Is There Such a Thing as Theological Medicine?

The idea that science must be understood in existential contradiction to religion and even theology is more of a conviction than a philosophical or experiential necessity. Indeed, we may now propose "Theological Medicine" as a new terminology for a perennial reality: that most physicians, health care providers, patients, and their caretakers experience the reality of illness within a theological framework, at least for those who have some degree of spiritual or religious belief. Developing a curriculum in Theological Medicine could develop a mechanism to offer appropriate training to healthcare providers. Such a course would have to be created and delivered by experienced physicians and nursing staff, spiritual advisors, clergy representatives such as pastors or priests from different churches or faith communities, bioethicists, psychologists, social workers, psychotherapists, patient support group members, members of institutional review boards, researchers, and even legal advisors, if available. Continuing professional education requirements also create an opportunity to introduce and evaluate competency in theological medicine, an emerging discipline that could add significant value to the lived experience of medical practice which remains based on the uniquely rich relationship between physician and patient.

What do the teachers want? A targeted needs assessment survey for prospective didactic training of psychiatry medical educators

Objectives

Physicians and psychologists at psychiatric university hospitals are assigned teaching tasks from the first day of work without necessarily having the prerequisite training in teaching methods. This exploratory survey provides a needs-based analysis for the prospective didactic training of physicians and psychologists at psychiatric hospitals in Germany, Austria and Switzerland.

Methods

An online questionnaire was distributed at medical schools via email in German-speaking countries in Europe. All physicians involved in teaching medical students at psychiatry faculties were eligible to participate in the survey. Participants were further requested to recruit eligible participants (snowball sampling). Responses were analyzed descriptively, and differences between groups were calculated using nonparametric Mann-Whitney U tests (p<.05).

Results

Overall, 97 respondents (male=55, female=42; mean age= 40.6) from 19 medical schools completed the survey. The respondents consisted of 43 residents, 39 specialists, 6 chief physicians and 9 psychologists. Of the respondents, 97.6% rated didactic competence as either highly relevant or rather relevant for teaching medical students. The highest overall interest was shown for bedside teaching (mode=4; IQR: 2-4) and error culture (mode=3; IQR: 2-4). Respondents expressed the highest training needs for topics regarding presentation and communication (mode=3; IQR: 2-3). Resident physicians were significantly more interested in bedside teaching (U=362.0, p=0.004) and roleplay (U=425.0; p=0.036) than specialist physicians, who were more interested in examination didactics (U=415.0; p=0.022). Chief physicians displayed significantly deeper interest in group dynamics (U=51; p=0.023) than specialist physicians. In-person training was preferred by a majority of respondents, and 27.4% preferred online/web-based training.

Conclusions

The majority of physicians and psychologists at psychiatric university hospitals considered professional development for faculty to be helpful for teaching medical students. Bedside teaching and error culture management were the most desired teaching topics for training medical teachers. Tailored educational interventions are recommended, with target-oriented priorities for different hierarchical levels.

[Presence and future of the teaching of anatomy, histology and embryology in the medical curriculum]

Hazai orvosképző helyeinken az emberi test szerkezetét az anatómia, szövet- és fejlődéstan egységében tanítjuk. Ez a dolgozat áttekinti és gondolatokat fogalmaz meg tárgyunk jelenével és jövőjével kapcsolatban. Az orvosképzés sarokkövét jelentő anatómiaoktatásnak úgy kell választ adnia a rohamléptékben fejlődő orvostudomány kérdéseire és igényeire, hogy mindeközben egy megváltozott társadalmi és gazdasági környezethez igazodó orvosképzést kell szolgálnia. Oktatógárdánknak olyan hallgatókkal kell közösen fáradoznia a tudás átadásán, akik egy digitális, sokszor virtuális világban nőttek fel, de nagyon is valóságos, gyakorlati képzés során kell orvossá válniuk. A tudás átadásának új módszertanával kell kiegészítenünk a valóságot megmutató jógyakorlatot, melyben a makroszkópos anatómiai tudást a boncasztalnál, a mikroszkópos anatómiai tudást a mikroszkóp mellett értetjük meg, s ebben a fejlődéstani ismeretek nélkülözhetetlen és folyamatos kiinduló- és támpontot adnak. A korlátozott számú előadások a tényközlés helyett a megértetést, a gyakorlatok a megtapasztalást kell hogy szolgálják, míg a vizsgák egy tanár-diák komplementer képességei mentén átadott tudásanyag objektív, igényes tükrét kell hogy nyújtsák. Új és leendő anatómus munkatársaink számára a tudományos munka és a kiérdemelt függetlenség jövőjét kell láttatnunk és biztosítanunk, melyben a rezidens- és szakorvosképzés, valamint a makroszkópos anatómiai témájú tudományos témák, munkatervek felé való gondolkodás nyit új utakat. Ápoljuk és gyakoroljuk, ami magyar és nemzetközi képzésünk visszajelzései alapján kiváló és igényelt, de keresnünk kell tárgyunk további helyét és lehetőségét mind a graduális, mind a posztgraduális képzésben és a tudományban. Orv Hetil. 2024; 165(9): 323–331.

Reimagining human dissection in preclinical medical education using studio-based learning: A retrospective pilot study

Human dissections in the current medical curriculum are conducted using a checklist approach to prioritize the exposure of anatomical structures. In this setting, anatomy educators are labored to enhance their engagement during the dissection. To address this issue, we considered the current medical education pedagogies and identified a novel approach of studio-based learning (SBL) for application in a Human Dissection Workshop. This study aimed to (1) evaluate students' perceptions of SBL, (2) appraise the impact of SBL on anatomical knowledge learning, and (3) interpret the results of a validated questionnaire. Workshop participants were recruited from Year 2 medical students at the Chinese University of Hong Kong from the 2020 and 2021 cohorts. Fifty-one students participated in the workshop (N = 24 [2020], N = 27 [2021]), and 50 of them completed the postworkshop questionnaire rated on a 5-point Likert scale. Nineteen items were validated using a factor analysis. The interpretation of the questionnaire results demonstrated the different learning outcomes of the workshop, which included (1) enhancing students' knowledge and spatial understanding of anatomical structures, (2) strengthening students' appreciation of gross pathologies and clinical relevance, and (3) promoting higher-order thinking skills. To our knowledge, this is the first study to introduce SBL in medical education. The successful implementation of the workshop reflects the promising potential of SBL for enhancing human dissection and supplementing the medical curriculum.

Artificial Intelligence in Medicine: Cross-Sectional Study Among Medical Students on Application, Education, and Ethical Aspects

BACKGROUND

The use of artificial intelligence (AI) in medicine not only directly impacts the medical profession but is also increasingly associated with various potential ethical aspects. In addition, the expanding use of AI and AI-based applications such as ChatGPT demands a corresponding shift in medical education to adequately prepare future practitioners for the effective use of these tools and address the associated ethical challenges they present.

OBJECTIVE

This study aims to explore how medical students from Germany, Austria, and Switzerland perceive the use of AI in medicine and the teaching of AI and AI ethics in medical education in accordance with their use of AI-based chat applications, such as ChatGPT.

METHODS

This cross-sectional study, conducted from June 15 to July 15, 2023, surveyed medical students across Germany, Austria, and Switzerland using a web-based survey. This study aimed to assess students' perceptions of AI in medicine and the integration of AI and AI ethics into medical education. The survey, which included 53 items across 6 sections, was developed and pretested. Data analysis used descriptive statistics (median, mode, IQR, total number, and percentages) and either the chi-square or Mann-Whitney U tests, as appropriate.

RESULTS

Surveying 487 medical students across Germany, Austria, and Switzerland revealed limited formal education on AI or AI ethics within medical curricula, although 38.8% (189/487) had prior experience with AI-based chat applications, such as ChatGPT. Despite varied prior exposures, 71.7% (349/487) anticipated a positive impact of AI on medicine. There was widespread consensus (385/487, 74.9%) on the need for AI and AI ethics instruction in medical education, although the current offerings were deemed inadequate. Regarding the AI ethics education content, all proposed topics were rated as highly relevant.

CONCLUSIONS

This study revealed a pronounced discrepancy between the use of AI-based (chat) applications, such as ChatGPT, among medical students in Germany, Austria, and Switzerland and the teaching of AI in medical education. To adequately prepare future medical professionals, there is an urgent need to integrate the teaching of AI and AI ethics into the medical curricula.

