4th-year Medical Students Research Articles

Cyanide Poisoning.

Cyanide Poisoning.

Impact of Cultural Competency Training in Naturopathic Medical Students: Self-Assessed Changes in Awareness, Knowledge, Skills, and Attitudes

Introduction: Cultural competency training is a growing requirement in medical schools across North America. Although accredited naturopathic medical schools now include some elements of cultural competency training throughout their programs, no literature to date has evaluated the effect of cultural competency curriculum among naturopathic medical students. This study evaluated the impact of a cultural competency training program of 4th-year naturopathic medical students at an accredited naturopathic medical educational institution in North America. Methods: Pre- and post-training online surveys were completed by naturopathic medical students using a 1 to 5 numerical scale (least to most confident), self-evaluating their awareness, knowledge, skills, and willingness to change behaviours, with some survey items adapted from the short version of the Cross-Cultural Care Survey (Harvard). Descriptive statistics were calculated, and a paired two-sided Wilcoxon signed-rank test was used to examine changes between pre- and post-training responses. Results: Out of 134 students enrolled in the training, 46 participants completed both the pre- and post-training surveys and were included in the final analysis. There was a statistically significant increase in self-rated confidence from pre- to post-training across all individual survey items spanning improvements in cultural competency awareness, knowledge, skills, and attitudes among students who completed both surveys. Conclusions: Results from this study indicate that cultural competency training of naturopathic students may improve their subjective assessment of their awareness, knowledge, skills, and attitudes related to working with diversity in clinical practice. Future research would benefit from using validated assessment scales, reducing loss to follow up, and investigating factors such as social demographics, prior training, and lived experience amongst participants.

Teaching Health Equity in the Time of COVID-19: a Virtual Look Through the Lens of Structural Racism.

IntroductionIn the context of marked health disparities affecting historically marginalized communities, medical schools have an obligation to rapidly scale up COVID-19 education through the lens of structural racism.AimTo develop and implement a virtual curriculum on structural racism in a required COVID-19 course for medical students using “just-in-time” training.SettingAcademic medical institution during the height of COVID-19 in the spring of 2020.ParticipantsThree hundred ninety-three 3rd and 4th-year medical students prior to re-entry into clinical care.Program DescriptionThree educational sessions focused on (1) racial health disparities, (2) othering and pandemics, and (3) frameworks to address health inequity. The virtual teaching methods included narrated recorded presentations, reflections, and student-facilitated small group dialogue.Program EvaluationIn matched pre- and post-surveys, participants reported significant changes in their confidence in achieving the learning objectives and high satisfaction with small group peer facilitation.DiscussionThe use of “just-in-time” training exploring the intersection between COVID-19 and structural racism facilitated the delivery of time-relevant and immediately clinically applicable content as students were preparing to re-enter a transformed clinical space. Similar approaches can be employed to adapt to changing healthcare landscapes as academic medical centers strive to build more equitable health systems.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11606-022-07516-2.

How do medical students learn about SDH in the community? A qualitative study with a realist approach

Introduction The need to learn social determinants of health (SDH) is increasing in disparate societies, but educational interventions are complex and learning mechanisms are unclear. Therefore, this study used a realist approach to identify SDH learning patterns, namely context (C), mechanism (M), and outcomes (O) in communities. Methods A 4-week clinical practice program was conducted for 5th- and 6th-year medical students in Japan. The program included SDH lectures and group activities to explore cases linked to SDH in the community. The medical students' structural reflection reports for learning SDH were thematically analyzed through CMO perspectives. Results First, medical students anticipated the concept of SDH and participated in a community in which a social model was central. They then transformed their perspective through observational learning and explanations from role models. Second, medical students’ confrontation of contradictions in the medical model triggered integrated explanations of solid facts. Third, conceptual understanding of SDH was deepened through comparison and verbalization of concrete experiences in multiple regions. Fourth, empathy for lay people was fostered by participating from a non-authoritative position, which differed from that in medical settings. Conclusion Medical students can learn about the connections between society and medicine through four types of SDH learning patterns.

