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Schreidah CM, Robinson LN, Pham DX, Balaji D, Tinsley MS. The Case for Advocacy Curricula and Opportunities in Medical Education: Past Examples to Inform Future Instruction. Acad Med 2024; 99:482-486. [PMID: 38166320 DOI: 10.1097/acm.0000000000005615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
ABSTRACT With recent advances in understanding racial, socioeconomic, and mental health issues in medicine and their relation to policy and legislation, medical professionals are increasingly involved in local and national advocacy efforts. At the frontlines of these initiatives are medical students who, in addition to completing required coursework and clinical training, devote themselves to serving patients through civic participation. The burgeoning evidence concerning health care disparities and inequity, along with greater awareness of racial and socioeconomic discrimination, have made advocacy an essential aspect of many students' medical training. Every year, thousands of medical students join national medical advocacy organizations, in addition to regional, state, and local groups. Despite the rich history of medical student involvement in advocacy, there remains much speculation and skepticism about the practice as an essential component of the medical profession. From early initiatives pushing for national health insurance after World War II to encouraging antidiscrimination policies and practices, medical students have been collectively working to create change for themselves and their patients. Through efforts such as banning smoking on airplanes, creating safe syringe programs, and protesting against police brutality, many medical students work tirelessly in advocacy despite minimal educational support or guidance about the advocacy process. Given that medical student advocacy continues to grow and has shown measurable successes in the past, the authors believe that these efforts should be rewarded and expanded upon. The authors examine historical examples of medical student advocacy to suggest ways in which advocacy can be integrated into core medical school curricula and activities. They call attention to opportunities to support students' development of knowledge and skills to facilitate legislative change, expansion of interprofessional collaborations and credit, and curricular updates to promote social and health equity.
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Hildenbrand T, Kuhn S, Everad F, Hassepaß F, Neudert M, Offergeld C. [Views of assistant professors on digital transformation in otorhinolaryngology education : Current status and perspectives in undergraduate and advanced training]. HNO 2024; 72:303-309. [PMID: 38587662 PMCID: PMC11045641 DOI: 10.1007/s00106-024-01468-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Digital transformation in curricular teaching in medicine comprises the use of digital teaching and learning formats as well as the transfer of digital skills for medical staff. Concepts of knowledge transfer and competency profiles also have to be adapted and transferred in advanced training due to necessary changes. OBJECTIVE The aim of this study was an evaluation of the current state of digital transformation in otorhinolaryngology teaching in undergraduate and advanced training at otorhinolaryngology departments of university medical centers in Germany. MATERIALS AND METHODS A questionnaire with nine questions on digital transformation was sent to the assistant professors of 37 national university ENT departments. The anonymous survey was conducted online via the online platform SurveyMonkey®. RESULTS Of the contacted assistant professors, 86.5% participated in the survey. Teaching sessions on digital skills for medical students are part of the curriculum in only 25% of ENT departments. Digital teaching formats are used by half of the departments in undergraduate training. Only 56.25% of the assistant professors receive support to realize the changes required by digital transformation. In 40.62% of departments, the issue of digital transformation is broached during advanced training, but only 28.12% use digital teaching methods to train junior doctors. CONCLUSION Aspects of digital transformation are implemented mainly in undergraduate education, partly driven by the COVID 19 pandemic. Overall, there is still considerable backlog in undergraduate and advanced training in ENT.
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Affiliation(s)
- T Hildenbrand
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
| | - S Kuhn
- Institut für Digitale Medizin, Universitätsklinikum Gießen-Marburg & Philipps-Universität Marburg, Marburg, Deutschland
| | - F Everad
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - F Hassepaß
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - M Neudert
- Klinik für Hals-Nasen- und Ohrenheilkunde, Universitätsklinikum Carl-Gustav-Carus, Dresden, Deutschland
| | - C Offergeld
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
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Neff KE, Puttagunta KS, Grob KL, Ahmed AZ, Daniel MM. Institutionalizing Health Justice Frameworks in Medical Education. Acad Med 2021; 96:S194-S195. [PMID: 34705694 DOI: 10.1097/acm.0000000000004316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Katherine E Neff
- Author affiliations: K.E. Neff, K.S. Puttagunta, K.L. Grob, A.Z. Ahmed, M.M. Daniel, University of Michigan Medical School
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Pillai P, Bagwell S, Orman J, Beamsley M. Health Advocacy Learning Activities for Medical Students in Clinical Clerkship Training: Why We Are Changing Our Model. Acad Med 2021; 96:S195. [PMID: 34705695 DOI: 10.1097/acm.0000000000004310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Parvathy Pillai
- Author affiliations: P. Pillai, S. Bagwell, J. Orman, M. Beamsley, University of Wisconsin School of Medicine and Public Health
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Abstract
PURPOSE Artificial intelligence (AI) is a rapidly growing phenomenon poised to instigate large-scale changes in medicine. However, medical education has not kept pace with the rapid advancements of AI. Despite several calls to action, the adoption of teaching on AI in undergraduate medical education (UME) has been limited. This scoping review aims to identify gaps and key themes in the peer-reviewed literature on AI training in UME. METHOD The scoping review was informed by Arksey and O'Malley's methodology. Seven electronic databases including MEDLINE and EMBASE were searched for articles discussing the inclusion of AI in UME between January 2000 and July 2020. A total of 4,299 articles were independently screened by 3 co-investigators and 22 full-text articles were included. Data were extracted using a standardized checklist. Themes were identified using iterative thematic analysis. RESULTS The literature addressed: (1) a need for an AI curriculum in UME, (2) recommendations for AI curricular content including machine learning literacy and AI ethics, (3) suggestions for curriculum delivery, (4) an emphasis on cultivating "uniquely human skills" such as empathy in response to AI-driven changes, and (5) challenges with introducing an AI curriculum in UME. However, there was considerable heterogeneity and poor consensus across studies regarding AI curricular content and delivery. CONCLUSIONS Despite the large volume of literature, there is little consensus on what and how to teach AI in UME. Further research is needed to address these discrepancies and create a standardized framework of competencies that can facilitate greater adoption and implementation of a standardized AI curriculum in UME.
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Affiliation(s)
- Juehea Lee
- J. Lee is a third-year medical student, University of Toronto, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Annie Siyu Wu
- A.S. Wu is a third-year medical student, University of Toronto, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - David Li
- D. Li is a second-year medical student, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
| | - Kulamakan Mahan Kulasegaram
- K. Kulasegaram is associate professor, Department of Family and Community Medicine, University of Toronto and The Wilson Centre, University Health Network, Toronto, Ontario, Canada
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Mitchell AK, Redding KC, Bayer CR, Patrickson J, McNeal M. Using Learning Communities to Address Important Diversity Discussions. Acad Med 2021; 96:S193-S194. [PMID: 34705693 DOI: 10.1097/acm.0000000000004336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Ashley K Mitchell
- Author affiliations: A.K. Mitchell, K.C. Redding, C.R. Bayer, J. Patrickson, M. McNeal, Morehouse School of Medicine
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Chang RS, Kloosterman N, Ukwuani S, Carpenter HL, Miller B. The Social Mission Committee: Establishing a Student-Based Organization to Advance Awareness of Socially Conscious Medicine. Acad Med 2021; 96:S179-S180. [PMID: 34705677 DOI: 10.1097/acm.0000000000004301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Rachel S Chang
- Author affiliations: R.S. Chang, N. Kloosterman, S. Ukwuani, H.L. Carpenter, B. Miller, Vanderbilt University School of Medicine
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Barzansky B, Etzel SI. MD-Granting Medical Schools in the United States, 2020-2021. JAMA 2021; 326:1077-1087. [PMID: 34546320 DOI: 10.1001/jama.2021.12944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Barbara Barzansky
- Medical Education Group, American Medical Association, Chicago, Illinois
| | - Sylvia I Etzel
- Medical Education Group, American Medical Association, Chicago, Illinois
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Abstract
The discontinuation of the United States Medical Licensing Examination Step 2 Clinical Skills (CS) in 2020 in response to the COVID-19 pandemic marked the end of a decades-long debate about the utility and value of the exam. For all its controversy, the implementation of Step 2 CS in 2004 brought about profound changes to the landscape of medical education, altering the curriculum and assessment practices of medical schools to ensure students were prepared to take and pass this licensing exam. Its elimination, while celebrated by some, is not without potential negative consequences. As the responsibility for assessing students' clinical skills shifts back to medical schools, educators must take care not to lose the ground they have gained in advancing clinical skills education. Instead, they need to innovate, collaborate, and share resources; hold themselves accountable; and ultimately rise to the challenge of ensuring that physicians have the necessary clinical skills to safely and effectively practice medicine.
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Affiliation(s)
- Timothy K Baker
- T.K. Baker is senior associate dean for academic affairs and associate professor, Department of Internal Medicine, University of Nevada, Reno, School of Medicine, Reno, Nevada
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Fadoju D. Will Our To-Do Lists Change After COVID-19? Acad Med 2021; 96:939. [PMID: 33570849 DOI: 10.1097/acm.0000000000003975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Deborah Fadoju
- Second-year medical student, The Ohio State University College of Medicine, Columbus, Ohio;
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Lomis KD, Santen SA, Dekhtyar M, Elliott VS, Richardson J, Hammoud MM, Hawkins R, Skochelak SE. The Accelerating Change in Medical Education Consortium: Key Drivers of Transformative Change. Acad Med 2021; 96:979-988. [PMID: 33332909 DOI: 10.1097/acm.0000000000003897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The American Medical Association's (AMA's) Accelerating Change in Medical Education (ACE) initiative, launched in 2013 to foster advancements in undergraduate medical education, has led to the development and scaling of innovations influencing the full continuum of medical training. Initial grants of $1 million were awarded to 11 U.S. medical schools, with 21 schools joining the consortium in 2016 at a lower funding level. Almost one-fifth of all U.S. MD- and DO-granting medical schools are represented in the 32-member consortium. In the first 5 years, the consortium medical schools have delivered innovative educational experiences to approximately 19,000 medical students, who will provide a potential 33 million patient care visits annually. The core initiative objectives focus on competency-based approaches to medical education and individualized pathways for students, training in health systems science, and enhancing the learning environment. At the close of the initial 5-year grant period, AMA leadership sought to catalogue outputs and understand how the structure of the consortium may have influenced its outcomes. Themes from qualitative analysis of stakeholder interviews as well as other sources of evidence aligned with the 4 elements of the transformational leadership model (inspirational motivation, intellectual stimulation, individualized consideration, and idealized influence) and can be used to inform future innovation interventions. For example, the ACE initiative has been successful in stimulating change at the consortium schools and propagating those innovations broadly, with outputs involving medical students, faculty, medical schools, affiliated health systems, and the broader educational landscape. In summary, the ACE initiative has fostered a far-reaching community of innovation that will continue to drive change across the continuum of medical education.