Addressing the Gap of Nutrition in Medical Education: Experiences and Expectations of Medical Students and Residents in France and the United States

Distinct pedagogical approaches within medical curricula in France and in the U.S. reflect a growing recognition of the importance of nutrition to address major public health challenges. However, recent generations of medical students have expressed mixed opinions regarding nutrition education. What pedagogical approach may improve nutrition education? Despite different medical systems, students from both France and the U.S. share similar concerns and expectations, that nutrition knowledge must be embedded in the curriculum and must be engaging. Hands-on, system-based, epistemological, and multidisciplinary approaches need better articulation to forge a robust medical curriculum. In the rapidly changing contexts of medicine and public awareness, social science research may facilitate recommendations for improved nutrition education.

Development and evaluation of a pre-clerkship spiral curriculum: data from three medical school classes

Pre-clerkship curricula of most Liaison Committee on Medical Education (LCME)-accredited medical schools are divided into blocks by organ system, leaving a significant amount of information susceptible to loss due to prolonged nonuse. We describe the implementation of a formal Spiral Curriculum that periodically revisits material from previous blocks. Learners were surveyed on receptivity to the curriculum across three graduating classes at a single medical school. Medical school graduate classes of 2020, 2021, and 2022 were surveyed at the end of their pre-clerkship years (2018-2020). The class of 2022 actually received the Spiraled Curriculum intervention, for which the authors created 500 board exam style multiple-choice questions, periodically administered via mandatory in-class sessions ranging from 10 to 20 questions reviewing content from previous blocks with designated expert faculty. Response rates were 36% (n = 46), 45% (n = 52), and 32% (n = 40) for classes of 2020, 2021, and 2022, respectively. On a Likert scale (1 = strongly disagree, 5 = neutral, 10 = strongly agree), the classes of 2020, 2021, and 2022 provided statistically significant differences in their belief that a Spiraled Curriculum would/did help them retain information as 8.2 (SD 1.7), 8.2 (SD 2.2), and 5.0 (SD 3.0) (n < 0.05). All classes endorsed neutral confidence in the existing pre-clerkship curriculum in themselves to prepare for United Stated Medical Licensing Examination (USMLE) Step 1, and in their retention of previous block material with no statistically significant differences between classes. USMLE Step 1 scores did not differ significantly between classes (n = 0.21). Those who did not receive the Spiral Curriculum were highly receptive to it in theory, while those who actually received the intervention gave a neutral rating. Per survey comments, implementation of a Spiraling Curriculum would ideally be administered as either team-based or self-directed activities, and a Spiraling Curriculum may be difficult to implement in accelerated (18 month) pre-clerkship formats.Practice points Question: What is the receptivity of medical students to a formal Spiral curriculum that uses time-spaced repetition sessions of board exam style questions to revisit previous block content of their pre-clerkship years?Findings: In this single-center, quasi-experimental study, the two control group medical school classes had very positive theoretical reception to a Spiral curriculum proposal (rated 8 out of 10) while the class who actually received the Spiral curriculum provided a statistically significant lower neutral rating (rated 5 out of 10), citing preference for a team-based or self-directed format.Meaning: Medical students are strongly in favor of structured time-spaced repetition with board exam style questions to revisit previous material but prefer a format that does not interfere with time to personalize their medical school experience.

Medical Education during the COVID-19 Pandemic: A Reflection on the JHUSOM Experience

Background

We sought to understand the relative risk of COVID-19 infection and identify risk factors for infection to identify targets for mitigation among medical students.

Methods

An observational cohort study of Johns Hopkins School of Medicine students was conducted from June 2020 to July 2021. Blood samples were collected and tested at three visits to assess for the presence of antibodies against SARS-CoV-2. Additionally, a questionnaire was administered at each visit to collect demographic information and assess potential social and behavioral risk factors.

Results

264 students enrolled in the study, and 38 participants completed all study requirements by study end. Roughly 6% of the first- and second-year classes had a reported positive COVID-19 test compared to 5% of third- and fourth-year students. By visit 3, 92% of medical students had detectable antibodies against COVID-19 compared to 4% during the study enrollment period. From study enrollment to visit 3, there was a 10-fold increase in the percentage of students reporting attending large social gatherings and dining in restaurants.

Conclusions

Overall, few COVID-19 cases were found among medical students, even those on clinical rotations. As the study progressed, students reported engaging in higher-risk social behaviors in conjunction with increasing vaccination rates among students.

Health literacy profiles of medical students in an Australian Doctor of Medicine programme: A cross-sectional study using the Health Literacy Questionnaire

ISSUE ADDRESSED

With the emerging focus on designing health-literate organisations and health care systems, it is essential to understand the health literacy profiles of the medical workforce including medical students, as medical professionals play a key role in within these systems. Medical professionals contribute to good patient health outcomes through enabling access to appropriate health care, provision of quality health information and collaborative shared decision-making, which are fundamental health literacy competencies. The aim of this study is to identify health literacy strengths and weaknesses of medical students enrolled in an Australian Doctor of Medicine programme.

METHODS

Students from all 4 years of an Australian Doctor of Medicine programme were invited to complete an anonymous, online survey in January 2021. Health literacy profiles were identified using the 9-domain, 44-item multi-dimensional Health Literacy Questionnaire, a validated tool which comprehensively evaluates health literacy strengths and weaknesses from diverse perspectives. Demographic characteristics and social attributes were also recorded. The results were compared with Australian Bureau of Statistics data.

RESULTS

Eighty-six participants completed the survey. Most participants were female students (57%) who spoke English at home (88%) with tertiary-educated fathers (60%) and resided in locations associated with high socioeconomic status during adolescence (61%). Males scored significantly higher in three domains which explored health information access and appraisal, and ability to actively engage with health care providers. Students' scores were significantly lower than the Australian general population in Domain 6 (Ability to actively engage with health care providers) and Domain 7 (Navigating the health care system).

CONCLUSIONS

Medical students' health literacy profiles indicate areas of weakness in their ability to engage with health care providers and to navigate the health system. Medical educators will need to create opportunities to address these weaknesses within medical curricula. Gender differences identified in self-rated ability to access and appraise health information requires further exploration. SO WHAT?: Further understanding of health literacy profiles of medical students may influence design of medical school curricula.

Effectiveness of Near-Peer-Taught Case Reviews on Students' Confidence in National Board of Medical Examiners (NBME) Exams

Introduction A key element to a first-year medical student's (MS1) education is guidance and practice in applying anatomy, pathophysiology, diagnosis, and treatment concepts to clinical vignettes. One potential solution to providing effective clinical reasoning training is the involvement of second-year medical students (MS2s) in small group sessions as teachers to provide more personalized instruction via case-based learning sessions. Near-peer teaching has been shown to benefit students' confidence in learning and improve test scores. Similarly, case-based learning is heavily associated with an improved understanding of complex topics. As such, this study assessed the efficacy of near-peer teaching with concomitant case-based style presentations on improving the comfort of MS1s with their understanding of the curriculum content and their comfort with applying their knowledge to clinical scenarios. Methods This randomized controlled crossover trial included several small-group study sessions, each consisting of five MS1s and led by an MS2 who reviewed selected clinical cases in a standardized slide decks. The control arm was provided the same slide decks but did not participate in the MS2-led sessions. During the first course, students were assigned to either the control or intervention group and then crossed over to the opposite group (control to intervention and vice versa) in every subsequent course. Comfort with the curriculum material was then assessed through pre and post surveys, with the post surveys administered after the MS1s took their final NBME examination for that course. Results The study was cut short due to COVID-19 precautions limiting in-person sessions. Nevertheless, the post survey demonstrated an increased understanding of pathological concepts for the intervention group compared to the control group. Conclusions Future work on near-peer group study sessions should enroll a larger sample size with measures to improve the response rate to better test whether near-peer-led case reviews had a significant effect on students' understanding of anatomical concepts and confidence during NBME examinations.

Training medical students in motivational interviewing using a blended learning approach: a proof-of-concept study

Background

Difficulties in implementing behavior change in patients with chronic diseases are common in clinical practice. Motivational interviewing (MI) helps clinicians to support patients in overcoming ambivalence while maintaining self-determination. The inclusion of MI in German medical training curricula is still rare. Furthermore, the effects of systematic teaching of MI, especially via blended learning, have hardly been investigated.

Methods

Medical students participated in three curricular events related to MI, consisting of instructional videos and theoretical and practical components in a blended learning format. The aim of the study was to investigate the effect of teaching MI in students' medical education. A controlled, non-randomized study was conducted with an intervention group and a control group. Both groups completed questionnaires on their experience and knowledge related to MI, completed a knowledge test and rated their satisfaction with the course. MI was taught in the 6th semester of medical coursework as part of a psychosomatic course, in the 8th semester during a psychiatry course and in the 9th semester during a weekly psychiatry clerkship.

