Clinical Education Research Articles

Bibliometric analysis of scholarly publications related to family medicine in Thailand

BackgroundFamily medicine has been recognized as a medical specialty in Thailand. However, there is a lack of information about scholarly publications. Bibliometric analysis is a valuable methodology for identifying research trends and knowledge gaps in this field. This study aims to analyze scholarly publications related to family medicine in Thailand. MethodThis bibliometric analysis was conducted based on the PubMed search in March 2023. All relevant literature related to 'family medicine' and 'Thailand' was retrieved. Performance analysis examined the publication trends from 1963 to 2023, the top 10 journals publishing relevant articles, and the number of publications by research areas. Science mapping depicted clusters of co-occurring author keywords, their relationships, and the research themes' trend over two decades. ResultsA total of 1,483 publications were retrieved. The number of publications showed an upward trend, increasing from 61 before 2000 to 359 in 2020. The Journal of the Medical Association of Thailand was the leading journal, publishing 267 articles (18.0%). Research areas were categorized into Basic Knowledge (n=211), Clinical Problem Solving (n=714), Health Service (n=256), Health System (n=254), and Medical Education (n=48). Science mapping identified six clusters based on 106 co-occurrence keywords, including public health, health services, medical issues in older adults, healthcare access, epidemiology, and others. Research themes have shifted from infectious diseases and public health to primary care and non-communicable diseases. ConclusionFuture research should focus more on implementation at a population level and healthcare system, with more investigation into geriatric care and child and maternal health.

Pregnancy care experiences for adults with congenital heart disease in the United States

BackgroundResearch to reduce maternal morbidity due to cardiovascular disease is vitally important in the United States, especially for the growing number of individuals with congenital heart disease (CHD) reaching childbearing age. Understanding patient experiences through patient engagement is critical to designing research that is aligned with the needs of adults with CHD undergoing pregnancy. MethodsThis patient engagement project, grounded in human centered design, focuses on the discovering patient and healthcare provider priorities for reducing maternal morbidity in CHD through patient centered outcomes research (PCOR). In this first stage, a capacity building consortium of over 90 key partners, including patients, advocates, healthcare providers, and researchers, was assembled. Baseline education on patient engagement, PCOR, and survey instrument design was delivered virtually. Two questionnaires were designed to elicit tacit knowledge – one for patients and one for providers – regarding gaps and needs across four key pillars: access to clinical care, patient and provider education, mental health, and research opportunities. The pillars were determined through thematic summaries from consortium discussions. ResultsThe patient questionnaire received 828 responses (age range: 18-60 years) from 48 U.S. states. The provider questionnaire garnered 218 responses from professionals. Several common themes for areas of research were observed across all pillars including improved access to specialized cardio-obstetric care and improved education about the need for specialized care. Healthcare providers cited insufficient care coordination models and resources as a major barrier to providing effective clinical care. Both patients and providers expressed a need for improved access to mental health care. While only 28% of patient respondents who underwent a pregnancy reported a pre-existing mental health diagnosis, nearly 2/3 reported having significant anxiety symptoms related to their pregnancy. Of those with significant symptoms, 44% were unable to access mental health services. Additionally, only 55% of healthcare providers reported referral for assessment and treatment if mental health concerns arose during or after pregnancy. ConclusionThe results provide valuable insights into the unique challenges faced by patients with CHD and their providers during pregnancy. By addressing the identified gaps through PCOR, we can work towards a goal to improve maternal care for women with CHD.

Concordance of ChatGPT With American Burn Association Guidelines on Acute Burns.

Burn injuries often require immediate assistance and specialized care for optimal management and outcomes. The emergence of accessible artificial intelligence technology has just recently started being applied to healthcare decision making and patient education. However, its role in clinical recommendations is still under scrutiny. This study aims to evaluate ChatGPT's outputs and the appropriateness of its responses to commonly asked questions regarding acute burn care when compared to the American Burn Association Guidelines. Twelve commonly asked questions were formulated by a fellowship-trained burn surgeon to address the American Burn Association's recommendations on burn injuries, management, and patient referral. These questions were prompted into ChatGPT, and each response was compared with the aforementioned guidelines, the gold standard for accurate and evidence-based burn care recommendations. Three burn surgeons independently evaluated the appropriateness and comprehensiveness of each ChatGPT response based on the guidelines according to the modified Global Quality Score scale. The average score for ChatGPT-generated responses was 4.56 ± 0.65, indicating the responses were exceptional quality with the most important topics covered and in high concordance with the guidelines. This initial comparison of ChatGPT-generated responses and the American Burn Association guidelines demonstrates that ChatGPT can accurately and comprehensibly describe appropriate treatment and management plans for acute burn injuries. We foresee that ChatGPT may play a role as a complementary tool in medical decision making and patient education, having a profound impact on clinical practice, research, and education.

