measures, and potential therapies. RESULTS We compared grades and standard deviations of grades between two classes: one learned in the lecture hall format (2018) and the other learned employing the two-envelopes method (2019). There was a non-statistically significant trend toward better grades with reduced dispersion of grades in the class that learned with the two-envelope method. CONCLUSIONS We describe a novel method for active learning that enhances self-learning and peer learning, and we observed better knowledge acquisition and reduced knowledge dispersion that were not statistically significant.
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Affiliation(s)
- Moshe Y. Flugelman
- Lady Davis Carmel Medical Center, Department of Cardiovascular Medicine, Haifa, Israel
- Technion Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa, Israel
| | - Robert M. Glueck
- Technion Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa, Israel
| | - Doron Aronson
- Technion Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa, Israel
- Rambam Medical Center, Department of Cardiology, Haifa, Israel
| | - Avinoam Shiran
- Lady Davis Carmel Medical Center, Department of Cardiovascular Medicine, Haifa, Israel
- Technion Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa, Israel
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Owolabi J. ASIC Framework Simplified and Operationalised - An Operational Matrix for Optimising the Use of Technologies and Innovations in Medical Education. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:149-156. [PMID: 35173514 PMCID: PMC8841754 DOI: 10.2147/amep.s351642] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
The ASIC [adaptation, standardisation, integration and compliance] framework was developed to set the standard for the use of innovations and technologies in medical education. There is a need to develop frameworks and reference guides for educational technologies [EdTechs] and innovations, noting that EdTechs are becoming increasingly important to the delivery of medical education. The ASIC framework as previously published presents four major tenets including: adaptation, standardisation, integration and compliance. The operational matrix is now developed and presented in this article. Each tenet of the ASIC framework has key requirements or questions that the user of an EdTech or educational innovation should address. Each question represents a key requirement to be satisfied by the user of the EdTech to satisfy the ASIC tenets. Each question is also equally weighted as every other one. The matrix has 12 key questions, representing 12 key requirements. The results measurement can either be a fraction of 12 or a percentage. As a requirement, the minimum score under each category is 2 out of 3; ideally, optimisation of an educational innovation or technology requires that all boxes are checked in the affirmative. However, a minimum of 2 out of 3 in every category would indicate a minimum score or threshold. This effort is in line with previous and ongoing efforts to ensure that educational technologies and innovation that are deployed to deliver medical education are adapted for optimal performance, standardised for the use of training, integrated into the medical education delivery system, and compliant with professional, institutional, and regulatory standards.
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Affiliation(s)
- Joshua Owolabi
- Anatomy Department, Division of Basic Medical Sciences, University of Global Health Equity, Butaro, Rwanda
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Sanz-Martos S, López-Medina IM, Álvarez-García C, Álvarez-Nieto C. Educational program on sexuality and contraceptive methods in nursing degree students. NURSE EDUCATION TODAY 2021; 107:105114. [PMID: 34507261 DOI: 10.1016/j.nedt.2021.105114] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/13/2021] [Accepted: 08/18/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Previous educational programs about sexuality and contraceptive methods are delivered through vertical teaching methodology and use an increase in knowledge level as an indicator of effectiveness; however, attitudes towards contraceptive use are not addressed. OBJECTIVES This study aimed to evaluate the effect of a peer-educational intervention to improve knowledge level and attitudes regarding contraceptive methods in university students. DESIGN A pre-post quasi-experimental study. SETTINGS Young university students from a Spanish university. PARTICIPANTS 131 students in their second year of the Nursing degree program. METHODS An intervention consisting of two 3-hour sessions was conducted. The first session introduced the main aspects of contraceptive methods and was conducted by the teacher. The second session began with student presentations about contraceptive methods, followed by clinical simulations of a family planning service that the students had to implement and solve. RESULTS There was a 71.43% improvement in the knowledge level scale score and a 2.17% improvement in the attitudes towards the use of contraceptive methods; both were statistically significant (p < 0.001). For 11 of the 15 items in the knowledge scale, a significantly higher proportion of success was found after the intervention. CONCLUSION Peer-educational intervention was effective in improving knowledge level and attitudes about contraceptive methods.
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Affiliation(s)
- Sebastián Sanz-Martos
- Department of Nursing, Faculty of Health Sciences, University of Jaén, Building B3, office 214, Campus Las Lagunillas, 23071 Jaén, Spain.
| | - Isabel M López-Medina
- Department of Nursing, Faculty of Health Sciences, University of Jaén, Building B3, office 265, Campus Las Lagunillas, 23071 Jaén, Spain.
| | - Cristina Álvarez-García
- Department of Nursing, Faculty of Health Sciences, University of Jaén, Building B3, office 241, Campus Las Lagunillas, 23071 Jaén, Spain.
| | - Carmen Álvarez-Nieto
- Department of Nursing, Faculty of Health Sciences, University of Jaén, Building B3, office 243, Campus Las Lagunillas, 23071 Jaén, Spain.
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Medical Students' Perspective and Knowledge of Asymptomatic Hyperuricemia and Gout Management: A Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9121639. [PMID: 34946365 PMCID: PMC8701223 DOI: 10.3390/healthcare9121639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022] Open
Abstract
The prevalence and incidence of gout doubled from 1990 to 2017. Therefore, we can expect that a number of doctors have come across a patient with gout in their daily practice. Hence, we wanted to investigate how familiar our medical students, as future medical professionals, are with gout. This cross-sectional survey included Medical Studies students from the two largest universities in Croatia: the University of Split School of Medicine, and the University of Zagreb School of Medicine, and included a total of 221 fifth or sixth year medical students. Most students gave correct answers to questions about treatment approach and non-pharmacological interventions in asymptomatic hyperuricemia (>80%). Less than 3% of all students agreed they knew enough about care for patients with asymptomatic hyperuricemia, whereas almost 15% thought they were well familiar with care for gout patients. Less than 8% of students considered their school education adequate on both topics, and less than 2% were aware of the existence of EULAR guidelines. Physicians lacking in the latest knowledge on the pathophysiology of gout, the influence of lifestyle, and genetic factors limits their ability to properly manage gout. With increasing prevalence, gout should be more represented in medical students’ education.
