Shared decision-making in undergraduate nursing and medical education: An explorative dual-method study

OBJECTIVE

This study explores how shared decision-making (SDM) is integrated in undergraduate nursing and medical education.

METHODS

A dual-method design was applied. The integration of SDM in medicine and nursing education programs (i.e. SDM on paper) was explored through document analyses; the integration of SDM in curricula (i.e. SDM in class) through interviews with teachers and curriculum coordinators (N = 19).

RESULTS

A majority of the education programs featured SDM, mostly non-explicit. In curricula SDM was generally implicitly featured in compulsory courses across all study years. SDM was often integrated into preexisting theories and models and taught through various methods and materials. Generally, teachers and supervisors were not trained in SDM themselves. They assessed students' competence in SDM in a summative manner.

CONCLUSION

Overall, SDM was featured in undergraduate nursing and medical education, however, very implicitly.

Assessment approaches in undergraduate health professions education: towards the development of feasible assessment approaches for low-resource settings

BACKGROUND

Feasible and effective assessment approaches to measuring competency in health sciences are vital in competency-based education. Educational programmes for health professions in low- and middle-income countries are increasingly adopting competency-based education as a strategy for training health professionals. Importantly, the organisation of assessments and assessment approaches must align with the available resources and still result in the fidelity of implementation. A review of existing assessment approaches, frameworks, models, and methods is essential for the development of feasible and effective assessment approaches in low-resource settings.

METHODS

Published literature was sourced from 13 electronic databases. The inclusion criteria were literature published in English between 2000 and 2022 about assessment approaches to measuring competency in health science professions. Specific data relating to the aims of each study, its location, population, research design, assessment approaches (including the outcome of implementing such approaches), frameworks, models, and methods were extracted from the included literature. The data were analysed through a multi-step process that integrated quantitative and qualitative approaches.

RESULTS

Many articles were from the United States and Australia and reported on the development of assessment models. Most of the articles included undergraduate medical or nursing students. A variety of models, theories, and frameworks were reported and included the Ideal model, Predictive Learning Assessment model, Amalgamated Student Assessment in Practice (ASAP) model, Leadership Outcome Assessment (LOA) model, Reporter-Interpreter-Manager-Educator (RIME) framework, the Quarter model, and the model which incorporates four assessment methods which are Triple Jump Test, Essay incorporating critical thinking questions, Multistation Integrated Practical Examination, and Multiple Choice Questions (TEMM) model. Additional models and frameworks that were used include the Entrustable Professional Activities framework, the System of Assessment framework, the Reporter-Interpreter-Manager-Educator (RIME) framework, the Clinical Reasoning framework (which is embedded in the Amalgamated Student Assessment in Practice (ASAP) model), Earl's Model of Learning, an assessment framework based on the Bayer-Fetzer Kalamazoo Consensus Statement, Bloom's taxonomy, the Canadian Medical Education Directions for Specialists (CanMEDS) Framework, the Accreditation Council for Graduate Medical Education (ACGME) framework, the Dreyfus Developmental Framework, and Miller's Pyramid.

CONCLUSION

An analysis of the assessment approaches, frameworks, models, and methods applied in health professions education lays the foundation for the development of feasible and effective assessment approaches in low-resource settings that integrate competency-based education.

TRIAL REGISTRATION

This study did not involve any clinical intervention. Therefore, trial registration was not required.

Illustration of self-perceived knowledge, skills, and interests in undergraduate dental students using a visual metaphor- results of a monocentric cross-sectional study

BACKGROUND

Self-assessment and self-reflection of competencies are crucial skills for undergraduate students. This monocentric cross-sectional study aims to assess the self-perceived knowledge, skills and interests in conservative dentistry and periodontology of third-, fourth-, and fifth-year dental students by the Pictorial Representation of Illness and Self-measure (PRISM).

METHODS

Seventy-five undergraduate dental students (n = 25 of each year) who studied between 2021 and 2022 at the Department of Cariology, Endodontology and Periodontology at the University of Leipzig, Germany, were included. All of them underwent a PRISM-based interview regarding their perceived knowledge, practical skills, and interests in conservative dentistry as well as its sub-disciplines. The distances in the PRISM task (in millimeters) were measured and compared between the groups. Spearman's Rho was used to reveal correlations between knowledge, skills, and interests in the cohort.

RESULTS

Perceived theoretical knowledge and practical skills differed significantly between groups for the sub-disciplines periodontology, cariology, restorative dentistry and preventive dentistry (p < 0.05). However, students' interests did not significantly vary between groups (p > 0.05). In the field of conservative dentistry and its sub-disciplines, significant moderate to high positive correlations were found between knowledge and skills (p < 0.01), and weak to moderate positive correlations were found between interests and knowledge (p < 0.05). Regarding the relationship between perceived interests and skills, only restorative dentistry, endodontology and periodontology were significant and only moderate to weak correlations were found (p < 0.05).

CONCLUSION

PRISM revealed differences in perceived knowledge and skills between third-, fourth-, and fifth-year dental students. Correlations were found between perceived knowledge and skills, as well as between interests and knowledge. PRISM may be a promising tool to support students and teachers in dental education.

The teaching of Radiology in other university studies

After the implementation of the European Space for Higher Education, the contents of the Radiology and Physical Medicine Area that were taught in the Medicine Degree have also been incorporated into the new degrees of Dentistry, Nursing, Physiotherapy, Podiatry, and, to a lesser extent, Pharmacy, Occupational Therapy, Logopedia, and Biomedical Engineering As a whole, the basic concepts of radiology and radiological protection are taught in Murcia in 5 different degrees with a total of 52.5 ECTS credits, participating in the training of 1219 students each academic year. This incorporation in the new degrees has tripled the number of subjects in which undergraduate teaching is taught, and doubled both the number of ECTS credits and the number of undergraduate students to whom it directs its training work. Thus, given the possible creation of new university degrees in the near future (Diagnostic Imaging and Radiotherapy Technicians), it would be necessary to involve a greater number of accredited professionals, from different specialties, and to optimize teaching resources (bibliography, material teacher, clinical cases, etc.,) for its usefulness in the different subjects that share similar contents.

Long-term trends in international medical electives fees: a database mining study

BACKGROUND

Abroad medical electives are recognized as high-impact practice and considered a necessity to provide global health training. As of recently, the COVID-19 pandemic and its related travel restrictions prohibited most international elective activities. Another important barrier to abroad electives that received comparably little attention is elective and application fees, which - combined - may be as high as $5000 per month, and may prevent students with limited financial resources from applying for an international elective. Elective fees have never been systematically analyzed and trends in teaching and application fees have rarely been subject to dedicated scientific investigations.

METHODS

Using data from two large elective reports databases, the authors addressed this gap in the literature. The authors analyzed trends in abroad elective fees within the last 15 years in some of the most popular Anglo-American elective destinations among students from Germany, including the United States of America, Australia, New Zealand, the Republic of South Africa, Ireland and the United Kingdom.

RESULTS

The authors identified n = 726 overseas elective reports that were uploaded between 2006 and 2020, of which n = 438 testimonies met the inclusion criteria. The United Kingdom and Australia were the most popular elective destinations (n = 123 and n = 113, respectively), followed by the Republic of South Africa (n = 104) and the United States of America (n = 44). Elective fees differed substantially-depending on the elective destinations and time point. Median elective fees were highest in the United States of America (€ 1875 for a 4-week elective between 2018-2020), followed by the Republic of South Africa (€ 400) and Australia (€ 378). The data also suggests an increasing trend for elective fees, particularly in the United States.

CONCLUSIONS

Rising fees warrant consideration and a discussion about the feasibility of reciprocity and the bidirectional flow of students in bidirectional exchange programs.

Preparing undergraduate student paramedics to consider their mental health during clinical placement in Australia

INTRODUCTION

This article explores the impact of mental health issues on paramedics in Australia, particularly Post-Traumatic Stress Disorder, caused by their exposure to high levels of stress. The prevalence of Post-Traumatic Stress Disorder is higher among paramedics than any other occupation, and this could be a cause for concern, especially for undergraduate student paramedics. The article examines the need to build resilience among student paramedics to help them handle the trauma they may experience during clinical placement.

METHODS

This study conducted a two-step process to review literature and university handbooks to determine the level of education provided to paramedic students on Post-Traumatic Stress Disorder and resilience during clinical placement, due to the lack of research in this area. The first step involved a search for relevant articles, while the second step involved a search of the Australian Health Practitioner Regulation Agency website to identify paramedicine programs and a manual evaluation of each undergraduate pre-registration paramedicine curriculum in Australia.