Results

Data from the intervention group (n = 35) and control group (n = 14) were analyzed, with 65.7% of students participating in all three parts of the curriculum. Overall interest in learning MI was high, with M = 2.92 (SD = 1.00). The results indicate a greater increase in knowledge over time in the intervention group. The majority (62.86%) stated that the curriculum was relevant to their future career. Free-form text responses indicated a high level of satisfaction with practical relevance.

Conclusion

This study demonstrates the usefulness of an MI curriculum for medical students. The integration of MI into medical curricula is a promising curricular addition to improve doctor-patient communication. Future research should address patient perceptions of MI competencies and the persistence of acquired competencies.

Grounded in reality: artificial intelligence in medical education

Background

In a recent survey, medical students expressed eagerness to acquire competencies in the use of artificial intelligence (AI) in medicine. It is time that undergraduate medical education takes the lead in helping students develop these competencies. We propose a solution that integrates competency-driven AI instruction in medical school curriculum.

Methods

We applied constructivist and backwards design principles to design online learning assignments simulating the real-world work done in the healthcare industry. Our innovative approach assumed no technical background for students, yet addressed the need for training clinicians to be ready to practice in the new digital patient care environment. This modular 4-week AI course was implemented in 2019, integrating AI with evidence-based medicine, pathology, pharmacology, tele-monitoring, quality improvement, value-based care, and patient safety.

Results

This educational innovation was tested in 2 cohorts of fourth year medical students who demonstrated an improvement in knowledge with an average quiz score of 97% and in skills with an average application assignment score of 89%. Weekly reflections revealed how students learned to transition from theory to practice of AI and how these concepts might apply to their upcoming residency training programs and future medical practice.

Conclusions

We present an innovative product that achieves the objective of competency-based education of students regarding the role of AI in medicine. This course can be integrated in the preclinical years with a focus on foundational knowledge, vocabulary, and concepts, and in clinical years with a focus on application of core knowledge to real-world scenarios.

Clinical Empathy and Its Correlates Among Indian Medical Students: A Cross-Sectional Study of Bihar

Background Clinical empathy is standing in the patient's shoes and perceiving his/her emotions to experience the patient's feelings. Practicing empathy ensures an enticing prospect in patient care. This study was done among undergraduate medical students to assess their empathy level and the factors affecting it. Methods This was a cross-sectional study conducted with 400 medical students in Bihar, India. Students not willing to participate were excluded from the study. The coding system was designed to strictly maintain anonymity. The study tools included the Jefferson Scale for Physician Empathy - Student Version (JSPES), a semi-structured questionnaire on the general profile, a perceived stress scale (PSS), and a multidimensional scale of perceived social support (MSPSS). Participants were allotted 20 minutes to complete the test and submit their responses. Results were expressed as means and standard deviations (SDs), with appropriate statistical tests applied. The data were presented in tables, and statistical significance was checked at a 5% level. All statistical analyses were conducted using SPSS software. Results The arithmetic mean (±SD) of empathy scores was 99.87±14.71. Empathy was found to be positively correlated with social support and negatively with stress. The factors found to be significantly associated with empathy on univariate analysis were subjected to stepwise multiple linear regression, which provided a six-factor model comprising gender, choice of future specialty, stress, social support, residence, substance abuse, and stay in hospital as an attendant. Conclusions Stress and social support were found to be significant predictors of empathy. The female gender, living in urban areas, and having previous experience of hospital stay as an attendant of a patient were positively associated with empathy. In contrast, choosing a technical branch as a future specialty and substance abuse were negatively associated with empathy. Stress management, enhancement of social support, and avoidance of habit-forming substances could be beneficial in improving empathy among doctors. Since we could only identify a few factors, we recommend further studies on this topic to explore other factors.

Integrating climate change and health topics into the medical curriculum - a quantitative needs assessment of medical students at Heidelberg University in Germany

Objectives

Climate change (CC) is of major importance for physicians as they are directly confronted with changing disease patterns, work in a greenhouse gas intensive sector and can be potential advocates for healthy people on a healthy planet.

Methods

We assessed third to fifth year medical students' needs to support the integration of CC topics into medical curricula. A questionnaire with 54 single choice-based items was newly designed with the following sections: role perception, knowledge test, learning needs, preference of educational strategies and demographic characteristics. It was administered online to students at Heidelberg medical faculty. Data sets were used for descriptive statistics and regression modelling.

Results

72.4% of students (N=170, 56.2% female, 76% aged 20-24 years) (strongly) agreed that physicians carry a responsibility to address CC in their work setting while only 4.7% (strongly) agreed that their current medical training had given them enough skills to do so. Knowledge was high in the area of CC, health impacts of CC, vulnerabilities and adaptation (70.1% correct answers). Knowledge gaps were greatest for health co-benefits and climate-friendly healthcare (55.5% and 16.7% of correct answers, respectively). 79.4% wanted to see CC and health included in the medical curriculum with a preference for integration into existing mandatory courses. A multilinear regression model with factors age, gender, semester, aspired work setting, political leaning, role perception and knowledge explained 45.9% of variance for learning needs.

Conclusion

The presented results encourage the integration of CC and health topics including health co-benefits and climate-friendly healthcare, as well as respective professional role development into existing mandatory courses of the medical curriculum.

Histology as a paradigm for a science-based learning experience: Visits by histology education spirits of past, present, and future

The term "histology" was coined a little over 200 years ago and the subject has always relied on microscopy as its defining technology. Microscopy was and still is an essential approach for the description of cellular components and their arrangements in living organisms. For more than a century and a half, histology or microanatomy has also been part of the basic science education for biomedical students. Traditionally, it has been taught in two major components, a didactic transfer of information, either in a lecture or self-learning format, and in active-learning laboratory sessions. These two modes of histology instruction conform with the dual-processing theory of learning, one being more automatic and depending mainly on rote memorization, whereas the other is analytical, requiring more advanced reasoning skills. However, these two components of histology education are not separate and independent, but rather complementary and part of a multi-step learning process that encourages a scientific analysis of visual information and involves higher-level learning skills. Conventional, as well as modern electronic instruction methods (e-learning) have been used in complementary ways to support the integrated succession of individual learning steps as outlined in this manuscript. However, as recent curricular reforms have curtailed instructional time, this traditional format of teaching histology is no longer sustainable and a reflective reassessment of the role of histology in modern biomedical education is a timely necessity.

Revitalizing primary care is the key to people's health in the post-COVID era

Growing evidence shows that primary care-oriented systems achieve better health outcomes, more health equity, and lower costs. Despite this strong evidence, such care has been chronically underfunded. If a council focused on primary care had existed during the height of the coronavirus disease 2019 (COVID-19) pandemic, it could have helped rapidly mobilize primary care to address vaccine equity and shore up public health, particularly in rural and historically marginalized urban communities. We believe an infrastructure investment plan should include oversight, tools, and resources for rebuilding primary care. Researchers have tried to compare the number of deaths due to "neglected tropical diseases" and that due to COVID - total deaths in the former cases are greater than COVID deaths. We should take into consideration a few issues: (a) distinction between health (as a human right) and health care (as commodity), (b) "clinical health" and "public health," (3) primary health care (as the backbone of public health) as well as community-based horizontal program NOT to be replaced by selective primary health care or GOBI or any disease-centered vertical program.

Needs assessment of essential anatomy: The perspective of adult primary care resident physicians

Curricular development and modification involve first identifying a problem and then performing a needs assessment, which can guide the design of curricular components. Pedagogical changes, coupled with reductions in curricular time for gross anatomy, pose challenges and impose restrictions within medical school curricula. In order to make anatomy education effective and efficient, it is important to determine the anatomy considered essential for medical education through a targeted needs assessment. In this study, 50 adult primary care resident physicians in family medicine (FM) and internal medicine (IM) were surveyed to assess the importance of 907 anatomical structures, or groups of structures, across all anatomical regions from a curated list based on the boldface terms in four primary anatomy texts. There were no statistically significant differences in the ratings of structures between the two groups for any anatomical region. In total, 17.0% of structures, or groups of structures, were classified as essential, 58.0% as more important, 24.4% as less important, and 0.7% as not important. FM residents rated tissues classified as skeleton, nerves, fasciae, anatomical spaces, blood vessels, lymphatics, and surface anatomy (p < 0.0001) significantly higher than IM residents, but there were no differences in the rating of muscles or organs (p > 0.0056). It was notable that 100.0% of cranial nerves were classified as essential, and 94.5% of surface anatomy structures were classified as essential or more important. It is proposed that results of this study can serve to inform curricular development and revision.

