Patients’ Attitudes Towards Bedside Teaching in Iran

IntroductionSkills in peer teaching, assessment, and feedback are increasingly documented internationally as required graduate attributes in medicine. Yet these skills are rarely taught in medical schools. We sought to design and deliver a short but effective teacher training (TT) program for medical students that could be easily integrated into the professional development curriculum. This study sought to evaluate such a pilot program, based on student perception.MethodsThe study took place at a major metropolitan teaching hospital, where 38 medical students were invited to attend a voluntary, newly designed four-module TT program. In total, 23/38 (61%) of invited students attended. Mixed methods were used for evaluation. Questionnaires were completed by 21/23 (91%) of students, and 6/23 (26%) of students participated in a focus group.ResultsStudents reported that as a result of the program they felt more confident to facilitate small group teaching activities and to provide feedback to peers using the suggested frameworks. Students would like the program to contain more in-depth educational theory and to allow a more time for small group learning activities. They would also like to see opportunities for participation across all clinical schools.ConclusionThe TT program was successful in increasing student awareness of educational theory and practice, thereby improving their confidence in teaching and assessing their peers and making them feel better prepared for their careers as medical practitioners. Key improvements to the program are needed in terms of more in-depth theory and more time spent on small group learning. This might be achieved by complementing the course with e-learning.

We aimed to implement the European Resuscitation Council (ERC) basic life support (BLS) and automated external defibrillator (AED) course as a mandatory peer-led training programme for medical students and to evaluate the satisfaction with this course. Medical students certified as ERC BLS/AED instructors were recruited as student trainers and organizers of the course, which was included as a mandatory part of the curriculum for second-year medical students before first clinical rotation. After each course, questionnaires were distributed to evaluate the peer-led training programme. In total, 146 students were trained and assessed. The quality of the course was rated as 9.4±0.8 (10-point scale, 10 being best), and the majority (95%) felt better prepared for their clinical rotation. Implementation of the ERC BLS/AED course as a mandatory peer-led training programme for medical students is feasible. The course has been very well accepted and the students feel better prepared for their first clinical rotation.

Simulation-based training is increasingly used in pediatrics to teach technical skills, teamwork, and team communication, and to improve potential deficiencies in pediatric emergency care. Team performance must be observed, analyzed, and evaluated by trained raters. The structured training of medical students for the assessment of simulated pediatric emergencies has not yet been investigated. We developed a rater training program for medical students to assess guideline adherence, teamwork, and team communication in simulated pediatric emergencies. Interrater reliability was measured at each training stage using Kendall tau coefficients. In 10 out of 15 pairs of raters interrater reliability was moderate to high (tau>0.4), whereas it was low in the remaining 5 pairs of raters. The interrater reliability showed good agreement between medical students and expert raters at the end of the rater training program. Medical students can be successfully involved in the assessment of guideline adherence as well as teamwork and team communication in simulated pediatric emergencies.

To evaluate the satisfaction and self-confidence levels among midwifery students in clinical training programmes at Palestinian universities and to identify associated factors. A descriptive, cross-sectional study. Clinical training programmes at five universities across the West Bank, Palestine, during the second semester of the 2023-2024 academic year. A convenience sample of 116 final-year (third- and fourth-year) midwifery students actively engaged in clinical training. The primary outcomes were satisfaction and self-confidence, measured using validated scales adapted from the National League for Nursing. Demographic factors (university, academic year, training area, gender) were analysed as secondary measures influencing the primary outcomes. Students reported moderate satisfaction (mean=3.38±0.75, 95% CI: 3.25 to 3.51) and high self-confidence (mean=3.61±0.73, 95% CI: 3.49 to 3.73). A strong positive correlation was found between satisfaction and training area (r=0.693, p<0.001), and between self-confidence and timing of clinical training (r=0.45, p=0.01). Students from the southern West Bank expressed the highest satisfaction (mean=3.55, p<0.001). Multiple linear regression identified academic year (B=0.9096, p=0.029 for satisfaction; B=0.9239, p=0.028 for self-confidence) and gender (B=-1.7776, p=0.035 for satisfaction; B=-1.8062, p=0.033 for self-confidence) as significant predictors of both outcomes, with male students reporting lower levels. Geographical disparities and gender significantly influence midwifery students' clinical training experiences in Palestine. These findings highlight the need for equitable distribution of training resources, the implementation of gender-sensitive mentorship programmes and tailored support for students in advanced academic years to improve educational outcomes and build a capable healthcare workforce.

