Clinical Medicine Course Research Articles

Integration of the USMLE (United States License Examination) training system into the Curriculum Fergana Medical Institute of Public Health

The United States occupies a leading position in the world in terms of the level and effectiveness of scientific research. Health care in the United States is provided with the most modern medical equipment, medicines and consumables. Today, most of the Nobel Prizes in medicine go to the United States - 18 of the last 25 recipients were American citizens or visiting scientists. Americans account for half of all drugs created in the last 20 years. In American medicine, a quality control system for services has been established, the rights of the patient and his relationship with the doctor are regulated by a serious legislative framework. Medical school usually consists of four years of study and study in the USA. Traditionally, the first two years consist of basic science and clinical medicine courses such as anatomy, biochemistry, histology, microbiology, pharmacology, physiology, cardiology, pulmonology, gastroenterology, endocrinology, psychiatry, and neurology. USMLE Step 1/COMLEX Level 1 medical licensing commissions are accepted upon completion of the preclinical phase of the study.

Investigating the Relationship between Multiple Mini-Interview Communication Skills Outcomes and First-Year Communication Skills Performance and Reflections in Students at the Ontario Veterinary College.

An important outcome for veterinary education is ensuring that graduates can provide an appropriate level of care to patients and clients by demonstrating core competencies such as communication skills. In addition, accreditation requirements dictate the need to assess learning outcomes and may drive the motivation to incorporate relevant and appropriate methods of entry assessments for incoming students. Predicting the success of Doctor of Veterinary Medicine (DVM) students based on entry assessment performance has been scantly investigated and can be challenging. Specifically, no research presently exists on predicting DVM students' first-year performance in relation to communication skills at the time of program entry. Objectives of this exploratory study were to investigate (a) the relationship between communication skills outcomes from multiple mini-interview (MMI) data and first-year academic performance related to communication and (b) the relationship between communication skills outcomes from MMI data and self-reported first-year communication reflections. A retrospective single-class study was conducted. Data were analyzed using descriptive statistics, correlation statistics, regression models, and paired t-tests to identify relationships among variables. Paired t-tests showed that students felt more prepared to meet second-year expectations over first-year expectations. Spearman's correlation revealed an association between MMI communication scores and one pre-year 1 survey question related to professionalism. Noo relationships were observed between MMI communication scores and marks from a self-reflection assignment in a communications course, or grades from a clinical medicine course that included clinical communication. The merit for further exploration of the relationship between communication competencies and student performance is discussed.

Blended teaching of medical ethics during COVID-19: practice and reflection

BackgroundWith the advancement of information technology, teachers have become able to overcome the limitations of time and room capacity by carrying out teaching activities online. This practice, however, also presents new challenges. The present study explores how to fully capitalize on the advantages of online and offline teaching and improve the quality and impact of the teaching delivered. This article presents an analysis of the planning, implementation, evaluation, and reflection process of reforming the Fujian Medical University (FJMU) medical ethics course.MethodsAfter early attempts using the Small Private Online Course (SPOC) and flipped classroom formats, this paper focuses on the comprehensive active implementation of blended teaching practice. In terms of teaching practice, this research makes targeted improvements to overcome the known shortcomings of SPOCs and flipped classrooms, including the significant preparatory workload and lacking enthusiasm for classroom participation, by redesigning the course and evaluation method and changing the role of the teacher in blended teaching. Subsequently, the study used a stratified sampling method to select 20 students enrolled in the clinical medicine course at Fujian Medical University (FJMU). Their course experience was investigated using a semi-structured interview. Interview content related to evaluating teaching effect was extracted and encoded for subsequent qualitative analysis.ResultsA qualitative analysis of the student evaluation of blended teaching as implemented on the medical ethics course showed that the main factors influencing student engagement are the method of assigning tasks and that of testing learning outcomes. Student participation in class is influenced by the richness of the curriculum resources available and the role played by the teacher.ConclusionThis research presents a discussion of blended teaching and suggests improvements that can be made to address low student engagement and poor classroom participation. This round of blended teaching was shown to improve learning autonomy and classroom participation and to support students in the development of their clinical abilities and higher-order thinking skills. These findings provide a reference for the implementation of online teaching during the COVID-19 pandemic.