Artificial Intelligence Teaching as Part of Medical Education: Qualitative Analysis of Expert Interviews

BACKGROUND

The use of artificial intelligence (AI) in medicine is expected to increase significantly in the upcoming years. Advancements in AI technology have the potential to revolutionize health care, from aiding in the diagnosis of certain diseases to helping with treatment decisions. Current literature suggests the integration of the subject of AI in medicine as part of the medical curriculum to prepare medical students for the opportunities and challenges related to the use of the technology within the clinical context.

OBJECTIVE

We aimed to explore the relevant knowledge and understanding of the subject of AI in medicine and specify curricula teaching content within medical education.

METHODS

For this research, we conducted 12 guideline-based expert interviews. Experts were defined as individuals who have been engaged in full-time academic research, development, or teaching in the field of AI in medicine for at least 5 years. As part of the data analysis, we recorded, transcribed, and analyzed the interviews using qualitative content analysis. We used the software QCAmap and inductive category formation to analyze the data.

RESULTS

The qualitative content analysis led to the formation of three main categories ("Knowledge," "Interpretation," and "Application") with a total of 9 associated subcategories. The experts interviewed cited knowledge and an understanding of the fundamentals of AI, statistics, ethics, and privacy and regulation as necessary basic knowledge that should be part of medical education. The analysis also showed that medical students need to be able to interpret as well as critically reflect on the results provided by AI, taking into account the associated risks and data basis. To enable the application of AI in medicine, medical education should promote the acquisition of practical skills, including the need for basic technological skills, as well as the development of confidence in the technology and one's related competencies.

CONCLUSIONS

The analyzed expert interviews' results suggest that medical curricula should include the topic of AI in medicine to develop the knowledge, understanding, and confidence needed to use AI in the clinical context. The results further imply an imminent need for standardization of the definition of AI as the foundation to identify, define, and teach respective content on AI within medical curricula.

Barriers to research opportunities among osteopathic medical students

CONTEXT

Despite the increase of importance placed on research, both by residency program directors and the medical field at large, osteopathic medical students (OMS) have significantly fewer research experiences than United States (U.S.) allopathic medical students and non-U.S. international medical graduates. However, few studies have addressed this long-standing discrepancy, and none directly have focused on osteopathic medical students to assess their unique needs. The literature would benefit from identifying the barriers osteopathic medical students encounter when participating in research and understanding the currently available resources.

OBJECTIVES

To assess the barriers that OMS face when seeking research opportunities, identify resources currently available to osteopathic medical students at their respective schools, and investigate factors that contribute to an osteopathic medical student's desire to pursue research opportunities. Additionally, to investigate osteopathic medical students' confidence in research methodology.

METHODS

A survey was created by the investigators and administered to participants over a three-month period via a GoogleForm. Research participants were surveyed for demographic information, as well as their involvement in research projects in the past, mentor availability, institutional resources, motivation to participate in research, individual barriers to participation, and confidence in their ability to do independent research. Responses were de-identified and analyzed using Microsoft Excel functions to count data and calculate percentages, as well as Pearson's chi square analysis.

RESULTS

After relevant exclusion, 668 responses were included. Of the students surveyed, 85.9% (574) indicated they currently and/or in the past were involved in research. More than half of the respondents that are not currently involved in research are interested in pursuing it (86.9%; 344). The primary barriers students reported facing include lack of time (57.8%; 386), feeling overwhelmed and unsure how to start (53.4%; 357), and lack of access to research (53%; 354). 34.7% (232) of students stated they either did not have resources from their school or were unsure whether these resources were available. The two most cited motivations to pursue research included boosting their residency application and/or interest in the area of study. Male gender and current research were associated with reported confidence in research ( [4, n=662]=10.6, p<0.05).

CONCLUSIONS

Findings from this study provide a synopsis of the barriers to research opportunities among osteopathic medical students. Notably, ⅓ of OMSs reported an absence or unawareness of available research resources at their osteopathic medical schools.

A Mixed-Methods Needs Assessment for a Longitudinal Surgical Preparation Course in Undergraduate Medical Education

OBJECTIVE

To assess the unmet needs associated with surgical education and skill development during the pre-clerkship years of medical school.

DESIGN

A mixed-methods design was employed that leveraged semi-structured interviews and quantitative surveys followed by qualitative analysis.

SETTING

A large midwestern academic medical center.

PARTICIPANTS

Eighteen participants were enrolled representing second year medical students with an interest in surgery, surgical residents, and attending surgeons from a diverse array of surgical specialties.

RESULTS

Unanimous support for the creation of a pre-clerkship surgical skills course emerged due to 2 main themes: (1) gaps in current surgical education offerings and (2) the value of early exposure to surgery and surgical skills followed by longitudinal practice. The components that participants deemed essential to a well-designed course were also revealed. Each stakeholder group (medical students, residents, surgeons) would benefit across all factors uncovered.

CONCLUSIONS

There is a significant unmet need across all stakeholder groups for the creation of a longitudinal surgical skills course for pre-clerkship medical students. Future studies should seek to design a curriculum based on these study results and assess a pilot version of the curriculum to understand its feasibility under application.

Chronic diseases of lifestyle curriculum: Students' perceptions in primary health care settings

BACKGROUND

Community-based primary health care (PHC) forms the foundation of healthcare in South Africa. Medical programmes need to equip future health practitioners to face the challenges of the rising burden of chronic diseases of lifestyle (CDL) in different communities. Community-based education (CBE) contributes to developing knowledge, skills and attitudes appropriate to the challenges experienced in the PHC context.

AIM

To explore medical students' perceptions of the current CDL curriculum and related programmes during CBE rotations.

SETTING

The study was conducted among fourth- and fifth-year medical students at the University of the Free State, South Africa.

METHODS

Focus group discussions were conducted and data were analysed thematically.

RESULTS

Themes included perceptions of the CDL curriculum, relevance thereof for the PHC setting and barriers and challenges to implementing PHC programmes. This study identified foundational CDL content that needs to be incorporated or revisited at strategic points. Participants identified the need to contextualise educational programmes and focus on affordable, culturally acceptable and holistic healthcare prevention strategies. Barriers and challenges included high patient load, resource constraints, the lack of continuous care and focus on communicable diseases. Community-based education rotations were described as meaningful opportunities to develop professional attributes, competencies and skills.

CONCLUSION

This study identified foundational concepts to consider at key points throughout the curriculum. Incorporating creative and reflective learning activities in CDL modules can prepare students for the realities of PHC settings.Contribution: This study provides insight into medical students' perceptions of the CDL curriculum and informs future curriculum content for CDL modules.

LGBTQ+ Healthcare Teaching in UK Medical Schools: An Investigation into Medical Students' Understanding and Preparedness for Practice

OBJECTIVES

Lesbian, gay, bisexual, trans* and queer/questioning + (LGBTQ+) healthcare teaching within UK medical schools is currently lacking, potentially impacting on patients' confidence in health services and ability to access care. The current study conducted a multi-site analysis aiming to investigate medical students' perceptions towards the teaching of LGBTQ+ healthcare in UK medical schools, as well as to gain a greater understanding of medical students' level of knowledge of LGBTQ+ healthcare, and preparedness for working with LGBTQ+ patients.

METHODS

Medical students (N = 296) from 28 UK institutions responded to a 15-question online survey distributed via course leads and social media. Thematic analysis of qualitative data was conducted, as well as statistical analysis of quantitative data using SPSS.

RESULTS

Only 40.9% of students reported having any teaching on LGBTQ+ healthcare, 96.6% of whom said this was one-off or very irregular sessions. Only 1 in 8 felt their knowledge and skills on LGBTQ+ healthcare was sufficient. 97.2% of students questioned wanted more knowledge on LGBTQ+ healthcare.

CONCLUSION

The current study highlighted that UK medical students felt underprepared for working with LGBTQ+ patients due to insufficient education. Given that teaching on LGBTQ+ healthcare is often optional and extra-curricular, it may not be reaching those who need it most. The authors are calling for the mandatory inclusion of LGBTQ+ healthcare in the teaching of all UK medical schools, within their individual curriculum frameworks, and with regulatory support from the General Medical Council. This will ensure a wider understanding among medical students, and subsequently qualified doctors, of the health inequities and unique health issues LGBTQ+ people face, which will better equip them to provide high-quality care to LGBTQ+ patients, and start to tackle the inequities they face.

Teaching of the Black Population's Health: Anti-Racist Lenses for a Paradigm Shift to Address Racial Inequities

Health (and its dialectical pair-illness) is determined by multiple factors: social class, educational background, income, occupation, and race/skin color. Racism can directly impact physical and psychological illnesses, with an effect on social conditions of health. This paper discusses: (1) racism as a root cause of health inequities in Brazil and elsewhere, and (2) how students at the University of Brasilia School of Medicine respond to an anti-racist curriculum. We emphasize that an environment of profound exchanges in the teaching-learning process, adopting anti-racism praxis as a competency in the medical curriculum, is a paradigm shift in medical education and future practice.