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Affiliation(s)
- Kimberly D Lomis
- K.D. Lomis is vice president, Undergraduate Medical Education Innovations, American Medical Association, Chicago, Illinois
| | - Sally A Santen
- S.A. Santen is senior associate dean, Evaluation, Assessment and Scholarship, Virginia Commonwealth University, Richmond, Virginia, and consultant, American Medical Association, Chicago, Illinois
| | - Michael Dekhtyar
- M. Dekhtyar was research associate, American Medical Association, Chicago, Illinois, at the time this work was completed
| | | | - Judee Richardson
- J. Richardson is director of research and program evaluation, American Medical Association, Chicago, Illinois
| | - Maya M Hammoud
- M.M. Hammoud is associate chair for education, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan, and senior advisor, American Medical Association, Chicago, Illinois
| | - Richard Hawkins
- R. Hawkins was vice president, Medical Education Outcomes, American Medical Association, Chicago, Illinois, at the time this work was initiated, and is currently president and chief executive officer, American Board of Medical Specialties, Chicago, Illinois
| | - Susan E Skochelak
- S.E. Skochelak is group vice president, Medical Education, American Medical Association, Chicago, Illinois
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Fesser N. To Do or Not to Do: On Being a Medical Student During COVID-19. Acad Med 2021; 96:939-940. [PMID: 33711844 DOI: 10.1097/acm.0000000000004055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Nicolas Fesser
- Second-year medical student, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York; ; Twitter: @NicoFesser
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Afolabi T, Borowsky HM, Cordero DM, Paul DW, Said JT, Sandoval RS, Davis D, Ölveczky D, Chatterjee A. Student-Led Efforts to Advance Anti-Racist Medical Education. Acad Med 2021; 96:802-807. [PMID: 33711839 DOI: 10.1097/acm.0000000000004043] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Over the past decade, medical schools across the United States have increasingly dedicated resources to advancing racial and social justice, such as by supporting diversity and inclusion efforts and by incorporating social medicine into the traditional medical curricula. While these changes are promising, the academic medicine community must apply an anti-racist lens to every aspect of medical education to equip trainees to recognize and address structural inequities. Notably, organizing and scholarly work led by medical students has been critical in advancing anti-racist curricula. In this article, the authors illustrate how student activism has reshaped medical education by highlighting examples of student-led efforts to advance anti-racist curricula at Harvard Medical School (HMS) and at the University of California, San Francisco (UCSF) School of Medicine. HMS students collaborated with faculty to address aspects of existing clinical practice that perpetuate racism, such as the racial correction factor in determining kidney function. They also responded to the existing curricula by noting missed opportunities to discuss structural racism, and they planned supplemental sessions to address these gaps. At UCSF, students identified specific avenues to improve the rigor of social medicine courses and developed new curricula to equip students with skills to confront and work to dismantle racism. The authors describe how HMS students, in an effort to improve the learning environment, developed a workshop to assist students in navigating microaggressions and discrimination in the clinical setting. At UCSF, students partnered with faculty and administration to advocate pass/fail grading for clerkships after university data revealed racial disparities in students' clerkship assessments. In reviewing these examples of students' advocacy to improve their own curricula and learning environments, the authors aim to provide support for students and faculty pursuing anti-racist curricular changes at their own institutions.
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Affiliation(s)
- Titilayo Afolabi
- T. Afolabi is a fourth-year student, Harvard Medical School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-1273-2183
| | - Hannah M Borowsky
- H.M. Borowsky is a fourth-year student, University of California, San Francisco School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0001-8779-7873
| | - Daniella M Cordero
- D.M. Cordero is a fourth-year student, University of California, San Francisco School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0003-4207-5708
| | - Dereck W Paul
- D.W. Paul Jr is a fourth-year student, University of California, San Francisco School of Medicine, San Francisco, California; ORCID: https://orcid.org/0000-0001-6099-5933
| | - Jordan Taylor Said
- J.T. Said is a fourth-year student, Harvard Medical School, Boston, Massachusetts; ORCID: http://orcid.org/0000-0002-0357-6916
| | - Raquel Sofia Sandoval
- R.S. Sandoval is a fourth-year student, Harvard Medical School and Harvard Kennedy School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-0770-4030
| | - Denise Davis
- D. Davis is a clinical professor of medicine, University of California, San Francisco, specialist for diversity, University of California, San Francisco, and vice president, Diversity, Equity, and Inclusion, Academy of Communication in Healthcare, San Francisco, California
| | - Daniele Ölveczky
- D. Ölveczky is a physician, Department of Medicine, Beth Israel Deaconess Medical Center (BIDMC), inclusion officer, Department of Medicine, BIDMC, and assistant professor, Department of Medicine, Harvard Medical School, Boston, Massachusetts; ORCID: https://orcid.org/0000-0001-8972-4483
| | - Avik Chatterjee
- A. Chatterjee is a physician, Boston Health Care for the Homeless Program, assistant professor, Boston University School of Medicine and Boston Medical Center, part-time lecturer, Harvard Medical School, associate epidemiologist, Division of Global Health Equity, Department of Internal Medicine, Brigham and Women's Hospital, and faculty supervisor, the Racial Justice Coalition, Harvard Medical School, Boston, Massachusetts; ORCID: http://orcid.org/0000-0001-8437-6774
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Vasquez Guzman CE, Sussman AL, Kano M, Getrich CM, Williams RL. A Comparative Case Study Analysis of Cultural Competence Training at 15 U.S. Medical Schools. Acad Med 2021; 96:894-899. [PMID: 33637658 DOI: 10.1097/acm.0000000000004015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE Twenty years have passed since the Liaison Committee on Medical Education (LCME) mandated cultural competence training at U.S. medical schools. There remain multiple challenges to implementation of this training, including curricular constraints, varying interpretations of cultural competence, and evidence supporting the efficacy of such training. This study explored how medical schools have worked to implement cultural competence training. METHOD Fifteen regionally diverse public and private U.S. medical schools participated in the study. In 2012-2014, the authors conducted 125 interviews with 52 administrators, 51 faculty or staff members, and 22 third- and fourth-year medical students, along with 29 focus groups with an additional 196 medical students. Interviews were recorded, transcribed, and imported into NVivo 10 software for qualitative data analysis. Queries captured topics related to students' preparedness to work with diverse patients, engagement with sociocultural issues, and general perception of preclinical and clinical curricula. RESULTS Three thematic areas emerged regarding cultural competence training: formal curriculum, conditions of teaching, and institutional commitment. At the formal curricular level, schools offered a range of courses collectively emphasizing communication skills, patient-centered care, and community-based projects. Conditions of teaching emphasized integration of cultural competence into the preclinical years and reflection on the delivery of content. At the institutional level, commitment to institutional diversity, development of programs, and degree of prioritization of cultural competence varied. CONCLUSIONS There is variation in how medical schools approach cultural competence. Among the 15 participating schools, longitudinal and experiential learning emerged as important, highlighting the needs beyond mere integration of cultural competence content into the formal curriculum. To determine efficacy of cultural competence programming, it is critical to conduct systematic assessment to identify and address gaps. While LCME standards have transformed aspects of medical education, further research is needed to clarify evidence-based, effective approaches to this training.
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Affiliation(s)
- Cirila Estela Vasquez Guzman
- C.E. Vasquez Guzman is a family medicine postdoctoral fellow, Oregon Health & Science University, Portland, Oregon
| | - Andrew L Sussman
- A.L. Sussman is associate professor, Comprehensive Cancer Center and Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Miria Kano
- M. Kano is assistant professor, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Christina M Getrich
- C.M. Getrich is associate professor, Department of Anthropology, University of Maryland, College Park, Maryland
| | - Robert L Williams
- R.L. Williams is Distinguished Professor, Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico
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Salahou A, Rahmon D, Fedorowicz M. Medical Students Confront Racism and Systemic Oppression Amidst a Global Pandemic. Acad Med 2021; 96:e18. [PMID: 33538480 DOI: 10.1097/acm.0000000000003966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Abiba Salahou
- Second-year medical student, Oakland University William Beaumont School of Medicine, Rochester, Michigan; ; ORCID: https://orcid.org/0000-0001-9627-1822
| | - Dalia Rahmon
- Second-year medical student, Oakland University William Beaumont School of Medicine, Rochester, Michigan; ORCID: https://orcid.org/0000-0002-4038-0314
| | - Michelle Fedorowicz
- Fourth-year medical student, Oakland University William Beaumont School of Medicine, Rochester, Michigan; ORCID: https://orcid.org/0000-0003-4578-522X
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Brown T, Berman S, McDaniel K, Radford C, Mehta P, Potter J, Hirsh DA. Trauma-Informed Medical Education (TIME): Advancing Curricular Content and Educational Context. Acad Med 2021; 96:661-667. [PMID: 32675789 DOI: 10.1097/acm.0000000000003587] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The majority of patients and medical students experience some form of psychological trauma or adversity across their life course. All forms of trauma can be associated with adverse health consequences and can negatively affect learning and professional development. Trauma-informed care (TIC) offers a framework to address and mitigate these consequences and promote safety and health. The Substance Abuse and Mental Health Services Administration describes 6 domains of TIC: safety; trust and transparency; peer support; collaboration and mutuality; empowerment, voice, and choice; and cultural, historic, and gender issues. At present, TIC is not taught routinely in undergraduate medical education (UME)-a crucial educational gap given that UME grounds the development of key perspectives and practices that students use throughout their careers. Further, given the prevalence of preexisting trauma among learners and the likelihood of new traumatic exposures during training, medical schools' processes, practices, and learning environments may risk exacerbating or even causing trauma. To address this educational need and support students and their future patients, the authors propose a trauma-informed medical education (TIME) framework. TIME informs medical schools' curricular content and educational context. In UME, curricular content should address trauma epidemiology, physiology, and effects; trauma-informed clinical skills including sensitive communication and physical exam techniques; and trauma-informed self-care techniques including education on organizational resources, how to elicit supports, and personal self-care practices. A trauma-informed educational context encompasses curricular development, including student-faculty coproduction of educational content; curricular delivery, including faculty development on TIC principles; and learning environment, including trauma-informed educational practices, medical student advising, institutional policies, and recruitment. TIME offers practical strategies to support teaching, learning, educational administration, and professional development and aims to inspire new strategies for effective learner and faculty engagement. TIME aims to foster students' development of competency in TIC and promote student engagement, learning, health, and well-being.
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Affiliation(s)
- Taylor Brown
- T. Brown is a third-year medical student, Harvard Medical School, Boston, Massachusetts
| | - Sarah Berman
- S. Berman is a fourth-year medical student, Harvard Medical School, Boston, Massachusetts
| | - Katherine McDaniel
- K. McDaniel is a third-year medical student, Harvard Medical School, Boston, Massachusetts
| | - Caitlin Radford
- C. Radford is a third-year medical student, Harvard Medical School, Boston, Massachusetts
| | - Pooja Mehta
- P. Mehta is a first-year resident, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jennifer Potter
- J. Potter is professor of medicine, Harvard Medical School, Boston, Massachusetts
| | - David A Hirsh
- D.A. Hirsh is the George E. Thibault Academy Associate Professor and director, HMS Academy, Harvard Medical School, Boston, Massachusetts
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Consorti F, Kanter SL, Basili S, Ho MJ. A SWOT analysis of Italian medical curricular adaptations to the COVID-19 pandemic: A nationwide survey of medical school leaders. Medical Teacher 2021; 43:546-553. [PMID: 33556296 DOI: 10.1080/0142159x.2021.1877266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND There is a growing literature on how medical education adapts to the COVID-19 pandemic. However, there is a need to examine the facilitators and barriers of these adaptations. This study explores the strengths, weaknesses, opportunities, and threats (SWOT) of how Italian medical schools adapted their curricula to the COVID -19 pandemic. METHODS The authors conducted an online survey of directors of medical curricula in Italy. Free-text responses to open-ended questions about curricular adaptations and reflections on these adaptations were analysed using qualitative thematic analysis. RESULTS Twenty out of 60 Italian medical school directors completed the survey. Strengths identified were rapid responses and a spirit of cooperation. Weaknesses included dependency on clinical facilities, teachers' limited skills to use technology, and lack of mental health support for staff. Opportunities highlighted were clear government rules, new ways of teaching and a renewed focus on underrepresented topics. Threats expressed included impaired relationships, difficulties related to online assessment, lack of IT access, and legal and insurance issues. CONCLUSIONS This study, in documenting the curricular adaptations of Italian medical schools during an active global pandemic, and recording the perspectives of medical education leaders, offers important lessons for the future.
