Medical Education Curriculum Research Articles

‘One Health’ Approach to Infectious Diseases and Prevention of Antimicrobial Resistance: A Review

This review paper aims to provide an understanding on current concepts of ‘One Health’ approach in the field of public health with a special focus on infectious diseases and prevention of antimicrobial resistance. 'One Health' is an approach to designing and implementing programmes, policies, legislation, and research in which multiple sectors communicate and work together to achieve better public health outcomes. The scope of ‘One Health’ includes zoonotic diseases, antimicrobial resistance, food safety and security, vector-borne diseases that come from insect bites or animals, environmental contamination, and other health threats shared by people, animals, and the environment. The World Health Organization (WHO) is working closely with the Food and Agriculture Organization of the United Nations (FAO) and the World Organization for Animal Health (OIE) to promote multi-sectoral responses to food safety hazards, risks from zoonoses, and other public health threats at the human-animal-ecosystem interface and provide guidance on how to reduce those risks for a better living in our planet Earth. Our medical education curriculum should also offer a first exposure to both the concepts of ‘One Health’ and the collaborative processes required to manage issues associated with human, animal, and environmental health. Bangladesh Journal of Medical Microbiology, January 2022;16(1):25-30

Peering Into the Future: A First Look at the CBME Transition to Practice Stage in Diagnostic Radiology

Queen's University (Kingston, ON, Canada) adopted a competency-based medical education (CBME) curriculum for Diagnostic Radiology residency training in an accelerated manner in 2017, with the curriculum comprised of four stages of training. This article focuses on the final stage (Transition to Practice), during which assessment methods of the new national curriculum (implemented in July 2022) were piloted. This study aims to highlight the challenges and opportunities associated with the implementation of CBME in Diagnostic Radiology training and specific considerations for programs undergoing this curricular transition. Ethics approval was provided by the affiliated hospital Research Ethics Board. All relevant electronic assessments pertaining to all trainees who had completed the Transition to Practice stage (n=3) were collated, deidentified, analyzed, and presented in tabulated format. A total of 39 evaluations completed by 13 assessors were assessed, with an average time of 3minutes and 6seconds to complete an assessment form. Also, 95% of evaluations were rated as entrustments. However, no residents met the minimum number of required entrustments for all five stage-specific Entrustable Professional Activities. These 39 evaluations included 219 milestone rating scores, with 86% rated as "achieved." Following review by the residency program Competence Committee, all three residents were promoted from the Transition to Practice stage. Challenges in CBME implementation include the number and quality of resident assessments. Strategies for success may include providing clear guidelines and training for both faculty and residents, early identification and intervention, and adopting a holistic evaluation strategy. CBME has the potential to enhance medical education quality by emphasizing learner progress toward competency and providing personalized feedback and support.

Early Exposure to Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+) Medicine: Assessing Confidence and Comfort in Preclinical Medical Students.

Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+) individuals face unique health challenges when compared to the general population. Physicians can play an integral role in either addressing these health inequities or further perpetuate discrimination. Despite the growing LGBTQ+ population in the United States and exposure during clinical care, many medical schools still lack an effective, standardized LGBTQ+ healthcare curriculum. Researchhas shown that when medical students receive exposure to LGBTQ+ healthcare topics, it results in superior quality of care. Considering the unique challenges LGBTQ+ individuals face, coupled with the perception medical students have of the current LGBTQ+ curriculum, and the positive impact LGBTQ+ education may have on patient care, there is a need for an effective and standardized LGBTQ+ curriculum in medical school education. The aim of this study was to assess the effectiveness of a two-hour interactive LGBTQ+ workshop at increasing confidence and comfortability in LGBTQ+ topics and healthcare education for preclinical medical students. Twenty-five first- and second-year medical students participated in an optional two-hour interactive LGBTQ+ workshop. The first hour consisted of a lecture overviewing LGBTQ+ clinical medicine from a physician specializingin LGBTQ+ topics and care. The second hour was made up of four 15-minute stations. Students were split up evenly and rotated through these four stations consisting of: (1) a one-on-one standardized patient simulation, (2) discussion-based case scenarios, (3) an interactive seminar on transgender healthcare, and (4) a debriefing station. All facilitators and standardized patients were members of the LGBTQ+ community. Consenting participants were provided with a pre- and post-survey consisting of basic demographic questions, and 16 LGBTQ+ healthcare specific statements that they answered using a 7-point Likert scale. Fifteen of the 25 (60%) preclinical medical students completed all components of both the pre- and post-survey. 53.3% of the respondents were heterosexual, while 40% identified as being a part of the LGBTQ+ community. Survey results demonstrated a significant increase compared to the pre-workshop baseline in preclinical student comfort and confidence in 12 out of the 16 LGBTQ+ healthcare specific statements after completion of the workshop. Our study suggests that focused education, such as through workshops, on LGBTQ+ topics can significantly increase preclinical student comfort and confidence when encountering LGBTQ+ clinical scenarios. In the future, we hope this workshop is implemented within our core medical school curriculum as a mandatory course to reach a wider audience. This workshop offers an efficient and effective model for other medical schools to implement to educate their medical students on LGBTQ+ healthcare topics.