Nursing students’ evaluation of clinical placement education quality: a national database analysis

Nursing students’ evaluation of clinical placement education quality: a national database analysis

Career Advancement Insights from Certified Pharmacy Technicians: Enhanced Opportunities for the Pharmacy Technician Workforce

Sustainable career advancement opportunities for pharmacy technicians will be a critical part of patient-centered community pharmacy environments as the role of the pharmacist provider expands. (1) To determine the impact of a Pharmacy Technician Certification Board pharmacy (PTCB) certification on career advancement and professional growth metrics; (2) To assess technicians' role in advanced pharmacy services before and after certification; and (3) To identify changes in pharmacist services when a certified pharmacy technician (CPhT) was added to the provider team. A 73-question web-based survey was distributed to all PTCB certified pharmacy technicians (CPhT) in the United States, Washing D.C., Puerto Rico, Guam, and the US Virgin Islands. The survey was distributed by PTCB in April 2021 with a 28-day collection period. The survey included multiple choice, rating scale, and free text questions centered on five domains: Practice experience, Career aspirations, Compensation, Pharmacy practice motivations, and Impact of COVID-19 pandemic. 23,007 CPhTs completed the survey. Respondents were primarily female (85.5%), age 30-39 (32.8%), and ≥ 10 years CPhT experience (42.8%). The majority of respondents cited improvement of patient health (77.4%), career advancement opportunities (53.5%), the ability to expand their role during emergencies (e.g., COVID-19) (52.6%), and future career advancement opportunities (51.7%) as benefits of CPhT certification. Increases in job responsibility after certification included changes occurring in roles related to clinical pharmacy services, patient education, preventive health services, provider communication, and staff training. Respondents agreed that PTCB-certification allowed for the expansion of pharmacists' services where they practiced, including clinical services (18.5%), patient education (18.3%), and preventive health services (18.1%). CPhT's value certification for its benefits on career advancement, personal growth, and salary enhancement. Affirmation of skill and training through certification is also recognized to positively influence patient care and the pharmacy's ability to provide advanced patient care and services.

Environmental Sustainability in Oral Health Professional Education: Approaches, Challenges, and Drivers-ADEE Special-Interest Group Report.

This paper reports on the scholarship activity of the 'Sustainability in Dentistry' Special-interest Group (SiG), which met at the Association for Dental Education in Europe (ADEE) annual conference in Liverpool on 25 August 2023. The aim of this study was to (i) identify current teaching practices and approaches to embedding Environmental Sustainability (ES) in the curriculum in ADEE attendee schools and (ii) explore existing barriers/challenges to incorporating ES in dental education and consider potential solutions. A mixed-methods approach was used to fulfil the aims of this study. A pre-workshop questionnaire was used to explore current teaching practices, challenges and drivers of embedding ES in the curriculum. An interactive workshop at the in-person meeting in Liverpool was used to propose key strategies to overcome the most frequent challenges to embedding ES in the curriculum. The majority of respondents (56%) reported that their institutions do not currently teach ES. Traditional didactic forms of teaching were mostly reported to teach ES in non-clinical environments, and a transition to more environmentally sustainable materials and instruments was the most popular response for clinical teaching. Key barriers to embedding ES in the curriculum were identified, including time constraints and the overloaded curriculum, a lack of expertise/knowledge to teach and lack of practical guidance to support educators, limited learning resources for staff and students and resistance from colleagues regarding the relevance of ES in dentistry. The special-interest group participants proposed strategies to overcome these challenges that centred around 14 themes. This paper reports recent scholarship activity by ADEE's 'Sustainability in Dentistry' SiG. Key strategies for overcoming the most common challenges to embedding ES in the curriculum are also discussed.

Nurturing clinical teachers' professional learning: A phased approach.