RESULTS

This study conducted a systematic search of national and international literature and Australian undergraduate pre-registration paramedicine programs to identify any studies pertaining to the education of paramedic students in resilience and Post Traumatic Stress Disorder. The search found that only 15 (5.95 %) of the 252 reviewed subjects had reference to mental health, resilience or Post-Traumatic Stress Disorder, with only 4 (1.59 %) of them discussing these topics in preparation for clinical practice. The study highlights the lack of emphasis on student paramedic self-care as an essential underpinning for clinical placement preparation in the curriculum.

CONCLUSION

This literature review concludes that appropriate training and support, teaching resilience, and promoting self-care are crucial in preparing paramedic students for the emotional and psychological demands of their work. Equipping students with these tools and resources can improve their mental health and well-being and enhance their ability to provide high-quality care to patients. Promoting self-care as a core value in the profession is essential in creating a culture that supports paramedics in maintaining their own mental health and well-being.

Internet use 101 in college: Do undergraduates want to learn healthier internet use?

Background

Internet overuse is an emerging public health emergency, especially for college students in the United States. The purpose of this study was to assess college students' internet usage and interest in learning healthy internet usage skills as part of a college curriculum.

Study design

Participants completed an online anonymous questionnaire which included the short version of the Internet Addiction Test, a modified Youth Health Movement survey, and questions regarding their interest in healthy internet use coursework.

Methods

A total of 402 participants were recruited via an email LISTSERV of current undergraduates and recent graduates who had taken at least one class within a child and adolescent mental health studies minor while enrolled in a large university.

Results

Overall, 70% of participants reported that they use the internet excessively, and a majority of participants reported that internet use has negatively affected their sleep and increased their anxiety. Seventy percent of participants reported that they would benefit from instruction on healthy internet usage via formal courses for credit or online modules.

Conclusions

Students are aware of the difficulty in managing their internet use in college and are motivated to engage in novel courses on healthy internet usage. Academic institutions should consider developing courses or modules on healthy internet use.

The influence of a digital clinical reasoning test on medical student learning behavior during clinical clerkships

Recently, a new digital clinical reasoning test (DCRT) was developed to evaluate students' clinical-reasoning skills. Although an assessment tool may be soundly constructed, it may still prove inadequate in practice by failing to function as intended. Therefore, more insight is needed into the effects of the DCRT in practice. Individual semi-structured interviews and template analysis were used to collect and process qualitative data. The template, based on the interview guide, contained six themes: (1) DCRT itself, (2) test debriefing, (3) reflection, (4) practice/workplace, (5) DCRT versus practice and (6) 'other'. Thirteen students were interviewed. The DCRT encourages students to engage more in formal education, self-study and workplace learning during their clerkships, particularly for those who received insufficient results. Although the faculty emphasizes the different purposes of the DCRT (assessment of/as/for learning), most students perceive the DCRT as an assessment of learning. This affects their motivation and the role they assign to it in their learning process. Although students appreciate the debriefing and reflection report for improvement, they struggle to fill the identified knowledge gaps due to the timing of receiving their results. Some students are supported by the DCRT in exhibiting lifelong learning behavior. This study has identified several ways in which the DCRT influences students' learning practices in a way that can benefit their clinical-reasoning skills. Additionally, it stresses the importance of ensuring the alignment of theoretical principles with real-world practice, both in the development and utilization of assessment tools and their content. Further research is needed to investigate the long-term impact of the DCRT on young physicians' working practice.

The state of undergraduate palliative care education at Austrian medical schools - a mixed methods study

BACKGROUND

There is an increasing demand for universal, high-quality access to palliative care in Austria. To ensure this, the implementation of palliative care in the medical studies curriculum is essential. This is the first study to investigate the state of undergraduate palliative care education at Austrian medical schools.

METHODS

For this mixed-methods study with concurrent embedded design, expert interviews and online surveys were conducted between March and August 2022. The interviews were subjected to a thematic analysis according to Braun and Clarke, while the questionnaires were analysed descriptively-statistically. For the final integration, the results of both methods for each topic are presented and discussed complementarily. Both the primary qualitative and supportive quantitative data were collected to combine the advantages of the in-depth nature of the qualitative data and the consistent structure of the quantitative data to provide a more precise representation of the state of teaching.

RESULTS

Twenty-two persons participated in the study, of whom twenty-one participated in the interview and eight in the questionnaire. The participants were experts in palliative care teaching at Austrian medical schools. Currently, palliative care is taught at seven out of the eight universities. Large differences were found in the number of hours, organisation, teaching formats, and interprofessional education. At present, three universities have a chair for palliative care and at least five universities have access to a palliative care unit.

CONCLUSION

Undergraduate palliative care education in Austria is very heterogeneous and does not meet the minimum standards suggested by the European Association for Palliative Care (EAPC) curriculum recommendations. However, several universities are planning measures to expand palliative care teaching, such as the introduction of mandatory teaching or the establishment of new teaching formats. Better coordination and networking within and between universities would be beneficial for the expansion and quality of teaching.

Selection tools and student diversity in health professions education: a multi-site study

Student diversity in health professions education (HPE) can be affected by selection procedures. Little is known about how different selection tools impact student diversity across programs using different combinations of traditional and broadened selection criteria. The present multi-site study examined the chances in selection of subgroups of applicants to HPE undergraduate programs with distinctive selection procedures, and their performance on corresponding selection tools. Probability of selection of subgroups (based on gender, migration background, prior education, parental education) of applicants (N = 1935) to five selection procedures of corresponding Dutch HPE undergraduate programs was estimated using multilevel logistic regression. Multilevel linear regression was used to analyze performance on four tools: prior-education grade point average (pe-GPA), biomedical knowledge test, curriculum-sampling test, and curriculum vitae (CV). First-generation Western immigrants and applicants with a foreign education background were significantly less likely to be selected than applicants without a migration background and with pre-university education. These effects did not vary across programs. More variability in effects was found between different selection tools. Compared to women, men performed significantly poorer on CVs, while they had higher scores on biomedical knowledge tests. Applicants with a non-Western migration background scored lower on curriculum-sampling tests. First-generation Western immigrants had lower CV-scores. First-generation university applicants had significantly lower pe-GPAs. There was a variety in effects for applicants with different alternative forms of prior education. For curriculum-sampling tests and CVs, effects varied across programs. Our findings highlight the need for continuous evaluation, identifying best practices within existing tools, and applying alternative tools.

Cultural Attitudes towards General Practice within Medical Schools: Experiences of GP Curriculum Leaders

INTRODUCTION

UK undergraduate medical curricula are under pressure to become more community-focused and generalist in approach to equip all future doctors with generalist skills and increase recruitment to generalist specialities like general practice. However, the amount of general practice teaching in UK undergraduate curricula is static or falling. Undervaluing, in the form of general practice denigration and undermining, is increasingly recognised from a student perspective. However, little is known about the perspectives of academics working within medical schools.

AIM

To explore the cultural attitudes towards general practice within medical schools as experienced by general practice curriculum leaders.

METHODS

A qualitative study using semi-structured interviews of eight general practice curriculum leaders in UK medical schools. Purposive sampling for diversity was used. Interviews were analysed using reflexive thematic analysis.

FINDINGS

Seven themes were identified covering 'a kaleidoscope of attitudes towards general practice', 'overt everyday denigration of general practice', 'a hidden curriculum of undervaluing general practice', 'valuing general practice: representation, recognition and respect', 'relating to others, relating to oneself', 'power, empowerment and vulnerability', and 'the pandemic as an opportunity'.

CONCLUSIONS

Cultural attitudes towards general practice were diverse: a spectrum varying from valuing general practice to overt denigration, with a 'hidden curriculum' of subtle undervaluing of general practice. Hierarchical, tense relationships between general practice and hospital were a recurring theme. Leadership was identified as important in setting the tone for cultural attitudes, as well as indicating general practice is valued when general practitioners are included within leadership. Recommendations include a shift in narrative from denigration to mutual speciality respect between all doctors.

Does the 'Educational Alliance' conceptualize the student - supervisor relationship when conducting a master thesis in medicine? An interview study

BACKGROUND

Completing a master thesis (MT) is mandatory in many undergraduate curricula in medicine but a specific educational framework to guide the supervisor-student relationship during the MT has not been published. This could be helpful to facilitate the MT process and to more effectively reach the learning objectives related to science education in medicine. An attractive model for this purpose is the 'Educational Alliance' (EA), which focusses on the three components 'clarity and agreement on (a) goals, (b) tasks and (c) relationship & roles'. This study investigated factors that can either facilitate or hinder the process of MTs, and related these to the components of the EA.

METHODS

We conducted semi-structured face-to-face interviews with 20 students and - separately - with their 20 corresponding supervisors, after the MT had been accepted. The interviews included open questions on factors facilitating or hindering the success of the MT. Audio recordings of the interviews were anonymized and transcribed, and then analysed by qualitative content analysis. Also, quantitative data were gathered on satisfaction with the MT process and the supervisory quality (using Likert-type questions).