BackgroundPsychotherapy is central to the treatment of mental disorders, highlighting the importance of medical students and residents developing competencies in this area. Chinese medical residents have expressed a strong need for psychotherapy training, yet they are generally dissatisfied with the current offerings. This paper presents the protocol for an evidence-based, well-structured psychotherapy teaching program aimed at medical students and residents.ObjectiveThis study involves a randomized controlled trial of a 2-day multimodal intensive educational intervention designed to evaluate the effectiveness of a new psychotherapy teaching program for medical students and residents in China. The primary outcomes include participants’ knowledge and utilization of psychotherapy, training program acceptability, self-reported self-efficacy, and motivation to apply psychotherapy.MethodsThis 2-arm randomized controlled trial was conducted at Sir Run Run Shaw Hospital. The study aimed to recruit approximately 160 medical students and residents, with about 80 participants in the intervention group and 80 in the control group. Both groups completed a baseline survey before participation, reporting their psychotherapy knowledge, utilization of psychotherapy, self-efficacy, and self-motivation. The intervention group received a 2-day multimodal intensive educational intervention (supervision-based online teaching), while the waitlist control group did not receive any intervention during this period. Both groups were followed up for 8 weeks, completing the same survey administered at baseline. At the end of the study, the control group received the intervention. The primary outcome measure was the change in trainees’ psychotherapy knowledge before and after the intervention training. Secondary outcome measures included changes in the trainees’ utilization of psychotherapy, self-reported self-efficacy, and self-reported motivation for psychotherapy. Additionally, training program acceptability was assessed. Analysis of covariance was used to analyze the primary outcomes. Pearson correlations and regression analysis explored factors associated with the knowledge score at baseline. The secondary outcomes, including participants’ psychotherapy utilization, confidence, and motivation, were analyzed using the same methods as for knowledge. All tests were 2-tailed, with a significance level set at P<.05.ResultsA total of 160 participants were recruited and randomized between January 4 and 12, 2024. Baseline assessments were conducted from January 28 to February 1, 2024. The psychotherapy training program for the intervention group took place on February 3 and 4, 2024. Posttraining assessments were conducted starting April 1, 2024. Due to withdrawals, incomplete surveys, and data loss, we had a total of 113 participants: 57 in the intervention group and 56 in the control group. The amount of data varied across measures. The data analysis was finished in August 2024.ConclusionsThis study aims to evaluate the effectiveness of the multimodal psychotherapy training program for medical students in China. If this brief, cognitive behavioral therapy–based psychotherapy skill training proves effective, the potential mental health impact of its nationwide expansion could be significant.Trial RegistrationClinicalTrials.gov NCT06258460; https://clinicaltrials.gov/ct2/show/NCT06258460International Registered Report Identifier (IRRID)DERR1-10.2196/58037