Medical Students' Perception Towards Choosing Pathology Program at Jazan University, Saudi Arabia

PURPOSE

The selection of a specific medical specialty is crucial to medical students and is increasingly associated with future job satisfaction and success in the medical field. We aim to evaluate the perception of medical students at Jazan University towards choosing pathology as a future career and the factors influencing their decisions in order to better the employability of graduates and provide information to both the labor force and curriculum designers.

METHODS

An observational cross-sectional study was conducted among a random sample of (391) students at the faculty of medicine, Jazan University, from the 2nd to 6th year who registered as a formal student in the academic year 2021/2022. Data was collected via (web-based) a self-administered questionnaire because of COVID-19 pandemic. Chi-squared tests and regression analysis were performed.

RESULTS

In this investigation, 92.9% of participants responded. Only 16.2% of undergraduates selected pathology as a future career choice. Among the participants who desired to choose pathology as a career, 28.6% preferred hematopathology as a future sub-specialty. Around 16% considered the most crucial reason for not choosing pathology is the preference for direct patient contact. The differences in age groups, academic level, GPA, and educational level of father between respondents who having a desire to choose pathology as a future career were found to be significantly different.

CONCLUSION

Among the respondents involved in this study, only 16.2% were interested in pathology, while 3.1% chose the field as their first future career choice. Our findings can be applied to help undergraduate better prepare for the future and encourage them to apply to the pathology program to address the shortage of pathologists in the area. Qualitative research is a need to explore the perceptions of current pathology residents and the reasons that can encourage them to choose this important specialization as a future career.

Imagine all you want, but…

3D printing is an emerging trend in medical care [1]. Medical libraries can play a key role in advancing this new technology [2]. Using a National Library of Medicine (NLM) grant, the medical library was able to purchase a basic 3D printer to create models for patient care and medical education. Despite a slow rollout for the new technology, there was a strong need once word of mouth spread about the new 3D printer. The one-year grant cycle, as well as the following three years, provide supporting evidence that even a basic 3D printer can advance patient care for clinicians and improve medical education for students [3]. The popularity of the technology, clinical support and demand, as well as student interest can drive the program forward on its own and support the medical library's mission to improve community care and create an environment of enhanced learning [1].

Perception of Online Learning Among Undergraduate Medical Students of Eastern India: A Cross-Sectional Study

Background In 2020 WHO declared the coronavirus disease 2019 (COVID-19) outbreak as a global pandemic. To flatten the curve of infection, a nationwide lockdown was declared by the Indian government. All the schools and colleges were shut for an indefinite period. Like all other streams, medical education also got severely hampered. Adapting themselves to the changing environment, teachers started using different teaching-learning methods and media to get across to the students. The objective of the research was to study the perception of medical students towards online teaching during the COVID pandemic. Methods A descriptive cross-sectional study was conducted by the distribution of a pre-validated online questionnaire to medical students of West Bengal. From the collected data, relevant statistical averages and census domains were calculated. The chi-square test was done and assessed with a p≤0.05 significance level. Results A significant increase was noted in the time spent by students on various online teaching activities (p<0.05). Video tutorials, e.g., YouTube, were ranked as the most effective mode (17.2%), followed by live tutorials via Microsoft Teams, etc. (8.9%). A significant number (30.2%) of students strongly favoured online teaching over face-to-face teaching. Major challenges of online learning cited by students were internet connectivity issues (79.8%) followed by family distraction (37.9 %) and inconvenient timing of the classes (20.1%). Conclusion Our study highlighted the benefits, disadvantages and barriers to online learning from the perspective of undergraduate medical education in India. Even though the online mode of teaching was found to be beneficial in the context of the COVID-19 pandemic, it cannot be used as an absolute substitution for face-to-face teaching in the given context.

Developing professional identity among undergraduate medical students in a competency-based curriculum: Educators' perspective

Professional identity formation (PIF) refers to the possession and exhibition of the conduct of a medical professional. It's an external representation of a medical personnel's feelings, beliefs, experiences, and values that influence the provision of holistic patient care. Apart from training medical students to be competent and skilled physicians, one of the goals of today's medical education must be to encourage them to achieve professional identity formation. Many medical schools across the globe have made this explicit during the clinical years of study, but we believe that professional identity formation starts as early as day one of medical school. So, for educators, apart from delivering basic science subject content during early years of study, the creation of learning opportunities and pedagogic space in the curriculum to enhance competencies of PIF becomes mandatory. This competency-based educational approach will help medical students transform and reconsider their own values and beliefs by relating to the behaviors that are expected by the profession, colleagues, and patients when they graduate as medical doctors. In this paper, we discuss how a competency-based curriculum should provide opportunities for students to interact and communicate effectively with patients and colleagues, to self-reflect on their own personal identity before creating a professional identity that is unique to the profession, to make the right judgment and confidently practice medicine in a business-based healthcare system.

Planetary health education in medical curricula in the Republic of Ireland

BACKGROUND

The World Health Organization considers climate change an urgent global health challenge requiring prioritised action. A recent global survey reported that only 15% of medical schools have incorporated climate change and health into the curriculum.

OBJECTIVES

This research study was carried out from November 2020 and April 2021 using the Planetary Health Report Card (PHRC) initiative to assess the current level of planetary health teaching in medical schools in the Republic of Ireland. PHRC is a student-led international public initiative, which aims to compare medical schools using a planetary health report card. The assessment was submitted as a final report to the Irish Medical Council and to the medical schools involved.

RESULTS

Very few learning outcomes in Irish medical curricula directly address or include the concept of planetary health. Inclusion of specific topics remains reliant on individual lecturer interest. While most universities have excellent research centres which cover specific aspects of planetary health, the links between these institutes and medical schools have not been created.

CONCLUSIONS

Overall, there are promising examples of planetary health themes throughout the current Irish medical curricula, however, these remain poorly implemented or embedded within the curricula. Medical schools should incorporate education on planetary health to ensure graduates are equipped as to become medical leaders practising in a changing world.

Awareness of Medical Research among the Resident Doctors in a Tertiary Care Hospital in India

Aim

The aim of this study was to study the awareness of medical research (MR) among resident doctors in a tertiary care hospital.

Materials and Methods

This is a descriptive and cross-sectional study conducted for 30 days among the residents of paraclinical, surgical, and nonsurgical specialties, based on a customized self-prepared questionnaire. Convenience sampling was done. Undergraduates, interns, and faculty members were excluded from the study. Scoring was given from 1 to 10 based on their responses to the ten knowledge-based questions in the questionnaire. Data regarding the publication of research articles if any, obstacles in conducting research, and suggestions to improve the research awareness were recorded. Descriptive analysis of the data was done. Based on the scoring, they were divided into three groups: below average if the score is <5, average if the score is 5-7, and above average if the score is 8-10.

Results

A total of 364 resident doctors were included in the study. They were divided into three groups which include paraclinical (n = 56, 15%), surgical (n = 132, 36%), and nonsurgical branches (n = 176, 48%). Scores for the three levels, i.e., below average, average, and above average were 0, 39% (n = 140), and 61% (n = 224), respectively. Forty-eight percent of participants had a publication. Obstacles for conducting the research included lack of time (55%), lack of interest (29%), lack of guidance (35%), and lack of material and teaching (45%). The majority (n = 300, 82%) suggested that conducting more interactive sessions or teaching programs may help in improving the awareness on research.

Conclusions

Most of the resident doctors had a fair knowledge of MR but its application into practice was limited. Including research as a part of the medical curriculum, conducting educational programs or conferences oriented on research may improve the awareness about research.

Perceptions of US Medical Students on Artificial Intelligence in Medicine: Mixed Methods Survey Study

BACKGROUND

Given the rapidity with which artificial intelligence is gaining momentum in clinical medicine, current physician leaders have called for more incorporation of artificial intelligence topics into undergraduate medical education. This is to prepare future physicians to better work together with artificial intelligence technology. However, the first step in curriculum development is to survey the needs of end users. There has not been a study to determine which media and which topics are most preferred by US medical students to learn about the topic of artificial intelligence in medicine.

OBJECTIVE

We aimed to survey US medical students on the need to incorporate artificial intelligence in undergraduate medical education and their preferred means to do so to assist with future education initiatives.

METHODS

A mixed methods survey comprising both specific questions and a write-in response section was sent through Qualtrics to US medical students in May 2021. Likert scale questions were used to first assess various perceptions of artificial intelligence in medicine. Specific questions were posed regarding learning format and topics in artificial intelligence.