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Affiliation(s)
- Fabrizio Consorti
- Faculty of Medicine and Dentistry, University Sapienza of Rome, Rome, Italy
| | | | - Stefania Basili
- Faculty of Medicine and Dentistry, University Sapienza of Rome, Rome, Italy
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19
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Abstract
Contemporary curricular reform in medical education focuses on areas that current physician-educators were likely not exposed to during medical school, such as interprofessional teamwork; informatics; health care systems improvement; and diversity, equity, and inclusion. Thus, faculty may not be ready to support the planned curricular reform without adequate faculty development to acquire the necessary knowledge and skills. In an era with increasing demands on faculty, new approaches that are flexible and adaptable are needed. The University of California, San Francisco, School of Medicine implemented a new curriculum in 2016, which constituted a major curricular overhaul necessitating extensive faculty development. Based on this experience, the author proposes 8 guiding principles for faculty development around curricular reform: (1) create a blueprint to inform design and implementation of faculty development activities; (2) build on existing resources, networks, and communities; (3) target different needs and competency levels for different groups of faculty; (4) encourage cocreation in the workplace; (5) promote collaboration between content experts and faculty developers; (6) tap into faculty's intrinsic motivation for professional development; (7) develop curriculum leaders and faculty developers; and (8) evaluate for continuous improvement. Each of these principles is illustrated with examples, and when available, supported by references to relevant literature. Considering the current wave of curricular reform, both at the undergraduate and graduate levels, these principles can be useful for other institutions.
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MESH Headings
- Adult
- Curriculum/standards
- Curriculum/statistics & numerical data
- Curriculum/trends
- Education, Medical, Undergraduate/standards
- Education, Medical, Undergraduate/statistics & numerical data
- Education, Medical, Undergraduate/trends
- Faculty, Medical/education
- Female
- Guidelines as Topic
- Humans
- Male
- Program Development
- San Francisco
- Schools, Medical/standards
- Schools, Medical/statistics & numerical data
- Schools, Medical/trends
- Young Adult
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Affiliation(s)
- Sandrijn M van Schaik
- S. M. van Schaik is professor of pediatrics and director of faculty development, University of California, San Francisco, School of Medicine Bridges Curriculum, San Francisco, California; ORCID: https://orcid.org/0000-0002-2297-3511
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20
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Kapadia SJ. Perspectives of a 2nd-year medical student on 'Students as Partners' in higher education - What are the benefits, and how can we manage the power dynamics? Med Teach 2021; 43:478-479. [PMID: 33086905 DOI: 10.1080/0142159x.2020.1779922] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The 'Students as Partners' model has been redefining the way we see student-staff relationships in Higher Education. In a world where hierarchical teaching and learning has dominated for decades, this concept has been refreshing. I have seen the benefits first-hand, having participated in a 2-week student-staff collaboration to redesign the year-one medical curriculum at the Imperial College School of Medicine. However, inherent to such partnerships can be imbalanced power dynamics, which may pose a barrier and prevent the project from achieving its potential. The sources and impacts of these power dynamics are complex and the solutions multi-faceted. In our project, these imbalances of power were mitigated because the correct steps were taken both by the educators, as well as by the organisation. We produced outputs that led to significant change in the curriculum, in the short space of 2 weeks. I attribute this largely to the careful management of power dynamics throughout. In the current milieu of COVID-19, student-staff collaboration will be a valuable source of research; mitigating the impacts of power dynamics will undoubtedly improve productivity and motivation.
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21
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Cairney-Hill J, Edwards AE, Jaafar N, Gunganah K, Macavei VM, Khanji MY. Challenges and opportunities for undergraduate clinical teaching during and beyond the COVID-19 pandemic. J R Soc Med 2021; 114:113-116. [PMID: 33460334 PMCID: PMC7944554 DOI: 10.1177/0141076820980714] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jess Cairney-Hill
- Newham University Hospital, Barts Health NHS Trust, London E13 8SL, UK
- Centre for Medical Education, Institute of Health Sciences Education, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Whitechapel E1 2AD, UK
| | - Amy E Edwards
- Newham University Hospital, Barts Health NHS Trust, London E13 8SL, UK
- Centre for Medical Education, Institute of Health Sciences Education, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Whitechapel E1 2AD, UK
| | - Nora Jaafar
- Newham University Hospital, Barts Health NHS Trust, London E13 8SL, UK
- Centre for Medical Education, Institute of Health Sciences Education, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Whitechapel E1 2AD, UK
| | - Kirun Gunganah
- Newham University Hospital, Barts Health NHS Trust, London E13 8SL, UK
| | - Vladimir M Macavei
- Newham University Hospital, Barts Health NHS Trust, London E13 8SL, UK
- Centre for Medical Education, Institute of Health Sciences Education, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Whitechapel E1 2AD, UK
| | - Mohammed Y Khanji
- Newham University Hospital, Barts Health NHS Trust, London E13 8SL, UK
- Barts Heart Centre, Barts Health NHS Trust, West Smithfield, London EC1A 7BE, UK
- NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London EC1A 7BE, UK
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22
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Muller D, Parkas V, Amiel J, Anand S, Cassese T, Cunningham T, Kang Y, Nosanchuk J, Soriano R, Zbar L, Karani R. Guiding principles for undergraduate medical education in the time of the COVID-19 pandemic. Med Teach 2021; 43:137-141. [PMID: 33142072 DOI: 10.1080/0142159x.2020.1841892] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
As the early epicenter of the COVID-19 pandemic, New York City's medical schools experienced dramatic disruptions in every aspect of medical education. Remote learning was created, seemingly overnight, clerkships were disrupted, licensing examinations were cancelled, teaching faculty were redeployed, student volunteers rallied, and everyone was required to shelter at home. Seismic changes were required to adapt the authors' educational programs to a constantly evolving, unpredictable, and ever-worsening public health crisis. Entirely new communication strategies were adopted and thousands of decisions had to be made, often with little time to carefully reflect on the consequences of those decisions. What allowed each school to navigate these treacherous waters was a set of guiding principles that were used to ground each conversation, and inform every decision. While the language varied somewhat between schools, the core principles were universal and framed a way forward at a time when information, data, precedent, and best practices did not exist. The authors share these guiding principles in the hope that colleagues at other medical schools will find them to be a useful framework as we all continue to cope with the impact of COVID-19 on the future of medical education.
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Affiliation(s)
- David Muller
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Valerie Parkas
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan Amiel
- Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Shashi Anand
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Todd Cassese
- Medical Education, Albert Einstein College of Medicine, New York, NY, USA
| | - Tara Cunningham
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yoon Kang
- Weill Cornell Medical College, New York, NY, USA
| | - Joshua Nosanchuk
- Medical Education, Albert Einstein College of Medicine, New York, NY, USA
| | - Rainier Soriano
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lori Zbar
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Medical Education and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Reena Karani
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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23
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Nnamani Silva ON, Hernandez S, Kim EH, Kim AS, Gosnell J, Roman SA, Lin MYC. Surgery Clerkship Curriculum Changes at an Academic Institution during the COVID-19 Pandemic. J Surg Educ 2021; 78:327-331. [PMID: 32888850 PMCID: PMC7430287 DOI: 10.1016/j.jsurg.2020.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/23/2020] [Accepted: 07/13/2020] [Indexed: 06/02/2023]
Abstract
PROBLEM The COVID-19 pandemic has suspended the surgery clinical clerkship for third-year medical students at numerous institutions across the world. As a result, educators and students have adapted rapidly. There is a paucity of precedents regarding urgent and brusque formal curricular changes for medical students enrolled in surgical clinical rotations. APPROACH The University of California, San Francisco Department of Surgery created a surgically focused extended mastery learning rotation (EMLR). The surgery clerkship leadership designed a curriculum consisting of multiple learning strategies compatible with virtual learning environments. The primary aims of the newly developed EMLR were to help students consolidate their foundational science knowledge before their return to clinical medicine in an altered learning environment. The EMLR is currently underway, and further studies are necessary to evaluate its effectiveness.
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Affiliation(s)
- Ogonna N Nnamani Silva
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Sophia Hernandez
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Edward H Kim
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Alexander S Kim
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Jessica Gosnell
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - Sanziana A Roman
- Department of Surgery, University of California San Francisco, San Francisco, California.
| | - Matthew Y C Lin
- Department of Surgery, University of California San Francisco, San Francisco, California
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24
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Newcomb AB, Duval M, Bachman SL, Mohess D, Dort J, Kapadia MR. Building Rapport and Earning the Surgical Patient's Trust in the Era of Social Distancing: Teaching Patient-Centered Communication During Video Conference Encounters to Medical Students. J Surg Educ 2021; 78:336-341. [PMID: 32709566 PMCID: PMC7373024 DOI: 10.1016/j.jsurg.2020.06.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/29/2020] [Accepted: 06/20/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Effective physician communication improves care, and many medical schools and residency programs have adopted communication focused curricula. The COVID-19 pandemic has shifted the doctor-patient communication paradigm with the rapid adoption of video-based medical appointments by the majority of the medical community. The pandemic has also necessitated a sweeping move to online learning, including teaching and facilitating the practice of communication skills remotely. We aimed to identify effective techniques for surgeons to build relationships during a video consult, and to design and pilot a class that increased student skill in communicating during a video consult. METHODS Fourth-year medical students matched into a surgical internship attended a 2-hour class virtually. The class provided suggestions for building rapport and earning trust with patients and families by video, role play sessions with a simulated patient, and group debriefing and feedback. A group debriefing generated lessons learned and best practices for telemedicine communication in surgery. RESULTS Students felt the class introduced new skills and reinforced current ones; most reported higher self-confidence in target communication skills following the module. Students were particularly appreciative of opportunity for direct observation of skills and immediate faculty feedback, noting that the intimate setting was unique and valuable. Several elements of virtual communications required increased focus to communicate empathy and concern. Proper lighting and positioning relative to the camera were particularly important and body movement required "narration" to minimize misinterpretation. A patient's distress was more difficult to interpret; asking direct questions was recommended to understand the patient's emotional state. CONCLUSIONS There is a need to teach video-conference communication skills to enable surgical teams to build rapport in this distinct form of consultation. Our training plan appears effective at engaging learners and improving skills and confidence, and identifies areas of focus when teaching virtual communication skills.