The transition from medical student to practicing physician affects the complex processes of professional identity formation and professionalism, which have a lasting effect on the physician's career development. This study explored two different transitional processes of medical students in Taiwan, the associated rituals during this transitional period (the 'liminal phase') and their effect on the formation of professional identity. Using snowball sampling, we recruited 13 medical students from two training systems: six from the traditional postgraduate year programme and seven from the accelerated postgraduate year (A-PGY) programme. Semi-structured interviews were thematically analysed to identify significant themes that encapsulated trainees' experiences. A consistent and mutually confirmed discussion ensured the identification of robust recurring themes. A comparative analysis of the two training modalities provided critical insights into the relative impact of the training dynamics. The A-PGY cohort, subjected to an altered 'incorporation' ritual, encountered an influx of unexpected symbolic social power, complicating their transformation within the liminal phase. Without a defined internship like in the PGY system, A-PGY trainees exhibited confusion and inconsistencies in professional identity formation marked by conflicting internal and external perceptions. This ambiguity affected their clinical training, social integration and overall development of professionalism. The absence of a structured, sequential liminal phase increased conflict and diminished motivation, culminating in an incomplete self-crafting journey for A-PGY trainees. This study highlights the impact of the well-sequenced implementation of rituals in liminality on professional identity formation. A good transition training programme for medical students should compass sequential rituals in the liminal phase, including clear starting and ending points, supervision by seniors, guided reflection and plenty of opportunities for observation and imitation in context. Optimal training and pivotal elements in a medical training system warrant delicate design and further research when developing and changing the structure of the training programme.

Objective: To describe, introduce, and assess student perceptions of a structured clinical training programme for pharmacy students that meets the expectations of advanced pharmacy practice experiences of Doctor of Pharmacy (Pharm.D.) programmes accredited by the Accreditation Council for Pharmacy Education. Methods: A clinical training programme was held from July to September 2019. Training included hands-on hospital rotations focusing on essential pillars of pharmaceutical care including ensuring proper medical indication, effectiveness, safety, and patient adherence (total of 160 hours). The study population included 35 senior pharmacy students from the University of Petra. Results: Qualitative answers from students showed positive responses associated with the programme’s pre-training orientation, clinical training, preceptors involved, and student’s clinical knowledge and skills. Conclusion: The piloted introduction of a structured clinical training programme for pharmacy students was successful. Students reported positive evaluations and perceptions of clinical training sites and staff as well as their clinical and practical skills. The main challenge students encountered was transportation to the practice site.

BackgroundThere is little to no data evaluating long term usage of point of care ultrasound (POCUS) after a training intervention for medical students. The purpose of this study was to examine the impact of an intensive POCUS training program on medical student’s usage at 9-months post-program.MethodsThis was a prospective cross-sectional study of rising second year medical students who participated in a 2-week summer POCUS training program. Instruction consisted of 8 h of asynchronous online didactic material, 2–4 h of daily hands-on instructor-led and independent scanning, and instruction on how to teach POCUS. Students were assessed pre- and post-program, and again at 9 months post-program to evaluate POCUS usage.ResultsA total of 56 students participated in the program over 2 summers; 52 (92.9%) responded to the 9-month post-program survey. At 9 months, 49 (94.2%) of students taught POCUS after the program to peers or faculty. Students reported serving as a POCUS instructor in 283 subsequent teaching sessions accounting for 849 h of POCUS instruction time. Six (11.5%) students were involved in the creation of a POCUS interest group on their regional campus, 7 (13%) created a POCUS curriculum for their student interest group, and 4 (7.7%) created an opt-in co-curricular POCUS program for students at their regional campus. Three (5.8%) students did not serve as educators after the program and only one student reported not using POCUS again after the program.ConclusionAfter a 2-week intensive POCUS training program for medical students, the majority of students demonstrated continued involvement in POCUS learning and education at 9-month follow-up including serving as peer instructors and assisting with limitations in financial resources and trained faculty.

Objective:To determine student’s perception of bedside clinical teaching and to correlate it with their performance in assessment.Methods:This cross-sectional study of correlational survey was conducted at Services Institute of Medical Sciences in September 2019, involving students of final professional year who filled a proforma to rate their bedside teaching experience during clinical rotations using rating scale. Mean scores of items were determined with score < 3 reflecting dis-satisfaction. Mean scores were compared between high and low performing students using student’s t test.Results:Total of 160 students participated. Physical environment domain was assigned lowest scores by students (mean 2.94±0.74) followed by teaching task by teachers (3.04±0.72), group dynamics (3.16±0.81) and patient comfort and attitude towards patient (3.87±0.60). Teaching task by teacher had maximum stems with scores < 3 needing significant improvement. Students with low academic performance were more unsatisfied with group dynamics of bedside teaching (p value 0.009), especially lack of equal opportunities of participation for every member (p value <0.000) in clinical rotations.Conclusion:Small size group with adequate space for bedside training and faculty training can enhance learning experience of students. Ensuring active participation of each group member during bedside learning can improve academic performance of students.