Introducing Clinical Pathology Course to Fourth Year Medical Students as a Bridge between Pre-clinical and Clinical Medical Sciences

There isn’t any vertical integration of pre-clinical and clinical sciences subjects in the existing Kathmandu University MBBS curriculum. Many of the graduates are not able to correlate the clinico-pathological aspects of various diseases as a result the rational use of investigations for diagnosing various diseases is compromised. There are few published examples of implementation of pathology instruction courses during the clinical years of medical training but it is not universally practiced. This lack of exposure to pathology may lead to poor understanding of laboratory testing and the role of pathologists in patient care.
 To set and implement an exemplary vertical integration of pre-clinical science with clinical science.
 A 12 credit hours clinical pathology education course comprising clinical hematology, cytopathology and histopathology was developed. Students belonging from the ongoing fourth year MBBS course of Birat Medical College were enrolled in the course. All of the interactive lecture sessions were delivered via an e-learning interface, using the Zoom platform as the main teaching methods. Evaluation of students’ achievement of learning objectives was conducted through distributing pre and post-test online multiple-choice questionnaires. Chi-square tests were used to compare the variables between pre-test and post-test questionnaire responses.
 Results suggested that the designed clinical pathology course is valuable. The pretest and post-test questionnaire responses revealed the positive impact regarding the importance of introducing clinical pathology courses within the clinical year of MBBS undergraduate curriculum. Response rate to the online session was 100%. The point of agreement between the pre-test and post-test questionnaire responses were highly achieved after intervention of the clinical pathology course. A statistically significant result (p < 0.05) between all of the pre-test and post-test questionnaire responses was noted. There was a strong positive recommendation for incorporating clinical laboratory medicine courses within the MBBS clinical science curriculum.
 The improvement observed among fourth-year MBBS students on learning the importance of clinical pathology courses was encouraging. This experience thus contributed to set and implement an exemplary vertical integration of pre-clinical science with clinical science.

Effect Evaluation of “Organ System-Centered” Course in Clinical Teaching

Objective: To evaluate the effect of applying the integrated teaching method of clinical medical courses centered on organ system in clinical teaching. Methods: 120 clinical medical students of grade 2019 in our school were selected as the research object, and divided into experimental group and control group according to different teaching methods. The control group was given the conventional teaching method, and the experimental group was given the organ system-centered curriculum integration teaching mode on the basis of the control group. The teaching effects of the two groups were compared. Results: Experimental medical students’ final examination scores, case analysis ability and satisfaction of teaching mode in the experimental group were significantly higher than those in the control group (P Conclusion: Using the integrated teaching method of clinical medicine courses centered on organ system in teaching has a significant effect on improving students’ comprehensive learning ability.

Practice of Clinical Teaching Reform based on Health Belief Model

The purpose of this study is to study the effect of this health education mode on the practice of clinical teaching reform based on the health belief model. We made an attempt and satisfaction survey on three teaching methods of clinical medicine courses for 90 students in our school. The results show that the clinical teaching method based on the health belief model is novel, clear in thinking, focused and easy to understand and remember. At the same time, taking cases to analyze, it strengthens the training of clinical thinking, cultivates a kind of ability and stimulates learning interest. This shows that the practice of clinical teaching reform based on health belief model is basically complete and feasible, and provides a set of scientific and reasonable methods for clinical teaching in the future.

University of Florida College of Medicine.

University of Florida College of Medicine.

Wright State University Boonshoft School of Medicine.

Wright State University Boonshoft School of Medicine.

Albert Einstein College of Medicine.

Albert Einstein College of Medicine.

University of Arizona College of Medicine-Tucson.

University of Arizona College of Medicine-Tucson.

Florida International University Herbert Wertheim College of Medicine.

Florida International University Herbert Wertheim College of Medicine.

Keck School of Medicine of the University of Southern California.

Keck School of Medicine of the University of Southern California.

Discussion on the undergraduate education mode of critical care medicine majoring in clinical medicine

To discuss the feasibility of offering specialized courses of critical care medicine in undergraduate clinical medicine education, so as to alleviate the shortage of critical care medicine staffs and lay a foundation for improving the success rate for the treatment of critical cases. The undergraduates majoring in clinical medicine from 2008 to 2011 in Guizhou Medical University (the former Guiyang Medical College) were enrolled. After they had been enrolled in the undergraduate education for 3 years and were ready for Grade four, which meant basic medicine teaching had been completed and clinical medicine teaching was about to start, they were introduced and preached to each discipline, including critical care medicine. The undergraduates were free to choose professional direction of clinical training in Grade four. Students majoring in clinical medicine from 2012 to 2014 were free to choose their major direction when they entered the school. From September 2011 to July 2019, the university had cultivated 246 undergraduates majoring in clinical critical care medicine from 2008 to 2014, and the critical care medicine professional team of affiliated hospital had undertaken 540 teaching hours. By July 2019, all students had graduated on time, with an employment rate of 100%. Forty students took postgraduate programs in our school and other schools, accounting for 16.3%. Professional education of critical care medicine in the undergraduate course of clinical medicine can mobilize students' interest in learning and subjective initiative, which is conducive to career selection. During the clinical training, the students can identify and timely cure critical care cases in the early stage, and partly alleviate the current shortage of critical care medical staffs.