К ВОПРОСУ О КОММУНИКАТИВНЫХ ПОЗИЦИЯХ В ОБЩЕНИИ СТУДЕНТОВ ЛЕЧЕБНОГО ФАКУЛЬТЕТА ВГМУ

Objectives.To study the communicative positions (CP) in the communication of medical faculty students of VSMU and to analyze their dynamic features. Material and methods.The study involved 532 students of the medical faculty. The 2nd-year students numbered 386 people (117 boys and 269 girls); the 6th-year students were represented by 146 persons (33 boys and 113 girls).The study of communicative positions in communication was carried out using the methodology of E.I. Rogov «Transactional analysis of communication». Results.The students showed a higher representation of a child’s («dependent») position among the 2nd-year medical students, the dominance of an adult’s position among the 6th-year medical students, the lowest representation of the parental position in the total sample, a more pronounced dynamic increase in the «adult - child - parent» (ACP) formula and a decrease in the «adult - parent - child » (APC) formula in girls compared to young men. Conclusions.The identified general and gender features of CP in communication indicate that the information and educational environment created at VSMU on the whole has a beneficial effect on the formation of communication skills of future doctors, which is manifested in the flexible choice of CP in communication, adequate to the requirements of the educational process by the medical faculty students.The results of the study can be used in the educational process of VSMU, the activities of the socio-pedagogical and psychological services, the work of academic group tutors.

Simulation-based medical education in Thailand: a cross-sectional online national survey

BackgroundSimulation-Based Medical Education (SBME) is a teaching method commonly used in undergraduate medical education. Although Thai medical schools have developed a system that incorporates SBME, various aspects of that system require improvement. We surveyed medical school administrators, instructors, and students about SBME in their institutions and the obstacles involved in its implementation, as well as their experiences, expectations, and attitudes regarding the current system.MethodsWe conducted a cross-sectional online survey between August 2019 and July 2020 among administrators, instructors, and 6th-year medical students. A structured questionnaire was developed and distributed to volunteers as an online survey. We recorded details about the SBME system as well as participant characteristics, obstacles, experiences, expectations, and attitudes. We used descriptive statistics as appropriate.ResultsWe received responses from 15 (68.2%) administrators, 186 instructors, and 371 (13.7%) sixth-year medical students. SBME was commonly used in teaching and evaluation but less so in research. It was mainly used to improve psychomotor tasks, knowledge, patient care, and communication skills. The expected outcomes were improvements in students’ performance, knowledge, and practice. The clinical courses were longer and had fewer participants than the pre-clinical courses. Obstacles encountered included shortages of faculty and simulators, time and space limitations, inadequate faculty training, and insufficient financial support. The administrators surveyed had positive attitudes toward SBME. Medical students reported having experience with SBME and strongly agreed that it was beneficial; however, they expected fewer students per class and more learning time to be devoted to these methods.ConclusionsSBME in Thailand is focused on teaching and assessment. The system could be improved through better-trained faculty, greater available space, more simulators, and sufficient funding. There were also some aspects that failed to meet students’ expectations and need to be addressed. However, participants expressed positive attitudes toward SBME.Trial RegistrationTCTR20210524003 (Thai Clinical Trials Registry).

The association between physical activity and prevalence of anxiety and depression in medical students during COVID-19 pandemic: A cross-sectional study

BackgroundThe COVID-19 pandemic has affected medical students both physically and mentally. Medical students have had to take online classes, which may have decreased their physical activity (PA) and increased their risk of mental health. This research aimed to explore the association between mental health problems and PA levels. Materials and methodsA cross-sectional study was conducted on 1st–6thyear medical students, at a university in Southern Thailand; from September to October 2021. The participants completed online questionnaires; including, demographic data, Global Physical Activity, PHQ-9 and the GAD-7 questionnaire. The association between PA levels and mental health was assessed using ordinal logistic regression. ResultsAmong 325 medical students, 42.8% were males and 51.1% were clinical medical students. The prevalence of moderate to severe depression and anxiety was 31% and 12.9%. In total, 49.7% of participants had low PA levels. Pre-clinical students had a higher risk of depression (OR 2.11 p-value 0.001) and anxiety (OR 2.20 p-value 0.045) than clinical students. We also found that moderate or high PA levels were not a significant factor with mental health status (p-value of depression 0.447, 0.823 and p-value of anxiety 0.362, p-value 0.574, respectively). ConclusionThere were a lot of medical students with moderate to severe depression and anxiety, and about half of those had low PA levels; especially, pre-clinical students that learned online study activities. There was no significant association between PA levels and mental health status. However, the faculty should reconsiderate their medical student to increase physical activities and redesign the curriculum to support their students during these challenging times.