Introduction: Pulmonary hypertension (PH) is a fascinating subject which interdigitates with many specialities as the classification of the condition into five groups testifies. Knowledge of the condition is, in our experience, poor among medical students. As doctors, this subject is relevant regardless of future career direction. To address this gap, we have arranged a formal training programme for medical students each term at St George’s University of London. Aim: To improve knowledge in PH among our medical students Methods: For over 10 years medical students have been performing specialist subject modules (SSM) in PH over a term. This involves weekly meetings with Professor Brendan Madden, opportunities to attend Right Heart Catheterisation lists, Computed Tomography scanning, lung function testing, cardiac MRI, PH outpatient clinics, multidisciplinary team meetings and ward rounds. At the end of the study period, each student prepares a 4,000 word PH related project and gives a 5 minute presentation; and provides feedback on the course. The grade attained contributes towards their end of year grade. Results: For the past 10 years, 200 second year medical students (10 students each term, for two terms a year), participated in this course. All rated their experience very useful and reported that the lessons learnt helped them with their future medical cases. Patient feedback was also positive. 70% attained an honours grade. None failed. 7 students presented their work at international scientific meetings. Conclusion: We believe that PH is poorly taught at medical school and projects such as ours helps to address this.

BACKGROUND: Fast food consumption is one of the risk factors for human health. The present study was conducted with the objective to investigate how students’ characteristics (attitude, control beliefs, and normative beliefs) motivate the consumption of fast food. METHODS: In this cross-sectional study, a total number of 401 students of Kurdistan University of Medical Sciences, Sanandaj, Iran, were randomly selected and studied in 2015. A questionnaire was administered to collect information about student’s demographic characteristics as well as their attitudes and beliefs towards using fast food. Correlation analysis and multivariate analysis of variance (MANOVA) followed by univariate ANOVA were used to interpret the results. RESULTS: The mean age of participants was 21.20 ± 2.80 years and 254 (67.20%) of them were female. Furthermore, 60.54% of the students were found with tendency to use fast food. The MANOVA analysis showed that the effect of gender on students’ characteristics was significant (P = 0.005), however the effect of grade was marginally insignificant (P = 0.053). Post-hoc univariate ANOVA showed that the gender was highly associated with control beliefs (P = 0.030) and normative beliefs (P = 0.004). No significant association was found between gender and student’s attitude (P = 0.610). CONCLUSION: A training program for medical students in Kurdistan University of Medical Sciences is recommended to encourage students to reduce the consumption of fast food.

To assess the student's and patients' perspectives about bedside teaching and to identify possible barriers that delay effective bedside teaching. This cross-sectional study was conducted at two teaching hospitals in Peshawar with 153 participants through non-probability serial sampling from December 2017 to March 2018. Interview-based validated questionnaires were used and pilot tested as well. Ethical approval was taken with the participant's consent. Data were analyzed using SPSS version 19.0 using descriptive statistics. Among the total 79 students, all of them completed the questionnaires with a 100% response rate. However, from the 76 patients only 74 responded with a response rate of 97%. The majority of the patients (n=58; 78%) were satisfied with bedside teaching with no problems faced. During the bedside teaching only (n= 13; 18.2%) felt anxious while others, enjoyed (n= 59; 80.5%) with satisfaction and only 13% (n= 10) thought their privacy was breached. The satisfied students with the time spent on bedside teaching were (n= 52; 65.5%) while (n= 30; 38.7%) thought thirty minutes time was not enough. The hurdles faced were lack of practice (37.3%), fear of embarrassment in front of peers (21.3%), and lack of confidence to approach the patient (16%). The patients showed positive attitude and enjoyed bedside teaching. The students preferred it as a valuable tool for clinical experience. However, time constraints, lack of practice, lack of confidence, confidentiality, and anxiety must be overcome to make bedside teaching a useful method. Effective teaching still requires good teaching methodologies with confidence and competency.

