Medical Education Competencies Research Articles

Gender competence in medical education.

Gender competence in medical education.

AN ASSESSMENT OF MEDICAL STUDENTS’ PERCEPTIONS TOWARDS PROFESSIONALISM IN HEALTH CARE AT HUE UNIVERSITY OF MEDICINE AND PHARMACY, HUE UNIVERSITY

Professionalism has become one of the core competencies in medical education which will shape physicians’s behavior in the future to provide high-quality and patient-centered care services. Objectives: To assess the perceptions and attitudes of medical students regarding professionalism in health care. Methods: A cross-sectional descriptive study was carried out with 717 second-year and fifth-year medical students of Hue University of Medicine and Pharmacy, Hue University. Results: Students’ perception on professionalism was not high, at 3.85 out of 5 points. In which, “respect” was the domain having highest score and “communication skills” was the lowest recognition domain (4.15 and 3.54 out of 5, respectively). Preclinical students had higher perception than students having clinical experiences in all aspects of professionalism (p<0.05). Conclusion: Priority should be given to train professionalism and communication skills through the early clinical exposure program and hidden curriculum across all years of medical education program. Furthermore, the core aspects of professionalism are needed to be consistently identified and evaluated in the training program among medical universities in Vietnam

Interdisciplinary Teaching of Digital Competencies for Undergraduate Medical Students - Experiences of a Teaching Project by Medical Informatics and Medicine.

The increasing digitalization of medicine stressed the importance of teaching digital competencies in undergraduate medical education. However, in many medical curricula in Germany, medical informatics is underrepresented. Due the upcoming reorganization of medical undergraduate education in Germany, topics previously assigned to medical informatics represent curricular challenges for all medical disciplines. Against this background, experiences from the project DigiWissMed show how medical informatics can support the teaching of digital competencies in all disciplines of medical education. Therefore, interdisciplinary teaching teams of medical informatics professionals and physicians were formed. In different academic years, this teaching teams jointly designed and implemented new seminars to convey digital competencies. The seminars covers topics such as technology acceptance, telemedicine and assistive health care related to the medical specialty. So, in the project DigiWissMed, the practicability and usefulness of interdisciplinary teaching teams to convey digital competencies could be demonstrate. In the digitalization process of medicine, medical informatics plays a key role. For future-proof medical education, experts of this field should be involved in teaching digital competencies, too.

The problem of psychological competence in medical education: from professional knowledge to skills

The article analyzes the problem of psychological competence in medical education, the main approaches to the problem of professional becoming a specialist. The stages of development of the doctor in the professional sphere, stages of formation of professional abilities from professional knowledge to skills in the process of mastering the profession are considered. The general characteristic of professional formation and level of professionalism is given. The analysis of stages of professional formation of specialists is presented, psychological and pedagogical peculiarities of formation of professional competence of future physicians at the stage of professional formation are determined. The analysis of scientific sources suggests that the problem of studying professional development is in the constant focus of many scholars who determine the nature and stages of professional development, psychological peculiarities, psychological and pedagogical conditions and factors of professional development of the individual. The professional competence of a doctor is a complex of skills acquired in the process of training the knowledge, skills and abilities necessary for the performance of their professional duties. Professional competence of physician-psychologist includes not only emotional-sensual sphere, but also knowledge and skills required for both physician and psychologist.
 The educational process of preparing a future doctor should include not only a professional but also a personal development of a specialist, both at the pre-graduate stage and at the post-graduate level. The main ideas of the concept of self-regulation of the professional genesis of the physician's personality are revealed.

Cultural competency in graduate medical education: A necessity for the minimization of disparities in healthcare.

Despite the growing advancements in clinical diagnosis and therapeutics, racial and ethnic disparities in healthcare continue to persist as a daunting challenge. Several studies have indicated that minorities in the United States have significantly higher rates of undiagnosed medical conditions [1,2]. Among a multitude of causes; poverty, lack of access to healthcare, lack of education, etc. have been identified as the major causes that result in healthcare related disparities in populations belonging to socio-cultural and economic minorities [3].

Systems-Based Practice: Time to Finally Adopt the Orphan Competency.

Systems-Based Practice: Time to Finally Adopt the Orphan Competency.