Nurturing clinical teachers' professional learning: A phased approach.

Development of a Virtual Reality Training Tool Promoted at Skill Acquisition in Preparatory Clinical Education for Pharmacy Students and Verification of Its Educational Effectiveness: Preparation of Liquid Medications

In recent years, virtual reality (VR) technology has garnered attention as an educational tool. It is believed to be beneficial to utilize VR technology for the acquisition of pharmacist skills. Therefore, we developed a VR training tool aimed at acquiring skills in the preparation of pharmaceuticals in preparatory clinical education for pharmacy students. Additionally, we evaluated the effectiveness of the VR training tool by having beginners learn about the preparation of liquid medications through VR materials or existing texts (Tx) and assessing their learning outcomes in subsequent practical exams. The study included 12 participants in the VR group and 10 in the Tx group. For the items "smoothly and rhythmically performing a series of actions or operations," "aligning the meniscus with eye level during scale confirmation," "marking lines on the dispensing bottle," and "placing lines at the appropriate scale on the dispensing bottle," students in the VR group were significantly more capable in practical application. The time required to prepare the liquid medication was significantly shorter for students in the VR group, with over half of the Tx group students exceeding 10 min and terminating the task. According to the survey results, many students cited VR as a method for acquiring dispensing skills. Based on these results, our developed VR training tool for liquid formulation showed usefulness in teaching practical skills to beginners.

Development of a Virtual Pediatric Holistic Comfort Care Clinic.

Guided by the tenets of Kolcaba's holistic comfort theory, we developed, implemented, and evaluated a simulated online pediatric advanced practice health center. The Pediatric Comfy Care Clinic (PCCC) was created to enhance person-centered diagnostic reasoning and holistic advanced management skills for family nurse practitioner students. Our interprofessional team used a standardized approach to online design and development while integrating essential holistic comfort theory concepts for student engagement and assessment of learning. We explored outcomes of pre- and postclinic quizzes and student reflection data using mixed methods. Significant differences (P<.001) were noted in all postpractice quizzes in each affiliated PCCC module with variable student outcomes on graded clinic encounters. Important student perspectives on teaching and learning in the virtual clinic were noted. A comfort theory-driven, simulated, and digitally enhanced virtual clinic is feasible and valuable with important implications for holistic advanced practice.

국내 간호대학생의 임상수행능력 관련 변인에 대한 체계적 문헌고찰 및 메타분석

The purpose of this study is to conduct a systematic review and meta-analysis of variables related to clinical competence of Korean nursing students. A total of 63 studies were selected from domestic studies published from January 2014 to December 2023 and analyzed using the R program. The effect size was analyzed by dividing the effect of clinical competence into cognitive, affective, and psychomotor domains. Clinical competence related variables were derived from 27 variables in 3 domains. The effect sizes of the average clinical competence of all three domain variables showed large effect sizes, with the cognitive domain being the largest at 0.65, followed by the psychomotor domain at 0.62 and the affective domain at 0.52. Among all variables, problem-solving process had the largest effect size at 0.87, and character had the second largest effect size at 0.81. In the control effect analysis, there was statistical significance depending on the measurement tool in the cognitive domain, and there was a statistical difference depending on the number of subjects and the measurement tool in the psychomotor domain. Based on the results of this study, I propose that variables with a large effect size on clinical competence be set as learning outcomes and utilized to improve clinical practical education programs.

Clinicians' Knowledge, Attitudes, and Practices Regarding the Management of Functional Gastrointestinal Disorders With Neuromodulators and Psychological Treatment.