The Use and Teaching of Telemedicine in Allergy/Immunology Training Programs.

The use of telemedicine has greatly increased since the onset of the coronavirus disease 2019 (COVID-19) pandemic. This review discusses the types of telemedicine, current telehealth curricula in medical education, and benefits and disadvantages of incorporation of telemedicine into Allergy/Immunology training programs. The majority of Allergists/Immunologists use telemedicine in their clinical practice with leaders in graduate medical education recommending inclusion of telemedicine in training. Fellows-in-training reported that use of telemedicine in Allergy/Immunology training during the pandemic mitigated some concerns for lack of adequate clinical experience. Still, no standardized curriculum for telemedicine training in Allergy/Immunology exists, although curricula from internal medicine and primary care residencies can provide a framework for incorporation of telemedicine training into fellowship. Benefits of telemedicine in Allergy/Immunology training include enhanced immunology training, home environment monitoring, and flexibility to reduce physician burnout while disadvantages include limited physical examination skill building and lack of a standardized curriculum. As telemedicine has been widely accepted in medicine with high patient satisfaction, it is necessary to incorporate a standardized telehealth curriculum in Allergy/Immunology fellowship training, both as a tool for patient care as well as trainee education.

Assessment of Knowledge and Perception Regarding Deep Brain Stimulation Among Medical Students in Saudi Arabia.

Deep brain stimulation (DBS) is a neurosurgical procedure approved for treating psychiatric and movement disorders, including Parkinson's disease (PD), essential tremor, dystonia, and other neurological conditions. The widespread use of DBS may not be reflected in the medical education curricula in Saudi universities, thus jeopardizing future patients' access to it. This study aims to investigate the knowledge and attitudes of medical students toward DBS as a therapeutic option. A descriptive cross-sectional questionnaire-basedstudy was conducted. The survey was distributed on online platforms to acquire responses from different regions of Saudi Arabia. The target population was medical students in the preclinical and clinical phases of medical education from different regions of Saudi Arabia. A total of 1075 medical students from various medical schools in Saudi Arabia were included. More than half of the students aged 21 to 23 (50.1%) were females (63.2%). More than half of the students have correctly recognized DBS as aFood and Drug Administration (FDA)-approved treatment (59.7%). Only 20.1% of the students stated that they received adequate education/training about DBS. About 53.8% of the students had self-rated their knowledge as poor, whereas 20.6% had rated their knowledge as good.A negative bias was more observed among the older students and students with a family history of DBS treatment.Half of the participants (54.1%) indicated that DBS is associated with severe adverse effects. A significant association between the level of knowledge about DBS and the academic level was observed. Almost half of the medical students had poor knowledge and unfavorable attitude towardDBS in Saudi Arabia. The current medical curricula are incommensurable with the clinical implications of DBS, which may deny future patients from such an effective therapeutic option. We recommend incorporating DBS teaching sessions to enhance future physicians' awareness and understanding of the benefits of this intervention.

Analyzing the Evolution of Medical Ethics Education: A Bibliometric Analysis of the Top 100 Cited Articles.

Ethics education plays a pivotal role in healthcare by providing professionals and students with the essential competencies to navigate intricate ethical challenges. This study conducts a comprehensive bibliometric analysis of the most-cited articles on ethics education, investigating parameters such as citation count, document types, geographical origin, journal analysis, publication year, author analysis, and keyword usage. The findings reveal a substantial impact characterized by high citation counts and the influence of a prominent publication focusing on the hidden curriculum and structure of medical education. Moreover, the analysis demonstrates a discernible increase in research output since 2000, signaling a growing recognition of the significance of ethics education in the healthcare domain. Notably, specific journals, particularly those dedicated to medical education and ethics, emerge as major contributors in this field, publishing many articles. Renowned authors have made noteworthy contributions, and emerging themes encompass the ethical implications of virtual reality and artificial intelligence in healthcare education. Additionally, undergraduate medical education garners significant attention, emphasizing the importance of establishing ethical values and professionalism early. Overall, this study highlights the imperative of interdisciplinary collaboration and the necessity for effective ethics education programs to equip healthcare professionals with the requisite skills to navigate complex ethical challenges. The findings inform educators, curriculum developers, and policymakers about enhancing ethics education and ensuring the ethical competence of future healthcare practitioners.