Communicative and social competence in the medical curriculum of the Medical University of Innsbruck: learning objectives, content, and teaching methods.

Aim: The Austrian Competence Level Catalogue for Medical Skills clearly states the importance of teaching communicative and social competence in the different subject areas of undergraduate medical and dental education. This paper aims to present an overview of the academic courses at the Medical University of Innsbruck that explicitly address the promotion of communication and social skills in medical students.Method: This paper focuses on educators’ descriptions of how communicating with patients is taught. The Medical University’s longitudinal curriculum on medical interviewing is presented in detail. The courses on ethical principles in the dissection course, palliative medicine, and gender medicine are also outlined as examples. In addition, lecturers (n=536) participated in an online survey to determine the teaching and testing content regarding patient communication and to measure the value attached to the associated teaching and learning methods.Results: The examples given by educators to illustrate learning objectives, educational content, and the teaching methods used to impart communicative and social competence provide an overview of the courses which focus on this topic or intentionally address it during the course. The results of the online survey offer a broad overview of the awareness of the topic at the university. Different testing formats are used to assess the skills being taught.Conclusion: Familiarity with the various teaching methods used in the different courses is important for developing communicative and social competence in medical education. Active networking is necessary to anchor communicative and social competency as a major thread throughout an entire medical curriculum.

P0680 / #1208: IMPROVEMENT IN SELF-REPORTED COMPETENCE AND CONFIDENCE AFTER A PICU NURSING SKILLS FAIR

Aims & Objectives: There has been extensive investigation of self-rated competence and confidence in physician medical education. However, there are few studies evaluating its utility in nursing education and none in pediatric critical care medicine. Our objective was to determine whether there was improved self-reported competence and/or confidence in the areas of daily tasks, chest tubes, EVDs, diabetic ketoacidosis and bag valve mask ventilation following a mandatory nursing skills fair. Methods: All pediatric intensive care unit (PICU) nurses completed a questionnaire distributed before and after an educational skills fair. Nurses ranked their competence and confidence on a 4 point scale (1-very competent/confident to 4 not competent/confident) for each of the areas of interest. Data were all deidentified prior to analysis. Statistical analysis utilized t-test. Results: Sixty-nine nurses participated in the skills fair. Average PICU experience was 66.21 months (0-336 months) in the cohort. There was no difference in self-reported competence and confidence as a group. Subdivided by PICU experience, those with ≤ 36 months experience(n=36) reported significantly less competence and confidence in all areas queried when compared to those with >36 months(n=33.) Self-reported competence and confidence significantly improved in all, but the less experienced nurses continued to report less competence and confidence than their colleagues at the end of the day (Figure 1.)Conclusions: Less experienced nurses reported less perceived competence and confidence than their more experienced colleagues prior to the skills fair. Overall, both groups reported improvement following the exercise. These data highlight areas that may be utilized to improve nursing education and patient care.

Comparison of self and simulated patient assessments of first-year medical students\u2019 Interpersonal and Communication Skills (ICS) during Objective Structured Clinical Examinations (OSCE)

BackgroundInterpersonal and communication skills (ICS) are important core competencies in medical education and certification. In this study, we identified self- and simulated patient (SP)-reported ratings of US first-year medical students’ ICS and the influence of age and gender on performance appraisal during the Objective-Structured Clinical Examination (OSCE).MethodsOSCE participants, including 172 first-year medical students and 15 SPs were asked to evaluate the students’ ICS using the American Board of Internal Medicine–Patient-Satisfaction Questionnaire (ABIM–PSQ), electronically and via paper, respectively. Self- and SP-reported ratings of students’ ICS were presented as the median on a 5-point Likert-scale and as three categories defined as “good,” “very good,” and “inadequate.”ResultsSPs assessed all 172 students in the OSCE, while 43.6% of students assessed their own performance. The majority of students and SPs evaluated the students’ ICS as very good. 23.3% of SPs and 5.3% of students rated the medical students’ ability to encourage patient question-asking and answer questions as inadequate (P < 0.002). Neither age nor gender influenced the medical students’ self-assessment of ICS. Female SPs assigned lower scores to students in regard to respecting patients and encouraging patient question-asking and answering. Older SPs was more likely to assign lower scores on all survey questions.ConclusionsIn the present study, self- and SP-reported ratings of first-year medical students’ ICS were mainly “very good” with no influence of students’ age or gender. Older age and female gender among the SPs were associated with a reduction in SP-reported ratings of students’ ICS.

