O que a medicina ensina quando não ensina medicina: currículo oculto e formação moral

From boutique to basic: a call for standardised medical education in global health

Midwives have been involved formally and informally in the training of medical students and residents for many years. Recent reductions in resident work hours, emphasis on collaborative practice, and a focus on midwives as key members of the maternity care model have increased the involvement of midwives in medical education. Midwives work in academic settings as educators to teach the midwifery model of care, collaboration, teamwork, and professionalism to medical students and residents. In 2009, members of the American College of Nurse-Midwives formed the Medical Education Caucus (MECA) to discuss the needs of midwives teaching medical students and residents; the group has held a workshop annually over the last 4years. In 2014, MECA workshop facilitators developed a toolkit to support and formalize the role of midwives involved in medical student and resident education. The MECA toolkit provides a roadmap for midwives beginning involvement and continuing or expanding the role of midwives in medical education. This article describes the history of midwives in medical education, the development and growth of MECA, and the resulting toolkit created to support and formalize the role of midwives as educators in medical student and resident education, as well as common challenges for the midwife in academic medicine. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health.

IntroductionWith the development of laparoscopic simulation, medical students are motivated to expand their knowledge and proficiency in basic surgical skills. This study aims to demonstrate their capability and readiness for surgical clerkships and, ultimately, surgical residency. This study’s primary objective is to ascertain academic surgeons’ perspectives regarding laparoscopic simulation in undergraduate medical education and to determine if early exposure may afford medical students additional opportunities during their surgical clerkships.MethodsA survey was created to ascertain surgeon perspectives on medical students’ early exposure to laparoscopic simulation. Five-point Likert scales were used to indicate surgeon perspectives. The survey was conducted over the two days of the meeting; all attendees' meeting inclusion criteria were encouraged to participate. Surgeons practicing within the state of Alabama, with prior experience overseeing the development and training of medical students before June 1, 2022, and attending the AL Chapter American College of Surgeons 2022 Annual Meeting were eligible to complete the survey. Only completed surveys were included for analysis.Statement 1: “Pre-clinical exposure to laparoscopic simulators is beneficial to the training and development of medical students pursuing a surgical career.”Statement 2: “I am more likely to allow medical students to participate in laparoscopic surgery cases if they have had prior exposure to, and training with, laparoscopic simulators.”ResultsAn on-site survey was conducted among 18 surgeons consisting of 14 full-time faculty attendings, two post-graduate year-five residents, and two post-graduate year-three residents, all practicing in academic medicine with experience overseeing the training of medical students. In response to Statement 1, 33.3% of respondents strongly agree and 66.6% agree. In response to Statement 2, 61.1% of respondents strongly agree, 33.3% agree, and 5.6% were undecided.DiscussionOur study provides evidence to support the inclusion of laparoscopic simulation training in undergraduate medical education to enhance medical students' basic surgical skills and improve their clinical experience. Further research could inform the development of effective laparoscopic simulation training programs that prepare medical students transitioning to surgical residency.

The present study aims at locating the appropriate site for the training of medical students. It is argued that in community oriented med1cal education the training of medical students should take place where more patients come for consultation. This will result 1n students having a greater exposure to patients with a variety of medical problems. In order to find out the places where more patients went for medical advice, a questionnaire was des1gned and filled out by one percent of the population of Esfahan, one of the main provinces of the Islamic Republic of Iran. A total of 33,714 questionnaires were filled out. The questions asked were whether the respondent had any medical complaints in the previous month, whether s/he had been hospitalised during the previous month, and if that was the case, how s/he had managed the problem 11,230 respondents reported of at least one medical problem, but only 9,818 had sought medical advice. 9,672 respondents out of 9,818 underwent treatment in outpatient clinics and the rest were hospitalised Among the 146 hospitalised cases, only 74 cases were in teaching hospitals, that is only 0 7% of the total number of respondents who reported that they had medical problems. 945 respondents reported at least four days rest at home, that is 6 times more than hospitalised cases. The results of the study indicate that hospitals may not be the only right place for the training of medical students. Places such as outpatient departments and ambulatory care centers attend to more patients and therefore give students greater exposure to a variety of medical problems. Key Words: community, medical education, outpatient, ambulatory care.