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Affiliation(s)
- Anna B Newcomb
- Inova Fairfax Medical Campus, Division of Trauma Acute Care Surgery, Falls Church, Virginia.
| | - Margaret Duval
- George Washington School of Medicine and Health Sciences, Washington, District of Columbia
| | - Sharon L Bachman
- Inova Fairfax Medical Campus, Department of Surgery, Falls Church, Virginia
| | - Denise Mohess
- Inova Fairfax Medical Campus, Department of Medicine, Falls Church, Virginia
| | - Jonathan Dort
- Inova Fairfax Medical Campus, Department of Surgery, Falls Church, Virginia
| | - Muneera R Kapadia
- University of North Carolina at Chapel Hill, Department of Surgery, Chapel Hill, North Carolina
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25
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Merritt R, Baird J, Clyne B. Demographics and Career Intentions of Graduates of Combined Baccalaureate-MD Programs, 2010-2017: An Analysis of AAMC Graduation Questionnaire Data. Acad Med 2021; 96:108-112. [PMID: 33394662 DOI: 10.1097/acm.0000000000003576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE Combined baccalaureate-MD programs exist to fulfill a variety of educational missions, including to promote the development of physician-scientists, increase workforce diversity, promote primary care careers, and meet the needs of underserved patients. The authors sought to determine the demographics of combined program graduates, as well as their intention to practice in primary care (IPPC) and intention to work with the medically underserved (IWMU), as compared with graduates of traditional MD programs. METHOD Data from the 2010-2017 Association of American Medical Colleges Graduation Questionnaire, a national survey of graduating medical students, were recategorized (e.g., as combined program or traditional program) before analysis. Logistic regression models on the 2 primary outcomes (IPPC and IWMU) were conducted to estimate odds ratios for the effects of covariates and predictors (e.g., gender, underrepresented in medicine [URM] group member, type of medical degree program). RESULTS Data from a total of 109,028 respondents were included (3,182 from combined and 105,846 from traditional programs). Compared with students in traditional programs, those in combined programs were more likely to be younger (age at graduation ≤ 29: 3,143, 98.8% vs 89,688, 84.7%) and female (1,813, 57.0% vs 52,013, 49.1%) but less likely to identify as a URM group member (276, 8.7% vs 14,757, 13.9%). In an adjusted logistic regression model, graduating from a combined program, identifying as female, and IWMU predicted significantly greater odds of IPPC, while identifying as a URM, identifying as female, and having debt predicted significantly greater odds of IWMU. Graduating medical students who indicated family medicine as a career specialty were more likely to indicate an IWMU. CONCLUSIONS Medical students graduating from combined programs were more likely to indicate an IPPC but were no more likely to indicate an IWMU than traditional program graduates.
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MESH Headings
- Adult
- Career Choice
- Education, Medical, Graduate/statistics & numerical data
- Education, Medical, Graduate/trends
- Education, Medical, Undergraduate/statistics & numerical data
- Education, Medical, Undergraduate/trends
- Educational Measurement/statistics & numerical data
- Female
- Humans
- Logistic Models
- Male
- Odds Ratio
- Socioeconomic Factors
- Students, Medical/psychology
- Students, Medical/statistics & numerical data
- Surveys and Questionnaires
- United States
- Young Adult
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Affiliation(s)
- Rory Merritt
- R. Merritt is assistant dean of medicine and assistant professor of emergency medicine, Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Janette Baird
- J. Baird is associate professor of emergency medicine, Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Brian Clyne
- B. Clyne is associate professor of emergency medicine and vice chair for education, Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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26
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Cheng X, Chan LK, Pan SQ, Cai H, Li YQ, Yang X. Gross Anatomy Education in China during the Covid-19 Pandemic: A National Survey. Anat Sci Educ 2021; 14:8-18. [PMID: 33217164 DOI: 10.1002/ase.2036] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 10/30/2020] [Accepted: 11/13/2020] [Indexed: 05/25/2023]
Abstract
The Covid-19 pandemic launched the use of online courses in Chinese medical schools during February 2020. To evaluate the state of gross anatomy education in China during the pandemic, a nationwide survey was conducted through convenience sampling by email or respondent invitations on social media. A total of 359 questionnaires were received from the respondents. The first response from a given school was included in the study to represent that school, thus, 77 questionnaires were used for analyses. Schools represented were from all provinces in mainland China as well as Hong Kong and Macao. The survey found that before the pandemic, 74.0% and 33.8% of the 77 schools conducted online theoretical and practical sessions, respectively, on gross anatomy, and 36 (46.8% of 77) had temporarily suspended practical sessions at the time the survey was conducted. Body donation programs were also affected with 26.0% and 27.3% of the 77 schools having suspended donation programs or saw a decreased number of donations. During the pandemic, 40.3% of the 77 schools kept or initiated the implementation of active learning, and online assessment was continued in 49.4% of the 77 medical schools. Another 26 (33.8%) schools initiated online assessment during the pandemic. A total of 359 answers were included for the analysis of the "teachers' perception of the online teaching experience." Over half (51.0%) of the 359 responded teachers were very statisfied or satisfied with the effectiveness of online teaching during the pandemic. A total of 36.2% of these respondents preferred to implement online teaching of theoretical sessions after the pandemic, and 89 (24.8%) teachers were keen to return to traditional face-to-face anatomy education.
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MESH Headings
- Anatomy/education
- COVID-19/epidemiology
- COVID-19/prevention & control
- COVID-19/transmission
- China
- Curriculum/statistics & numerical data
- Curriculum/trends
- Education, Distance/statistics & numerical data
- Education, Distance/trends
- Education, Medical, Undergraduate/methods
- Education, Medical, Undergraduate/statistics & numerical data
- Education, Medical, Undergraduate/trends
- Faculty/psychology
- Faculty/statistics & numerical data
- Humans
- Pandemics/prevention & control
- Personal Satisfaction
- Schools, Medical/statistics & numerical data
- Schools, Medical/trends
- Students, Medical/psychology
- Students, Medical/statistics & numerical data
- Surveys and Questionnaires/statistics & numerical data
- Tissue and Organ Procurement/statistics & numerical data
- Tissue and Organ Procurement/trends
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Affiliation(s)
- Xin Cheng
- Department of Histology and Embryology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Medical College, Jinan University, Guangzhou, People's Republic of China
| | - Lap Ki Chan
- Department of Biomedical Sciences, Macau University of Science and Technology, Macao Special Administrative Region, People's Republic of China
| | - San-Qiang Pan
- Department of Anatomy, Medical College, Jinan University, Guangzhou, People's Republic of China
| | - Hongmei Cai
- Department of Histology and Embryology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Medical College, Jinan University, Guangzhou, People's Republic of China
| | - Yun-Qing Li
- Department of Anatomy, Histology and Embryology, K.K. Leung Brain Research Centre, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Xuesong Yang
- Department of Histology and Embryology, Key Laboratory for Regenerative Medicine of the Ministry of Education, Medical College, Jinan University, Guangzhou, People's Republic of China
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27
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Kim JW, Myung SJ, Yoon HB, Moon SH, Ryu H, Yim JJ. How medical education survives and evolves during COVID-19: Our experience and future direction. PLoS One 2020; 15:e0243958. [PMID: 33338045 PMCID: PMC7748283 DOI: 10.1371/journal.pone.0243958] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/02/2020] [Indexed: 11/19/2022] Open
Abstract
Background Due to the outbreak of coronavirus disease 2019 (COVID-19), school openings were postponed worldwide as a way to stop its spread. Most classes are moving online, and this includes medical school classes. The authors present their experience of running such online classes with offline clinical clerkship under pandemic conditions, and also present data on student satisfaction, academic performance, and preference. Methods The medical school changed every first-year to fourth-year course to an online format except the clinical clerkship, clinical skills training, and basic laboratory classes such as anatomy lab sessions. Online courses were pre-recorded video lectures or live-streamed using video communication software. At the end of each course, students and professors were asked to report their satisfaction with the online course and comment on it. The authors also compared students’ academic performance before and after the introduction of online courses. Results A total of 69.7% (318/456) of students and 35.2% (44/125) of professors answered the questionnaire. Students were generally satisfied with the online course and 62.2% of them preferred the online course to the offline course. The majority (84.3%) of the students wanted to maintain the online course after the end of COVID-19. In contrast, just 13.6% of professors preferred online lectures and half (52.3%) wanted to go back to the offline course. With the introduction of online classes, students' academic achievement did not change significantly in four subjects, but decreased in two subjects. Conclusions The inevitable transformation of medical education caused by COVID-19 is still ongoing. As the safety of students and the training of competent physicians are the responsibilities of medical schools, further research into how future physicians will be educated is needed.
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Affiliation(s)
- Ju Whi Kim
- Office of Medical Education, Seoul National University College of Medicine, Seoul, South Korea
| | - Sun Jung Myung
- Office of Medical Education, Seoul National University College of Medicine, Seoul, South Korea
- * E-mail:
| | - Hyun Bae Yoon
- Office of Medical Education, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang Hui Moon
- Office of Medical Education, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyunjin Ryu
- Office of Medical Education, Seoul National University College of Medicine, Seoul, South Korea
| | - Jae-Joon Yim
- Office of Medical Education, Seoul National University College of Medicine, Seoul, South Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
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28
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Stites SD, Rodriguez S, Dudley C, Fiester A. Medical Students' Exposure to Ethics Conflicts in Clinical Training: Implications for Timing UME Bioethics Education. HEC Forum 2020; 32:85-97. [PMID: 32410016 DOI: 10.1007/s10730-020-09412-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
While there is significant consensus that undergraduate medical education (UME) should include bioethics training, there is widespread debate about how to teach bioethics to medical students. Educators disagree about course methods and approaches, the topics that should be covered, and the effectiveness and metrics for UME ethics training. One issue that has received scant attention is the timing of bioethics education during medical training. The existing literature suggests that most medical ethics education occurs in the pre-clinical years. Follow-up studies indicate that medical students in their clinical rotations have little recall or ability to apply ethics concepts that were learned in their pre-clinical training. Trainees also report a desire for medical ethics to be taught in the context of practical application, which would suggest that the timing of pre-clinical ethics education is flawed. However, moving bioethics training to the clinical years should not be assumed to be the solution to the problems of recall and theory application. We argue that the effectiveness of timing bioethics education will depend on when medical students witness or experience particular categories of ethical dilemmas during their training. Our overarching hypothesis is that ethics education will be most effective when the bioethics training on a particular topic correlates to experiential exposure to that ethical issue. The purpose of our current study was to describe medical students exposure to particular categories of ethical conflicts, dilemmas, or issues. Our results may help bioethics educators better strategize about the most effective timing of medical ethics training in UME.
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Affiliation(s)
- S D Stites
- University of Pennsylvania, 423 Guardian Dr., Blockley Hall Floor 14, Philadelphia, PA, 19104, USA
| | - S Rodriguez
- University of Pennsylvania, 423 Guardian Dr., Blockley Hall Floor 14, Philadelphia, PA, 19104, USA
| | - C Dudley
- University of Pennsylvania, 423 Guardian Dr., Blockley Hall Floor 14, Philadelphia, PA, 19104, USA
| | - A Fiester
- University of Pennsylvania, 423 Guardian Dr., Blockley Hall Floor 14, Philadelphia, PA, 19104, USA.