One Institution\u2019s evaluation of family medicine residency applicant data for academic predictors of success

BackgroundFamily Medicine residencies are navigating recruitment in a changing environment. The consolidation of accreditation for allopathic and osteopathic programs, the high volume of applicants, and the forthcoming transition of the United States Medical Licensing Exam (USMLE) Step 1 to pass/fail reporting all contribute. This retrospective cohort study evaluated which components of a student’s academic history best predict readiness for residency.MethodsIn 2020, we analyzed applicant data and initial residency data for program graduates at a single residency program between 2013 and 2020. This included undergraduate education characteristics, medical school academic performance, medical school academic problems (including professionalism), STEP exams, location of medical school, and assessments during the first 6 months of residency. Of 110 matriculating residents, assessment data was available for 97 (88%).ResultsPre-matriculation USMLE data had a positive correlation with initial American Board of Family Medicine (ABFM) in-training exams. Pre-matriculation exam data did not have a positive correlation with resident assessment across any of the six Accreditation Council for Graduate Medical Education (ACGME) competency domains. A defined cohort of residents with a history of academic struggles during medical school or failure on a USMLE exam performed statistically similarly to residents with no such history on assessments across the six ACGME competency domains.ConclusionsApplicants with a history of academic problems perform similarly in the clinical environment to those without. While a positive correlation between pre-matriculation exams and the ABFM in-training exam was found, this did not extend to clinical assessments across the ACGME competency domains.

Pedagogical conditions for the formation of communicative competence of students of medical higher education in the process of preparation

This article presents the pedagogical conditions for the formation of communicative competence in the preparation of students for medical careers in medical universities and opportunities for the development of their communicative competence, the stages of the process of assessing students' communicative competence in medical education and the development of interpersonal and intercultural practical competencies. with quality professional communicative competencies Orientation to education, the availability of modern information in the educational process, the application of communicative competence in professional activities, the principles of communicative education, primarily related to the goals and objectives of education, the development of communicative competence of teachers and psychologists, communication process, communication culture, education - the views of modern scientists in the communicative field of education, the requirements of the educational process in professional activity Opportunities for the development of creative activity through training, the level of communicative competence of students in medical universities, the development of communicative competence through social sciences and humanities, the promotion of self-communicative development of future medical workers, the activation of all components of communicative competence in the educational process of interconnectedness from oriented constructivist technologies The use of communicative principles in the educational process, the analysis of the application of the concept of principle in the educational process, the humanization of the teacher's relationship with students and the development of communicative skills, the principles of communicative competence, the principles of communicative competence, the principle of functional the principle of multifunctionality, the peda of communicative learning environmental role of the principle of the process of science, communicative and methodical preparation for connection to fundamental principles of relations in the process of education, communication lines and analyzed the contents of principles to practical application processes have been given in principle the concept of approaches to analysis.

Defining Learning Outcomes as a Prerequisite of Implementing a Longitudinal and Transdisciplinary Curriculum with Regard to Digital Competencies at Hannover Medical School

Background:Worldwide educational programs face the challenge how to define and integrate digital competencies in medical education. This article describes the implementation of learning outcomes with respect to digital competencies in the compulsory curriculum at Hannover Medical School (MHH).Methods:An interdisciplinary MHH project group was constituted consisting of physicians and experts in medical informatics and in curriculum development. Over the course of 7 work sessions the group compared different international and national frameworks dealing with digital competencies for physicians. By a consensus driven approach the working group drew up a collection of learning outcomes which were regarded relevant to be incorporated in the curriculum at MHH.Results:The analysis of different frameworks indicated that data literacy is a central domain within all viewed preexisting catalogs. During the course of the project group analysis, 57 learning outcomes with respect to digital competencies were identified as necessary to be integrated in the compulsory curriculum. They were divided in 5 main categories: “handling of medical data,” “the digital infrastructure of the health system,” “scope of application: usage in patient care and in the field of preventive medicine,” “medico-legal and ethical basics,” and “transformation processes in medicine due to digitalization.”Conclusions:The MHH project group concluded that medical students should be taught digital competencies that enable an understanding of underlying functional principles of digital systems rather than their correct utilization. The presented project indicates that a close interdisciplinary collaboration of physicians and medical informaticians can be a promising approach to incorporate digital competencies in the undergraduate medical curriculum.