RESULTS

We were able to analyse all 40 interviews, related to 20 MTs. From the transcripts, we extracted 469 comments related to the research question and categorized these into the four main categories (a) 'Preparation', (b) 'Process', (c) 'Atmosphere', (d) 'Value of the MT'. Interviewees highlighted the importance of a careful preparation phase, clear expectations, a clear research plan, thorough and timely feedback, mutual agreement on timelines, and a positive working atmosphere. Each of these factors could be brought in line with the three components of the EA framework: agreement and clarity of goals, tasks, relationships & roles. Satisfaction with the MT process was rated 8.75 ± 1.22 SD (of 10) points by supervisors, and 7.80 ± 1.61 SD points by students, while supervision quality was rated + 1.51 ± 0.63 SD (scale from - 2 to + 2) by supervisors, and + 1.26 ± 0.93 SD by students.

CONCLUSION

We propose the EA framework as a useful guidance for students, supervisors, and the university towards conducting successful MTs in medicine. Based on the findings, we provide specific recommendations for students, supervisors, and university.

New innovations and educational process in undergraduate neurology education in blended learning

Many undergraduate students suffer from 'neurophobia,' which refers to a lack of knowledge or confidence in neurology, and this can influence their career choices. Various measures have been taken to address this issue, including the implementation of new technologies and methodologies. Significant advancements have been made in the development of blended learning, and the integration of student-centered learning modules, multimedia, and web-based devices has become a common teaching approach. Nonetheless, the optimal delivery form, as well as assessment for the selected learning format and teaching quality in both theory and clinical practice, are being investigated. The purpose of this review is to provide a summary of the current understanding of blended learning as well as innovative methods, technologies, and assessments of undergraduate neurology education. It aims to highlight opportunities for implementing a novel, comprehensive learning model with a suitable blended learning method within a framework of customized technology-assessment processes for future neurology classes, encompassing both theoretical and clinical training.

Training Ethical Competence in a World Growing Old: A Multimethod Ethical Round in Hospital and Residential Care Settings

Ethical challenges are traditionally described in a negative light, even though moral conflict can express the individual ability to perceive when something is not working and promote change. The true question, therefore, is not to how to silence moral conflict but how to educate it. Although the need for ethical support of health- and social-care professionals in elderly care is clearly perceived, there is no universal method for providing effective interventions. The authors hypothesize that adequate training sessions can help care professionals enhance this skill, once clear goals and specific educational techniques are set. This research tests the hypothesis on twenty care professionals working in acute and residential care settings for the elderly, building on the ethics round method. Mixed methods drawn from literature and the experience of educators were adapted to meet different educational goals. Moral issues can hardly be removed from a context characterized by increasing demand and decreasing resources, but they can be recognized and addressed with common efforts, a critical attitude, and a growth mindset. Enhancing these skills in qualified workers can help them accept the reality of work, release pressure, and identify common team goals. Introducing these skills before graduation can help future workers avoid unreal expectations and reduce frustration and early job quit rates.

A Bioinformatic Approach to Enhance Undergraduate Student Understanding of the Cancer-Immunity Cycle

Recent advances in tumor immunology and cancer immunotherapy have generated significant interest in the field of immuno-oncology. With the promise of these advances comes an increasing need to train the next generation of scientists who will support ongoing basic and clinical research efforts in this field. At this time, however, there remains a documented underrepresentation of tumor immunology as a core content area in many undergraduate science curricula. This study introduces a novel pedagogical strategy that aimed to promote undergraduate student interest in tumor immunology in ways that support recent education guidelines published by the American Association of Immunologists, and it highlights the efficacy of this approach in enhancing student understanding of concepts relevant to the Cancer-Immunity Cycle. Using RNA-sequencing data obtained from clinical specimens catalogued in The Cancer Genome Atlas, students performed Kaplan-Meier survival analyses to identify Cancer-Immunity Cycle genes with prognostic significance. After correlating expression of such genes with tumor-infiltrating immune cell populations using a bioinformatic tool to deconvolute whole tumor-transcriptome data, students undertook an exercise that requires integration of course content and findings from the primary literature to generate hypotheses about the influence of genetic factors and immune cell types on the Cancer-Immunity Cycle and overall patient outcome. A pre-/post-project assessment instrument demonstrated the efficacy of this approach as a means of improving undergraduate student understanding of core cancer immunology concepts. This report describes these data and discusses potential ways in which the project can be adapted to extend its utility to broad and diverse student populations.

The impact of interactive synchronous HyFlex model on student academic performance in a large active learning introductory college design course

HyFlex learning environments have been meeting the unique needs of students and institutions for nearly 20 years. However, it was the pandemic that gave HyFlex its widespread acceptance and application. Literature suggests that HyFlex may now be considered part of the new norm in education and therefore, further study is needed on how it affects both teaching and learning. Our flipped design thinking course leverages active learning requiring the instructor and students to interact extensively. We piloted a specific version of HyFlex we named "Interactive Synchronous HyFlex" where students can participate on a daily basis in person or synchronously online. In this specific instance of HyFlex we explore: (1) Does student academic performance differ in the HyFlex environment compared to the Face to Face only environment? And (2) Does student academic performance differ based on how they chose to participate in the HyFlex course? Data were collected for this quasi-experimental study design on overall semester grades and three significant design projects during the semester. We compared the course offered as a Face to Face only experience to the course offered as a HyFlex course enabling remote participation. Second, we parse students in the HyFlex course into two categories: those who did not participate remotely vs. those who participated remotely once or more times. Students in the HyFlex course had a significantly different grade distribution earning more A's and more F's than their Face to Face only counterparts. Given the positive results of the Interactive Synchronous HyFlex approach, we plan to continue implementing it in our introductory design course though we will increase our attention on the remote students as they may need additional scaffolding to be successful.

A Survey of Clinical Immersion Experiences in Biomedical Engineering

Immersion in clinical environments is generally believed to be a valuable experiential learning opportunity for students in biomedical engineering, both at the undergraduate and the graduate level. Immersion is believed to foster an understanding of medical culture, clinical operations, interprofessional collaboration, and oftentimes allows students to either identify unmet clinical needs. The National Institutes of Health supports efforts through grants to incorporate these clinical immersion programs into biomedical engineering curricula, and this has potentially facilitated an expansion of these programs across the United States. Unknown is how common clinical immersion experiences are in biomedical engineering programs, in general how these are organized and executed, and their goals. We conducted a survey of biomedical engineering programs to learn how many programs offer clinical immersion experiences, over what timeframe and in what formats, and what is known about their goals and learning outcomes. We present here the results of that survey which includes 52 clinical immersion courses and programs, 14 of which either are or were previously funded by the NIH. Each of these courses or programs engages, on average, about 27 students per year, but range in size from 2 to 160. The duration of the immersion experience likewise varies greatly from 3 to 400 h. The objectives of these programs are mostly to identify problems, develop engineering solutions to problems, or to learn clinical procedures. Despite the impressive breadth of experiences revealed by this survey, we still know relatively little about their impact on student learning, motivation, identity, or career path. Desired outcomes and assessment strategies must be better aligned with the structure of the clinical immersion experiences themselves if we are to determine if they are effective in meeting those outcomes, including those of professional preparation.

A Qualitative Study of Medical Students' Perspectives on Distance Learning During COVID-19

Introduction

With the Coronavirus disease 2019 [COVID-19] pandemic, changes were undertaken out of necessity to allow medical students to continue their education. The aim of this study is to create key themes for educators to consider when implementing distance learning strategies into the curriculum based on 2nd year graduate entry medical students experience of learning and engagement with the use of distance learning during the COVID-19 pandemic.

Materials and Methods

A qualitative study with a phenomenological methodology was set within a constructivist paradigm. A volunteer sampling strategy was used to recruit participants. Nine semi-structured, audio-recorded interviews were undertaken and transcribed verbatim. A thematic analysis was undertaken of the transcripts using the Braun and Clarke framework with an open-coded approach.

Results

Exploration of the student experience generated an understanding of the learning process. The concept of adaptability emerged based on the themes of technology, environment, study skills and human interaction.

Discussion

Necessary changes to the formal curriculum affected medical students learning and experience that demanded adaptability. The 'new normal' generated a context within which students were communicating and interacting in ways creating individual challenges for students and educators.

Conclusion

With the advancements in information, communication and technology, distance learning is likely to be further incorporated in undergraduate training long term. Its position should be one that is harmonious within the wider educational realm that engages and meets the needs of the students. The rich understanding exposes adaptations and considerations for educators to improve the student experience.