Characteristics of academic medicine change agents as revealed by 4th-year medical students' reflections-on-practice.

At present, formal training in adult learning principles, educational theories, and educational methods is not a core objective of most medical school curricula. As academic medical centers aim to develop the next generation of medical educators, students must be provided an opportunity to learn educational principles, engage in supervised teaching activities, and develop experiences in academic medicine to foster interest early in their development as educators. We developed a longitudinal medical education elective for fourth-year medical students, which was comprised of attending five seminars, leading 15 teaching sessions, formulating a medical education project, and writing a reflective essay. The seminars covered the history of medical education in the USA, adult learning theory and teaching principles, use of various teaching strategies and formats, construction and organization of curricula, effective models of evaluation and feedback provision, and principles of educational research. This exploratory quasi-experiment incorporated a concurrent mixed methods data collection approach via pre- and post-seminar surveys and narrative reflection essay document analyses. Learners revealed favorable changes in their self-efficacy and self-perceived knowledge and attitudes towards medical education. A qualitative analysis of the reflective essays revealed five thematic categories (learning impacts, medical educator growth, leadership growth, medical school reflections, and future professional plans) and thirteen sub-categories. Students found many opportunities to implement high-quality educational projects, expressed commitment to pursuing teaching careers, and felt better equipped to assume a leadership role as change agents in academic medicine. Findings are likely relevant to critical stakeholders who advocate for the inclusion of formal educational skills training into medical education curricula.

Highly Engaged Video-Watching Pattern in Asynchronous Online Pharmacology Course in Pre-clinical 4th-Year Medical Students Was Associated With a Good Self-Expectation, Understanding, and Performance.

BackgroundOnline video-based learning is more common in higher education. Investigating students' viewing behaviors while watching online video lectures is essential for instructors to understand their learning status so that the course content, structure, and media selection can be improved continuously. The current study identified the engagement level of the learners based on their online video-watching behaviors, and tested the correlation between the engagement level and learning outcome.MethodsThe action logs of watching online video lectures in 2020 Spring Pharmacology of the 4th-year medical students of the 6-year course and their feedbacks by questionnaires after each exam during the semester were provided anonymously. The data were analyzed and visualized for an efficient way to comprehend and interpret. To define the student's engagement level in his or her video-based learning journey, three viewing criteria, “Completion,” “Pausing,” and “Repeated watching” were identified. We evaluated the association between the engagement level and the students' learning outcomes, including their learning satisfaction, knowledge acquisition progresses based on assessment results, and the grades measured by the instructors.ResultsThe graphs and the charts demonstrate whether the students allocated enough time to finish the video lectures (completion), paused for a while, then resumed the video (pausing), or replayed the specific sections of video content (repeated watching). The engagement level with video lectures, evaluated by pre-defined thresholds for “Completion,” “Pausing,” and “Repeated watching” had a positive correlation with the learning outcomes.ConclusionsWe suggested that an engagement dashboard containing real-time visualized information on students' online video-watching behaviors can be developed to help instructors to monitor students' learning progress and improve teaching in a timely fashion. It can also help each student to re-feel the stimulation of peers, prompt self-monitoring, improve their learning attitudes and disciplines for better learning outcomes. This innovative way of assessing student's engagement during online video-based learning can also be used for quality assurance purposes.