Role of written examination in the assessment of attitude ethics and communication in medical students: Perceptions of medical faculties.

BACKGROUND:The study aims to record the perceptions of medical faculties regarding the effectiveness of theory-based examination to assess the newly introduced competencies of attitude ethics and communication (AETCOM) in the competency-based medical curriculum for Indian medical graduates.MATERIALS And METHODS:This is an analytical cross-sectional study performed on the month of February 2020 where a prevalidated questionnaire consisting of components of AETCOM was e-mailed to the teaching faculties of IQ City Medical College via Google Forms. Consenting faculties responded. Their results were analyzed by inbuilt Google statistics and were cross-verified with SPSS 20.0.RESULTS:Sixty percent faculties strongly agree regarding the beneficial role of mandatory inclusion of AETCOM competencies in competency-based medical education. About 61.66% of faculties strongly agree that both formative assessment and summative assessment of AETCOM are essential. Although 48.33% of faculties believed that theoretical questions can be used to assess AETCOM, 51.66% of faculties do not agree that theory examination serves as an effective tool to assess AETCOM. They believe that AETCOM cannot be written on paper and attitude can change in reality when facing a real-world clinical scenario in contrast to what is written in answer script during creative writing.CONCLUSIONS:Assessment of AETCOM is essential and it should be preferably done via a practical approach in a real-world simulated scenario and not by written theoretical examination.

In Search of Medical Professionalism Research: Preliminary Results from a Review of Widely Read Medical Journals.

Professionalism is a core concept in medicine. The extent to which knowledge about professionalism is anchored in empirical research is unknown. Understanding the current state of research is necessary to identify significant gaps and create a road map for future professionalism efforts. The authors conducted an exploratory literature review to characterize professionalism research published in widely read medical journals, identify knowledge gaps, and describe the sources of funding for the identified studies. The authors focused on Medline's Abridged Index Medicus and 4 core Medline education-oriented journal and developed a search filter using text words found in the article title or abstract addressing professionalism. Articles were further filtered to include those indicating a research focus. The search strategy resulted in 461 professionalism research articles for analysis. Articles were divided into themes of education (n = 212, 45.9%), performance (n = 83, 18%), measurement development (n = 13, 2.8%), remediation (n = 53, 11.5%), and well-being (n = 100, 21.6%). There were 36 studies from 1980 to 2002 (Era 1: before publication of Accreditation Council for Graduate Medical Education competencies) and 425 from 2003 to 17 (Era 2: after Accreditation Council for Graduate Medical Education publication of competencies). Professionalism education was the most common topic area, and most studies were from single institutions with results based on convenience samples. Most studies received no funding or were funded by the authors' own institution. Little empirical research is available on professionalism in widely read medical journals. There has been limited external research funding available to study this topic. More investment in high quality professionalism research is justified and should be encouraged.

Utilizing Psychodynamic Principles to Teach Professionalism to Medical Students Through an Innovative Curriculum.

Professionalism is a fundamental expectation of practicing medicine and a core competency in medical education, yet the methods of how to teach and evaluate it are still experimental. Professionalism involves self-reflection, a psychodynamic understanding of the patient's and the doctor's predicament, and conflict resolution, so psychiatrists are uniquely qualified to teach it. This article describes an innovative course that utilizes psychodynamic principles to teach professionalism to medical students. The authors present a novel 2-year curriculum for teaching professionalism to first- and second-year medical students utilizing psychodynamic principles to help develop awareness of others' feelings and motivations, self-reflection, compassion, empathy, and skills in ethical conflict resolution by means of written and oral narrative exercises. Outcomes are evaluated by the student ratings about the course and the faculty, and by using the test for emotional intelligence (EI), administered as a baseline and then at the end of each year. Each subsequent year the students demonstrated a statistically significant increase in EI scores, student evaluations of the course ranked among the highest in the medical school, clerkship supervisors and residency training directors noted the high degree of professionalism of the students, and the number of student applicants to psychiatry residency were consistently higher than the national average. In addition, this course was awarded the 2018 Alpha Omega Alpha Honor Medical Society's Edward B. Harris Medical Professionalism Award for the best professionalism course of U.S. medical schools. Psychodynamic principles are fundamental for teaching medical professionalism at a medical-student level. Professionalism also serves as a way to introduce students to psychiatry early in the curriculum, and psychiatrists and other mental health professionals are uniquely qualified to teach medical professionalism.