Long-Term Effectiveness and Sustainability of Integrating Peer-Assisted Ultrasound Courses into Medical School-A Prospective Study.

Ultrasound diagnostics is an important examination method in everyday clinical practice, but student education is often inadequate for acquiring sufficient basic skills. Individual universities have therefore started integrating (extra)curricular training concepts into medical education. This study aimed to evaluate sustainable skills development through participation in peer-assisted ultrasound courses. From 2017, students in the clinical part of medical school could opt for extracurricular peer-assisted ultrasound courses. Depending on the format (10-week course/2-day compact course) these comprised 20 teaching units focusing on abdominal and emergency ultrasonography. Students attending compulsory workshops at the start of their practical year were enrolled in this study, allowing for a comparison between the study group (attended ultrasound course) and the control group (did not attend ultrasound course). Competency from two out of four practical exams (subjects: "aorta", "gallbladder", "kidney" and "lung") was measured, and a theory test on the same subject areas ("pathology recognition") was administered. Additional questions concerned biographical data, subjective competency assessment (7-point Likert scale), and "attitude to ultrasound training in the curriculum". Analysis included 302 participants in total. Ultrasound courses had been attended on average 2.5 years earlier (10-week course) and 12 months earlier (2-day compact course), respectively. The study group (n = 141) achieved significantly better results than the control group (n = 161) in the long-term follow-up. This applies both to practical exams (p < 0.01) and theory tests (p < 0.01). After course attendance, participants reported a significantly higher subjective assessment of theoretical (p < 0.01) and practical (p < 0.01) ultrasound skills. Peer-assisted ultrasound courses can sustainably increase both theoretical and practical competency of medical students. This highlights the potential and need for standardised implementation of ultrasound courses in the medical education curriculum.

Clinical Leadership and Integration of Triple Bottom Line for Planetary Health

The accelerating global concern of climate change and its link with human health requires sustainability to be a crucial part of healthcare quality. The protection of planetary health in the context of ecological and social determinants of health require the integration of all aspects of health services including the professionals, management, and administration. Clinical health professionals particularly hold a critical position in this scenario, as they are mandated to protect individuals and communities from diseases caused or accelerated by environmental factors. Therefore, to combat the negative impacts of climate change on human health, the trusted voice of clinicians needs to be raised for communicating climate risks and solutions to patients, the public, and policymakers.&#x0D; Medical colleges’ curricula and continuing education programs require an alignment of climate and health education. This will equip future and current health professionals with skills for planetary health, regardless of their area of health focus. Clinical teaching and training with an updated medical education curriculum focusing on prevention; self-care; patient empowerment; lean service delivery such as community-based interventions; minimizing waste of medications and consumables, and low carbon emission alternatives is imperative to health service’s contribution in enhancing the quality of ecological sustainability.&#x0D; It has been documented that if the healthcare sector is ranked as a country, it would be the 5th largest CO2 emitter in the world with 4.4% global net emissions of greenhouse gases.1 The WHO has recently reported that 60% of healthcare facilities in the global south are ill equipped to handle existing waste loads. The healthcare community, clinicians, and hospital management are well-placed to play a vital role as change agents with Health in All Policies approach by protecting health during the current climate crises. An eco-friendly, equitable, interprofessional, and transdisciplinary approach is required to create a resilient healthcare sector that works harmoniously with nature while coping with increasing disease burdens and challenges to healthcare infrastructure.&#x0D; The triple bottom line is a holistic framework that helps organizations consider the environmental, social, and economic costs of their actions.2 In a healthcare setting, triple bottom line incorporates environmental and social impacts with patient-based outcomes and financial costs to measure the sustainability of healthcare interventions and services.2 It is an approach to reduce the adverse effects of healthcare delivery on the environment by incorporating improved sustainable quality and resource stewardship. The overall sustainable value is measured when the patient-based outcomes comprising utilization of a system, service, or process in healthcare are weighed against the “planet, people, and profit”.&#x0D; In conclusion, embedding sustainability principles, core knowledge, and practice in health professional expertise; the voice of clinicians in advocacy and policy to minimize healthcare sector greenhouse gases and ecologic footprint; and cross-sectoral solutions to the climate crisis are the only way forward for sustainable healthcare and the planet.&#x0D; Editor-in-Chief