Interprofessional Clinical Simulation-Based Education to Develop Professional Identity and Professionalism in Japanese Medical and Nursing Students

Introduction: We conducted a multi-occupational team simulation training for medical and nursing students and clarified how professional identity and professionalism attitudes change with interprofessional education (IPE). Methods: Thirty-nine 4th-year medical students and 48 2nd-year nursing students were enrolled and distributed to the educational intervention group and the control group. We used a vocation identity scale including lower four subscales, a scale for professionalism including lower five subscales, a readiness for inter-professional learning scale (RIPLS), and an interdisciplinary education perception scale (IEPS). Results: Among the medical students, IPE using an advanced patient simulator improved the scores on the vocational identity scale, scale for professionalism, RIPLS, and IEPS. Among the nursing students, IPE improved the scores on the vocational identity scale, scale for professionalism, RIPLS, and IEPS. Conclusion: On-the-job training using simulated clinical training by a multi-occupational team improved vocational identification and professionalism.

Correlation Learning Style with Grade Point Average Fourth Year Medical Student

BACKGROUND: Learning achievement is an important indicator to determine the learning and teaching process, each student has a different learning style. Student learning learns how they choose the suitable method and the results obtained optimally. A student must also learn their learning styles to choose methods or ways of learning that are appropriate to their character. AIM: Knowing the relationship between learning style and cumulative Grade Point Average (GPA) of 4th-year students at the Faculty of Medicine, Universitas Baiturrahmah. METHODS: The scope of this research covers the fields of medical science, especially medical education, correlative analytical research with cross-sectional design. The study was conducted at the Medical Faculty Universitas Baiturrahma. The study was conducted from May to January 2019. The affordable population in this study were 4th-year students numbered 80 students with the Simple Random Sampling technique. Data analysis was univariately presented in the form of a frequency distribution table and bivariate analysis using the correlation test using the SPSS program. RESULTS: At most with female gender, namely (71.3%), the highest place is at most boarding, namely (77.5%), most have quad-model learning styles, namely (80%), most have a GPA graduated that is (61.3%), there is a relationship between the learning style and the GPA of 4th-year medical students with a value of p = 0.024 (p < 0.05) and r = 0.0253. CONCLUSION: It can be concluded that the 4th-year medical students have the most female sex, the most places to live are boarding, quad-model learning style, and there is a correlation between learning styles and the 4th year GPA Medicine at Universitas Baiturrahmah.

Recognition of emerging cardiac diagnoses byechocardiography in 5th-year medical students - the role of focused e-learning.

Recognition of emerging cardiac diagnoses byechocardiography in 5th-year medical students - the role of focused e-learning.

An Orthopaedic Virtual Clinical Clerkship for Visiting Medical Students: Early Successes and Future Implications

The visiting orthopaedic clerkship is viewed by both students and program directors as an important part of the orthopaedic surgery residency application process, despite being criticized as costly and inefficient. Restrictions due to the COVID-19 pandemic prevented students from participating in in-person clerkships at institutions other than at their home programs, necessitating a virtual replacement for the in-person orthopaedics clerkship experience. It remains unclear how the virtual clerkships will affect the application process this year, and moving forward. We describe and review our institution's initial experience with a virtual orthopaedic clerkship. We hypothesize that students would view the virtual clerkship as valuable, and that students would see a role for such clerkships going forward. A virtual orthopaedic surgery clerkship was created and students were invited to enroll. Thirty-one 4th-year medical students participated. Each clerkship included 8 two-hour sessions. Each session was moderated by a faculty member, and participants included only medical students. Students presented virtual cases, which provided the basis for the discussion and education. At the conclusion of each clerkship, students were given an anonymous survey assessing various aspects of the clerkship. Twenty-seven students responded to the survey. Overall, 15 students rated the experience as outstanding, 11 excellent, and 1 good. Twenty-two students saw a role for virtual clerkships moving forward, and five students did not see a role moving forward. Student reported strengths of the clerkship included direct faculty interaction, structured curriculum, and student-centered discussions. Lack of hands-on experience was cited as the biggest weakness. Students valued the opportunity for a virtual clerkship, and most could envision a role for such virtual clerkships moving forward. We suggest that virtual clerkships may be a cost-effective and useful tool in helping both students and programs navigate the residency selection process.