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29
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Bravery BD, Shi K, Nicholls L, Chelvarajah R, Tieu MT, Turner S, Windsor A. Oncology and Radiation Oncology Awareness in Final Year Medical Students in Australia and New Zealand. J Cancer Educ 2020; 35:1227-1236. [PMID: 31332623 DOI: 10.1007/s13187-019-01586-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study aimed to determine final year students' core oncology and radiation oncology knowledge and attitudes about the quality of teaching in medical programmes delivered in Australia and New Zealand. Does the modern medical programme provide core oncology skills in this leading global cause of mortality and morbidity? An online survey was distributed between April and June 2018 and completed by 316 final year students across all 21 medical schools with final year cohorts in Australia and New Zealand. The survey examined teaching and clinical exposure, attitudes and core knowledge for oncology and radiation oncology. Several questions from a survey done of graduates in 2001 were repeated for comparison. We found that clinical exposure to oncology and its disciplines is low. Students rated oncology and haematology the worst taught medical specialties at medical school. Students reported the most confidence identifying when surgical management of cancer may be indicated and much lower levels of confidence identifying when systemic therapy and radiation therapy may be helpful. The majority of students had no formal course content on radiation therapy and more than one third of final year students erroneously believed that external beam radiation therapy turned patients radioactive. Exposure to oncology practice and the teaching of core oncology knowledge remains low for medical students in Australia and New Zealand. Many areas of oncology teaching and knowledge have worsened for medical students in Australia and New Zealand over the past 20 years. Well-established gaps in the core oncology knowledge of medical graduates must be urgently addressed given the increasing incidence of cancer and ongoing underutilisation of radiation therapy in particular.
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Affiliation(s)
- Benjamin D Bravery
- School of Medicine, University of Notre Dame Australia, Sydney, New South Wales, Australia.
| | - Kate Shi
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Luke Nicholls
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | | | - Minh Thi Tieu
- Calvary Mater Newcastle Hospital, Waratah, New South Wales, Australia
- University of Newcastle, Callaghan, New South Wales, Australia
| | - Sandra Turner
- University of Newcastle, Callaghan, New South Wales, Australia
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia
| | - Apsara Windsor
- University of Newcastle, Callaghan, New South Wales, Australia.
- Faculty of Radiation Oncology, Royal Australian and New Zealand College of Radiologists, Sydney, New South Wales, Australia.
- Central Coast Cancer Centre, Gosford, New South Wales, Australia.
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30
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Thompson TJU, Collings AJ, Earwaker H, Horsman G, Nakhaeizadeh S, Parekh U. Forensic undergraduate education during and after the COVID-19 imposed lockdown: Strategies and reflections from India and the UK. Forensic Sci Int 2020; 316:110500. [PMID: 32927413 PMCID: PMC7474872 DOI: 10.1016/j.forsciint.2020.110500] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 09/03/2020] [Indexed: 12/12/2022]
Affiliation(s)
- T J U Thompson
- School of Health & Life Sciences, Teesside University, Middlesbrough, TS1 3BX, UK.
| | - Amber J Collings
- School of Health & Life Sciences, Teesside University, Middlesbrough, TS1 3BX, UK.
| | - Helen Earwaker
- Institute of Criminal Justice Studies, University of Portsmouth, Portsmouth, PO1 2UP, UK.
| | - Graeme Horsman
- School of Health & Life Sciences, Teesside University, Middlesbrough, TS1 3BX, UK.
| | - Sherry Nakhaeizadeh
- Department of Security and Crime Science, UCL, Centre for the Forensic Sciences, 35 Tavistock Square, London, WC1H 9EZ, UK.
| | - Utsav Parekh
- Department of Forensic Medicine, Pramukhswami Medical College, Gujarat, India.
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Cheng X, Chan LK, Li H, Yang X. Histology and Embryology Education in China: The Current Situation and Changes Over the Past 20 Years. Anat Sci Educ 2020; 13:759-768. [PMID: 32162490 DOI: 10.1002/ase.1956] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 06/10/2023]
Abstract
In mainland China, histology and embryology (HE) are taught in one course as an essential component of medical curricula. The effectiveness of HE courses directly affects the quality of medical students. To determine the present situation and changes in HE teaching in Chinese medical schools, a nationwide survey was conducted among the HE departmental leaders. In total, 66 responses were included in the study, representing prominent Chinese mainland medical schools. The results revealed that most HE teachers have medical educational backgrounds; an increasing number of teaching staff with PhDs have joined the teaching staffs. A range of 71 to 90 HE curriculum contact hours is predominant. The ratio of theory to practice for HE contact hours is 1:1 at half of the surveyed medical schools. The numbers of students in each laboratory are less than 30 and from 31 to 60 at 23 and 36 medical schools, respectively. Virtual microscopy is employed in 40% of the surveyed medical schools. Didactic teaching is the most common strategy, although new teaching approaches are being employed gradually. During the past 20 years, both the total number of HE teachers and the number of HE teachers with medical educational backgrounds have been reduced in at least half of the surveyed schools. A total of 83.33% of the surveyed schools have reduced their HE contact hours. Almost half of the Chinese medical schools remained unchanged in both their ratio of theory to practice and the number of students in each laboratory. The data derived from this study help to understand the development of the HE discipline at Chinese medical schools.
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MESH Headings
- China
- Curriculum/statistics & numerical data
- Curriculum/trends
- Education, Medical, Undergraduate/history
- Education, Medical, Undergraduate/organization & administration
- Education, Medical, Undergraduate/statistics & numerical data
- Education, Medical, Undergraduate/trends
- Educational Measurement/history
- Educational Measurement/methods
- Educational Measurement/statistics & numerical data
- Embryology/education
- Histology/education
- History, 21st Century
- Humans
- Schools, Medical/history
- Schools, Medical/organization & administration
- Schools, Medical/statistics & numerical data
- Schools, Medical/trends
- Students, Medical/statistics & numerical data
- Teaching/history
- Teaching/organization & administration
- Teaching/trends
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Affiliation(s)
- Xin Cheng
- Department of Histology and Embryology, Medical College, Jinan University, Guangzhou, People's Republic of China
| | - Lap Ki Chan
- Macau University of Science and Technology, Macao SAR, People's Republic of China
| | - He Li
- Department of Histology and Embryology, Hubei University of Medicine, Shiyan, People's Republic of China
| | - Xuesong Yang
- Department of Histology and Embryology, Medical College, Jinan University, Guangzhou, People's Republic of China
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Wang C, Xie A, Wang W, Wu H. Association between medical students' prior experiences and perceptions of formal online education developed in response to COVID-19: a cross-sectional study in China. BMJ Open 2020; 10:e041886. [PMID: 33122327 PMCID: PMC7597486 DOI: 10.1136/bmjopen-2020-041886] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES (1) Understanding the characteristics of online learning experiences of Chinese undergraduate medical students; (2) Investigating students' perceptions of ongoing online education developed in response to COVID-19 and (3) Exploring how prior online learning experiences are associated with students' perceptions. DESIGN Students' familiarity with online learning modes and corresponding perceived usefulness (PU) according to their previous experiences were investigated using an online survey. The survey also collected data on students' perceptions through their evaluation of and satisfaction with current online learning. SETTING In response to the educational challenges created by COVID-19, medical schools in China have adopted formal online courses for students. PARTICIPANTS The questionnaire was sent to 225 329 students, of whom 52.38% (118 080/225 329) replied, with valid data available for 44.18% (99 559/225 329). METHODS Pearson correlations and t-tests were used to examine the relationship between familiarity and PU. Multiple linear regression and logistic regression analyses were used to determine the impact of prior learning experiences and its interactions with gender, area, learning phase and academic performance on students' perceptions. RESULTS Students' PU had a significant positive correlation with their familiarity with online learning modes (p<0.01). Students' evaluation of and satisfaction with their current online education were positively associated with their familiarity (β=0.46, 95% CI 0.45 to 0.48, p<0.01; OR 1.14, 95% CI 1.13 to 1.14, p<0.01) with and PU (β=3.11, 95% CI 2.92 to 3.30, p<0.01; OR 2.55, 95% CI 2.37 to 2.75, p<0.01) of online learning. Moreover, the higher the students' learning phases, the lower the associations between PU and students' evaluation of and satisfaction with ongoing online education. CONCLUSIONS Medical students in China have experiences with various online learning modes. Prior learning experiences are positively associated with students' evaluation of and satisfaction with current online education. Higher learning phases, in which clinical practices are crucial, and high academic performance led to lower evaluation and satisfaction scores.
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MESH Headings
- Betacoronavirus
- COVID-19
- China
- Coronavirus Infections/epidemiology
- Coronavirus Infections/prevention & control
- Education, Distance/methods
- Education, Medical, Undergraduate/organization & administration
- Education, Medical, Undergraduate/trends
- Female
- Humans
- Male
- Models, Educational
- Models, Organizational
- Needs Assessment
- Pandemics/prevention & control
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/prevention & control
- Qualitative Research
- SARS-CoV-2
- Social Perception
- Students, Medical/psychology
- Young Adult
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Affiliation(s)
- Cixiao Wang
- School of Educational Technology, Faculty of Education, Beijing Normal University, Beijing, China
| | - A'na Xie
- National Center for Health Professions Education Development, Peking University, Beijing, China
| | - Weimin Wang
- National Center for Health Professions Education Development, Peking University, Beijing, China
- Peking University Health Science Center, Peking University, Beijing, China
| | - Hongbin Wu
- National Center for Health Professions Education Development, Peking University, Beijing, China
- Institute of Medical Education, Peking University, Beijing, China
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Lamb S, Chow C, Lindsley J, Stevenson A, Roussel D, Shaffer K, Samuelson W. Learning from failure: how eliminating required attendance sparked the beginning of a medical school transformation. Perspect Med Educ 2020; 9:314-317. [PMID: 32804346 PMCID: PMC7550439 DOI: 10.1007/s40037-020-00615-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Concern about medical student attendance has been rising over the last decade. Thinking a required attendance policy would fix things, we instituted such a mandate in 2010 only to find that although students were present at lecture and other learning sessions they were disengaged. In addition, we experienced growing distrust between faculty and students and tensions between the Student Affairs and Curriculum offices. After five years, we dismantled the policy in favor of encouraged attendance. We discuss both positive and negative surprising consequences that followed this new approach to attendance which has reshaped our vision for the medical school learning experience. It has been transformative and has afforded us the opportunity to redefine our results in accord with the culture in which we aspire to live and work.