Enhancing Curricula About Diversity, Equity, Inclusion, and Justice in Undergraduate Medical Education

Curricula in medical education continue to evolve as societal demographics shift and medical innovation transforms the practice of medicine. The next generation of physicians must be well trained, prepared, and adept to provide health care to diverse patient populations. The last few years have witnessed increased awareness about racial and social injustice, with medical institutions acting swiftly to create and implement or enhance curricula about diversity, equity, inclusion, and justice (DEIJ) including topics such as antiracism, bias, cultural humility and sensitivity, and health care disparities and inequities. In this review article, we highlight the incorporation of DEIJ into undergraduate medical education with a focus on the standards provided by the Liaison Committee on Medical Education. We draw on examples of enacted and revised DEIJ curricula in medical education including student activism, clinical electives at pediatric residency programs targeting historically underrepresented in medicine (UIM) students, and community building for UIM students through participation in professional affinity organizations. The article also addresses current state legislation that could affect medical student learning about DEIJ and patient care. [ Pediatr Ann . 2023;52(7):e249–e255.]

“Faculty experience during transition to new Competency Based Medical Education Curriculum” – A nationwide survey from India

“Faculty experience during transition to new Competency Based Medical Education Curriculum” – A nationwide survey from India

A Statistician’s perspective on Re-Orientation Of Medical Education in Medical Curriculum

Background: Re-Orientation of Medical Education (ROME) is an essential and important part of medical education. Biostatistics play an important role in medical field research. In this article, I have discussed the reorientation of medical education, statistician’s role in it, what would be taught in that program and its importance. Materials and Methods: Total number of students of 7th semester are divided into 4 groups. Each group selects their own topic. After that, they discussed the related topic and from the proposal to their research/study. Before going to the field to collect the data, the group leaders went to the respective study areas to get the proper permission from the concerned authorities. Results: The group of students have arranged health education, drama, quiz, awareness programmes, and treatment on a small scale in the study areas. Small problems/sufferings are treated in the camp and major problems have been referred to medical college hospital. So, many awareness programs were also conducted in the community and schools depending upon the study topics. Statistician trained the medical students in various aspects under ROME posting. Students were prepared their final report submitted in the Department of Community Medicine after the final approval by the Head of department. Conclusion In this article, I have concluded that this type of ROME posting is very useful and increases the visibility of the medical students. Automatically, research and its usefulness are increased among the medical students in their career. All medical colleges come forwarded to implement this ROME posting in their medical colleges and universities to improve the medical students’ research knowledge and techniques. Keywords: reorientation of medical education, medical students, statistician, medical education, medical curriculum

Attitudes and Perception of the REFLECT Communication Curriculum for Clinical Oncology Graduate Medical Education

Communication and interpersonal skills are essential components of oncology patient care. The REFLECT (Respect, Empathy, Facilitate Effective Communication, Listen, Elicit Information, Compassion, and Teach Others) curriculum is a novel framework to improve and refine physician/patient interactions for oncology graduate medical trainees. We seek to evaluate the attitudes and perceptions of the REFLECT communication curriculum among oncology trainees. Seven-question and 8-question Likert scale surveys (1 = not beneficial and 5 = beneficial) were distributed to resident/fellow participants and faculty mentors, respectively. Questions asked trainees and faculty about their perceptions of improvement in communication, handling of stressful situations, the value of the curriculum, and overall impression of the curriculum. Descriptive statistics determined the survey’s baseline characteristics and response rates. Kruskal–Wallis rank sum tests were used to compare the distribution of continuous variables. Thirteen resident/fellow participants completed the participant survey. Six (43.6%) Radiation Oncology trainees and 7 (58.3%) Hematology/Oncology fellows completed the trainee survey. Eight (88.9%) Radiation Oncologists and 1 (11.1%) Medical Oncologist completed the observer survey. Faculty and trainees generally felt that the curriculum increased communication skills. Faculty responded more favorably to the program’s impact on communication skills (median 5.0 vs. 4.0, p = 0.008). Faculty were more assertive about the curriculum’s capabilities to improve a learner’s ability to handle stressful situations (median 5.0 vs. 4.0, p = 0.003). Additionally, faculty had a more favorable overall impression of the REFLECT curriculum than the residents/fellows (median 5.0 vs. 4.0, p < 0.001). Radiation Oncology residents felt more strongly that the curriculum enhanced their ability to handle stressful topics, compared to Heme/Onc fellows (median 4.5 vs. 3.0, range 1–5, p = 0.379). Radiation Oncology trainees felt more consistently that the workshops improved their communication skills, compared to Heme/Onc fellows (median 4.5 vs. 3.5, range 1–5, p = 0.410). The overall impression between Rad Onc resident and Heme/Onc fellows was similar (median 4.0, p = 0.586). Conclusions: Overall, the REFLECT curriculum enhanced communication skills of trainees. Oncology trainees and faculty physicians feel that the curriculum was beneficial. As interactive skills and communication is critical to build positive interactions, further work is needed to improve the REFLECT curriculum.