An Exploratory Mixed Method Cross-Sectional Study to Identify Opportunities to Increase Enrollment and Retention of Native Hawaiian Students in an Undergraduate Dietetic Program

BACKGROUND

Native Hawaiians (NH) are underrepresented in dietetics, contributing to less than 1% of the profession nationally. Increasing the number of NH Registered Dietitian Nutritionists (RDN) is one mechanism to facilitate improved health outcomes in disparate populations.

OBJECTIVES

1) Identify and summarize NH student interests in the field of nutrition and dietetics; 2) Identify and contextualize factors that support and prohibit achievement of academic goals and aspirations; 3) Identify NH students' responsibility to the community; 4) Explore the context around NH alumni enrollment in nutrition and dietetics and their perceived impact of RDNs in the community; 5) Identify and describe supporting agencies that foster academic and professional success.

DESIGN

This exploratory mixed-methods cross-sectional study surveyed all levels of NH nutrition and dietetics students in the University of Hawai'i (UH) System. In addition, in-depth interviews were conducted with NH students, NH alumni, and supporting agencies to identify supports and barriers, explore the context of NH enrollment in nutrition and dietetics, and the contribution of dietetics to the NH community.

PARTICIPANTS/SETTING

Eighty-one NH students enrolled in a nutrition course across the UH system were surveyed. Nine of the 81 NH students surveyed, eight NH alumni, and persons from 15 identified supporting agencies were interviewed.

ANALYSIS

Survey responses were descriptively analyzed. Open-ended survey questions and interviews were analyzed through content analysis. To ensure findings were guided by NH perspective, data were triangulated by researchers and a NH dietetics advisory council.

RESULTS

Food and chronic disease prevention and management were topics that drew NH students to the field. Bridge/scholarship programs supported NH academic achievement. Education-related cost was a perceived barrier. Alumni and students shared varying degrees of responsibility to serve the NH community. Increasing the connection between NH values and the nutrition and dietetics curriculum are an identified need.

CONCLUSION

Findings illuminate opportunities to drive future programmatic efforts. The framework used in this study should be adaptable to other programs to support overall dietetics diversity initiatives.

Impact of hands-on practice with HugoRAS and Versius System simulators on the attractiveness of robotic surgery among medical and nurse undergraduate students

The scenario of robotic surgery is rapidly evolving with the introduction of new robotic systems. A structured learning program in robotic surgery during academic education is often lacking, especially for undergraduates; as a result, many students may be unaware of indications to robotic surgery and technological progress. The aim of the study is to evaluate the knowledge and interest toward robotic surgery of medical and nurse students, and to analyze how the attractiveness may change after a hand-on training course with new simulators of Hugo RAS and Versius System. We performed a cross-sectional study involving medical and nurse students recruited on a voluntary basis at ASST Santi Paolo and Carlo, Milan; participants were invited to join a hands-on practice simulation with the Hugo RAS and/or Versius Trainer Simulator. Before the hand-on exercise, students were asked to fulfill an online anonymous questionnaire addressing knowledge and interest toward robotic surgery. After a 2-h hands-on exercises at the Hugo RAS and/or at the Versius Trainer simulator (preceded by a brief lecture on robotic surgery and new systems), participants were asked to complete a second-round questionnaire to evaluate changes in attractiveness toward robotic surgery. Data were recorded in a database; after a descriptive analysis of the variables, median values were compared with the Mann-Whitney U test, frequencies with the Fisher's exact test and in the case of paired observations (before and after the simulation), the Mc Nemar test was used. Forty-one undergraduates agreed to participate. Twenty-three nursing students and 18 medical students were recruited. Some of them had a basic knowledge in robotic surgery and were able to figure out some surgical indications, given the presence of a robotic program already settled up at the institution. Before the hands-on course, 44.0% nurse students and 36.6% of medical students were interested in surgical disciplines and robotic surgery. After the simulation, all students (100%) reported a high level of interest in robotic surgery and some of them required for a dedicated internship (p < 0.001). The students provided also feedback on the perceived ease-of-use of the robotic simulators (on a scale 0-10); overall, the median score was 8, IQR [7-8], with no differences between nursing and medical students (p = 0.482). In conclusion, the study demonstrates a great interest toward robotic surgery as a part of medical and nurse education. A hands-on simulation further improved the interest of undergraduates from both backgrounds. The technological progress with the availability of new surgical systems will be the future challenge of training programs and should be considered at all levels of education.

Clinical pharmacy undergraduate education in China: a comparative analysis based on ten universities' training programs

BACKGROUND

In recent years, the scale of personnel training for clinical pharmacy professionals in China has expanded increasingly, however, the shortage of clinical pharmacists is still prominent. In 2018, the Ministry of Education of China released national standards for the teaching quality of undergraduate majors at regular colleges and universities, which has developed a core policy for undergraduate clinical pharmacy training. To explore the training methods for clinical pharmacy professionals in China and to promote the healthy and sustainable development of the clinical pharmacy education system. This study comparatively analyzed the training programs for clinical pharmacy undergraduates in China's ten universities, discussed training programs suitable for clinical pharmacy professionals in China.

METHODS

The clinical pharmacy education programs in these ten universities were obtained through official school websites or by interviewing relevant people, and then compared and analyzed.

RESULTS

The school with the largest number of courses and the most class hours in general courses is University A1 (34 courses, 1316 class hours), and the school with the most credits is University B1 (75.5 credits). The schools with the largest number of courses and the most class hours in the basic courses are University A1 (50 courses, 1997 class hours), and the schools with the most credits are University B3 and University B1 (105.5 credits). The schools with the largest number of courses in the core courses are University C1 (23 courses), and the school with the most credits and class hours is University B2 (51 credits, 914 class hours). The school with the most class hours in practical teaching is University B6 (1406 class hours), and the schools with the longest internship time are University A1 and University B6 (52 weeks).

CONCLUSIONS

There was substantial variation in programs. There remains a gap between the existing educational model and clinical training in pharmacy in China and developed countries. China should explore the most appropriate method for undergraduate education in clinical pharmacy based on studying foreign excellent educational models and the experience of China.

Co-curricular Immersion as a Public-Private Capacity Building Activity

The COVID-19 pandemic exacerbated the already increasing challenge of establishing immersive, co-curricular activities for engineering students, particularly for biomedical-related activities. In the current work, we outline a strategy for co-curricular learning that leverages a private-public partnership in which methods for capacity-building have enabled mutually beneficial outcomes for both organizations. A contemporary issue for many non-profits is identifying effective ways to build capacity for consistent service delivery while at the same time embracing the volunteer activities of students; a challenge is that the lifecycle of a university student is often not aligned (much shorter) with the needs of the non-profit. The public-private partnership simultaneously meets the service motivation of students with the needs of the host. This paper includes two case studies that illustrate the implementation of the methods for capacity-building and related outcomes.

Perception from students regarding online synchronous interactive teaching in the clinical year during COVID-19 pandemic

AIM

The global pandemic of COVID-19 has led to extensive practice of online learning. Our main objective is to compare different online synchronous interactive learning activities to evaluate students' perceptions. Moreover, we also aim to identify factors influencing their perceptions in these classes.

METHODS

A cross-sectional, questionnaire-based study focusing on clinical year medical students' perceptions and feedback was conducted between February 2021 -June 2021 at the University of Hong Kong. Online learning activities were divided into bedside teaching, practical skill session, problem-based learning (PBL) or tutorial, and lecture. A questionnaire based on the Dundee Ready Education Environment Measure (DREEM) was distributed to 716 clinical year students to document their perceptions.

RESULTS

One hundred responses were received with a response rate of 15.4% (110/716, including 96 from bedside teaching, 67 from practical skill session, 104 from PBL/tutorial, and 101 from lecture). For the mean score of the DREEM-extracted questionnaire, online PBL/tutorial scored the highest (2.72 ± 0.54), while bedside scored the lowest (2.38 ± 0.68, p = 0.001). Meanwhile, there was no significant difference when we compared different school years (p = 0.39), age (p = 0.37), gender (p = 1.00), year of internet experience (<17 vs ≥17 years p = 0.59), or prior online class experience (p = 0.62). When asked about students' preference for online vs face-to-face classes. Students showed higher preferences for online PBL/tutorial (2.06 ± 0.75) and lectures (2.27 ± 0.81). Distraction remains a significant problem across all four learning activities. A multivariate analysis was performed regarding students' reported behavior in comparison with their perception through the DREEM-extracted questionnaire. The results showed that good audio and video quality had a significant and positive correlation with their perception of online bedside teaching, practical skill sessions, and PBL/tutorial. It also showed that the use of the video camera correlated with an increase in perception scores for lectures.

CONCLUSION

The present analysis has demonstrated that students' perception of different online synchronous interactive learning activities varies. Further investigations are required on minimizing distraction during online classes.