RESULTS

We surveyed 390 US medical students with an average age of 26 (SD 3) years from 17 different medical programs (the estimated response rate was 3.5%). A majority (355/388, 91.5%) of respondents agreed that training in artificial intelligence concepts during medical school would be useful for their future. While 79.4% (308/388) were excited to use artificial intelligence technologies, 91.2% (353/387) either reported that their medical schools did not offer resources or were unsure if they did so. Short lectures (264/378, 69.8%), formal electives (180/378, 47.6%), and Q and A panels (167/378, 44.2%) were identified as preferred formats, while fundamental concepts of artificial intelligence (247/379, 65.2%), when to use artificial intelligence in medicine (227/379, 59.9%), and pros and cons of using artificial intelligence (224/379, 59.1%) were the most preferred topics for enhancing their training.

CONCLUSIONS

The results of this study indicate that current US medical students recognize the importance of artificial intelligence in medicine and acknowledge that current formal education and resources to study artificial intelligence-related topics are limited in most US medical schools. Respondents also indicated that a hybrid formal/flexible format would be most appropriate for incorporating artificial intelligence as a topic in US medical schools. Based on these data, we conclude that there is a definitive knowledge gap in artificial intelligence education within current medical education in the US. Further, the results suggest there is a disparity in opinions on the specific format and topics to be introduced.

A Mixed Methods Assessment of the Management Role of Physicians

Introduction

Physicians are increasingly confronted with new requirements in their daily job, which go beyond the mere treatment of patients. The aim of this Mixed-Method-Study is to better understand management as it relates to physicians' daily work, to clarify the physicians' perception of their management role and to examine physician's self-assessed competence in these functions.

Methods

We used three different instruments: Semi-structured interviews, a self-assessment survey and direct observations to evaluate managerial activities performed by residents. Both latter were based on instruments established for management research.

Results

Interviewed residents were familiar with the term "Management" but had difficulties in defining it. Concerning managerial functions in context of their daily work, we identified three main categories: Self-management, Patient-management and Management of the ward. In this context, physicians named numerous examples of management tasks and for which they felt ill prepared. Eighty-eight residents participated in the self-assessment survey and rated the majority of the management tasks as necessary for the residents' work. Although physicians estimated the proportion of managerial work to comprise only 40.6%, a much higher number of mere management tasks could be identified through direct observations (n = 12). Activities related to management were more often observed than genuine physician tasks.

Discussion

This study illustrates the prominent role of management activities in context of the residents' work, while at the same time showing that residents do not feel sufficiently educated, prepared nor competent in management tasks.

Histology education in an integrated, time-restricted medical curriculum: Academic outcomes and students' study adaptations

In an ever-changing medical curricular environment, time dedicated for anatomical education has been progressively reduced. This happened at the University of Michigan Medical School starting in 2016-2017 when preclinical medical education was condensed to one year. Histology instruction remained integrated in organ system courses but reduced to a lecture-only format without scheduling time for laboratory exercises, requiring students to study virtual histology slides on their own time. In accordance with the shortened instructional time, the number of histology examination questions was reduced more than twofold. This study analyzed students' histology examination results and assessed their motivation to learn histology and use of educational opportunities before and after these curricular changes were implemented. Students' motivation to learn histology and their evaluation of histology lectures increased in the new curriculum. However, students devoted less study time to studying histology. Students' cumulative histology examination scores were significantly lower in the new curriculum and the number of students with overall scores <75%, defined as a substandard performance, increased more than 15-fold. Academically weaker students' histology scores were disproportionately more affected. As medical educational strategies, priorities, and curricular frameworks continue to evolve, traditional didactic topics like histology will need to adapt to continue providing educational value to future health care providers.

A Needs-Based Analysis of Teaching on Vaccinations and COVID-19 in German Medical Schools

The COVID-19 pandemic highlights the need for improving public confidence in vaccines. Academic gaps and redundancies on vaccinations must be identified to revise the medical curriculum for up-to-date training of medical students. This cross-sectional survey assessed the status of vaccine-related teaching in general and specific to COVID-19 in medical schools across Germany. A total of 4313 medical students completed a questionnaire comprising items on national learning goals and perceived needs for teaching on vaccinations. Mixed methods were used to analyse data quantitatively for relative frequencies (%) and correlations between teaching items and semesters (Spearman’s rho), and qualitatively (content analysis). Our findings showed that 38.92% of the students were dissatisfied with teaching on vaccine-preventable diseases, but the perceived satisfaction increased in later semesters (r = 0.46, p < 0.001). Moreover, 75.84% and 68.15% of the students were dissatisfied with teaching related to vaccine scepticism and vaccine-related communication strategies, respectively. Furthermore, 63.79% reported dissatisfaction with teaching on COVID-19 disease and 72.93% with teaching on COVID-19 vaccines. A total of 79.12% stated they educated others on COVID-19 and its vaccines and 75.14% felt responsible to do so. A majority of the medical students were dissatisfied with teaching on dealing with vaccine scepticism, communication strategies and COVID-19 vaccines. We recommend practice-oriented vaccine education, especially for teaching communication skills to medical students.

Psychiatry training for medical students: A global perspective and implications for India's competency-based medical education curriculum

Competency-based medical education curriculum (CBME) has received traction worldwide. However, its adoption and implementation have significantly varied across the globe. The National Medical Commission, India (2019) has adopted CBME to improve the quality and content of training of medical students. However, the ongoing COVID-19 pandemic has spawned several challenges implementing the CBME. Therefore, there is a need to reflect on using novel teaching and assessment methods to enrich medical and psychiatric training. In this paper, we aimed to study global trends and characteristics of competency-based psychiatry training programs and how these experiences can be utilized to overcome challenges and facilitate the implementation of CBME in Psychiatry in the Indian context. A literature search was conducted using PubMed and Google Scholar databases. The findings are presented narratively. Psychiatry training for medical students greatly vary across the globe. High-income countries mainly have implemented CBME and have incorporated psychiatry training during the foundation/pre-clerkship period itself. There is more reliance on skill development and flexible and learning-based training vs. time-based training. Various enrichment activities have been incorporated into the medical curriculum to promote and strengthen psychiatry training for medical students, particularly in developed nations, which have yielded positive results. Although the COVID-19 pandemic has adversely affected the medical student's training, it has reiterated the significance of skill-based education and opened novel avenues for implementing the CBME.Medical educationists need to adapt themselves to provide CBME to the students. Making structural, curricular changes, orienting teachers, and students about the CBME, mentoring teachers, adopting novel training and assessment methods, utilizing enrichment activities, collaborating with educational institutions and technology providers, periodically evaluating the implementation of the CBME, and making appropriate course corrections are essential. In addition, there is a need to address structural barriers, such as lack of workforce, for better realization of the CBME objectives.eriodically evaluating the implementation of the CBME, and making appropriate course corrections are essential. Additionally, there is a need to address structural barriers, such as lack of workforce, for better realization of the CBME objectives.

Development and piloting of an instructional video quality checklist (IVQC)

PURPOSE

Medical education instructional videos are more popular and easier to create than ever before. Standard quality measures for this medium do not exist, leaving educators, learners, and content creators unable to assess these videos.

MATERIALS AND METHODS

Drawing from the literature on video quality and popularity, reusable learning objects, and multimedia and curriculum development principles, we developed a 26-item instructional video quality checklist (IVQC), to capture aspects of educational design (six items), source reliability (four items), multimedia principle adherence (10 items), and accessibility (six items). Two raters applied IVQC to 206 videos from five producers across topics from two organ systems (cardiology and pulmonology) encompassing four disciplines (anatomy, physiology, pathology, and pharmacology).

RESULTS

Inter-rater reliability was strong. According to two-rater means, eight multimedia items were present in over 80% of videos. A minority of videos included learning objectives (46%), alternative language translations (41%), when the video was updated (40%), analogies (37%), or references (9%). Producer ratings varied significantly (p < .001) across 17 of 26 items. There were no significant differences according to the video topic.

CONCLUSIONS

IVQC detected differences in elements of instructional video quality. Future work can apply this instrument to a broader array of videos and in authentic educational settings.