Little is known about the practical clinical application of neuromodulators and psychiatric treatments in patients with functional gastrointestinal disorders (FGIDs). We investigate the knowledge, attitudes, and practices of Korean clinicians regarding the use of neuromodulators and psychiatric treatments for FGIDs. This prospective, online, cross-sectional study was conducted between May and August 2022. A questionnaire regarding the knowledge, attitude, and practice of neuromodulators and psychiatric treatments for FGIDs was developed and administered to primary care clinicians and gastroenterologists in university hospitals in Korea. Overall, 451 clinicians from primary (n = 179, 39.7%), secondary (n = 113, 25.1%), and tertiary (n = 159, 35.3%) hospitals participated in the survey. Most of them considered that neuromodulators (98.7%) and psychiatric treatment (86.5%) were required for patients with FGIDs. However, approximately one-third of them did not prescribe neuromodulators, mainly due to unfamiliarity with the drugs, and only one-quarter considered psychiatric referral. Compared to gastroenterologists at university hospitals, primary care clinicians' prescriptions had a lower rate (87.2% vs 64.2%, P < 0.001) and shorter duration of neuromodulator. The psychiatric referral rate was lower for primary care clinicians than for gastroenterologists at university hospitals (19.0% vs 34.2%, P < 0.001). Knowledge, attitude, and practice levels regarding neuromodulators and psychiatric treatment among clinicians are inhomogeneous, and a knowledge gap exists between primary care clinicians and gastroenterologists at university hospitals. Encouraging ongoing education for Korean clinicians regarding the appropriate use of neuromodulators and psychiatric treatments in patients with FGIDs is suggested.

Anterior-Posterior View Acquisition During Videofluoroscopy: A Survey Study Exploring Influential Factors on Speech-Language Pathologists' Practice Patterns.

This study explored factors influencing speech-language pathologists' (SLPs') decision making surrounding anterior-posterior (AP) view inclusion practices during videofluoroscopic swallowing studies (VFSSs) in the United States. SLPs completing VFSSs were recruited to complete an online anonymous survey. Questions represented six constructs of interest including: (a) clinician demographics, (b) practice patterns, (c) diagnostic perceptions, (d) professional influences, (e) training and education, and (f) logistical facilitators and barriers. Binary logistic regression was used to explore the relationship between construct items and likelihood of AP view inclusion. A total of 136/213 (64%) of respondents reported obtaining an AP view routinely. Facilitators of AP view inclusion were post-acute work setting (OR = 3.40, p = .001); perception that department practices "probably" (OR = 5.65, p = .006) or "definitely" align (OR = 5.30, p = .006) with evidence-based practice; perception the AP view has "a lot" (OR = 4.17, p = .025) or "a great deal" (OR = 4.77, p = .028) of diagnostic value; perception that their department is "definitely" supportive (OR = 4.69, p = .040); "moderate" (OR = 4.75, p = .001) or "no" (OR = 7.51, p < .001) equipment limitations; and radiologist support greater than "extremely unsupportive or resistant" ("somewhat unsupportive" [OR = 5.74, p = .041], "neutral" [OR = 11.23, p = .002], "somewhat supportive" [OR = 13.92, p = .001], or "extremely supportive" [OR = 13.92, p = .001]). Barriers to AP view inclusion were geographic location in the southern U.S. census region (OR = 0.31, p = .007), being "significantly" influenced by coworker opinions (OR = 0.13, p = .018), and productivity tracking (OR = 0.21, p = .008). Environmental factors and organizational culture heavily influence AP view inclusion practices.

A Real-Life Laboratory Setting for Clinical Practice, Education, and Research in Family Systems Care: Protocol for a Transformational Action Research Study.

Burdening health and illness issues such as physical or mental illnesses, accidents, disabilities, and life events such as birth or death influence the health and functioning of families and contribute to the complexity of care and health care costs. Considerable research has confirmed the benefits of a family systems-centered care approach for patients, family caregivers, families, and health care professionals. However, health care professionals face barriers in working with families, such as feeling unprepared. Family systems-centered therapeutic conversations support families' day-to-day coping, resilience, and health. A family systems care unit (FSCU) was recently established as a real-life laboratory at one of the Swiss Universities of Applied Sciences. In this unit, health care professionals offer therapeutic conversations to families and individual family members to support daily symptom management and functioning, soften suffering, and increase health and well-being. These conversations are observed in real time through a 1-way window by other health care professionals, students, and trainees and are recorded with video for research and education. Little is known about how therapeutic conversations contribute to meaningful changes in burdened families and the benefits of vicarious learning in a real-life laboratory setting for family systems care. In this research program, we aim to deepen our understanding of how therapeutic conversations support families and individuals experiencing burdening health and illness issues and how the FSCU laboratory setting supports the learning of students, clinical trainees, and health care professionals. Here we apply a transformational action research design, including parallel and subsequent substudies, to advance knowledge and practice in family systems care. Qualitative multiple-case study designs will be used to explore the benefits of therapeutic conversations by analyzing recordings of the therapeutic conversations. The learning processes of students, trainees, and professionals will be investigated with descriptive qualitative study designs based on single and focus group interviews. The data will be analyzed with established coding methods. Therapeutic conversations have been investigated in 3 single-case studies, each involving a sequence of 3 therapeutic conversation units. Data collection regarding the second research question is planned. Preliminary results confirm the therapeutic conversations to support families' coping. This renders the FSCU a setting for ethically sensitive research. This program will not only support the health and well-being of families, but also contribute to relieving the financial and workforce burdens in the health and social care system. DERR1-10.2196/53090.