Anaesthesia skills and simulation training during the COVID-19 pandemic

Due to COVID-19 restrictions in the clinical practice areas and theatres of the Academic hospitals in Bloemfontein (South Africa), 4 th and 5th-year medical students of the University of the Free State had limited access to routine clinical and emergency cases. As part of their Anaesthesia rotation, students needed access and exposure to these clinical and emergency cases to fulfil the minimum training requirements set out in their curriculum. These included ultrasound techniques, administration and management of patients for general anaesthesia and administration of spinal anaesthesia, airway management and Cardiopulmonary Resuscitation (CPR).

PECULIARITIES OF INDEPENDENT WORK IN THE STUDY OF "CLINICAL PRACTICE" DISCIPLINE BY MEDICAL STUDENTS OF COURSE V AT OBSTETRICS AND GYNECOLOGY DEPARTMENT NAMED AFTER I.D.LANOVYY

The article highlights the features of independent work in the study of "Clinical Practice" by 5th-year medical students at the Department of Obstetrics and Gynecology. The article shows that well-organized independent work creates favorable conditions for the development of cognitive abilities of students and intensification of their work in obstetrics and gynecology. Practical self-training of medical students is a mandatory component of the educational and professional program to obtain a qualification level and aims to acquire their professional skills and abilities.
 Independent work is one of the most important components of the educational process, which involves the integration of different types of individual and collective learning activities, which is carried out both in classroom, extracurricular activities, without the participation of the teacher and under his direct supervision. Introduction of independent educational and cognitive activities and innovative approaches to its organization in the educational process is a qualitative step of the entire system of higher education because this process contributes to the advancement of students from education and the acquisition of knowledge to the skills and abilities of self-education. Clinical practice in obstetrics and gynecology is a process of consolidating theoretical knowledge, practical skills and abilities acquired in the process of student learning. The discipline includes practical classes and independent work of the student. Clinical practice occupies an important place in the training of physicians and the opportunity to consolidate their knowledge, skills and abilities and expand professional competence. The knowledge that students receive during clinical practice will allow them to conduct optimal treatment, to detect early clinical signs of the disease. Prospective physicians in senior courses study clinical disciplines to obtain high qualifications. Clinical practice for students is an important element of the process of training a highly qualified doctor and improves the effectiveness of training. An important role in the system of preparing students for acquisition practical professional skills and abilities of a doctor are assigned to clinical practice, which provides a combination of theoretical and practical components of training and is aimed at forming the ability of future doctors to practice medicine. Consolidate and deepen the ability to rational choice of therapy taking into account the mechanism of action, diagnosis, etiology, pathogenesis of the disease. Clinical practice includes practical classes and independent work of students.
 The normative discipline "Clinical Practice" is aimed at the development, first of all, of the professional competencies of the future doctor, is professionally oriented in the field of health care, which in turn contributes to the effective preparation of students. The discipline "Clinical Practice", which is mastered by 5th year medical students is formed as a set of closely related content modules, which are logical complete parts of theoretical and practical educational material corresponding to a particular object.

Teaching the Neurologic Examination

Background and Objectives To compare a blended learning approach with traditional face-to-face instruction in terms of their individual effectiveness in imparting neurologic examination (NE) skills in medical students. Methods We conducted a prospective controlled study of 4th-year medical students (n = 163) who were pseudorandomly distributed into 2 groups. Group A (n = 87) was subjected to a traditional teaching method comprising 2 face-to-face sessions. Group B (n = 76) underwent blended learning, which consisted of an individual preparation period using a course handbook and videoclips, plus a single face-to-face session. NE skill acquisition was assessed by an objective structured clinical examination (OSCE). Questionnaires were used for evaluation. Results Comparison of mean OSCE scores in groups A vs B revealed that NE skill acquisition was better in group B (blended learning), with a moderate effect size, a smaller OSCE score variance, and fewer students performing poorly than in group A (face-to-face instruction). Student evaluation revealed that both teaching approaches were well accepted, but a higher level of satisfaction was associated with the blended learning approach. This method also provided more time for practice and feedback. Discussion The blended learning approach is a highly efficacious and valued method for teaching NE skills. It offers instructors and faculty the advantage of successful skill acquisition in students despite the considerably reduced attendance time.