A Review and Meta-Analysis of the Prevalence and Health Impact of Polycystic Ovary Syndrome Among Medical and Dental Students.

Women currently comprise the majority of students graduating from medical school and face unique stressors not seen with their male counterparts. In particular, during their medical education, women with polycystic ovary syndrome (PCOS) experience symptoms of the disorder, which strongly impact both their academic and social lives. This in turn influences their academic and professional future. Although women as medical professionals, in general, are happy with their careers, awareness, and understanding on the part of medical educators will definitely be helpful to women medical students in their path to being successful medical professionals. The first objective of our current study is to find the prevalence of PCOS in medical and dental students. The second objective is to find the academic and health impacts of PCOS and what type of interventions are being adopted to relieve the symptoms. Using the keywords such as "PCOS," "medical students," and "dental students", the search engines PubMed, Embase, and Scopus were used to retrieve relevant articles published from 2020 to 2022. After removing the duplicates, 11 prospective cross-sectional studies were utilized for qualitative and quantitative analysis. The pooled prevalence of 2,206 female medical students diagnosed with PCOS was 24.7%. The students in the various studies were aware of their PCOS diagnosis and were taking therapeutic medications. The most common associated complications reported were BMI abnormalities, abnormal hair growth, and acne, along with other complications such as stress and poor academic and social life. The majority also had significant family histories of concurrent clinical conditions such as diabetes, hypertension, and other menstrual abnormalities. Considering the huge impact of PCOS, medical educators, policymakers, and all stakeholders should take proactive measures to accommodate students' needs and bridge the social gap. Special awareness of needed lifestyle changes should be a part of the medical education curriculum for an inclusive educational environment, as it will minimize the gender discrepancy in academic satisfaction and professional life.

Attitudes and Perceptions of the REFLECT Communication Curriculum for Clinical Oncology Graduate Medical Education