Bedside teaching (BST) is a crucial component of medical education. It entails the interaction of students with patients in outpatient clinics and inpatient wards under the supervision of their tutors in order to improve the clinical skills of the students and, ultimately, patient outcomes. This teaching relies heavily on patients' willingness and cooperation. The aim of this study was to assess the perception of Obstetrics and Gynecology (OB/GYN) patients regarding the presence and participation of medical students in BST. A cross-sectional survey was conducted among OB/GYN patients at the outpatient clinics and inpatient wards at King Fahd Hospital of the University (KFHU) in Al-Khobar from January 1 to April 30, 2023. Data were collected online through the Google Drive survey tool using a validated and pilot tested questionnaire. Data were analyzed utilizing SPSS version 26.0. Chi-squared test was employed to test for association between two categorical variables. Multiple logistic regression model was used to determine variables associated with positive attitudes. A total of 507 patients completed online questionnaire. A highly positive patients' attitude was observed toward the presence and participation of medical students during BST with a mean score of 81.8 ± 10.4. The acceptance rates were higher for female students compared to male students (91.9% vs 61.7%) and for senior doctors compared to junior doctors (89.9% vs 58.9%). Patients who came to the outpatient clinics were also more likely to accept students' presence than those who went to hospital wards. Age, marital status, and previous clinic visits were positively associated with the acceptance level of the presence and involvement of medical students in BST without a significant difference. In general, patients had a good perception of medical students' engagement in their care and that the gender of the medical students/doctors and clinical setting could affect this perception. Raising patients' awareness of their valuable role in male medical students' and doctors' education should be raised, as this will increase their acceptance during BST.

The primary purpose of the study was to develop and evaluate a training program for medical students in sexual history-taking and HIV risk assessment. Sexual-history-taking performance was evaluated in the semester subsequent to the one in which the students received the instruction. An additional purpose of the study was to determine whether students, following participation in a sexual-history training program, would take a sexual history when course instructions did not explicitly direct her/him to do so but the patient presented with HIV risk factors. A final goal was to find out whether direct participation in, versus only observation of, sexual-history interviews would improve performance. Adequate performance on measurement on knowledge and skills was defined as above 75% correct on content examinations and satisfactory performance of the sexual history. Results showed that, when course instruction directed students to take a sexual history, performance was excellent. When students were not specifically directed to take a sexual history, but the patient had an HIV risk factor, performance was not as consistent. Following participation in the training program, student attitudes about the importance of taking a sexual history were very positive. Finally, when a student conducted a sexual-history interview him/herself, compared with viewing other students taking a history, he/she showed no significant improvement in examination performance.

Definitive assessment of laparoscopic skill improvement after virtual reality simulator training is best obtained during an actual operation. However, this is impossible in medical students. Therefore, we developed an alternative assessment technique using an augmented reality simulator. Nineteen medical students completed a 6-week training program using a virtual reality simulator (LapSim). The pretest and post-test were performed using an object-positioning module and cholecystectomy on an augmented reality simulator(ProMIS). The mean performance measures between pre- and post-training on the LapSim were compared with a paired t-test. In the object-positioning module, the execution time of the task (P < 0.001), left and right instrument path length (P = 0.001), and left and right instrument economy of movement (P < 0.001) were significantly shorter after than before the LapSim training. With respect to improvement in laparoscopic cholecystectomy using a gallbladder model, the execution time to identify, clip, and cut the cystic duct and cystic artery as well as the execution time to dissect the gallbladder away from the liver bed were both significantly shorter after than before the LapSim training (P = 0.01). Our training curriculum using a virtual reality simulator improved the operative skills of medical students as objectively evaluated by assessment using an augmented reality simulator instead of an actual operation. We hope that these findings help to establish an effective training program for medical students.