COVID-19: achance for digitalization of teaching? : Report of experiences and results of a survey on digitalized teaching in the fields of anesthesiology, intensive care, emergency, pain and palliative medicine at the University of Leipzig

HintergrundDie SARS-CoV-2-Pandemie hat die Universitäten vor große Herausforderungen gestellt. Innerhalb kürzester Zeit galt es, Lehrveranstaltungen zu digitalisieren. Dies betraf auch den Bereich Anästhesiologie, Intensiv‑, Notfall‑, Schmerz- und Palliativmedizin an der Universität Leipzig.FragestellungZiel der fragebogengestützten Untersuchung war es herauszufinden, welche Veranstaltungen aus Sicht der Studierenden am ehesten digitalisiert werden können, und welche technische Infrastruktur die Lehrenden bei der Digitalisierung jeweils bestmöglich unterstützt.Material und MethodenFür die digitale Durchführung der Lehrveranstaltungen wurden Videopodcasts, digitale Lernmaterialien, Lehrfilme und Videokonferenzen genutzt. Je nach Veranstaltung wurden verschiedene dieser Angebote kombiniert. Darüber hinaus wurde ein Diskussionsforum für den Austausch zwischen Lehrenden und Studierenden etabliert. Zur Bewertung der Inhalte erfolgte im Anschluss eine Onlineevaluation.ErgebnisseAn der Befragung haben 82 Studierende teilgenommen. Als effektivste Angebote zur Wissensvermittlung wurden die Videopodcasts der Vorlesung (45,1 %) sowie der elektronische Unterricht am Krankenbett (34,1 %) bewertet. Insbesondere die Vorlesungen könnten nach Meinung von 92,7 % der befragten Studierenden auch dauerhaft digital ersetzt werden. Knapp 90 % haben die digitalen Lehrangebote der Klinik mit einer Gesamtnote von 1 oder 2 bewertet.Diskussion und ZusammenfassungIm Zuge des digitalen Semesters ließen sich einzelne Lehrformate unterschiedlich gut digitalisieren: Vorlesungen können aus Sicht der Studierenden auch langfristig besonders gut digital abgebildet werden, währenddessen die Digitalisierung des Unterrichts am Krankenbett bisher nicht adäquat möglich ist.Zusatzmaterial onlineDie Online-Version dieses Beitrags (10.1007/s00101-021-01016-4) enthält weitere Abbildungen.

Decline in empathy levels and sex differences in medical students from the Caribbean

Introduction: Empathy is an important trait in the training of medical students, as it has been shown that it improves the doctor-patient relationship. Objective: To evaluate the decline of empathy levels and possible sex differences in undergraduate medical students from the Universidad Central del Este, Dominican Republic. Materials and methods: Exploratory cross-sectional study. A Spanish version of the Jefferson Scale of Empathy for Medical Students (S-version) Scale was administered in September 2018 to 1 144 1styear to 5th-year medical students (887 women and 257 men). Data reliability was verified using the Cronbach’s alpha and the intraclass correlation coefficient (ICC). A generalized linear equation model (Type III) was applied to analyze data and the Wald chi-squared test was used to determine differences in overall empathy levels and the mean scores obtained in each of its three components based on the year of medical training and sex. Results: Cronbach’s alpha was satisfactory (0.839), and the ICC was 0.834 (F=5.68; p=0.005). The variability of the estimated curves in relation to empathic behavior by course (year of medical training) and sex was observed using linear and non-linear regression equations: Wald χ2=115.6, p=0.0001 between courses; and Wald χ2 =12.85, p=0.001 between men and women. Conclusions: Sex differences were observed regarding empathy levels in the study population. Moreover, a decline in empathy levels (overall empathy and Compassionate Care component in men and Walking in the Patient’s Shoes component in men and women) was also observed as students progressed in their medical training. The behavior of these data raises questions regarding the need to determine the factors causing these differences and the decline in empathy levels.