Closing the Gap: A Needs Assessment of Medical Students and Handoff Training

With the third generation of medical education reform put forward,medical education based on system and guidance with abilities has become a global medical education reform trend.One of the goals of medical education is global medical colleges should train students to make preparation for life-long learning,and form a lifelong learning culture gradually.Therefore,training medical students' life-long learning ability is the positioning of 21st century medical education.This article according to our country' s present situation of medical students' training model,expound the definition of life-long learning,training medical students' life-long learning ability the necessity and importance and effective methods of strengthening medical students'life-long learning ability. Key words: Medical students; Life-long learning; Training model

Throughout this century there have been many efforts to reform the medical curriculum. These efforts have largely been unsuccessful in producing fundamental changes in the training of medical students. The author challenges the traditional notion that changes to medical education are most appropriately made at the level of the curriculum, or the formal educational programs and instruction provided to students. Instead, he proposes that the medical school is best thought of as a "learning environment" and that reform initiatives must be undertaken with an eye to what students learn instead of what they are taught. This alternative framework distinguishes among three interrelated components of medical training: the formal curriculum, the informal curriculum, and the hidden curriculum. The author gives basic definitions of these concepts, and proposes that the hidden curriculum needs particular exploration. To uncover their institution's hidden curricula, he suggests that educators and administrators examine four areas: institutional policies, evaluation activities, resource-allocation decisions, and institutional "slang." He also describes how accreditation standards and processes might be reformed. He concludes with three recommendations for moving beyond curriculum reform to reconstruct the overall learning environment of medical education, including how best to move forward with the Medical School Objectives Project sponsored by the AAMC.

Background/aimPsychotherapy training for medical students and residents in China is still in development. To establish an appropriate training program, understanding medical students’ and residents’ current knowledge and attitudes toward psychotherapy is needed.MethodsOne hundred and forty-nine participants, including medical students, residents, and other health providers (HCPs), self-reported their understanding of 18 types of psychotherapy, negative attitude towards cognitive behavioral therapy (CBT), and their attitude towards psychological interventions and counseling in primary care (APIC-PC) through an online survey.ResultsParticipants’ understanding of psychotherapy was generally low (M = 26.25, SD = 22.99). Medical students’ (M = 34.42, SD = 22.61) and HCPs’ (M = 37.25, SD = 30.834) understanding was significantly higher than residents’ (M = 20.08, SD = 19.54), F(2, 146) = 8.63, p < .001. Participants from psychiatric departments (M = 33.85, SD = 25.89) understood more psychotherapy than those from non-psychiatric departments (M = 20.98, SD = 19.20), t(147) = 3.46, p < .001. Participants with a bachelor’s degree (M = 2.40, SD = 0.976) scored lower on the Negative Attitude Towards CBT Scale than participants with a graduate degree (M = 2.76, SD = 1.00), t(147) = -2.20, p = 0.029. All participants’ APIC-PC scores were relatively the same and indicated a neutral to slightly positive attitude towards psychotherapy and counseling practices. However, they showed a slightly negative attitude in the “willingness to counsel” subscale (M = 2.65, SD = 0.93).ConclusionThis study indicated a lack of knowledge of psychotherapy and a lack of psychotherapy courses for medical students and residents, especially those from non-psychiatric departments in China. Our findings suggest an urgent need for psychotherapy and relevant training for Chinese medical students and residents.Trial registrationThe study has been registered at ClinicalTrials.gov (Identifier: NCT06258460, website: httpsregister.clinicaltrials.gov).

BackgroundRecently, a competency assessment tool has been developed within the RIGHT project, a national quality improvement program for minimally invasive right hemicolectomy in patients with colon cancer. This study aimed to evaluate whether trained medical students can reliably evaluate minimally invasive right hemicolectomy videos using a competency assessment tool. MethodsNine expert colorectal surgeons, 13 trained medical students, and 17 untrained medical students assessed the surgical quality of 6 full-length minimally invasive right hemicolectomy videos with the competency assessment tool. The expert surgeons were trained using the competency assessment tool by the RIGHT project leaders, who were also involved in the development and validation of the competency assessment tool. Training for medical students included anatomy, step-by-step procedure explanation, and competency assessment tool review with 2 supervised video assessments. The untrained students were taught only anatomy and minimally invasive right hemicolectomy steps. The intraclass correlation coefficient was calculated to determine inter-rater reliability, and analysis of variance with the Bonferroni correction for multiple testing was used to assess potential differences between the groups per video. ResultsThe trained students demonstrated an overall excellent inter-rater reliability (intraclass correlation coefficient score of 0.885). When their scores were combined with those of the expert surgeons, a high inter-rater reliability was also demonstrated (intraclass correlation coefficient score of 0.945). Trained students consistently aligned with surgeons’ mean total scores, also accurately identifying lower quality surgeries. Untrained students assigned statistically significantly higher scores to the 3 lower quality surgeries as compared with expert surgeons and trained students. ConclusionAmong trained students, excellent inter-rater reliability and concordance with expert colorectal surgeons was found. The study highlights the potential to engage trained medical students for objective minimally invasive right hemicolectomy video assessment.