Abdominal POCUS Education for Clinicians: A Systematic Review of Teaching Methods for Point-of-Care Abdominal Ultrasonography.

This systematic review examines educational strategies in clinician-performed abdominal point-of-care ultrasound (POCUS), a critical skill with increasing relevance in medical care. Analyzing 28 studies, we highlight the strategies as well as advantages and disadvantages of various theoretical and practical components, including, for example, e-learning and simulation in training programs. The findings emphasize the necessity of blending various educational methods to enhance effectiveness and adaptability in training environments. Ultimately, robust training frameworks are essential to maximize diagnostic accuracy and improve patient outcomes in abdominal POCUS.

Effect of virtual case-based learning (CBL) using the flipped class and peer instruction on the motivation to learn basic sciences

BackgroundAccording to Self-Determination Theory, active learning methods, as alterations to the learning environment, can influence students’ academic motivation to learn. The purpose of this quasi-experimental study was to investigate the effect of virtual case-based learning sessions on the learning motivation of first- and second-year medical students.MethodsA total of 258 students, 128in the intervention group and 130 in the control group, were enrolled in the study. The control group consisted of medical students who had not previously participated in virtual case-based learning sessions and were trained in the same curriculum as the intervention group. Two questionnaires were created to evaluate learning motivation in basic science and the motivational outcomes of virtual case-based learning sessions, drawing on the three fundamental needs outlined in Self Determination Theory. The questionnaires were designed through individual interviews with students and validated using Lawshe’s method and Cronbach’s Alpha. The virtual case-based learning sessions were designed as a series of webinars on various topics, with students randomly divided into groups and assigned trained moderators. Clinical scenarios were designed by a team of basic scientists and clinical educators. Each virtual case-based discussion consisted of three phases and was completed in three days. Comparisons between two groups were made using the two-sample t-test and Pearson’s correlation coefficient was used to analyze the motivational consequence questionnaire.ResultsThe results of the study indicated that virtual case-based learning sessions had a significant impact on the learning motivation of basic science students (p < 0.01). Additionally, the most notable motivational consequences of CBL sessions were basic sciences applicability and its interestingness.ConclusionsThe study provides valuable insights into the effectiveness of virtual case-based learning sessions and suggests avenues for future research. The findings of this study could be useful for educators and institutions seeking to enhance the learning motivation of medical students through virtual case-based learning sessions. However, further research is needed to investigate the long-term effects of virtual case-based learning on student motivation and academic performance.

A multi-national survey-based evaluation of undergraduate/predoctoral endodontic education.

To evaluate the current status of endodontic education and assessment at an undergraduate/predoctoral level in dental schools worldwide. The current survey comprised a 50-item online questionnaire related to undergraduate endodontic education. The project leaders emailed the survey's details to faculty members responsible for endodontic teaching at one dental school in every country to seek their willingness to participate in the survey. After the faculty members accepted, the survey details were sent to participants along with the survey link. Simple descriptive statistics were used to represent the data. Amongst the 44 faculty members from different countries who agreed to participate, 36 completed the survey. Endodontic training starts in 50% of dental schools from the third year of the curriculum. Each dental school employs a diverse range of educational methods. During pre-clinical training, 19.4% of the participating dental schools used only natural teeth. Stainless-steel hand instruments, syringe irrigation with a needle, resin-based sealer and the cold lateral compaction technique are the most frequently used in pre-clinical and clinical training. A significant percentage of dental institutions necessitate that students treat a predetermined quantity of canals or teeth throughout their pre-clinical and clinical education. Dental institutions conduct formative, summative or a combination of the formative and summative throughout the clinical and pre-clinical phases of endodontic training. According to the data collected from this survey, there are considerable variations in the curriculum for undergraduate/predoctoral endodontic programmes amongst the surveyed dental schools. Pre-clinical and clinical education should integrate a larger array of modern tools and procedures.