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Affiliation(s)
- Sara Lamb
- Department of Internal Medicine and Pediatrics, University of Utah School of Medicine, 30 N. 1900 E., Salt Lake City, UT, 84132, USA.
| | - Candace Chow
- Department of Internal Medicine, University of Utah School of Medicine, 30 N. 1900 E., Salt Lake City, UT, 84132, USA
| | - Janet Lindsley
- Department of Biochemistry, University of Utah School of Medicine, 30 N. 1900 E., Salt Lake City, UT, 84132, USA
| | - Adam Stevenson
- Department of Pediatrics, University of Utah School of Medicine, 30 N. 1900 E., Salt Lake City, UT, 84132, USA
| | - Danielle Roussel
- Department of Anesthesiology, University of Utah School of Medicine, 30 N. 1900 E., Salt Lake City, UT, 84132, USA
| | - Kerri Shaffer
- Dean's Office, Office of Medical Education, Curriculum, University of Utah School of Medicine, 30 N. 1900 E., Salt Lake City, UT, 84132, USA
| | - Wayne Samuelson
- Department of Internal Medicine, University of Utah School of Medicine, 30 N. 1900 E., Salt Lake City, UT, 84132, USA
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Blood AD, Farnan JM, Fitz-William W. Curriculum Changes and Trends 2010-2020: A Focused National Review Using the AAMC Curriculum Inventory and the LCME Annual Medical School Questionnaire Part II. Acad Med 2020; 95:S5-S14. [PMID: 33626633 DOI: 10.1097/acm.0000000000003484] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Medical school curricula have evolved from 2010 to 2020. Numerous pressures and influences affect medical school curricula, including those from external sources, academic medical institutions, clinical teaching faculty, and undergraduate medical students. Using data from the AAMC Curriculum Inventory and the LCME Annual Medical School Questionnaire Part II, the nature of curriculum change is illuminated. Most medical schools are undertaking curriculum change, both in small cycles of continuous quality improvement and through significant change to curricular structure and content. Four topic areas are explored: cost consciousness, guns and firearms, nutrition, and opioids and addiction medicine. The authors examine how these topic areas are taught and assessed, where in the curriculum they are located, and how much time is dedicated to them in relation to the curriculum as a whole. When examining instructional methods overall, notable findings include (1) the decrease of lecture, although lecture remains the most used instructional method, (2) the increase of collaborative instructional methods, (3) the decrease of laboratory, and (4) the prevalence of clinical instructional methods in academic levels 3 and 4. Regarding assessment methods overall, notable findings include (1) the recent change of the USMLE Step 1 examination to a pass/fail reporting system, (2) a modest increase in narrative assessment, (3) the decline of practical labs, and (4) the predominance of institutionally developed written/computer-based examinations and participation. Among instructional and assessment methods, the most used methods tend to cluster by academic level. It is critical that faculty development evolves alongside curricula. Continued diversity in the use of instructional and assessment methods is necessary to adequately prepare tomorrow's physicians. Future research into the life cycle of a curriculum, as well optional curriculum content, is warranted.
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MESH Headings
- Academic Medical Centers/organization & administration
- Addiction Medicine/education
- Addiction Medicine/statistics & numerical data
- Analgesics, Opioid
- Canada/epidemiology
- Costs and Cost Analysis/economics
- Curriculum/trends
- Education, Medical, Undergraduate/methods
- Education, Medical, Undergraduate/trends
- Educational Measurement/methods
- Faculty, Medical/standards
- Firearms
- History, 21st Century
- Humans
- Nutritional Sciences/education
- Nutritional Sciences/statistics & numerical data
- Schools, Medical/history
- Schools, Medical/trends
- Students, Medical/statistics & numerical data
- Surveys and Questionnaires
- United States/epidemiology
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Affiliation(s)
- Angela D Blood
- A.D. Blood is director of curricular resources, Association of American Medical Colleges, Washington, DC
| | - Jeanne M Farnan
- J.M. Farnan is professor of medicine and associate dean, evaluation and continuous quality improvement, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Walter Fitz-William
- W. Fitz-William is senior data specialist, Association of American Medical Colleges, Washington, DC
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Brunner MR, Peters D, Portera MV, Fazili I, McBride M, Dennis M, Herr MJ. The organic formation of a wellness committee: A unique, student-led approach to implementing a wellness program in medical school. Perspect Med Educ 2020; 9:260-263. [PMID: 32246406 PMCID: PMC7459064 DOI: 10.1007/s40037-020-00574-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Medical school wellness programs are rapidly becoming a prevalent feature of medical education. The wellness component of medical education is addressed by a multitude of different approaches, but is often led by administrative faculty rather than students. APPROACH The first-year medical student authors collectively established a medical school wellness committee that is entirely student-driven. The goal of the wellness committee was to organize and promote student ideas centered on six aspects of wellness. EVALUATION The formation, initial successes, and hurdles to the inception and continuation of the committee are described in a repeatable way. REFLECTION This perspective provides insight into a student-led innovation that was formally accepted by faculty and administration to serve as part of the university's overall wellness initiatives.
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Affiliation(s)
- Michael R Brunner
- College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Daniel Peters
- College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Mary Virginia Portera
- College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Irtiqa Fazili
- College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Mary McBride
- College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Mallie Dennis
- College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Michael J Herr
- College of Medicine, Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, USA.
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36
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Doggrell SA. No apparent association between lecture attendance or accessing lecture recordings and academic outcomes in a medical laboratory science course. BMC Med Educ 2020; 20:207. [PMID: 32605579 PMCID: PMC7329538 DOI: 10.1186/s12909-020-02066-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/04/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND The effect of availability of lecture recordings on academic outcomes is not clear and it is not known whether these recordings change the association between lecture attendance and academic outcomes. Few surveys of lecture attendance or lecture recordings use by students are linked to academic outcomes. The aims were (i) to determine any association between lecture attendance and academic outcomes for students who had access to lecture recordings, (ii) to determine any association between accessing lecture recordings and academic outcomes and (iii) to use a survey to determine why students attend lectures and/or access lecture recordings in a course in medical laboratory science. METHODS Consenting students signed in when attending lectures and/or completed an online survey. Pearson's correlation coefficients were calculated to determine whether there was an association between attending lectures or accessing lecture recordings and academic outcomes. RESULTS Consent rates were high for both the sign-in (90%) and survey (64%). The main findings were that in 2017 and 2018: (i) the average lecture attendance was 39 and 27%, respectively, (ii) there was no association between lecture attendance and academic outcomes, (iii) there was no association between accessing lecture recordings and academic outcomes. Survey respondents were almost equally divided between those attending lectures weekly, sometimes or not. Reasons for attending lectures included greater perceived learning and interaction with staff and other students, while reasons for not attending related to inconvenience or other commitments. Lecture recordings were accessed to clarify, revise or catch up on content, or as an alternative to attending lectures. One-third of students provided additional feedback on accessing lecture recordings, and the most common themes were 'flexibility' and 'useful'. Lecture slides (PowerPoints), independently of lecture recordings, were used extensively by the students. CONCLUSIONS From this study, it does not seem that either lecture attendance or accessing lecture recordings are major determinants of academic outcomes for most students. As students vary in their lecture attendance and use of online resources including lecture recordings and lecture slides, academic staff should continue to provide a range of resources for students.
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Affiliation(s)
- Sheila Anne Doggrell
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4002, Australia.
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37
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Doggrell SA. No apparent association between lecture attendance or accessing lecture recordings and academic outcomes in a medical laboratory science course. BMC Med Educ 2020; 20:207. [PMID: 32605579 DOI: 10.1186/s12909-020-02066-9.pmid:32605579;pmcid:pmc7329538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/04/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND The effect of availability of lecture recordings on academic outcomes is not clear and it is not known whether these recordings change the association between lecture attendance and academic outcomes. Few surveys of lecture attendance or lecture recordings use by students are linked to academic outcomes. The aims were (i) to determine any association between lecture attendance and academic outcomes for students who had access to lecture recordings, (ii) to determine any association between accessing lecture recordings and academic outcomes and (iii) to use a survey to determine why students attend lectures and/or access lecture recordings in a course in medical laboratory science. METHODS Consenting students signed in when attending lectures and/or completed an online survey. Pearson's correlation coefficients were calculated to determine whether there was an association between attending lectures or accessing lecture recordings and academic outcomes. RESULTS Consent rates were high for both the sign-in (90%) and survey (64%). The main findings were that in 2017 and 2018: (i) the average lecture attendance was 39 and 27%, respectively, (ii) there was no association between lecture attendance and academic outcomes, (iii) there was no association between accessing lecture recordings and academic outcomes. Survey respondents were almost equally divided between those attending lectures weekly, sometimes or not. Reasons for attending lectures included greater perceived learning and interaction with staff and other students, while reasons for not attending related to inconvenience or other commitments. Lecture recordings were accessed to clarify, revise or catch up on content, or as an alternative to attending lectures. One-third of students provided additional feedback on accessing lecture recordings, and the most common themes were 'flexibility' and 'useful'. Lecture slides (PowerPoints), independently of lecture recordings, were used extensively by the students. CONCLUSIONS From this study, it does not seem that either lecture attendance or accessing lecture recordings are major determinants of academic outcomes for most students. As students vary in their lecture attendance and use of online resources including lecture recordings and lecture slides, academic staff should continue to provide a range of resources for students.
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Affiliation(s)
- Sheila Anne Doggrell
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, 4002, Australia.
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38
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Rothdiener M, Griewatz J, Meder A, Dall’Acqua A, Obertacke U, Kirschniak A, Borucki K, Koenig S, Ruesseler M, Steffens S, Steinweg B, Lammerding-Koeppel M. Surgeons' participation in the development of collaboration and management competencies in undergraduate medical education. PLoS One 2020; 15:e0233400. [PMID: 32502213 PMCID: PMC7274374 DOI: 10.1371/journal.pone.0233400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/04/2020] [Indexed: 12/19/2022] Open
Abstract
The teaching of professional roles in medical education is an interdisciplinary concern. However, surgeons require specific standards of professionalism for certain context-based situations. In addition to communication, studies require collaboration, leadership, error-/conflict-management, patient-safety and decision-making as essential competencies for surgeons. Standards for corresponding competencies are defined in special chapters of the German National Competency-based Learning Objectives for Undergraduate Medical Education (NKLM; chapter 8, 10). The current study asks whether these chapters are adequately taught in surgical curricula. Eight German faculties contributed to analysing mapping data considering surgical courses of undergraduate programs. All faculties used the MERlin mapping platform and agreed on procedures for data collection and processing. Sub-competency and objective coverage, as well as the achievement of the competency level were mapped. Overall counts of explicit citations were used for analysis. Collaboration within the medical team is a strongly represented topic. In contrast, interprofessional cooperation, particularly in healthcare sector issues is less represented. Patient safety and dealing with errors and complications is most emphasized for the Manager/Leader, while time management, career planning and leadership are not addressed. Overall, the involvement of surgery in teaching the competencies of the Collaborator and Manager/Leader is currently low. However, there are indications of a curricular development towards explicit teaching of these roles in surgery. Moreover, implicitly taught roles are numerous, which indicates a beginning awareness of professional roles.