Clinical students' reflections on the preclinical anatomy learning experience

Objectives

Anatomy is a fundamental pillar of medical knowledge that bridges basic medical science knowledge and clinical practice. However, integrated modern medical curricula have reduced the anatomy teaching content, and cadaveric dissection is no longer conducted. Medical graduates who lack anatomy knowledge are anticipated to be inadequately equipped for safe clinical practice. This study was aimed at exploring clinical year students' experiences regarding their anatomy learning during the preclinical phase in Malaysian medical schools. The findings reflect how the students' preclinical anatomy training prepared them for their clinical years of study.

Methods

A qualitative phenomenology study using the focus group discussion method was conducted on 30 final-year students from four public universities. Four focus group discussion sessions were conducted, and students' responses were transcribed and converted to electronic formats. The transcripts were analyzed thematically with ATLAS.ti software.

Results

The first-cycle coding of the text analysis generated 157 open codes based on the phrases used by the participants. The subsequent coding cycle produced 16 axial codes-groups of open codes with similar features. During the final coding cycle, the content and interrelations between the axial codes were categorized into six codes: (1) preclinical anatomy learning experience, (2) anatomy content and teaching, (3) anatomy-related competency, (4) the importance of anatomy knowledge in clinical practice, (5) the importance of early exposure to applied clinical anatomy, and (6) suggestions for future anatomy education.

Conclusions

The six identified themes reflected students' perceptions of their anatomy learning experience, the challenges that they faced during their preclinical years, and their opinions regarding the anatomy knowledge and skills that are functionally relevant during the clinical years. Their responses also echoed the need to improve anatomy teaching and learning, thereby emphasizing the importance of early clinical integration and application.

Comparison of PRISM and numeric scale for self-assessment of learning progress during a clinical course in undergraduate dental students

OBJECTIVES

To compare Pictorial Representation of Illness and Self-Measure (PRISM) and a numeric scale for self-reflection in dental students.

METHODS

Fourth year dental students were randomly assigned to each receive one interview based on PRISM or a numeric scale to self-assess their competencies at the beginning (t1), the middle (t2) and the end (t3) of integrated clinical course. Questionnaires were used to assess self-perceived benefit of the interviews at each time points.

RESULTS

Students in PRISM group perceived a higher benefit regarding the self-assessment of their practical skills at all time points (P < 0.05), for theoretical knowledge at t2 and t3 (P < 0.05) and reaching the course objectives at t3 (P = 0.04). At all time points, PRISM group rated their interview (P = 0.04), the applied instrument (PRISM, P = 0.01) and the benefit of the combination of both higher than numeric scale group (P < 0.05).

CONCLUSION

In this preliminary study, PRISM was superior against a numeric scale and can be recommended for dental education to facilitate self-assessment.

Neurophobia: A Side Effect of Neuroanatomy Education?

Neuroanatomy in the medical curriculum tends to be challenging for both lecturers and students. Students and lecturers perceive the relevance and importance of neuroanatomy differently. If not taught sufficiently, students develop a dislike or fear (termed neurophobia) for the subject. This fear prevents them from being receptive to the teaching and consequently applying the neuroanatomy knowledge in the clinical environment. Information on the approach and perception of undergraduate neuroanatomy lecturers in South Africa regarding neuroanatomy in the medical curriculum is scarce and inconclusive. A study was undertaken to explore the attitudes and perceptions of neuroanatomy lecturers towards the relevance of neuroanatomy, as well as the teaching techniques and approach thereof, in the medical curriculum. In order to determine whether the lecturers' teaching approach and attitudes could be a contributing factor to neurophobia. In a cross-sectional qualitative study, neuroanatomy lecturers from the nine South African medical schools were invited to complete an anonymous online questionnaire. Results were thematically analysed and grouped. Lecturing staff from seven of the medical schools participated in this study and included fourteen respondents. The respondents classified themselves mainly as either proficient (78.6%) or experts (15.8%) in their neuroanatomy teaching experience. All the respondents acknowledged that neuroanatomy is important in their students' medical training. A lecturer's perceptions and attitude towards the subject or content, greatly affect the facilitation approaches and techniques used. This might have far- reaching consequences for students as it might impact on their attitude towards the content.

[Exploration for and Practice of New-Model Undergraduate Education for Innovative Talents in Biomedicine]

With the rapid development of modern biomedical technology industry, background and knowledge of a single discipline will not be adequate to meet the needs of research and development of cutting-edge technology. The cultivation of innovative research talents with interdisciplinary background at the undergraduate level poses great challenges for higher education institutions. National-level research institutes, including state key laboratories and national clinical research centers, for example, have an enormous supply of technological human resources and resources for research and teaching, which is of critical importance for the training of innovative talents at the undergraduate level. Herein, taking as an example the West China Innovation Class of State Key Laboratory of Biotherapy, a special undergraduate program founded by the State Key Laboratory of Biotherapy, Sichuan University in 2016, we reported on the explorations and practices of a new model for cultivating innovative research talents at the undergraduate level. The new model features the leadership of a national-level research institute and an interdisciplinary approach.

Balancing acting and adapting: a qualitative study of medical students' experiences of early clinical placement

BACKGROUND

Clinical learning experience is an important part of medical education. In the clinical learning environment, students are exposed to various aspects of medical care and may train their skills under supervision. Supervision, in which students' learning needs and the outcomes of placements are met, is essential. The aim of this study was to explore medical students' experiences of the early stages of clinical training.

METHODS

In 2021, 18 individual semi-structured interviews were conducted with medical students after their first clinical placements in semester 5. The interviews were transcribed verbatim and analyzed using qualitative content analysis according to Graneim and Lundman.

RESULTS

The findings resulted in an overall theme: balancing acting and adapting. Three categories described that the clinical learning environment was a big leap from campus, that personal relationships influenced learning, and that the organization of clinical placements was suboptimal. The students were encouraged to push themselves forward to practice clinical skills. This, however, did not suit all the students; the cautious ones risked becoming passive spectators. The intended learning outcomes were not frequently used; rather, the supervisors asked the students what they had learned, or the students focused on what seemed to be important on the ward. The students tried to adapt to their supervisors' working situation and not to be a burden to them.

CONCLUSIONS

Our findings show that the transition from learning on campus was sometimes abrupt, as the students had to switch to a more active learning role. Ad hoc solutions in supervision occurred, which contributed to the experience that educational responsibilities were downgraded and the opportunities for clinical training varied. Rather than trying to change the circumstances, the students opted to adapt to the busy clinical learning environment.

Supporting College Choice Among International Students through Collaborative Filtering

In this paper we use historic score-reporting records and test-taker metadata to inform data-driven recommendations that support international students in their choice of undergraduate institutions for study in the United States. We investigate the use of Structural Topic Modeling (STM) as a context-aware, probabilistic recommendation method that uses test-takers' selections and metadata to model the latent space of college preferences. We present the model results from two perspectives: 1) to understand the impact of TOEFL score and test year on test-takers' preferences and choices and 2) to recommend to the test-taker additional undergraduate institutions for application consideration. We find that TOEFL scores can explain variance in the probability that test-takers belong to certain preference-groups and, by accounting for this, our system adjusts recommendations based on student score. We also find that the inclusion of year, while not significantly altering recommendations, does enable us to capture minor changes in the relative popularity of similar institutions. The performance of this model demonstrates the utility of this approach for providing students with personalized college recommendations and offers a useful baseline approach that can be extended with additional data sources.

A mobile platform-based app to assist undergraduate learning of human kinematics in biomechanics courses

Whole-body biomechanics examines different physical characteristics of the human body movement by applying principles of Newtonian mechanics. Therefore, undergraduate biomechanics courses are highly demanding in mathematics and physics. While the inclusion of laboratory experiences can augment student comprehension of biomechanics concepts, the cost and the required expertise associated with experiment equipment can be a burden of offering laboratory sessions. In this study, we developed a mobile app to facilitate learning human kinematics in biomechanics curriculums. First, a mobile-based computer-vision algorithm that is based on Convolutional pose machine (CPM), MobileNet V2, and TensorFlow Lite framework is adopted to reconstruct 2D human poses from the images collected by a mobile device camera. Key joint locations are then applied to the human kinematics variable estimator for human kinematics analysis. Simultaneously, students can view various kinematics data for a selected joint or body segment in real-time through the user interface of the mobile device. The proposed app can serve as a potential instructional tool to assist in conducting human motion experiments in biomechanics courses.