Background Communication and interpersonal skills are important medical components of oncology patient care. The REFLECT (Respect, Empathy, Facilitate Effective Communication, Listen, Elicit Information, Compassion, and Teach Others) curriculum is a novel communication to improve and refine physician/patient interactions for oncology graduate medical trainees. Each year, this comprehensive course consisted of quarterly (four-hour) workshops comprised of assigned reading, knowledge assessments, didactic lectures, expert guest lecturers, standardized patient (SP) simulations, role-playing, patient/expert panels, coaching, reflective writing, and debriefing/feedback sessions. We sought to evaluate the attitudes and perceptions of the communication curriculum in oncology trainees. Methods Surveys were developed to obtain perceptions of the REFLECT curriculum from trainee (Radiation Oncology and Medical Oncology) participants and faculty mentors. A 9-question and 11-question Likert scale surveys (1 = not beneficial, 5 = beneficial) was distributed to resident/fellow participants and faculty mentors, respectively. Questions asked trainee and faculty opinions about perception of improvement in communication, handling of stressful situations, value of curriculum, and overall impression of the curriculum. Surveys were distributed through Qualtrics, and were anonymous, voluntary, and non-incentivized. Results Twelve resident/fellow participants completed the participant survey. Five (41.6%) Radiation Oncology trainees and 7 (58.3%) Hematology/Oncology fellows completed the survey. Nine faculty members, 8 radiation oncologists and 1 medical oncologist, completed the faculty survey. In general, trainees felt that the curriculum improved their communication skills (mean = 3.5, range 1-5). Additionally, most also felt the workshop was beneficial in being able to handle certain topics (69.2%). Seven participants (54%) felt that the curriculum enhanced their communication. However, only 28.4% of trainees felt it was beneficial to their training. The overall impression was positive, with 77% of participants rating the curriculum as beneficial. Meanwhile, faculty members felt the curriculum was beneficial with average responses ranging from 4.5-5. There was a significantly more positive perception of the REFLECT curriculum among faculty members compared to trainees (p <0.05). Discussion While the REFLECT curriculum was perceived to enhance communication skills, trainees did not find the curriculum beneficial. On the other hand, faculty physicians and staff felt the curriculum was beneficial. As interactive skills and communication is critical to build positive interaction with patients, further work is needed to improve trainee's perception of the REFLECT curriculum. Communication and interpersonal skills are important medical components of oncology patient care. The REFLECT (Respect, Empathy, Facilitate Effective Communication, Listen, Elicit Information, Compassion, and Teach Others) curriculum is a novel communication to improve and refine physician/patient interactions for oncology graduate medical trainees. Each year, this comprehensive course consisted of quarterly (four-hour) workshops comprised of assigned reading, knowledge assessments, didactic lectures, expert guest lecturers, standardized patient (SP) simulations, role-playing, patient/expert panels, coaching, reflective writing, and debriefing/feedback sessions. We sought to evaluate the attitudes and perceptions of the communication curriculum in oncology trainees. Surveys were developed to obtain perceptions of the REFLECT curriculum from trainee (Radiation Oncology and Medical Oncology) participants and faculty mentors. A 9-question and 11-question Likert scale surveys (1 = not beneficial, 5 = beneficial) was distributed to resident/fellow participants and faculty mentors, respectively. Questions asked trainee and faculty opinions about perception of improvement in communication, handling of stressful situations, value of curriculum, and overall impression of the curriculum. Surveys were distributed through Qualtrics, and were anonymous, voluntary, and non-incentivized. Twelve resident/fellow participants completed the participant survey. Five (41.6%) Radiation Oncology trainees and 7 (58.3%) Hematology/Oncology fellows completed the survey. Nine faculty members, 8 radiation oncologists and 1 medical oncologist, completed the faculty survey. In general, trainees felt that the curriculum improved their communication skills (mean = 3.5, range 1-5). Additionally, most also felt the workshop was beneficial in being able to handle certain topics (69.2%). Seven participants (54%) felt that the curriculum enhanced their communication. However, only 28.4% of trainees felt it was beneficial to their training. The overall impression was positive, with 77% of participants rating the curriculum as beneficial. Meanwhile, faculty members felt the curriculum was beneficial with average responses ranging from 4.5-5. There was a significantly more positive perception of the REFLECT curriculum among faculty members compared to trainees (p <0.05). While the REFLECT curriculum was perceived to enhance communication skills, trainees did not find the curriculum beneficial. On the other hand, faculty physicians and staff felt the curriculum was beneficial. As interactive skills and communication is critical to build positive interaction with patients, further work is needed to improve trainee's perception of the REFLECT curriculum.

Early introduction to clinical radiation oncology through a self-directed competency-based medical student curriculum.

11038 Background: Specialty training is not traditionally incorporated into standard medical education and there is a deficiency in exposure to Radiation Oncology for “last minute” interested candidates, particularly from underrepresented backgrounds. Therefore, we implemented MERAO-200, an introductory 2-week in-person and virtual medical education curriculum without clinical prerequisites to facilitate early introduction to the field of Radiation Oncology and report its effect on student comfort and familiarity with radiation planning and contouring. Methods: Clinical students were enrolled in a 2-week elective without clinical prerequisites that integrated both clinical activities and self-directed learning through virtual contouring modules. The virtual curriculum was designed around three modules available on EduCase. A survey was conducted after completion of the modules that solicited self-identifying information and to assess their efficacy in increasing understanding of basic contouring skills. Paired t-tests were used to compare pre- and post-elective assessment results. Results: Twenty-three total students have completed MERAO-200 from Fall 2020 to Spring 2023. Of those, 15 submitted the survey. Eight (53%) students did not answer self-identifying information such as gender, race, ethnicity, or country of origin. Four (27%) students identified as Asian and 3 (20%) as white. No students identified as Hispanic, Latino or Spanish origin. Seven (46%) students identified as having USA as country of origin. Seven (47%) students reported interest in radiation oncology, medical oncology or surgical oncology. Three (20%) students were MS2, 7 (47%) were MS3, and 5 (33%) were MS4. Overall, there was a significant increase in comfort level using radiation planning software (p = 1.1e-4) as well as ability to find relevant contouring references (p = 4.2e-5). Knowledge of the anatomy and contouring principles also improved for the three modules: eye and brain (p = 2.8e-7), high grade glioma (3.2e-6), and head and neck nodal stations (4.5e-6). CNS module difficulty on a scale of 1-10 had a median difficulty score of 7 (range 3-8) and head and neck module difficulty was a median of 7 (range 3-10). Conclusions: Implementation of MERAO-200 improved medical student exposure to the field of Radiation Oncology and improved medical student comfort and familiarity with radiation planning and across all disease sites covered. More outreach work needs to be done to facilitate inclusion of minority student populations and students from underrepresented backgrounds. Early introduction at the medical student level could be a pathway to improve disparity in the field of Radiation Oncology.