Analysis of a Near Peer Tutoring Program to Improve Medical Students’ Note Writing Skills

Problem: The ability to document a patient encounter is integral for any physician. Previous studies indicate that medical students’ note writing skills are poor due to a lack of formal clinical documentation instruction. Barriers to formally teaching students how to write patient notes include the significant time burden and variability in faculty feedback. Implementing a near-peer teaching program to teach students how to write a patient note can overcome these barriers and fill this curricular gap. Intervention: Fourth year medical students who completed a Teaching in Medicine elective course were trained to provide individual feedback to 1st and 2nd year students on note writing as a part of their Introduction to Clinical Medicine course. In order to determine the effect of this two year, near-peer feedback program on note writing skills, we analyzed students’ scores on the note writing portion of two Objective Structured Clinical Exams that took place at the end of the 2nd and 3rd years of medical school. Context: The near-peer feedback sessions were implemented in the Fall of 2013 during the preclinical years of the medical school curriculum. Data from students who received near-peer feedback (N = 112) were compared to a historical control group who did not receive near-peer feedback on their note writing (N = 110). Objective Structured Clinical Exam scores that were specific to note writing skills, including the history, physical exam, and differential diagnosis subscales were examined. Impact: The near-peer feedback had a positive impact on the quality of patient notes. On the end of the 2nd year Objective Structured Clinical Exam, the near-peer feedback intervention group outperformed the no feedback group on the history and physical exam subscale scores but not on the differential diagnosis subscale score. One year later, the near-peer feedback intervention group continued to outperform the no feedback group on the physical exam subscale score, but not the history or the differential diagnosis subscale scores. Lessons Learned: Near-peer teaching improves student documentation of the history and physical exam, however only the effects on the physical exam portion persist into the clinical years of training. Writing up a differential diagnosis is a skill that develops through the clerkship experience regardless of exposure to feedback in the preclinical years. Implementing near-peer teaching in the medical school setting is feasible and can provide students with valuable learning experiences without relying on clinical faculty.

Case-Based e-Learning Experiences of Second-Year Veterinary Students in a Clinical Medicine Course at the Ontario Veterinary College.

Exposure to real-life clinical cases has been regarded as the optimal method of achieving deep learning in medical education. Case-based e-learning (CBEL) has been considered a promising alterative to address challenges in the availability of teaching cases and standardizing case exposure. While the use of CBEL has been positive in veterinary medical education, insight into students' learning experience with a CBEL tool have not been considered. This article investigates students' views around the utility and usability of a CBEL tool, as well as perceived effectiveness, clinical confidence, and impact of veterinary students' learning preferences on CBEL use. Through focus groups as well as pre- and post-use questionnaires, students expressed that the design and utility of the online cases, including their authenticity, played an instrumental role in perspectives and acceptance of the CBEL tool. Students perceived the CBEL tool as highly effective in both achieving CBEL outcomes and teaching a methodical approach to a clinical case. CBEL elements were also perceived to potentially contribute to increased clinical confidence after CBEL use. Additionally, exploration of students' preferred approach to learning revealed that hands-on learners and those who prefer to learn by practicing and applying knowledge were more likely to show positive perceptions of a CBEL tool. This article's findings can help guide educators in the future design and implementation of online cases in various capacities and provide a platform for further exploration of the effectiveness and use of CBEL in veterinary medical education.

Perception of health-related case studies in the context of introduction to clinical medicine course: students' and teachers' perspective.

Integrating theoretical and practical knowledge and stimulating students' active learning is the most important task of modern and high-quality healthcare education. By analyzing clinical cases, undergraduate medical students are trained to make accurate diagnoses, to choose appropriate therapy based on laboratory results and on adequate diagnostic tests. To examine the effect of clinical cases presentations on short-term memory as well as on the student's and teachers' evaluation of this method of teaching and learning in undergraduate medical studies. A total of 107 students in term 4 and term 5 enrolled in Trinity Medical Sciences University in St. Vincent and the Grenadines participated in this cross-sectional study. At the end of the semester, the students and the faculty were asked to complete a survey to assess their perception of case presentations (10 items, 4-point Likert-type scale, strongly agree to strongly disagree). The results of pre- and post-presentation quizzes were evaluated using the Wilcoxon signed rank test for paired samples. Term 4 and term 5 students significantly improved their achievement after intervention (Wilcoxon test Z = - 11.282, p < 0.001, and Wilcoxon test Z = - 10.167, p < 0.001, respectively). The analysis of progress among low- and high-performance students in both terms showed a significant increase in performance. Overall, median students' and teachers' attitude scores were positive. Clinical case presentation has a learning potential and facilitates positive interaction between instructors and students and supporting students to become reflective and competent physicians.