Comparison Viewpoints of Academic Members and Medical Students about Clinical Teaching Status in the Internal Medicine Wards in Tabriz University of Medical Sciences in Accordance to Ministry of Health Clinical Teaching Standards

Introduction: Investigating the situation of clinical teaching is an important part of beneficial clinical teaching and it is used in finding domains of strength and domains needed to improve. Thus, the goal of this study was to evaluate clinical teaching situation in the internal medicine wards at Tabriz University of medical sciences, based on standards prepared by the Ministry of Health. Methods: This was a cross-sectional study conducted from January to March 2019 in the Internal medicine wards. Participants were all academic members and medical students who were present in these wards during this investigation. The study tool was a checklist of standards that contained four areas: teaching rounds, morning reports, journal club, and outpatient clinic. Because of the varying number of items in the different parts of the checklist, we calculated the standard score for each part. Analysis of variance (ANOVA) was used to compare scores on the checklist among academic members and medical students. Result: Totally, 155 medical students and academic members participated in this study. Among them, 58 (37.4 %) were 5th-year medical students, 58 (37.4%) were final-year medical students and 39 (25.2%) were academic members. No statistically significant differences were found in mean standard scores for various areas of clinical teaching among academic members and medical students. Conclusion: Regarding the favorable running of outpatient clinics, morning reports, and journal clubs from viewpoints of medical students, some educational interventions are necessary to make better awareness and adherence to the Ministry of Health clinical teaching standards.

Simulation-based training following a theoretical lecture enhances the performance of medical students in the interpretation and short-term retention of 20 cross-sectional transesophageal echocardiographic views: a prospective, randomized, controlled trial

BackgroundBoth simulation-based training and video-based training serve as educational adjuncts for learning TEE among medical students. In the present study, we hypothesized that simulation-based training would better enhance the performance of medical students in the interpretation of 20 cross-sectional views compared to video-based training.MethodsA total of 120 4th-year undergraduate medical students were enrolled in the present study. The study began with a pre-test of all the participants, followed by a 90-min theoretical lecture and a post-test. Subsequently, the participants were randomly divided into the video-based group (Group V) and simulation-based group (Group S). Next, Group V received 60 min of TEE video learning, while Group S received 60 min of TEE simulator training. After the respective training, both the groups undertook the retention-test 1 and retention-test 2, 1 week and 1 month later, respectively. The performance for each test was evaluated by five views, which were selected randomly and, respectively, from a set of 20 cross-sectional views. The primary outcome was the performance of the retention-test 1. Secondary outcomes included: (1) comparison the performances of the pre-test, post-test, and retention-test 2 between two groups; (2) comparison the performances of pre-test and post-test in the same group; (3) comparison the performances of retention-test 1, and retention-test 2 in the same group.ResultsBetter performances were observed in Group S in both retention-test 1 (Group V: 63.2 [52.6, 77.6] vs. Group S: 89.5 [68.4, 100.0], P < 0.001) and retention-test 2 (Group V: 58.0 [48.0, 72.0] vs. Group S: 74.0 [64.0, 80.0], P < 0.001) compared to Group V. No statistically significant differences were observed in the performances of pre-test (Group V: 8.3 [4.2, 12.5] vs. Group S: 8.3 [4.2, 12.5], P = 0.825) or post-test (Group V: 46.2 [38.5, 57.7] vs. Group S: 44.2 [38.5, 56.7], P = 0.694) between the two groups. The improvement had been observed in the post-test, compared with pre-test in the same group, respectively (Group V in post-test: 46.2 [38.5, 57.7] vs. Group V in pre-test: 8.3 [4.2, 12.5], P < 0.001; Group S in post-test: 44.2 [38.5, 56.7] vs. Group S in pre-test: 8.3 [4.2, 12.5], P < 0.001). However, the performance in retention-test 2 was significantly reduced, compared with retention-test 1 in the same group, respectively (Group V in retention-test 2: 58.0 [48.0, 72.0] vs. Group V in retention-test 1: 63.2 [52.6, 77.6] P = 0.005; Group S in retention-test 2: 74.0 [64.0, 80.0] vs. Group S in retention-test 1: 89.5 [68.4, 100.0], P < 0.001).ConclusionsFollowing a 90-min theoretical lecture, simulation-based training better enhanced the performance of medical students in the interpretation and short-term retention of 20 cross-sectional views compared to video-based training.Trial registrationhttp://www.chictr.org.cn (ChiCTR2000033519, 3/June/2020).