P.060 Teamwork makes dreamwork: a stroke of genius

Background: Interprofessional collaboration is at the center of much of our work as Neurologists, yet often Medical Education inadequately prepares students for the complexities of interdisciplinary practice. Authentic, meaningful Interprofessional Education (IPE) requires consideration in involement of all individuals involved in interprofessional health care (IPHC) (Holbrook, 2013). Methods: We have collected authentic stories of acute stroke care through interviews with patients and other health care professionals on the acute stroke care team. Drawing on these narratives, we have crafted a multimedia story combining film, photography, and art. Results: This case will be integrated into Western University’s Undergraduate Medical Education curriculum but is intended to be a valuable tool for teaching IPE competencies in all IPE contexts. All media will be available thorugh Western Libaries open access Health Education Media Library. Main learning outcomes include improved recognition of HCP roles and the vital and diverse contributions of each team member. Conclusions: Drawing on the experiences of real stroke patients, families, and all other HCPs, we have crafted a rich educational case portraying the complexity of IPHC that will allow learners to reflect on the complex roles of health professoinals in a successful interprofessional team.

Patients’ Perceived Level of Clinician Knowledge of Transgender Health Care, Self-rated Health, and Psychological Distress Among Transgender Adults

Transgender, gender nonbinary, and genderqueer people are at increased risk for negative health outcomes, and medical school education is currently lacking on inclusion of these topics. However, there is little evidence of an association of clinician knowledge with the health of transgender people. To evaluate the associations of patients' perceptions of clinician knowledge with self-rated health and severe psychological distress among transgender people. In this cross-sectional study, a secondary data analysis of the 2015 US Transgender Survey (a survey of transgender, gender nonbinary, and genderqueer adults conducted across 50 states) Washington, DC, US territories, and US military bases in 2015 was performed. Data were analyzed from February to November 2022. Patients' perception of their clinician's knowledge about transgender health care. Self-rated health, dichotomized as poor or fair vs excellent, very good, or good, and severe psychological distress (scoring a validated threshold of ≥13 on the Kessler Psychological Distress Scale). The sample included a total of 27 715 respondents (9238 transgender women [33.3%; 55.1% weighted; 95% CI, 53.4%-56.7%], 22 658 non-Hispanic White individuals [81.8%; 65.6% weighted; 95% CI, 63.7%-67.5%], and 4085 individuals aged 45-64 years [14.7%; 33.8% weighted; 95% CI, 32.0%-35.5%]). Of 23 318 individuals who answered questions regarding their perceptions of their clinicians' level of knowledge, 5732 (24.6%) reported their clinician knows almost everything about transgender care, 4083 (17.5%) reported their clinician knows most things, 3446 (14.8%) reported their clinician knows some things, 2680 (11.5%) reported their clinician knows almost nothing, and 7337 (31.5%) reported they were unsure. Nearly 1 in 4 transgender adults (5612 of 23 557 individuals [23.8%]) reported having to teach their clinician about transgender people. In total, 3955 respondents (19.4%; 20.8% weighted; 95% CI, 19.2%-22.6%) reported fair or poor self-rated health and 7392 (36.9%; 28.4% weighted, 95% CI, 26.9%-30.1%) met the criteria for severe psychological distress. After adjusting for covariates, compared with individuals who reported their clinician knows almost everything about transgender care, exposure to clinicians with lower perceived levels of knowledge about transgender care was associated with significantly higher odds of fair or poor self-rated health (adjusted odds ratio [aOR] for knowing almost nothing, 2.63; 95% CI, 1.76-3.94; aOR for unsure, 1.81; 95% CI, 1.28-2.56) and severe psychological distress (aOR for knowing almost nothing, 2.33; 95% CI, 1.61-3.37; aOR for unsure, 1.37; 95% CI, 1.05-1.79). Respondents who had to teach a clinician about transgender people had higher odds of reporting fair or poor self-rated health (aOR, 1.67; 95% CI, 1.31-2.13) and severe psychological distress (aOR, 1.49; 95% CI, 1.21-1.83) compared with those who did not. The findings of this cross-sectional study suggest that there is an association between perceived clinician knowledge about transgender people and self-rated health and psychological distress among transgender people. These results highlight the importance of integration and enhancement of transgender health in medical education curriculum as a necessary intervention to improve the health of transgender people.