This research presents an experimental study using validated questionnaires to quantitatively assess the outcomes of art-based observational training in medical students, residents, and specialists. The study tested the hypothesis that art-based observational training would lead to measurable effects on judgement skills (tolerance of ambiguity) and empathy in medical students and doctors. An experimental cohort study with pre- and post-intervention assessments was conducted using validated questionnaires and qualitative evaluation forms to examine the outcomes of art-based observational training in medical students and doctors. Between December 2023 and June 2024, 15 art courses were conducted in the Rijksmuseum in Amsterdam. Participants were assessed on empathy using the Jefferson Scale of Empathy (JSE) and tolerance of ambiguity using the Tolerance of Ambiguity in Medical Students and Doctors (TAMSAD) scale. In total, 91 participants were included; 29 participants completed the JSE and 62 completed the TAMSAD scales. The results showed statistically significant post-test increases for mean JSE and TAMSAD scores (3.71 points for the JSE, ranging from 20 to 140, and 1.86 points for the TAMSAD, ranging from 0 to 100). The qualitative findings were predominantly positive. The results suggest that incorporating art-based observational training in medical education improves empathy and tolerance of ambiguity. This study highlights the importance of art-based observational training in medical education in the professional development of medical students and doctors.

The practicing phyician has long been a welcome participant in the training of medical students. Since World War II, however, his influence in medical education has diminished. A study at the University of Illinois College of Medicine was made with 20 practicing physicians who have returned to the fore in medical education in an innovative experiment in the remarriage of practice with theory. The physicians are involved in the University of Illinois School of Basic Medical Sciences at Urbana-Champaign (SBMS-UC) as nonsalaried clinical faculty from the east central Illinois region. Their task is to act as advisers, tutors, evaluators, and friends to the students. The School of Basic Medical Sciences has an innovative program that approaches the basic sciences through a series of clinical problems. From the very beginning, the student is exposed to clinical practice, hospital routine, and laboratory techniques and findings through his physician-adviser. The adviser and student

IntroductionGood interprofessional teamworking is essential for high quality, efficient and safe clinical care. Undergraduate interprofessional training has been advocated for many years to improve interprofessional working. However, few successful initiatives...

BackgroundThe medical curriculum and involvement of undergraduate students in injury prevention and safety promotion can play an important role in increasing awareness of its importance and in equipping students with...

Presently, the pharmaceutical industry funds about half of the costs of continuing medical education (CME) programs in the U.S. This contributes to the ethical problems that pervade the relationship between medicine and the pharmaceutical industry: trustworthiness and conflicts of interest. The problems are exacerbated by rationalizations prevalent on both sides that deny the ethical concerns. Commercialism and commercial bias are highly visible at large CME gatherings, and available data, while scanty, back up the view that physician attendees' subsequent prescribing practices are influenced by the commercial message. The industry believes that it will recoup $3.56 in increased sales for every dollar that it invests in CME. New guidelines instituted by the Accreditation Council for Continuing Medical Education (ACCME) in 2004 may succeed in reducing excessive commercial influence, especially since the Department of Health and Human Services has also warned the industry of possible anti-kickback violations if firewalls are not erected between CME funding and marketing of drugs. Critics counter that early indicators of improvement are lacking.

Background Simulated patients (SPs) and clinical teaching associates (CTAs) are now being used widely in undergraduate medical training programmes, with strong evidence in specialities such as gynaecology underlining their value when compared to using real patients. 1 There are no comparable studies in orthopaedics published yet. Increased use of SPs/CTAs in orthopaedics would reduce the need for patients to undergo potentially painful musculoskeletal examinations, and may actually prove to be more beneficial to students as learning aids. This study aims to conduct a controlled, double-blinded, crossover trial to investigate whether simulated patients are as effective a learning resource in the orthopaedic training of undergraduate medical students as real patients. Methodology 103 IC3 Royal College of Surgeons in Ireland (RCSI) students attending Cappagh National Orthopaedic Hospital for their IC3 orthopaedic attachment participated. Subjects were randomly allocated to one of the two study arms. One half of the subjects were assessed and trained using real patients and the other half using simulated patients (Hip osteoarthritis - week 1, Supraspinatus pathology - week 2). Students then crossed over to the other arm after one week, ensuring both groups were exposed to real and simulated patients, followed by an OSCE reassessment of one of the scenarios using real patients. Minimisation was used to ensure balance between groups in terms of certain factors (computer randomisation based on student’s age, sex, English language status and class ranking). Descriptive statistics will be used to evaluate differences in other baseline characteristics between participating students in the two arms of the trial. Repeated measures analysis of variance (ANOVA), adjusting for baseline covariates will be used to analyse scores. Results/outcomes Anticipated Preliminary results suggest that the group taught using SPs achieved higher results. Potential impact RCSI will integrate SP training as part of their undergraduate syllabus when results are confirmed. Reference O’Sullivan MEC, Lynn SM, Masiello M, Sinha A, Jones K. A prospective study comparing teaching by clinical teaching associates with traditional methods: BJOG 2013;pp326