Novice clinician educator professional identity formation through a longitudinal mentorship: a qualitative study

BackgroundThe professional identity of doctors is evolving with physicians now required to be ‘scholars’, facilitating the education of students and healthcare teammates as educators. Mentoring is widely practiced and is postulated to facilitate professional identity formation (PIF) through socialization.Preliminary literature review suggested few studies looking into how formal mentoring programmes affect PIF of novice clinician educators, particularly an Asian context. I hope to understand the perceived professional identity of such educators, and what changes in professional identity are observed after longitudinal mentorship, using the social cognitive career theory (SCCT) as an underpinning framework.MethodsA qualitative study explored perspectives of mentees with less than two years teaching experience and participating in a formal mentoring programme. Semi-structured interviews were conducted at the beginning and end of the programme. Thematic analysis and coding of these taped and transcribed interviews was performed and triangulated with an elite interview. Mind maps were constructed to appreciate the inter-relatedness of themes and evaluated using the SCCT framework. Methodology was anchored to the Consolidated Criteria for Reporting Qualitative Research checklist.ResultsSeven mentees were recruited. All were Chinese except for two Indians. All had less than six months experience with educational activities. None had formal training in medical education. Median duration postgraduate was six years. One was from a surgical discipline, others were from a range of medical disciplines. Themes identified included background influences, learning experiences and outcome expectations which affected self-efficacy, leading to mentees attaining goals and performing actions which effected their professional identity development, which was in-turn affected by contextual influences. Most perceived themselves as clinicians rather than medical educators. Concepts underpinning PIF included socialisation (role modelling and mentorship, communities of practice, sense of belonging), experiential learning, the hidden curriculum and reflective practice.ConclusionsNovice clinician educators mostly have a hierarchical identity. Role modelling and mentorship, active participation in communities of practice, promotion of a sense-of-belonging, experiential learning combined with reflective practice are important components for socialisation, synergistically facilitating PIF in novice clinician educators. Overcoming contextual barriers, being cognisant of cultural practices and addressing concerns in the hidden curriculum can assist educators in development of their professional identity.

Enhancing cardiology trainee competence through simulation-based pericardiocentesis training: a pilot programme evaluation

Abstract Introduction Cardiology training requires trainees to manage clinical duties whilst developing practical skills. Changes to the UK curriculum have resulted in reduced time available for procedural teaching. Pericardiocentesis is one of many required competencies. The Joint Royal College of Physicians Training Board cardiology curriculum cites the importance of simulation-based education to teach procedures. Procedural training encompasses the development of clinical reasoning alongside motor skills. Gange (1962) and Carless (2010) emphasized the importance of expert-guided practice, interactive teaching, and instant feedback in motor skills teaching to maximize the educational experience. Aim Develop a simulation teaching programme to enhance trainees' confidence and competency in pericardiocentesis. Procedures form part of a summative Direct Observation of Procedural Skills, enabling trainees to learn in a safe environment and use as evidence at their Annual Review of Competence Progression (ARCP). Method We developed a pilot programme for pericardiocentesis facilitated through high-fidelity equipment between February 2023 and February 2024. Participants were recruited through medical education departments. The sessions were delivered on a one-to-one basis by a cardiology consultant to facilitate discussion and interactivity. The teaching involved a core knowledge presentation, discussion of trainee experiences, case studies as examples, including review of echocardiography features. This was followed by clinical skills teaching of pericardiocentesis, utilizing a model, and transthoracic echocardiography. Trainees were sent anonymous feedback forms after the session. Results 46 cardiology registrars participated; 48% were within their first few years of training. 87% reported difficulty in practicing this skill in clinical practice due to: lack of exposure, other clinical responsibilities taking priority, and the need for consultant-delivered care on patients requiring an urgent or emergency procedure. Mean trainee confidence before teaching was 3.24 out of 5 (SD = 1.14), with a significant improvement to 4.48 (SD = 0.59 p&amp;lt;0.001). 52% improved in confidence by 1 unit and, 31% improved in confidence by 2 or more units. Trainees reported the following themes regarding the session: knowledgeable trainer, high fidelity equipment, instant feedback to predict, prevent, and overcome challenges, and a multi-modal approach to teaching, incorporating presentation and discussion on pericardial effusion, tamponade, and drainage. Conclusion Our programme offers a unique multi-modal teaching approach, with dedicated time with an expert. We supported the progress of 46 trainees and enhanced their training competencies. We aim to expand the programme to incorporate more procedures in line with growing curriculum requirements. Tracking trainee progress until ARCP outcomes will reveal the impact of simulation teaching on their experience and professional development.