A Scoping Review of Published Intimate Partner Violence Curricula for Medical Trainees

Intimate partner violence (IPV) affects many, and health care has the potential to provide a safe space for individuals experiencing IPV. However, physicians cite lack of time and education as barriers. The aim of this study is to complete a review of published IPV curricula in medical school, residency training, and postresidency training. We performed a scoping review to provide a quantitative assessment and summary review of existing IPV curricula. In May 2020, a librarian conducted a search of Ovid MEDLINE, Ovid EMBASE, and Scopus. We evaluated each article for the following curriculum content and structure items: (1) year introduced; (2) delivery method; (3) curriculum type; (4) curriculum content; (5) curriculum effectiveness; and (6) implementation barriers. Fifty-six articles met criteria, most were for medical school learners (n = 32, 57.1%) and short-term (lasting less than one academic year) (n = 41, 73.2%). For residency, IPV curricula were most frequently taught in family medicine, internal medicine, and emergency medicine. Formal lecture and use of standardized patients were the most popular delivery methods. Most curricula taught risk factors for and identification of individuals who have experienced IPV. The most cited implementation barrier was limited time in standard medical education, followed by inability to measure the effectiveness of the curriculum. There was great variation in the methods of assessing effectiveness of IPV curricula. Published IPV curricula are varied, without consistent validated tools for assessing efficacy. Future initiatives to establish a standard of competency for medical students regarding IPV, including a standard curriculum, may better ensure that physicians are capable of identifying and caring for individuals who have experienced IPV.

Health Care Students' Perspectives on Artificial Intelligence: Countrywide Survey in Canada

BACKGROUND

Artificial intelligence (AI) is no longer a futuristic concept; it is increasingly being integrated into health care. As studies on attitudes toward AI have primarily focused on physicians, there is a need to assess the perspectives of students across health care disciplines to inform future curriculum development.

OBJECTIVE

This study aims to explore and identify gaps in the knowledge that Canadian health care students have regarding AI, capture how health care students in different fields differ in their knowledge and perspectives on AI, and present student-identified ways that AI literacy may be incorporated into the health care curriculum.

METHODS

The survey was developed from a narrative literature review of topics in attitudinal surveys on AI. The final survey comprised 15 items, including multiple-choice questions, pick-group-rank questions, 11-point Likert scale items, slider scale questions, and narrative questions. We used snowball and convenience sampling methods by distributing an email with a description and a link to the web-based survey to representatives from 18 Canadian schools.

RESULTS

A total of 2167 students across 10 different health professions from 18 universities across Canada responded to the survey. Overall, 78.77% (1707/2167) predicted that AI technology would affect their careers within the coming decade and 74.5% (1595/2167) reported a positive outlook toward the emerging role of AI in their respective fields. Attitudes toward AI varied by discipline. Students, even those opposed to AI, identified the need to incorporate a basic understanding of AI into their curricula.

CONCLUSIONS

We performed a nationwide survey of health care students across 10 different health professions in Canada. The findings would inform student-identified topics within AI and their preferred delivery formats, which would advance education across different health care professions.

Self-Directed Learning During the COVID-19 Pandemic: Perspectives of South African Final-Year Health Professions Students

PURPOSE

Self-directed learning (SDL) has been advocated for effective training of final-year health professions students. COVID-19 challenges conventional teaching, learning, and assessment in the clinical environment. This study aimed to identify and explore enablers and barriers to SDL among final-year health professions students training during the COVID-19 pandemic.

METHODS

Adopting the SWOT (strengths, weaknesses, opportunities and threats) framework, this study explored the clinical learning and training experiences of final-year health professions students during the pandemic. A survey was conducted via online platforms. Data from 155 respondents were thematically analyzed.

RESULTS

Personal attributes such as reflection, self-determination, motivation, resilience, and positive learning behaviors and skills were identified as SDL enablers. Collaborative learning networks and online learning platforms facilitate learning needs and goals. Fear and anxiety, untrusted learning sites, uncertainty about graduation, financial issues and challenges in the learning environments were the major themes related to barriers to SDL.

CONCLUSION

The importance of SDL as a skill for uncertain times warrants further investigation in the training of future healthcare professionals. Inclusive planning and engagement with final-year health professions students to address identified stressors, as well as the creation of shared platforms where students are part of the decision-making processes for clinical learning and training are recommended. Responsive curricula that optimize unpredictable disruptions in clinical training are needed to equip students to diagnose their own learning needs and implement appropriate learning strategies.

Efficacy of Video-Based Forearm Anatomy Model Instruction for a Virtual Education Environment

INTRODUCTION

As virtual education becomes more widespread, particularly considering the recent COVID-19 pandemic, studies that assess the impact of online teaching strategies are vital. Current anatomy curriculum at Paul L. Foster School of Medicine consists of self-taught PowerPoint material, clinical vignette-centered team-based learning (dry lab), and prosection-based instruction (wet lab). This study examined the impact of video-based muscle model (VBMM) instruction using a student-designed forearm muscle model on anatomy quiz scores and student perceptions of its effectiveness with regards to learning outcomes.

METHODS

Students divided into Group 1 (54 students) and Group 2 (53 students) were assessed prior to and following a 3.5-minute video on anterior forearm compartment musculature using the muscle model. Group 1 began by completing a pretest, then received VBMM instruction, and then completed a posttest prior to participating in the standard dry lab and 1 hour wet lab. Group 2 completed the wet lab, then received the pretest, VBMM instruction, and posttest prior to participating in the dry lab. Both groups took an identical five-question quiz covering locations and functions of various anterior forearm muscles each time.

RESULTS

Mean scores were higher than no formal intervention with exposure to VBMM instruction alone (0.73 points, P = .01), wet lab alone (0.88 points, P = .002), and wet lab plus VBMM instruction (1.35 points, P= <.001). No significant difference in scores was found between instruction with VBMM versus wet lab alone (P = 1.00), or between either instruction method alone compared to a combination of the two methods (P = .34, .09). Student survey opinions on the VBMM instruction method were positive.

CONCLUSION

VBMM instruction is comparable to prosection-based lab with regards to score outcomes and was well received by students as both an independent learning tool and as a supplement to cadaveric lab. When compared to either instruction method alone, the supplementation of VBMM with cadaveric prosection instruction was best. VBMM instruction may be valuable for institutions without access to cadaveric specimens, or those looking to supplement their current anatomy curriculum.

The Impact of ERASMUS Exchanges on the Professional and Personal Development of Medical Students

The ERASMUS program is one of the most popular student exchange projects, particularly among the students of Central and Eastern European countries. However, limited research is available with regard to its influence on the professional and personal development of its participants. The study aimed at investigating the experiences and impact of the ERASMUS program on different domains of the personal and professional life of medical students. A questionnaire containing closed and open-ended questions was distributed among 269 former participants of the ERASMUS program from the Poznan University of Medical Sciences to collect qualitative and quantitative data regarding the topic. The response rate was 41%. Mastering professional foreign language skills was the most frequently reported benefit of ERASMUS (94%), followed by a change of approach towards learning by exposure to innovative teaching techniques, character, professionalism and cultural competency development, impact on the migration decisions of the students, as well as the opportunity to compare healthcare and educational systems across countries. Additionally, 57% of respondents stated that ERASMUS impacted their career plans, and few indicated that it had affected their specialty choice. Approximately 28% of respondents have worked abroad in healthcare or research since graduating. Participation in the ERASMUS program proved to be a unique opportunity for professional and personal development.

Perspectives of Clinical Teaching Fellows on preparedness for practice: a mixed-methods exploration of what needs to change

Supporting medical students in their transition to newly qualified doctor is an important educational priority. Clinical Teaching Fellows (CTFs), as both recent graduates and trained educators, are uniquely positioned to suggest curricular enhancements to support preparedness for practice. Our mixed-methods approach involved CTFs across eight UK teaching hospitals. We conducted five activity-oriented focus groups to explore what CTFs felt needed to change to increase preparedness for practice. We analysed these focus groups to create a dataset of their suggestions followed by a survey. The survey invited CTFs to rate and rank these suggestions in relation to their own self-rated preparedness for practice, with qualitative insights into their choices. We explored commonalities and differences between high and low confidence participants, with findings qualitatively illuminated. 24 CTFs attended focus groups from which we identified 28 curriculum items and 10 curriculum agendas. We collected 23 complete survey responses. All confidence groups rated communicating with colleagues and managing working life as unmet needs, whereas core clinical competencies such as history and examination were well met. Participants with low confidence identified more complex clinical competencies including clinical decision making, task prioritisation and end-of-life care as unmet needs, with decision making and prioritisation being the most important. Confident graduates rated higher professional competencies such as quality improvement, career planning and education as unmet needs but of low importance. Graded transition of responsibility was the highest ranked curriculum agenda. Qualitative insights included suggestions for how learning in clinical environments could be enhanced. Our findings suggest that transitioning from student to newly qualified doctor could be supported by graded entrustment and enhanced shadowing opportunities. Other recommendations include prioritising more complex clinical competencies, identifying wellbeing as part of preparedness for practice, equipping students to communicate with colleagues and aligning higher professional competencies with learners' needs.