Evaluation of physician candidates' attitudes towards phytotherapy practices with a new scale

IntroductionTo measure the attitudes of physician candidates concerning phytotherapy practices and determine the variables affecting their attitudes. MethodThe study data were collected from 524 physician candidates, who were medical faculty students, using a Scale on Attitudes toward Phytotherapy Practices developed by the researchers. Since there is no scale in the literature that reliably and validly reveals the attitudes of physician candidates toward phytotherapy practices, researchers have developed a new scale. Exploratory and confirmatory factor analyses were used in the process of scale development. Univariate and multiple statistical methods were used for descriptive data analysis. ResultsThe developed scale consisted of three factors, 'trust in phytotherapy', 'phytotherapy use’, and 'predisposition', and 23 items based on the five-point Likert type. It was found that physicians’ attitudes toward 'phytotherapy use' were closer to the positive side, while they were undecided concerning the subscales of 'trust in phytotherapy' and 'predisposition'. The attitudes of first-grade physician candidates toward phytotherapy practices were positive, but more negative attitudes were observed in later grades. ConclusionThese findings show that this newly developed scale is reliable and valid and can be used to measure the attitudes of physician candidates towards phytotherapy. In addition, it is thought that the use of phytotherapy can be extended with more scientific studies using different media channels, raising awareness among individuals about phytotherapy, and adding courses that include phytotherapy and its applications to the medical education curriculum.

Considerations for Designing and Implementing a Multi-institution Undergraduate Medical Education Experience.

Cancer Care Experience (CCE) is a unique elective educational program to further explore the subspecialty of oncology beyond the scope of the traditional undergraduate medical education curriculum. During the COVID-19 pandemic, CCE moved from an in-person to a virtual learning platform. This transition allowed program leaders to offer CCE as a multi-institutional program, with students participating from both Duke University School of Medicine and Penn State College of Medicine. Our study aimed to investigate the effectiveness of virtual learning, student perspectives on multi-institutional collaboration, and the program's impact on the student's understanding of oncology care and clerkship preparedness. Overall, students indicated CCE was an impactful program for them to learn more about oncology and that virtual learning was an effective learning platform. Furthermore, our results suggest students found the multi-institutional aspect valuable and that a multi-institution, hybrid (in-person and virtual) platform was preferred. Our study highlights the success of CCE as a multi-institution program and an effective elective program to expose students to the field of oncology further.

Improve student performance in the psychiatry subject with 3D animation

The integration of information communication and technology in medical education has led to the emergence of modern instructional tools, thus transforming pedagogy. Modern instructional tools like 3D animation are very effective tools for pedagogy, especially in subjects that involve complex concepts that are difficult to represent with traditional instructional tools such as textbooks, and lectures. The main objective of this study was to determine the effectiveness of using 3D animation in teaching psychiatry to clinical medicine students at the Kenya Medical Training College. The study used a randomized comparative design, where participants were randomly assigned to either a treatment group (3D animation) or a control group (textbook). Data were collected using self-administered questionnaires. The study targeted 61 respondents, and the sample size was 53 respondents (11 lecturers and 42 students). A pilot test to ensure the reliability and validity of the questionnaires was done on 30 respondents from the nursing department at Kenya Medical Training College. The analysis of the results was done using the Statistical Package for Social Sciences software version 29, whereby descriptive statistics were used to describe feedback from the lecturers and students while independent sample t-tests were used to determine the statistically significant difference in student scores. The t-test results showed a statistically significant difference in means between the two groups, with t (40) = -7.332, p &lt; 0.001 (two-tailed). The mean difference between the two groups was -8.190, with a standard error of 1.117. The 95% confidence interval of the difference ranged from -10.448 to -5.933. Therefore, the use of 3D animation had a statistically significant positive effect on test scores compared to textbook instructional materials in the context of teaching psychiatry. The study recommends the integration of 3D animations in the medical education curriculum at Kenya Medical Training College and other institutions of higher learning.