ESO-ESSO-ESTRO Multidisciplinary Course in Oncology for Medical Students: 4 Years of Experience (2016-2019)

The ESO-ESSO-ESTRO Multidisciplinary Course in Oncology is intended to fill the gap of the undergraduate fragmented oncology education, to provide insight into all theoretical and practical aspects of oncology, and to encourage future professional choices towards an oncology discipline. Students are exposed to (a) preclinical cancer topics; (b) natural history of the disease; (c) laboratory diagnostic tests; (d) medical, radiation, surgical, and palliative treatment; and (e) direct or through multidisciplinary patients' approach. Students are obliged to attend (i) all theoretical lectures, (ii) clinical case presentations, (iii) laboratories and ward visits, and (iv) to prepare and present a specific project under supervision. Participation is limited to 24 medical students who are selected through a competitive application process. Between 2016 and 2019, 96 students from 29 countries have attended. Data analysis derived from a given questionnaire demonstrates that most of the participants have declared that (1) they have achieved their expectations and objectives, (2) they have highly rated both clinical and non-clinical teaching oncological topics, and (3) they have been stimulated in developing a professional career in the field of oncology.

Pilot study to evaluate a novel measure of self-perceived competencies among dental students

BACKGROUND

PRISM is a novel approach to support self-reflection and learning appraisal in dental students, based on a visual metaphor. The aim of this study was to evaluate whether PRISM measurments would be reproducible and sensitive to detect learning progress in undergraduate dental students in their clinical years.

METHODS

Voluntarily participating dental students were included. To evaluate reproducibility, a mixed cohort of 10 students each in 3^rd, 4^th and 5^th year (total n = 30) was recruited and received three identically structured PRISM interviews within one week without any other teaching events. To assess perceived learning progress, 29 volunteer 3^rd year students participated in three interviews during their clinical simulation course (beginning, middle, end). Distances between Subject and Objects was measured in millimeter; objects were classified into close or branched clusters depending on their distance from each other on the PRISM board.

RESULTS

Values for perceived competencies within PRISM interviews during one week were comparable between the three time points in the mixed cohort (n = 30; p > 0.05). Comparing the three subgroups (3^rd, 4^th and 5^th year, each n = 10), PRISM indicated that 3^rd year students perceived their competencies are significantly lower than the 4^th and 5^th year students (p < 0.01). 3^rd year students had less often a branched cluster of objects than the other two groups (p < 0.05). PRISM showed that over time, 3^rd year students perceived a gain in their competencies in conservative dentistry and its sub-disciplines (p ≤ 0.01). The PRISM data indicated that by the end of the simulation course, the students appeared to show higher discrimination of their self-perceptions between sub-topics in conservative dentistry than at the start of the course (p = 0.01).

CONCLUSION

PRISM yields a reproducible measure of individual students' learning progress. It is a promising novel approach for appraisal in dental education. Further work is needed to confirm the generalisability of the findings.

Perceptions on the current content and pedagogical approaches used in end-of-life care education among undergraduate nursing students: a qualitative, descriptive study

BACKGROUND

With the aging of the population, high rates of cancer and comorbidity complexity, the end-of-life care for patients will be ever more important. Nurses have always played an essential role in end-of-life care. Insufficient education and training in end-of-life care has been regarded as a major reason of inadequate symptom recognition, symptom management, and communication which results in mental trauma for both the patient's family and attending health care providers. Undergraduate nurses do end-of-life care as part of their clinical learning. However, undergraduate nurses' perceptions of the education they received about end-of-life care are not documented.

OBJECTIVE

This study aimed to critically explore the current state of education regarding end-of-life care from the perspectives of undergraduate nurses.

METHODS

We used a descriptive qualitative design. Face-to-face semi-structured interviews were conducted from May to August 2020, with a purposive sample of 15 fourth-year undergraduate nurses who finished the internship. Data were transcribed verbatim and analyzed using content analysis.

FINDINGS

Three main themes relating to undergraduate nurses' experiences of end-of-life care education emerged from the thematic analysis: 1) Universities provide foundational knowledge about end-of-life care, but it still needs improvement; 2) Clinical practice consolidates and drives undergraduate nurses' knowledge, skills and confidence about end-of-life care; and 3) cultural attitudes of patients' family toward disease and death sometimes impedes learning and knowledge translation about end-of-life care.

CONCLUSION

Undergraduate nursing students benefit from not only theoretical content delivered in the university setting but also practice happened on clinical placement. The current undergraduate curriculum, related to end-of-life care, is disjointed. Meanwhile, undergraduate nurses' learning and knowledge translation of end-of-life care are impeded by cultural attitudes toward disease and death.

Research-based education in undergraduate occupational therapy and physiotherapy education programmes: a scoping review

BACKGROUND

In a research-based learning environment, students learn how to become critical thinkers and lifelong learners, and to generate discipline-enriching knowledge. Research training is important for all healthcare professionals and the integration of research in education can be one approach to improve evidence-based practice among future professionals. The purpose of this scoping review was to identify studies reporting on research-based education in undergraduate occupational therapy and physiotherapy curricula to document the current state of knowledge and to map factors that reflect and support the implementation of research-based education in undergraduate occupational therapy and physiotherapy programmes.

METHODS

A scoping review was used to systematically select and summarize existing literature. The search was conducted using a combination of keywords and MeSH terms in the following databases: EBSCO (Academic Search Elite, CINAHL, ERIC), MEDLINE, Embase, Education Source and grey literature. A thematic analysis identified strategies used to implement and promote research-based education in occupational therapy and physiotherapy bachelor programmes.

RESULTS

The database search identified 3068 records. 75 were eligible for full-text assessment and 27 studies were included. The studies were published between 1999 and 2021 and were conducted in Norway, Canada, South Africa, Australia, the United Kingdom, the United States, New Zealand, Ireland, Taiwan, Italy, and Iran. The study designs were mainly quantitative and qualitative, and studies included primarily occupational therapy and physiotherapy students. We identified the following four strategies: 'student engagement in research', 'curriculum improvement regarding EBP', 'EBP teaching' and 'journal club', where 'EBP teaching' was most frequently identified.

CONCLUSIONS

Findings from this scoping review suggest that ensuring students' competence in research methods is necessary for students to be able to read and understand research articles, which are important as foundational skills in undergraduate research training. Journal clubs can be a foundation for student engagement with research literature, and students' basic research skills may be facilitated through their involvement in research projects and by conducting systematic reviews. Further, cooperation with clinical practice is important, and the awareness of research-based education should be increased among both faculty members and students.

Opening up a tailored tutor qualification program for medical students to other healthcare students - a mixed-method study

BACKGROUND

Peer-led tutorials are widely used in medical education to promote practical skills acquisition and support faculty staff. Typically, student tutors are custom trained for this specific task. We investigated whether opening up an existing medical tutor qualification program to other degree programs is successful in terms of acceptance among students, acquisition of tutor-specific and interprofessional competencies, and which factors contribute to success or failure.

METHODS

We developed a two-day tutor qualification program and conducted it annually from 2016 to 2020 with medical and other healthcare students. At the end of each course, we administered a written survey in which the participants rated the following items: their attitudes towards interprofessional learning (using the UWE-IP-D Interprofessional Learning Scale), the interprofessional learning setting, the teaching approach, and their competency acquisition (each on a five-point Likert scale; 1 = strongly agree, 5 = strongly disagree). Furthermore, we assessed participants' qualitative feedback in free-text fields and performed inductive content analyses.

RESULTS

The study participation rate was high (response rate 97%; medical students: n = 75; healthcare students: n = 22). Participants stated high levels of competency acquisition (total M = 1.59, individual items' M's ranging from 1.20 to 2.05) and even higher satisfaction with the teaching approach (total M = 1.28, individual items' M's ranging from 1.43 to 1.05). Overall satisfaction with the training was M = 1.22; SD = 0.58. No significant differences in ratings were found between the student groups. The qualitative results showed that students appreciated the interprofessional setting and experienced it as enriching. The most positive feedback was found in didactics/teaching methods on role-plays and group work; most suggestions for improvement were found in the area of structure and organisation on breaks and time management.

CONCLUSIONS

Opening up an existing medical tutor qualification program to other student groups can be seen as fruitful to teach not only tutor-related aspects but also interprofessional competencies. The results demonstrate the importance of detailed planning that considers group composition and contextual conditions and provides interactive teaching methods to promote interprofessional experiences. This study offers important information about prerequisites and methodological implementation that could be important for the interprofessional redesign of existing training programs.

Data set and methodology involving pedagogical approaches to teach mental health and substance use in dental education

Objective

In this Data note, we provide a raw data set in the form of brief self-guided reflections. We also present the methodological approach to generate these reflections including an educational vignette so that other dental schools can plan for their teaching activities involving mental health and substance use topics.

Data description

Between 2015/16 and 2018/19, the University of British Columbia’s (UBC) undergraduate dental and dental hygiene students submitted optional written guided reflections to address ‘how can an educational vignette, depicting a patient with a history of substance use and mental health disorders accessing dental care, promote an open dialogue about stigma?’ From a total of 323 undergraduate students, 148 anonymous reflections between 200 and 400 characters each were received. The main ideas that may emerge from the reflections include ‘exploring power relations’ and ‘patient-centered care approach to counteract stigma’.