A modified Delphi approach to enhance nurturing of professionalism in postgraduate medical education in Singapore

INTRODUCTION

Nurturing professional identities instils behavioural standards of physicians, in turn facilitating consistent professional attitudes, practice, and patient care. Identities are socioculturally constructed efforts, thus we must account for the social, cultural, and local healthcare factors that shape physicians' roles, responsibilities and expectations. This study aims to forward a program to nurture professionalism amongst physicians in Singapore.

METHODS

A 3-phased-evidenced-based-approach was used. First, a systematic scoping review (SSR) was conducted to identify professionalism elements. Second, a questionnaire was created drawing from the SS's findings. Third, a modified Delphi involving local experts identifying socioculturally appropriate elements to nurture professionalism was conducted.

RESULTS

The 124 included articles in the SSR revealed definitions, knowledge, skills, and approaches to nurturing professionalism. The modified Delphi identified professional traits, virtues, communication, ethical, self-care, teaching and assessment methods, and support mechanisms.

CONCLUSION

Results formed the basis to a holistic and longitudinal program focused on instilling professional traits and competencies over time through personalised and holistic support of physicians. Findings will be of interest to medical communities in the region and beyond.

Association Between Learning Approaches and Medical Student Academic Progression During Preclinical Training

PURPOSE

Students have diverse learning preferences that can impact the achievement of learning outcomes. However, there is a lack of unequivocal evidence for an association between the learning preferences and academic success. The purpose of the study was to examine the association between learning approaches and academic success of medical students during the basic science curriculum.

METHODS

In this cross-sectional comparative study, low-achieving (n=80) and high-achieving students (n=50) from semesters 1 through 3 of the Ross University School of Medicine's basic science curriculum completed the Approaches and Study Skills Inventory for Students (ASSIST) short-form to provide data on their learning approaches. Student's-t test was applied to find statistical differences in learning approaches of low and high achievers, and point-biserial was used to analyze the correlation between academic performance and learning approaches. Mean sum scores with standard deviation on ASSIST short-form scales (deep, surface, and strategic approaches) as well as subscales are reported.

RESULTS

High-achieving students reported a preference for using deep and strategic learning approaches compared to low-achieving students (p < 0.05). Low achievers indicated that they predominantly used the surface approach to learning (p<0.05). Yet, "fear of failure," a subscale of the surface approach, was greater among high achievers. Additionally, significant gender differences were found on subscales of "lack of purpose," "syllabus bound," "unrelated memorization" (surface approach), and "time management" and "organized studying" (strategic approach).

CONCLUSION

Our results suggest that low-achieving medical students' predominant reliance on the surface approach to learning may affect their academic success and that it may be worthwhile to help medical students become aware of the effectiveness of their individual preferred learning approaches early on in their training. Identification and adoption of optimal learning approaches should increase the achievement of successful learning outcomes.

Approaches to building rapport with patients

In this article, I detail my rapport-building trial and error exercise and outline why addressing a patient's occupation at the beginning of a consultation worked during my history taking. Context permitting, addressing occupation can be useful when setting the tone and rhythm of a conversation, helping to focus explanations on the back of a patient's everyday experiences, and allowing a history-taker to address a patient's ideas, concerns and expectations more comfortably. Broaching occupation can also be a useful way to extrapolate information about disease risk factors and baseline understanding from the start. Whatever the rapport-building technique used, self-awareness seems to be a critical skill in this exercise, and an approach used with one patient may not necessarily be useful with another.

What happens to misunderstandings of biomedical concepts across a medical curriculum?

Research on the extent and nature of commonly misunderstood fundamental biomedical concepts across a medical curriculum is scarce. These misunderstandings could point toward robust misconceptions. We examined first whether common misunderstandings persist throughout a medical curriculum, followed by a fine-grained analysis to identify their nature. We designed and administered a 2-tier test to 987 medical students across our curriculum, with 8 questions covering the respiratory and cardiovascular systems, cell division, and homeostatic processes. Proportions of incorrect responses were computed. Four questions where misunderstandings persisted were further qualitatively analyzed. A one-way ANOVA showed the proportion of incorrect responses decreased significantly by students' academic year [F(6, 986) = 96.05, P < 0.001]. While novices and end-of -first-year students showed similar proportion of incorrect responses (P > 0.05), incorrect responses decreased significantly between first years and second years (P < 0.001). Thereafter, the proportion of incorrect responses remained stable from second to final year (P > 0.05), with ∼35% of incorrect responses. Five questions showed no decrease of incorrect responses between second and final years, with two questions where final year students performed marginally better than novices. A Chi-square analysis, with Bonferroni post hoc test, showed certain misunderstandings appeared frequently across the curriculum. The qualitative analysis of the open-ended questions yielded 15 categories of common misunderstandings of fundamental biomedical concepts in all years of training. If educators become aware of commonly misunderstood biomedical concepts, preventative measures could be taken to prevent robust misconceptions.

Unclear if future physicians are learning about patient-centred care: Content analysis of curriculum at 16 medical schools

PURPOSE

Given barriers of patient-centred care (PCC) among physicians and trainees, this study assessed how medical schools addressed PCC in curriculum.

METHOD

The authors used content analysis to describe PCC in publicly-available curriculum documents of Canadian medical schools guided by McCormack's PCC Framework, and reported results using summary statistics and text examples.

RESULTS

The authors retrieved 1459 documents from 16 medical schools (median 49.5, range 16-301). Few mentioned PCC (301, 21.2%), and even fewer thoroughly or accurately described PCC. Significantly more clerkship versus pre-clerkship (24.0% vs 12.6%, p < 0.00001), and elective compared with core course descriptions (24.7% vs 14.9%, p < 0.00001) mentioned PCC. The domain of foster a healing relationship was common (79.0%) compared with other domains: address concerns (16.5%), exchange information (14.9%), enable self-care (10.4%), share decisions (4.5%), and manage uncertainty (1.3%).

CONCLUSIONS

Overall, few documents mentioned or described PCC or related concepts. This varied by school, and was more frequent in clerkship and elective courses, suggesting that student exposure may be brief and variable. Thus, it remains unclear if medical students are fully exposed to what PCC means and how to implement it. Future research is needed to confirm if PCC content in medical curriculum is lacking.

Abortion education in Australian medical schools

This aim of this study was to gain an updated perspective of the teaching and learning experiences of abortion care among Australian medical students. All 2020 Australian final-year medical students were invited to complete a 12-question cross-sectional electronic survey. While it appears that abortion care is taught in most Australian medical schools, in some it is not, and where the topic is presented, structured and standardised teaching is still lacking. Students' confidence around abortion care once they are in practice is low, and the majority of students showed a strong desire to have more direct abortion placement exposure. The current abortion curriculum in Australia needs revision and refinement.

Can concept mapping support the quality of reflections made by undergraduate medical students? A mixed method study

BACKGROUND

Students perceive reflective writing as difficult. Concept mapping may be an alternative format for reflection, which provides support while allowing students to freely shape their thoughts. We examined (1) the quality of reflection in reflective concept maps created by first-year medical students and (2) students' perceptions about concept mapping as a tool for reflection.

METHODS

Mixed-method study conducted within the medical curriculum of Maastricht University, The Netherlands, consisting of: (1) Analysis of the quality of reflection in 245 reflective concept maps created by 40 first-year students. Reflection quality was analysed by assessing focus of reflection (technical/practical/sensitising) and depth of reflection (description/justification/critique/discussion). (2) Semi-structured interviews with 22 students to explore perceived effectiveness of reflective concept mapping.

RESULTS

Depth of reflection reached at least the level of critique in 82% of maps. Three factors appeared to affect the perceived effectiveness of concept mapping for reflection: (1) reflective concept map structure; (2) alertness to meaningful experiences in practice and (3) learning by doing.

CONCLUSION

These results yielded supportive evidence for concept mapping as a useful technique to teach novice learners the basics of effective reflection. Meaningful implementation requires a delicate balance between providing a supportive structure and allowing flexibility for the student.

Emerging workforce readiness in regenerative healthcare

The biology of regenerative medicine has steadily matured, providing the foundation for randomized clinical trials and translation into validated applications. Today, the growing regenerative armamentarium is poised to impact disease management, yet a gap in training next-generation healthcare providers, equipped to adopt and deliver regenerative options, has been exposed. This special report highlights a multiyear experience in developing and deploying a comprehensive regenerative curriculum for medical trainees. For academicians and institutions invested in establishing a formalized regenerative medicine syllabus, the Regenerative Medicine and Surgery course provides a patient-focused prototype for next-generation learners, offering a dedicated educational experience that encompasses discovery, development and delivery of regenerative solutions. Built with the vision of an evolving regenerative care model, this transdisciplinary endeavor could serve as an adoptable education portal to advance the readiness of the emergent regenerative healthcare workforce globally.