Self-reported mistreatment of Danish medical students

Abstract Background Evidence suggests that mistreatment of medical students (MS) exists and that it is associated with stress, anxiety, burnout, substance abuse etc. Mistreatment encompasses discrimination and sexual harassment and impacts MS’ ability to partake their education with increased risk of dropout. The aim of the study is therefore to explore whether Danish MS and junior physicians enrolled in the Clinical basic education (CBE) have experienced mistreatment during their studies. Methods An online survey was conducted by email and sent to 5234 MS enrolled in one of four medical Master programs in Denmark or in the CBE. Reminders were distributed by email, shared in Facebook groups, and presented during lectures, accompanied by cards with QR codes for the survey. Data collection took place during spring 2023 and 645 completed the questionnaire giving a response rate of 12 %. The questions were based on the Everyday Discrimination Scale. Descriptive statistics and multivariate logistic regression were used for data analysis. Results MS most often encounter mistreatment from physicians, other health professionals and patients during their clinical internships. They also encounter mistreatment from lecturers and peers. MS who self-identify with another ethnicity than Danish/European were 3.2 times more likely than MS identifying with Danish/European ethnicity to report mistreatment from other students (95% CI 1.76 -5.95). Men were also less likely than women to report mistreatment. The mistreatment reported by MS is predominantly based on gender, ethnicity, religion, and age. The most frequent experiences are stereotypical statements (71,8%), lack of respect (65,1%) and being ignored (54,1%). Conclusions Our results indicate that Danish MS experience mistreatment, which can potentially impact their mental health. These results underscore the need for targeted interventions to create an inclusive educational environment that fosters the well-being and success of MS. Key messages • Danish medical students often face mistreatment from peers and health professionals, and more often reported by woman and students identifying with ethnic backgrounds other than Danish/European. • Action by University management is needed to implement targeted interventions such as diversity training, as mistreatment can negatively impact students’ mental health and educational outcomes.

Creating a safe space: medical students’ perspectives on using actor simulations for learning communication skills

BackgroundCommunication skills are an essential part of clinical competence that need to be acquired during health professions education. Simulations are extensively used for learning communication skills and have long been integral to medical degree programmes. In this research we use qualitative methodology to explore fourth-year medical students’ experiences in simulations aimed at improving versatile doctor-patient communication, focusing on their learning with trained actors.MethodsThe data comprises reflective writings from 208 fourth-year medical students, gathered after a communication skills course. These students provided informed consent for their writings to be included in the research. We performed an inductive qualitative content analysis on the textual data, with findings presented as themes, supported by categories, codes, and excerpts from raw data to enhance the trustworthiness of the analysis.ResultsWe identified eight key themes capturing students’ learning experiences through simulations: practising in a safe learning environment, valuing feedback, gaining new perspectives, finding simulations valuable and enjoyable, boosting confidence and self-knowledge, and viewing simulations as authentic and engaging learning opportunities. Some students offered critical perspectives on simulations. Throughout the course, students learned diverse aspects of patient care, emotional and behavioural communication dynamics, and lessons from medical errors. Some students offered critical perspectives on simulations, and a few indicated they did not learn anything new.ConclusionsA safe learning environment is vital for encouraging learners to explore, make errors, and absorb feedback to improve their communication with patients. Students predominantly valued the communication skills training with actors and the constructive feedback received and given in the debriefing discussions. However, some students expressed critical views toward simulations. Simulations are not static; they evolve and require continual improvements. Hence, we advocate for the ongoing exploration and enhancement of communication skills learning methods, including simulations, with careful consideration for students’ vulnerability and the importance of psychological safety. Additionally, it is critical to address students’ perceptions that certain clinical teachers prioritise biomedical knowledge over communication skills. Providing tailored training for teachers regarding the learning methods and the desired outcomes of communication courses is essential.