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Affiliation(s)
- Miriam Rothdiener
- Competence Centre for University Teaching in Medicine, Baden-Wuerttemberg, Faculty of Medicine, University of Tuebingen, Tuebingen, Germany
| | - Jan Griewatz
- Competence Centre for University Teaching in Medicine, Baden-Wuerttemberg, Faculty of Medicine, University of Tuebingen, Tuebingen, Germany
| | - Adrian Meder
- Department of Trauma and Reconstructive Surgery, Berufsgenossenschaftliche Unfallklinik Tuebingen, University of Tuebingen, Tuebingen, Germany
| | - Alessandro Dall’Acqua
- Competence Centre for Evaluation of Teaching in Medicine, Baden-Wuerttemberg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Udo Obertacke
- Orthopaedic and Trauma Surgery Center, University Medicine Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
- Competence Centre of Final Year, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Andreas Kirschniak
- Department of General, Visceral and Transplant Surgery, University Hospital Tuebingen, Tuebingen, Germany
| | - Katrin Borucki
- Institute for Clinical Chemistry and Pathobiochemistry, University of Magdeburg, Magdeburg, Germany
| | - Sarah Koenig
- Insitute for Medical Teaching and Medical Education Research, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Miriam Ruesseler
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany
| | - Sandra Steffens
- Dean’s Office for Medical Education, Hannover Medical School, Hannover, Germany
| | - Bernhard Steinweg
- Department of Paediatric Cardiology, University of Bonn, Bonn, Germany
| | - Maria Lammerding-Koeppel
- Competence Centre for University Teaching in Medicine, Baden-Wuerttemberg, Faculty of Medicine, University of Tuebingen, Tuebingen, Germany
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Braschi E, Stacey D, Légaré F, Grad R, Archibald D. Evidence-based medicine, shared decision making and the hidden curriculum: a qualitative content analysis. Perspect Med Educ 2020; 9:173-180. [PMID: 32323113 PMCID: PMC7283448 DOI: 10.1007/s40037-020-00578-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Medical education should portray evidence-based medicine (EBM) and shared decision making (SDM) as central to patient care. However, misconceptions regarding EBM and SDM are common in clinical practice, and these biases might unintentionally be transmitted to medical trainees through a hidden curriculum. The current study explores how assumptions of EBM and SDM can be hidden in formal curriculum material such as PowerPoint slides. METHODS We conducted a qualitative content analysis using a purposive sample of 18 PowerPoints on the management of upper respiratory tract infections. We identified concepts pertaining to decision making using theory-driven codes taken from the fields of EBM and SDM. We then re-analyzed the coded text using a constructivist latent thematic approach to develop a rich description of conceptualizations of decision making in relation to EBM and SDM frameworks. RESULTS PowerPoint slides can relay a hidden curriculum, which can normalize: pathophysiological reasoning, unexplained variations in clinical care, the use of EBM mimics, defensive medicine, an unrealistic portrayal of benefits, and paternalism. DISCUSSION Addressing the hidden curriculum in formal curricular material should be explored as a novel strategy to foster a positive attitude towards EBM and SDM and to improve patient outcomes by encouraging the use of these skills.
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Affiliation(s)
- Emélie Braschi
- Lamont Primary Health Care Research Centre, Ottawa, ON, Canada.
| | - Dawn Stacey
- Faculty of Health Sciences, Ottawa Hospital Research Institute, Ontario, ON, Canada
| | - France Légaré
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Laval University, Québec, QC, Canada
| | - Roland Grad
- Herzl Family Practice Centre, Montreal, Canada
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Abstract
PROBLEM Global connectivity and awareness have significantly increased over the past 3 decades, yet medical education remains mostly unchanged in its delivery-local didactic teaching, supplemented with hands-on clinical experiences. APPROACH Beginning in 2016, the authors leveraged the livestreaming capabilities of Facebook and YouTube to create a platform called pathCast to broadcast pathology lectures to an international community of medical professionals. An interactive pathology curriculum was designed to address challenging topics across various subspecialties. Expert pathologists were invited to deliver 60-minute lectures using digital or glass slides or traditional slide decks. Remote (online) attendees interacted with lecturers in real time using the broadcasts' chat interface. Facebook's and YouTube's analytics were evaluated to assess the performance of all lectures. OUTCOMES From June 2016 to December 4, 2019, 53 speakers delivered 87 lectures representing 18 pathology subspecialties in 9 different languages (with 78 [89.7%] in English only) and from various geographic regions. The lectures hosted on the Facebook channel have garnered 8,333 followers and 52,171 views for a total of 386,200 minutes of watch time, and the lectures hosted on the YouTube channel have accumulated 5,891 subscribers and 292,735 views for a total of 50,674 hours of watch time. The lectures have been viewed by users from 1,093 unique cities across 124 countries. NEXT STEPS The authors will continue to develop the curriculum to further disseminate pathology education on a global scale.
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Affiliation(s)
- Emilio Madrigal
- E. Madrigal is an assistant in pathology, Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts. R. Mannan is an assistant professor of pathology, University of Pennsylvania, Philadelphia, Pennsylvania
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Rockarts J, Brewer-Deluce D, Shali A, Mohialdin V, Wainman B. National Survey on Canadian Undergraduate Medical Programs: The Decline of the Anatomical Sciences in Canadian Medical Education. Anat Sci Educ 2020; 13:381-389. [PMID: 32174032 DOI: 10.1002/ase.1960] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 02/21/2020] [Accepted: 03/11/2020] [Indexed: 06/10/2023]
Abstract
The anatomical sciences have always been regarded as an essential component of medical education. In Canada, the methodology and time dedicated to anatomy teaching are currently unknown. Two surveys were administered to course directors and discipline leaders to gain a comprehensive view of anatomical education in Canadian medical schools. Participants were queried about contact hours (classroom and laboratory), content delivery and assessment methods for gross anatomy, histology, and embryology. Twelve schools responded to both surveys, for an overall response rate of 64%. Overall, Canadian medical students spend 92.8 (± 45.4) hours (mean ± SD) studying gross anatomy, 25.2 (± 21.0) hours for histology, and 7.4 (± 4.3) hours for embryology. Gross anatomy contact hours statistically significantly exceeded those for histology and embryology. Results show that most content is delivered in the first year of medical school, as anatomy is a foundational building block for upper-year courses. Laboratory contact time for gross anatomy was 56.8 (± 30.7) hours, histology was 11.4 (± 16.2) hours, and embryology was 0.25 (± 0.6) hours. Additionally, 42% of programs predominantly used instructor/technician-made prosections, another 33% used a mix of dissection and prosections and 25% have their students complete cadaveric dissections. Teaching is either completely or partially integrated into all Canadian medical curricula. This integration trend in Canada parallels those of other medical schools around the world where programs have begun to decrease contact time in anatomy and increase integration of the anatomical sciences into other courses. Compared to published American data, Canadian schools offer less contact time. The reason for this gap is unknown. Further investigation is required to determine if the amount of anatomical science education within medical school affects students' performance in clerkship, residency and beyond.
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Affiliation(s)
- Jasmine Rockarts
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Danielle Brewer-Deluce
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Ari Shali
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Vian Mohialdin
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Bruce Wainman
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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42
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Pan SQ, Chan LK, Yan Y, Yang X. Survey of Gross Anatomy Education in China: The Past and the Present. Anat Sci Educ 2020; 13:390-400. [PMID: 32107879 DOI: 10.1002/ase.1952] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 02/21/2020] [Accepted: 02/22/2020] [Indexed: 05/24/2023]
Abstract
Medical education in mainland China has undergone massive expansion and reforms in the past decades. A nation-wide survey of the five-year clinical medicine programs aimed to examine the course hours, pedagogies, learning resources and teaching staff of anatomy both at present and over the past three decades (1990-1999, 2000-2009, and 2010-2018). The directors or senior teachers from 90 out of the 130 five-year clinical medicine programs were invited to fill out a factual questionnaire by email. Ultimately, sixty-five completed questionnaires were received from 65 different schools. It was found that the total number of gross anatomy course hours has decreased by 11% in the past 30 years and that systematic and regional anatomy have been increasingly taught separately among the surveyed medical schools. Problem-based learning has been adopted in thirty-five (54%) of the surveyed schools, and team-based learning is used in ten (15%) of the surveyed schools. The surveyed schools reported receiving more donated cadavers in recent years, with the average number increasing from 20.67 ± 20.29 in 2000-2009 to 36.10 ± 47.26 in 2010-2018. However, this has not resulted in a decrease in the number of students who needed to share one cadaver (11.85 ± 5.03 in 1990-1999 to 14.22 ± 5.0 in 2010-2018). A decreasing trend regarding the teacher-student ratio (1:25.5 in 2000-2009 to 1:33.2 in 2010-2018) was also reported. The survey demonstrated the historical changes in gross anatomy education in China over the past thirty years.
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MESH Headings
- Anatomy/education
- Anatomy/statistics & numerical data
- Anatomy/trends
- Cadaver
- China
- Curriculum/statistics & numerical data
- Curriculum/trends
- Dissection/statistics & numerical data
- Dissection/trends
- Education, Medical, Undergraduate/history
- Education, Medical, Undergraduate/statistics & numerical data
- Education, Medical, Undergraduate/trends
- Faculty/statistics & numerical data
- History, 20th Century
- History, 21st Century
- Humans
- Problem-Based Learning/statistics & numerical data
- Schools, Medical/history
- Schools, Medical/statistics & numerical data
- Schools, Medical/trends
- Students, Medical/statistics & numerical data
- Surveys and Questionnaires/statistics & numerical data
- Teaching/history
- Teaching/statistics & numerical data
- Teaching/trends
- Time Factors
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Affiliation(s)
- San-Qiang Pan
- Division of Anatomy, School of Medicine, Jinan University, Guangzhou, People's Republic of China
| | - Lap Ki Chan
- Department of Biomedical Sciences, Macau University of Science and Technology, Macao Special Administrative Region, People's Republic of China
| | - Yu Yan
- Division of Pathology and Pathophysiology, School of Medicine, Jinan University, Guangzhou, People's Republic of China
| | - Xuesong Yang
- Division of Histology and Embryology, School of Medicine, Jinan University, Guangzhou, People's Republic of China
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43
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Tsai YD, Tsai SH, Chen SJ, Chen YC, Wang JC, Hsu CC, Chen YH, Yang TC, Li CW, Cheng CY. Pilot study of a longitudinal integrated disaster and military medicine education program for undergraduate medical students. Medicine (Baltimore) 2020; 99:e20230. [PMID: 32443354 PMCID: PMC7461121 DOI: 10.1097/md.0000000000020230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Disaster medicine education in medical curricula is scarce and frequently nonexistent. It is reasonable to initiate educational approaches for physicians in this field at the medical school level. An understanding of disaster medicine and the health care system during massive casualty incidents has been recommended as an integral part of the medical curriculum in the United States and Germany.The goal of the reformed curriculum was to develop a longitudinal integrated disaster and military medicine education program extending from the first year to the sixth year based on previously separated clinical and military medicine topics. Emergency medicine physicians, military emergency medical technicians, and Tactical Combat Casualty Care instructors formed an interprofessional faculty group and designed a learning curriculum.A total of 230 medical students participated in the revised disaster preparedness curriculum. Satisfaction survey response rates were high (201/230, 87.4%). Most of the free-text comments on the program were highly appreciative. The students considered the number of teaching hours for the whole program to be adequate. The students showed significant improvements in knowledge and judgment regarding disaster medicine after the program.We found that medical students were highly interested, were appreciative of, and actively participated in this longitudinal integrated disaster and military medicine education program, but gaps existed between the students' scores and the educators' expectations. The educators believed that the students needed more disaster preparedness knowledge and skills.