Improving the Assessment of Resident Competency: Physical Medicine and Rehabilitation Milestones 2.0.

In 2015, the Accreditation Council for Graduate Medical Education published the Physical Medicine and Rehabilitation Milestones 1.0 as part of the Next Accreditation System. This was the culmination of more than 20 yrs of work on the part of the Accreditation Council for Graduate Medical Education to improve graduate medical education competency assessments. The six core competencies were patient care, medical knowledge, systems-based practice, practice-based learning and improvement, professionalism, and interpersonal and communication skills. While providing a good foundation for resident assessment, the Physical Medicine and Rehabilitation Milestones 1.0 was not without faults. With input from program directors, national organizations, and the public, the Physical Medicine and Rehabilitation Milestones 2.0 strives to further advance resident assessment, providing improvements through the integration of the harmonized Milestones and the addition of a supplemental guide.

Digital competencies in medical education in Switzerland: an overview of the current situation.

Background: Today’s medical students are growing up in a digital age in which the use of smartphones and smart devices is now irrevocably part of professional life. However, the abilities to use these devices that have become so ubiquitous in private life can only be partially transferred to work with patients and the medical setting. Since little is known about digitalization in medical education, the aim of this paper is to gain an overview of the current training in digital competencies at Swiss universities.Methods: The medical deans at all Swiss universities were contacted by telephone and informed about an online survey. The invitation to fill out the Survey Monkey questionnaire was subsequently sent by email to the specific contacts at each university. The survey consisted of questions to be answered using a defined scale and open-ended questions. The survey’s focus, topics involving digital competencies, is based on the content in the Principal Relevant Objectives and Framework for Integrative Learning and Education in Switzerland (PROFILES) and the National Competency-based Catalogue of Learning Objective in Undergraduate Medicine (NKLM).Results: All of the dean’s offices that were contacted participated in the survey. The topics on digitalization were all rated as relevant or very relevant. Our survey shows a heterogeneous picture in terms of implementing PROFILE and NKLM content. A few universities have well-established educational approaches or even implemented curricula, but often these are still in development. Participants also mentioned factors that are necessary for successfully setting up and implementing curricula dealing with digitalization and factors that can impede such efforts.Conclusion: The importance of acquiring digital competencies during medical study is known and recognized by all Swiss medical schools. Curricular integration varies in its progress and represents major challenges for the medical faculties. It is precisely the inclusion of students in such efforts that may be a potential response to this challenge.

A qualitative study of clinical narrative competence of medical personnel

BackgroundMedicine practiced with narrative competence is called narrative medicine, which has been proposed and used as a model of humane and effective medical practice. Despite the in-depth discussions of narrative medicine, the study of narrative competence in literature is limited; therefore, this study aims to explore the dimensions and connotations of the clinical narrative competence of medical personnel.MethodsThis qualitative study used in-depth interviews to collect participants’ experience and perspectives regarding narrative competence, followed by thematic analysis of the transcripts. Through purposive sampling, this study successfully recruited 15 participants (nine males and six females in 2018–2019) who were engaged in narrative medicine or medical humanity education from different medical schools and hospitals across Taiwan. The authors performed manual thematic analysis to identify the themes and concepts of narrative competence through a six-step theme generation process.ResultsThere were four major themes of narrative competence generalized and conceptualized: narrative horizon, narrative construction (including narrative listening, narrative understanding, narrative thinking, and narrative representation), medical relationship (including empathy, communication, affiliation, and inter-subjectivity), and narrative medical care (including responsive care, balanced act, and medical reflection). These four themes were further integrated into a conceptual framework and presented in a diagram.ConclusionsCultivating narrative competence in medical education can complement traditional biomedical orientation. Regardless of their treatment orientation, narrative medicine-informed health practitioners may take advantage of their multi-dimensional narrative competence, as presented in this article, to enhance their awareness and preparation in different areas of competence in medical services. In addition, the results of this study can be used as a framework for the development of the behavioral indicators of narrative competence, which can be taken as the basis for medical education curriculum design.