Development and Implementation of a Biometrics Device Design Project in an Introductory BME Course to Support Student Wellness

Mental health challenges have been rising across college campuses. To destigmatize wellness practices and promote student mental health, we present a novel technical project in an introductory bioengineering course that explores stress management techniques through physiology, biosensors, and design. We hypothesize that if students measure objective, physiologic impacts of stress management techniques on themselves, they may be more likely to realize the benefits and use those techniques when needed. Additionally, through this data-driven project, we aim to appeal to engineers' critical thinking nature. To support students in selecting stress management techniques for themselves, mindfulness is introduced and practiced in the course. Initial student feedback on the introduction of mindfulness into the classroom is positive. The COVID-19 pandemic has emphasized the need to focus on student wellbeing in addition to physical health. Integration of wellness into the core curriculum can normalize the use of these resources within engineering departments and colleges and equip students with stress management tools for their careers. Ultimately, this curricular development lays the groundwork for institutional enhancement of undergraduate STEM education by supporting student wellness through the engineering curriculum.

Supplementary Information

The online version contains supplementary material available at 10.1007/s43683-021-00060-1.

Outside the Classroom: An Evaluation of Equine Internships1

Equine internships provide real world experience for students but are lightly researched. This study explored student perceptions of equine internships. We hypothesized participants would report that equine internships were valuable and relate value with compensation, skill acquisition, networking, and job offers. An online survey examined respondents' perceived value of their internship. Of 228 respondents, 186 met the inclusion criteria. Data were examined using frequency counts, correlations, and chi-square contingency tables. Breeding internships (29%) were most common, with western training and performance (18%) second highest. Half (53%) had an internship requirement for their undergraduate degree; this did not affect perceived internship value (P = 0.76). Internship value tended to be higher when housing (P = 0.075) or compensation (P = 0.057) were included. Most (91%) believed their internship added to their classroom experience; 71% felt academically prepared. Respondents gained equine-related skills (81%), soft skills (83%), customer relations (63%), business management (51%), and administrative skills (33%). Of respondents, 67% use skills gained during their internship in their current job, and 83% were able to network within the equine industry. Half of internships resulted in a job offer from that company or another offer in their area of interest. Overall, 91% of the respondents felt their internship was valuable, and 87% would recommend their internship to other students. Perceived internship value positively correlated with networking (R=0.75; P<0.0001), gaining equine skills (R=0.49; P<0.0001), and job offers (R=0.24; P<0.002). These results suggest that equine internships are positive experiences and valuable for students.

Revisiting the ATP 30: the Factor Structure of a Scale Measuring Medical Students' Attitudes Towards Psychiatry

OBJECTIVE

Among the scales developed for assessing medical students' attitudes regarding psychiatry, "attitude towards psychiatry-30" (ATP-30) is probably the most widely used. Although this scale was originally deemed to form a unitary dimension without any meaningful subscales, the authors sought to re-examine its factor structure and the viability of subscales.

METHOD

Secondary data from a survey of 743 final-year medical students from nine medical schools in Sri Lanka were analyzed using exploratory factor analysis (EFA) with promax rotation and confirmatory factor analysis (CFA), to assess the underlying factor structure of ATP-30. Parallel analysis was used in determining the number of factors to retain. Items conceptually external to the emerging factors were discarded.

RESULTS

Three models based on literature (one-, five-, and eight-factor) were disproved by CFA. A six-factor solution encompassing 18 items was supported by EFA and CFA and was gender-invariant. These factors were, namely, the image of psychiatrists, psychiatric patients and mental illness, the efficacy of treatment, psychiatric teaching, career choice, and psychiatry as an evidence-based discipline. While "the image of psychiatrists" formed the most consistent subscale (ω = 0.71), the internal consistencies of the other subscales were modest (ω = 0.55-0.67). The overall 18-item scale showed good internal consistency (ω = 0.78).

CONCLUSION

The findings provide evidence of a multi-dimensional structure in medical students' attitudes towards psychiatry, endorsing six meaningful subscales of the ATP-30. Future researchers and educators can utilize these subscales in identifying specific areas where students' attitudes are more stigmatized, to be intervened during undergraduate training.

"Now I know how to not repeat history": Teaching and Learning Through a Pandemic with the Medical Humanities

We reflect on our experience co-teaching a medical humanities elective, "Pandemics and Plagues," which was offered to undergraduates during the Spring 2021 semester, and discuss student reactions to studying epidemic disease from multidisciplinary medical humanities perspectives while living through the world Covid-19 pandemic. The course incorporated basic microbiology and epidemiology into discussions of how epidemics from the Black Death to HIV/AIDS have been portrayed in history, literature, art, music, and journalism. Students self-assessed their learning gains and offered their insights using the SALG (Student Assessment of their Learning Gains), describing how the course enhanced their understanding of the current pandemic. In class discussions and written assignments, students paid particular attention to issues of social justice, political context, and connections between past pandemics and Covid-19. Student responses indicate enhanced understanding of the scientific and medical aspects of epidemics and also increased appreciation of the insights to be gained from the medical humanities. We discuss co-teaching the class during a real-time, twenty-four-hour-news-cycle pandemic, and the ways in which that experience underlines the value of a "critical medical humanities" approach for undergraduates.

"Learning by Doing": a Mixed-Methods Study to Identify Why Body Painting Can Be a Powerful Approach for Teaching Surface Anatomy to Health Science Students

Introduction

Teaching human anatomy to produce deeper understandings and knowledge retention in learners requires meaningful, engaging, and practical activities. Previous studies identify that most students who participated in body painting (BP) reported improved understanding of surface anatomy (SA). This study investigates the key factors underpinning how BP helps students learn SA.

Methods

The study involved an explanatory mixed-methods approach. Towards the end of an anatomy course, a survey was administered to three cohorts of first-year chiropractic, osteopathy, and Chinese medicine students and second-year biomedical sciences students over 3 years (n = 311; response rate = 30%). The survey assessed the effectiveness of BP as a hands-on, group-based approach for learning SA in practical class. Three student focus groups (n = 13) explored the key survey findings.

Results

Overall, 72% of student respondents reported BP activities helped them learn SA "quite a bit" or "very much". Multivariate analysis identified students found BP helped them learn SA by "remembering the position of the bones, joints, muscles, actions and insertions" (POR = 5.7; P < 0.001); "integrating textbook and other knowledge on a real live person" (POR = 2.4; P = 0.027); and "achieving a deeper understanding of SA" (POR = 5.2; P < 0.001). The qualitative findings describe specifically how BP helps students learn, understand, and remember SA.

Conclusions

The findings show the majority of students believed BP benefitted their learning of SA through enhancing engagement in self-directed classroom and out-of-hours learning opportunities, deeper understandings of form and function, retention of knowledge, and practical physical examination experiences palpating the variations in form between individuals.

Comparison of Haptic and Biometric Properties, Bacterial Load, and Student Perception of Fixative Solutions: Formaldehyde Versus Chilean Conservative Fixative Solution with and without Formaldehyde in Pig Kidneys

One of the most widely used solutions to fix and preserve organic tissues is formaldehyde, despite reservations regarding its toxicity and the fact that formaldehyde-embalmed bodies lose their original characteristics. Anatomy laboratories have been replacing formaldehyde with solutions that retain the characteristics of fresh tissue. For this purpose, alternative solutions with a very low concentration of formaldehyde or without any formaldehyde have been analyzed. The objective of this study was to compare biometry, coloration, haptic properties, and bacterial load on animal specimens (pig kidneys) embalmed with formaldehyde, and with Chilean Conservative Fixative Solution with and without formaldehyde (formaldehyde chCFS and formaldehyde-free chCFS). Also, the perception of health and biological science students toward specimens treated with different solutions was assessed. The results indicated that there were no significant differences in specimens' retraction, or bacterial load. Students showed a preference for organs embalmed in formaldehyde chCFS and formaldehyde-free chCFS; indicating that with these treatments they could better visualize structures and that the prosections had greater flexibility and the colors were more similar to those of fresh tissue. Additionally, students recommended the material embalmed in formaldehyde chCFS and formaldehyde-free chCFS for anatomy learning. In contrast, students indicated that formaldehyde-fixation negatively affected their practical experience. In conclusion, embalming with formaldehyde chCFS or formaldehyde-free chCFS provides an advantageous practical experience over the use of formaldehyde and may be an alternative to replace the use of formaldehyde in anatomy laboratories.