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Hahn EG. Integrative medicine and health in undergraduate and postgraduate medical education. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc46. [PMID: 33763531 PMCID: PMC7958908 DOI: 10.3205/zma001442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/09/2020] [Accepted: 10/19/2020] [Indexed: 06/12/2023]
Abstract
Background and objective: Integrative Medicine and Health (IMH) is a theory-based paradigm shift for health, disease and health care, which can probably only be achieved by supplementing medical roles and competences. Definition of IMH: The definitions of the Academic Consortium for Integrative Medicineand Health 2015 and the so-called Berlin Agreement: Self-Responsibility and Social Action in Practicing and Fostering Integrative Medicine and Health Globally are used. The basic features of evidence-based Integrative Medicine and Health (EB-IMH) are based on the recommendations on EBM by David L. Sackett. Global State of Undergraduate and Postgraduate Medical Education (UG-PGME) for IMH: The USA and Canada are most advanced in the development of IMH regarding practice, teaching and research worldwide. Despite socio-cultural peculiarities, they can provide guidance for Europe and especially for Germany. Of interest here are competences for UG-PGME in IMH in primary care and in some specialist disciplines (e.g. internal medicine, gynecology, pediatrics, geriatrics, oncology, palliative care). For these specialties, the need for an interprofessional UG-PGME for IMH was shown in the early stages of development. UG-PGME for IMH in Germany: In the course of the development of the new Medical Licensure Act in Germany (ÄApprO), based on a revision of the National Competence-based Catalogue of Learning Objectives for Medicine (NKLM 2.0) and new regulations for Postgraduate Medical Education in Germany, suggestions for an extension of UG-PGME are particularly topical. To some extent there are already approaches to IMH. Old and new regulations are set out and are partly compared. As a result, some essential elements of IMH are mapped in the new ÄApprO. The new regulations for Postgraduate Medical Education do not mention IMH. Conclusion: The development of medical competences for IMH in the continuum of the UG-PGME could be supported by the coordinated introduction of appropriate entrustable professional activities (EPA) and IMH sub-competences combined with appropriate assessment.
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Affiliation(s)
- Eckhart Georg Hahn
- Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, Department of Medicine 1, Erlangen, Germany
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De Bedout V, Williams NM, Muñoz AM, Londoño AM, Munera M, Naranjo N, Rodriguez LM, Toro AM, Miao F, Koru-Sengul T, Jaimes N. Skin Cancer and Dermoscopy Training for Primary Care Physicians: A Pilot Study. Dermatol Pract Concept 2021; 11:e2021145. [PMID: 33614219 PMCID: PMC7875653 DOI: 10.5826/dpc.1101a145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION The primary objective of this study was to determine the diagnostic accuracy and effect of an educational training on skin cancer course and dermoscopy use among primary care physicians in rural areas of Colombia. The secondary objective was to assess the diagnostic accuracy of skin cancer diagnosis and detection rate after 3 months of the initial training. METHODS Twenty-one primary care physicians from 6 rural areas of Colombia participated in a 2-day skin cancer and dermoscopy training, followed by a day-long hands-on session on dermoscopy at a free skin cancer screening event. Pre- and post-tests were performed using clinical and dermoscopic images to evaluate the user's ability to diagnose and differentiate benign and malignant neoplasms. In addition, participants' levels of confidence were assessed. RESULTS After the training, the sensitivity and specificity of characterizing skin lesions as benign or malignant or providing a specific diagnosis (ie, angioma, seborrheic keratosis, basal cell carcinoma, etc.) increased by 23.6% (62.9% to 86.5%; P < 0.0001) and 21% (54.7% to 75.7%; P < 0.0017), respectively. In addition, levels of confidence when diagnosing skin lesions changed from extremely low or low, to high or extremely high by 20.7% (38.3% to 59%) using dermoscopic images (odds ratio (OR) 3.22; 95% confidence interval (CI): 2.67-3.86; P < 0.0001). The secondary objective was not achieved due to loss of follow-up of the majority of participants. CONCLUSION Providers serving populations with limited healthcare access may benefit from education in diagnosing and differentiating skin cancer with the use of dermoscopy, which may ultimately improve patient care and reduce healthcare costs.
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Affiliation(s)
- Valeria De Bedout
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Natalie M. Williams
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ana M. Muñoz
- Department of Dermatology, Universidad Pontificia Bolivariana, Medellin, Colombia
| | - Ana M. Londoño
- Department of Dermatology, Universidad Pontificia Bolivariana, Medellin, Colombia
| | - Manuela Munera
- Department of Dermatology, Universidad Pontificia Bolivariana, Medellin, Colombia
| | - Natalí Naranjo
- Department of Dermatology, Universidad Pontificia Bolivariana, Medellin, Colombia
| | - Lina M. Rodriguez
- Department of Dermatology, Universidad Pontificia Bolivariana, Medellin, Colombia
| | - Alejandra M. Toro
- Department of Dermatology, Universidad Pontificia Bolivariana, Medellin, Colombia
| | - Feng Miao
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
- Sylvester Comprehensive Cancer Center, Miami, Florida, USA
| | - Natalia Jaimes
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
- Sylvester Comprehensive Cancer Center, Miami, Florida, USA
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