Editorial introductions

Editorial introductions

Establishment of scientific paper evaluation model of public hospitals

Objective To provide a new way for public hospitals to evaluate the interdisciplinary scientific innovation capacity. Methods Literature review method was adopted to analyze the current problems of public hospital evaluation model of scientific papers, feature matching method was used to build interdisciplinary science and technology innovation ability evaluation model. Results From the perspective of differences among disciplines, the characteristics of each clinical medicine course was analyzed, and feature matching method is applied to determine the academic journals directory by relevant experts to verify the rationality of affiliation, and then through the analysis of the academic influence of journal size, a comprehensive consideration of public hospitals interdisciplinary characteristics index evaluation system were built. Conclusions As one of the matured sorting algorithms, feature matching method and its application to the different disciplines of science and technology innovation model construction will obviously provide a good theoretical basis for scientific evaluation. Key words: Science and technology thesis evaluation; Feature matching method

The Evolution of an Integrated Advanced Regional Anatomy Course in a Doctor of Physical Therapy Curriculum

PURPOSETo describe the evolution of an integrative, clinically based advanced regional anatomy course within the second year of a Doctor of Physical Therapy (DPT) program.FOUNDATIONA model of vertical and horizontal integration, using clinically based approaches within a quarter during the second year of a DPT program, evolved over eighteen years with increased use of technology. Original methods of lectures, cadaver prosections, bony models and student presentations have evolved to include electronic examinations, diagnostic ultrasound and palpation laboratories, online sharing of surgical procedure assignments, and clinical case study and pathology discussions with cadaver prosections.DESCRIPTIONOne hundred second year DPT students participated in the newly modified 11 week course over a two year period. Clinical case study and pathology discussions with cadaver prosections, imaging lectures, and diagnostic ultrasound and palpation laboratory sessions were used. Weekly topics on body regions horizontally integrated snatomy with weekly regional topics in clinical medicine and clinical skills courses. For example, over two weeks students listened and discussed imaging of the cervical spine and shoulder girdle while handling and observing bony models, and discussed and observed variations of the brachial plexus, including a published case study, on cadaver prosections. Cervical spine and shoulder girdle structures were palpated in a lab prior to learning manual therapy skills in a clinical skills course. Students posted surgical procedure assignments about cervical disc replacement, nerve transfer for brachial plexus pathology, Bankart repair, and latissimus dorsi transfer concurrent with clinical medicine course lectures about medical approaches to cervical spine and shoulder girdle pathology. A diagnostic ultrasound laboratory session allowed students to observe anatomical structure while learning how to use the device, and a journal case study provided application of its use in physical therapy practice. Students were evaluated on their surgical procedure group assignment, competence in palpation, two electronic multiple choice and short answer examinations, and two cadaver‐based practical exams.OBSERVATIONSStudent course evaluations were positive. One hundred percent of students agreed that course assignments had instructional value, cadaver prosections were an important learning tool, and that palpation labs were effective in improving their skills. Student comments included: “By being able to actually see the structures in the lab, I learned more (than) I would have (by) just looking in a book or powerpoint”; “ the case study discussions in the lab were beneficial and contributed significantly to my learning experience in this course”; ”I thought it was very informative and useful to get back into the lab be able to see the structures again and helped facilitate learning in other courses as well particularly CS5 with hand placement”. Faculty identified improved handling skills, confidence, and competence in the concurrent clinical skills course.CONCLUSIONSEnhanced use of technology, clinical case studies, and palpation in a second year anatomy course facilitated integration within a quarter of an entry level DPT program. Maximizing integration within the curriculum may improve application of content with clinical medicine and skills courses, improve manual psychomotor skills, and enhance problem solving skills.Support or Funding InformationNone.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Applied anatomy, today's requirement for clinical medicine courses.

Anatomy as an indispensable part of the medical curricula, offering impeccable knowledge, prepares the students to enter the practical atmosphere. The aim of this study was to evaluate the clinical application of anatomy courses of the medical students in Zanjan University of Medical Sciences. This cross-sectional study was conducted in 2015 with census sampling on all clinical students (trainees and interns). To collect feedback from students, the questionnaire designed by researchers was used. The Likert rating scale of very high, high, medium, low, and very low was considered and scores of 5 (very high) to 1 (very low) were applied. Data were analyzed by SPSS software. Among the courses of anatomy, trunk anatomy has the greatest impact on clinical courses of medical students (P<0.001). Subjects of muscular system, lymphatic system, vascular system, and nervous system were of significant clinical application during clinical periods; however, no significant clinical application observed for skeletal system (P<0.05). Teaching clinical tips by professors can help improve the performance of medical students in clinical education. In addition, using three-dimensional anatomical software is suggested as well.