Millennial Medical Students' Educational Expectations of Anesthesia Clerkships

BACKGROUND

The unique characteristics of the millennial generation has promulgated changes in the workplace and in academia. A lack of national standards necessitates that anesthesia faculty create educational content for anesthesia clerkships. Assessing expectations before an anesthesia rotation would provide data to accommodate millennial medical students' needs and preferences for learning.

METHODS

A 16-question survey using Qualtrics software was created, with input from millennial medical students, to query preclinical medical students at the Oakland University William Beaumont School of Medicine on their educational expectations of an anesthesia clerkship.

RESULTS

Seventy-four surveys were completed, with 34 (46%) of 74 from first-year and 40 (54%) of 74 from second-year medical students. Daily feedback (44 [59%] of 74) and written exams (43 [58%] of 74) were preferred methods of evaluation. No lectures, observing in an operating room, and performing procedures on real patients were the preferred format for instruction. Two (23 [31%] or 74) to 3 (33 [45%] of 74) weeks was the preferred duration of an anesthesia rotation.

CONCLUSIONS

This study demonstrates that millennial medical students have preconceived educational expectations of an anesthesia clerkship, and identifies learning preferences that differ from the implemented anesthesia curriculum currently described in the literature.

"Finding My Own Way": The lived experience of undergraduate nursing students learning psychomotor skills during COVID-19

Background

Little is known about how nursing students learned psychomotor skills during the COVID-19 pandemic.

Aims

What is the lived experience of undergraduate nursing students learning psychomotor skills during the COVID-19 pandemic?

Methods

Using a phenomenological approach, eight undergraduate nursing students were interviewed about their experiences learning psychomotor skills during the pandemic.

Results

Thematic analysis revealed three main themes. “Finding My Own Way” described adapting learning styles and advocacy for learning. Sub-themes included perseverance and comradery. “Learning the Skills” described modifications to skills learning. Sub-themes included grace by professors, smaller group sizes, less practice, and “my brain is split in half,” describing the challenges of giving dual attention to COVID-19 and skills learning. “Stress of the Pandemic” described the stress of quarantine, isolation and online learning.

Discussion

Findings of this study may help nurse educators understand the challenges of learning skills during the pandemic. Implications are discussed.

"The education is a mirror of where palliative care stands in Israel today": An exploration of palliative care undergraduate education at medical schools in Israel

OBJECTIVE

Israel serves as a case study for understanding the importance of undergraduate palliative care (PC) education in implementing, developing, and enabling access to palliative care services. This article presents the findings collected from the five medical schools.

METHOD

This qualitative study supported by a survey explores and describes the state of undergraduate PC education at medical schools in Israel. The survey included questions on voluntary and mandatory courses, allocation of different course models, teaching methods, time frame, content, institutions involved, and examinations. Semi-structured interviews with teaching faculty were conducted at the same locations.

RESULTS

Eleven expert interviews and five surveys demonstrate that PC is taught as a mandatory subject at only two out of the five Israeli universities. To enhance PC in Israel, it needs to become a mandatory subject for all undergraduate medical students. To teach communication, cultural safety, and other basic competencies, new interactive teaching forms need to be developed and adapted. In this regard, nationwide cooperation is proposed. An exchange between medical schools and university clinics is seen as beneficial. The new generation of students is open to PC philosophy and multidimensional care provision but resources to support their growth as professionals and people remain limited.

SIGNIFICANCE OF RESULTS

This study underlines the importance of teaching in PC at medical schools. Undergraduate education is a central measure of PC status and should be used as such worldwide. The improvement of the teaching situation would automatically lead to a better practical implementation for the benefit of people. Medical schools should cooperate, as the formation of expertise exchange across medical schools would automatically lead to better PC education.

Comparison of Digital Camera Real-Time Display with Conventional Teaching Tube for Slit Lamp Microscopy Teaching

PURPOSE

To compare slit-lamp microscopy teaching outcomes with digital camera real-time display and conventional teaching tube in undergraduate education of clinical ophthalmology.

METHODS

Thirty-seven Year 4 medical students were assigned to two groups for slit lamp microscopy teaching with digital camera real-time display (n = 18) and teaching tube (n = 19). The outcome measures included a 5-item questionnaire on their experience and the quality of slit lamp photos taken by the students.

RESULTS

The overall satisfaction score was significantly higher in the group of digital camera real-time display compared with the group of teaching tube (4.5 ± 0.5 vs. 4.2 ± 0.7, P = .013). The former group also achieved higher quality score of the slit-lamp photography (4.1 ± 0.3 vs. 3.6 ± 0.5, P = .002).

CONCLUSIONS

The digital camera real-time display attachment is more effective in undergraduate ophthalmic education over conventional slit-lamp teaching tube. It is also more favored by students and is thus highly recommended for clinical ophthalmology education.

Fast-track flipping: flipped classroom framework development with open-source H5P interactive tools

BACKGROUND

The availability and popularity of laptops, tablet PCs and smartphones in private and work environments offers considerable potential for reasonably integrating blended learning formats into structured medical learning environments. The promising educational principle of the flipped classroom (FC) provides the opportunity to effectively combine e-learning and face-to-face teaching within a single framework. However, similar to most blended learning formats, the FC requires a solid groundwork of structured digitized learning content. As rearranging a whole curriculum is intense and time consuming, physicians occupied simultaneously in clinical practice and teaching may be confronted with a lack of time during this process.

METHODS

We developed two straightforward approaches to transforming a pre-existing, lecture-based otolaryngology curriculum into interactive videos within a Moodle learning management system. Special attention was given to reducing individual working time for medical professionals. Thus, while one approach was mainly guided by a medical professional to control the content-related quality of video processing, we investigated an alternative approach outsourcing work to a technician. Afterwards, the working time was analysed and compared. The resulting videos were revised with the H5P plugin for moodle to adjust the content where necessary.

RESULTS

We identified a fast-track approach for creating structured e-learning content suitable for flipped-classroom-based lectures, other blended learning formats, or even providing a whole curriculum online. The alternative approach significantly reduced working time for medical professionals but did not impair the content-related quality significantly.

CONCLUSIONS

The use of H5P interactive tools via Moodle LMS provides a major procedural benefit by allowing the easy adjustment of pre-existing video material into suitable online content. Reasonably outsourcing work to technicians can significantly reduce the working time of medical professionals without decreasing the quality of learning content. The presented workflow can be used as a flexible approach for flipped classroom frameworks or other blended learning strategies where interactive videos are applicable.

A multicentric study on stigma towards people with mental illness in health sciences students

BACKGROUND

There is evidence of negative attitudes among health professionals towards people with mental illness but there is also a knowledge gap on what training must be given to these health professionals during their education. The purpose of this study is to compare the attitudes of students of health sciences: nursing, medical, occupational therapy, and psychology.

METHODS

A comparative and cross-sectional study in which 927 final-year students from health sciences university programmes were evaluated using the Mental Illness: Clinicians' Attitudes (both MICA-2 and MICA-4) scale. The sample was taken in six universities from Chile and Spain.

RESULTS

We found consistent results indicating that stigma varies across university programmes. Medical and nursing students showed more negative attitudes than psychology and occupational therapy students in several stigma-related themes: recovery, dangerousness, uncomfortability, disclosure, and discriminatory behaviour.

CONCLUSIONS

Our study presents a relevant description of the attitudes of each university programme for education against stigma in the formative years. Results show that the biomedical understanding of mental disorders can have negative effects on attitudes, and that education based on the psychosocial model allows a more holistic view of the person over the diagnosis.

Integrating equity and social justice for indigenous peoples in undergraduate health professions education in Canada: a framework from a critical review of literature

Understanding how to create structural change by actively counteracting racialized ways of interacting with Indigenous peoples at an individual and organizational level within health care systems and health professions education is essential for creating a more inclusive, equitable, and healthier society. In health professions education, the primary means of teaching about health inequities has been to frame them as stemming from culturally or ethnically based issues. While attention to culturally specific practices can be valuable to health and healing in some contexts, education that solely focuses on Indigenous cultures risks perpetuating cultural stereotypes and othering, rather than focusing on how Eurocentric systems continue to exert oppressive effects on Indigenous peoples. We present an organizational transformation framework grounded in equitable partnerships from a comprehensive critical review of the literature on the integration of equity and social justice in undergraduate health professions education with a focus on Indigenous health. We did a thematic analysis of the results and discussions presented in the 26 selected articles to identify promising practices and challenges associated with the integration of equity and social justice in undergraduate health professions education. The framework resulting from this analysis is composed of three interrelated components: 1) adopt critical pedagogical approaches that promote Indigenous epistemologies; 2) partner with Indigenous students, educators and communities; 3) engage educators in critical pedagogical approaches and health equity issues. This framework could guide the development of contextually tailored interventions that contribute to decolonizing health professions education.