The Case for Integrating Multi-Source Data for a Fairer and Holistic Judgement of Competence in Medical Education & Training

Being a doctor in the 21st Century requires a diverse range of skills, a broad base of knowledge and a suite of professional values and attitudes that enable the clinical practice to be safe, effective and caring. Doctors, irrespective of their speciality, need to be knowledgeable and skilful not just in their area of expertise but also need a range of generic skills and capabilities such as communication, leadership, academic scholarship and research, teaching, quality improvement, advocacy, digital literacy to name a few. These capabilities, all relevant to clinical practice, are assessed routinely in clinical settings. This rich information about trainees, available from their formative assessments, does not inform high-stakes judgements about progression. Instead, these judgements are usually made on the basis of summative examinations conducted in simulated settings.&#x0D; &#x0D; Unfortunately, these summative assessments have consistently delivered results with a large magnitude of the differential between the outcomes of candidates, based on factors such as ethnicity, gender, other protected characteristics and also the country of primary medical qualification. Formative assessment during training, however, is individualised and tends not to show this level of difference; leading to a situation where failure in summative examinations comes as a surprise to both trainees and to training programme directors.&#x0D; &#x0D; There is evidence that periodic assessment of trainees’ acquisition of core capabilities can help make balanced, informed judgements about readiness for progression. The move from a pass/fail categorisation to a yet/not yet categorisation when coupled with appropriate remedial measures can improve, both the validity, as well as the fairness of assessments. &#x0D; &#x0D; The large magnitude of the differential in outcomes of high-stakes assessments cannot be fixed by tweaking current assessment systems. Instead, there needs to be a recognition that high-level of capabilities consistently demonstrated in the workplace need to play a role in judgements about progression. Failure to do so is unfair, wasteful of public finances, and in breach of the trust places by the public, in training safe and competent clinicians.

Examining aptitude and barriers to evidence-based medicine among trainees at an ACGME-I accredited program

BackgroundThe aims of Evidence-Based medicine (EBM) are to promote critical thinking and produces better patients’ outcome (Profetto-McGrath J, J Prof Nurs Off J Am Assoc Coll Nurs 21:364-371, 2005). Accreditation Council for Graduate Medical Education (ACGME) competencies require trainees to locate, appraise and apply clinical evidence to patients’ care. Despite the emphasis that ACGME place on EBM, few organizations provide adequate training in EBM. This is even more critical in regions where medical trainees matriculate from diverse backgrounds of undergraduate medical education, where EBM may not be emphasized nor taught at all. EBM practice has a history of research in the West, however, EBM has not been widely studied in the Middle East.MethodsClinicians and trainees at Hamad Medical Corporation (HMC) matriculate from many countries in the Middle East and North Africa (MENA) and Asia. Because trainees in Graduate Medical Education (GME) come to HMC from a variety of geographic backgrounds, it is assumed that they also have a variety of experiences and aptitudes in EBM. To assess trainees EBM attitudes and knowledge in the internal medicine department at HMC in Doha, Qatar, the authors surveyed residents and fellows using a two-part survey. The first part was adapted from the evidence-based practice inventory by Kaper to assess trainees’ attitudes and perceptions of EBM. Trainees were also asked to complete the Assessing Competency in Evidence Based Medicine (ACE) tool to evaluate their aptitude in different elements of EBM. The results from the two parts were analyzed.ResultsThe average score on the ACE tool among the participants was 8.9 (±1.6). Most participants rated themselves as beginners or intermediate in their EBM capabilities. Higher ACE scores were observed from participants with educational background from South Asia, and among those with more favorable attitudes towards EBM. There was no clear pattern that early incorporation of EBM into practice will result in better ACE score. Participants also reported reasonable abilities in EBM tasks and a favorable work atmosphere for EBM implementation. Lack of knowledge, resources, and time were the most reported barriers to utilizing EBM.ConclusionsWhile it is clear that participants are enthusiastic about EBM and see it as a useful method for clinical decision making, their aptitude in EBM is not optimal and there are gaps and barriers for them to practice.