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Affiliation(s)
- Yi-Da Tsai
- Department of Emergency Medicine, Tri-Service General Hospital
| | - Shih-Hung Tsai
- Department of Emergency Medicine, Tri-Service General Hospital
- Department of Physiology and Biophysics, Graduate Institute of Physiology
- Combat and Disaster Casualty Care Training Center, National Defense Medical Center, Taipei
| | - Sy-Jou Chen
- Department of Emergency Medicine, Tri-Service General Hospital
- Combat and Disaster Casualty Care Training Center, National Defense Medical Center, Taipei
| | - Yin-Chung Chen
- Department of Emergency Medicine, Tri-Service General Hospital
| | - Jen-Chun Wang
- Department of Emergency Medicine, Tri-Service General Hospital
| | - Chia-Ching Hsu
- Department of Emergency Medicine, Tri-Service General Hospital
| | - Ying-Hsin Chen
- Department of Emergency Medicine, Hualien Armed Forces General Hospital, Hualien
| | | | | | - Cheng-Yi Cheng
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
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Holtzman JN, Deshpande BR, Stuart JC, Feeley TW, Witkowski M, Hundert EM, Kasper J. Value-Based Health Care in Undergraduate Medical Education. Acad Med 2020; 95:740-743. [PMID: 31913881 DOI: 10.1097/acm.0000000000003150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PROBLEM Value-based health care (VBHC) is an innovative framework for redesigning care delivery to achieve better outcomes for patients and reduce cost; however, providing students with the skills to understand and engage with these topics is a challenge to medical educators. APPROACH Here, the authors present a novel, VBHC curriculum integrated into a required course for post-core clerkship students-launched in 2018 at Harvard Medical School and taught in conjunction with Harvard Business School faculty-that highlights key principles of VBHC most relevant to undergraduate medical education. The course integrates VBHC with related health disciplines, including health policy, ethics, epidemiology, and social medicine, using a case-based method. Students practice active decision making while learning key concepts to address value in clinical practice. OUTCOMES Since the course's inception in March 2018, 95 students (87%) completed the standardized course evaluation; the majority said VBHC content and pedagogical style (i.e., case-based learning) enhanced their learning. Students' critiques focused on too little integration with other disciplines (e.g., social medicine, ethics), the physical space, and inadequate time for debates about potential tensions between VBHC and other course disciplines. NEXT STEPS The authors believe that by exposing medical students to the principles of VBHC, students will fulfill the expectations of graduating physicians by excelling as critical thinkers, collaborative team members, and judicious care providers throughout their residency, clinical practice, and beyond. Future VBHC curricula expansions may include elective coursework, intensive seminar series, and formal dual degrees.
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Affiliation(s)
- Jessica N Holtzman
- J.N. Holtzman is an internal medicine resident, University of California, San Francisco, San Francisco, California; ORCID: http://orcid.org/0000-0002-1721-1512. B.R. Deshpande is a fourth-year medical student, Harvard Medical School, Boston, Massachusetts. J.C. Stuart is an internal medicine resident, Brigham and Women's Hospital, Boston, Massachusetts. T.W. Feeley is a senior fellow, Institute for Strategy and Competitiveness, Harvard Business School, Boston, Massachusetts, and professor emeritus of anesthesiology, University of Texas MD Anderson Cancer Center, Houston, Texas. M. Witkowski is a fellow, Institute for Strategy and Competitiveness, Harvard Business School, Boston, Massachusetts. E.M. Hundert is dean for medical education, and the Daniel D. Federman, M.D. Professor in Residence of Global Health and Social Medicine and Medical Education, Harvard Medical School, Boston, Massachusetts. J. Kasper is assistant professor of global health and social medicine, Harvard Medical School, Boston, Massachusetts
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Jeyakumar A, Dissanayake B, Dissabandara L. Dissection in the Modern Medical Curriculum: An Exploration into Student Perception and Adaptions for the Future. Anat Sci Educ 2020; 13:366-380. [PMID: 31168930 DOI: 10.1002/ase.1905] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 05/18/2019] [Accepted: 05/22/2019] [Indexed: 06/09/2023]
Abstract
For centuries cadaveric dissection has been a cornerstone of medical anatomy education. However, time and financial limitations in modern, compressed medical curricula, coupled with the abundance of alternate modalities, have raised questions about the role of dissection. This study was designed to explore student perceptions of the efficacy of a dissection program for learning musculoskeletal anatomy, and possible adaptations for appropriate inclusion of dissection in the modern medical curricula. A paper-based questionnaire was used to collect data from 174 medical students after completion of cadaveric dissections. Data were analyzed using both quantitative and qualitative methods. Students strongly believed that cadaver-based learning is essential to anatomy education and modern teaching modalities only complement this. Moreover, most students reported that dissection provided an additional, immersive learning experience that facilitated active learning and helped in developing manual competencies. Students with previous dissection experience or an interest in anatomy-related specialties were significantly more likely to attend dissection sessions. Students found that the procedural dissection components enhanced the knowledge of applied anatomy and is beneficial for the development of clinical skills. They welcomed the idea of implementing more procedure-based dissections alongside lectures and prosections-based practical (PBP) sessions. Cadaveric dissection plays an integral role in medical anatomy education. Time restraints and an increased focus on clinical significance, however, demand carefully considered adaptations of existing dissection protocols. The introduction of procedure-based dissection offers an innovative, highly engaging and clinically relevant package that would amalgamate skills essential to medical practice while retaining the benefits that have allowed dissection to stand the test of time.
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MESH Headings
- Accreditation/standards
- Accreditation/trends
- Betacoronavirus/pathogenicity
- COVID-19
- Coronavirus Infections/epidemiology
- Coronavirus Infections/prevention & control
- Coronavirus Infections/transmission
- Coronavirus Infections/virology
- Education, Distance/standards
- Education, Medical, Undergraduate/standards
- Education, Medical, Undergraduate/trends
- Humans
- Infection Control/standards
- Pandemics/prevention & control
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/prevention & control
- Pneumonia, Viral/transmission
- Pneumonia, Viral/virology
- SARS-CoV-2
- Students, Medical
- Vascular Surgical Procedures/education
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Affiliation(s)
- Albeir Y Mousa
- Division of Vascular and Endovascular Surgery, Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston Area Medical Center, Vascular Center of Excellence, Charleston, WV
| | - Mike Broce
- Center for Health Services and Outcomes Research, Charleston Area Medical Center Health Education and Research Institute, Charleston, WV
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47
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Klein Nulend R, Harris P, Shulruf B. Predictive validity of a tool to resolve borderline grades in OSCEs. GMS J Med Educ 2020; 37:Doc31. [PMID: 32566733 PMCID: PMC7291380 DOI: 10.3205/zma001324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 11/19/2019] [Accepted: 01/07/2020] [Indexed: 05/28/2023]
Abstract
There is inconclusive evidence suggesting which standard setting method yields the highest validity for pass/fail decisions in examinations. The Objective Borderline Method 2 (OBM2) is a decision-making tool for reclassification of borderline grades to clear pass or clear fail grades to resolve examiner uncertainty for high-stakes pass/fail decisions. This study evaluated the predictive validity of OBM2 pass/fail decisions, using consecutive years' Objective Structured Clinical Examination (OSCE) results within a medical cohort (n=271) at the University of New South Wales, Australia. OBM2 decisions in one OSCE (n=687) were compared to marks obtained in a subsequent OSCE via independent samples T-tests and analysis of variance (ANOVA). The extent of the relationship between these two variables determines the predictive validity of OBM2 decisions, given that past student grades are capable of predicting future performance. OBM2 decisions in an initial OSCE were found to have a statistically significant predictive nature for subsequent OSCE marks (p=.005). For initial decisions which reclassified to a pass grade, subsequent OSCE marks were significantly higher than for the cases where initial decisions were reclassified to a fail grade. Stronger associations were identified between related assessment domains/criteria compared to unrelated domains/criteria (Cohen's d=.469 vs Cohen's d=.388 respectively). Through demonstrating the OBM2 decisions' predictive association across exams there is support for the OBM2's predictive validity, deeming it a promising method to be used for resolving examiner uncertainty when making pass/fail decisions within OSCEs.
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Affiliation(s)
- Rowan Klein Nulend
- University of New South Wales, Office of Medical Education, Sydney, Australia
| | - Peter Harris
- University of New South Wales, Office of Medical Education, Sydney, Australia
| | - Boaz Shulruf
- University of New South Wales, Office of Medical Education, Sydney, Australia
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48
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Redmond CE, Crawford R, O'Neill DC, Lee MJ. Social Media as a Learning Resource for Medical Students. Ir Med J 2020; 113:64. [PMID: 32268057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- C E Redmond
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - R Crawford
- Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - D C O'Neill
- Department of Radiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - M J Lee
- Department of Radiology, Royal College of Surgeons in Ireland, Dublin, Ireland
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49
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Affiliation(s)
- Ezekiel J Emanuel
- Perelman School of Medicine, Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia
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50
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Clever K, Richter C, Meyer G. Current approaches to the integration of sex- and gender-specific medicine in teaching: a qualitative expert survey. GMS J Med Educ 2020; 37:Doc26. [PMID: 32328528 PMCID: PMC7171350 DOI: 10.3205/zma001319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/08/2019] [Accepted: 10/14/2019] [Indexed: 06/02/2023]
Abstract
Aim: Although criteria and recommendations for the successful integration of sex- and gender-sensitive aspects in medical teaching have already been published, only a few medical faculties in Germany have conducted the systematic integration of sex- and gender-sensitive medicine. The aim of this expert survey, therefore, was to describe the current approaches to the integration of sex- and gender-sensitive medicine in teaching in the sense of Good Practice. Method: Between April and June 2018, guided interviews were conducted with nine experts in the field of sex- and gender-sensitive medicine. Each of the experts had had experience of implementing sex- and gender-sensitive medicine at their universities. The expert interviews were then evaluated by means of quality content analysis, and frequency analyses were carried out. Results: Aspects of sex- and gender-sensitive medicine were integrated both longitudinally and selectively into the compulsory curriculum or elective fields of various medical, health and nursing science courses. In the opinion of the experts, medical studies should promote the students' gender sensitivity and in particular impart knowledge about the psychosocial and biological aspects of sex- and gender-related differences and sex- and gender-sensitive communication. For the methodological implementation of the integrated contents, didactic resources were partly adapted or developed. The players in the implementation process were confronted with various challenges, e.g. the involvement of the lecturers, the perception of sex- and gender-sensitive medicine as a women's theme as well as ensuring the sustainable integration of sex- and gender-sensitive medicine, which is also structurally anchored in the faculty. Aspects of the curricular integration (e.g. evidence-basing, relevance in examinations) and the structural anchoring (e.g. central organization, staff availability) were mentioned i.a. as being crucial for success. A combination of top-down and bottom-up processes, e.g. by involving the faculty management but also by supporting student initiatives, was described as conducive to success. Conclusion: The depicted approaches to the integration of sex- and gender-sensitive teaching contents give insight as to how sex- and gender-sensitive medicine can be integrated into the curricula. The interviews with the experts point to current themes related to sex- and gender-sensitive medicine and didactic resources. Moreover, it becomes clear which challenges are to be expected for the integration of sex- and gender-sensitive medicine in teaching and how these can be addressed. Particularly the involvement of the faculty's lecturers but also the sustainable integration and continual quality assurance of sex- and gender-sensitive contents present challenges of a crucial nature.
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Affiliation(s)
- Katharina Clever
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute of Health and Nursing Science, Halle (Saale), Germany
| | - Cynthia Richter
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute of Health and Nursing Science, Halle (Saale), Germany
| | - Gabriele Meyer
- Martin Luther University Halle-Wittenberg, Medical Faculty, Institute of Health and Nursing Science, Halle (Saale), Germany
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