Medical Education Curriculum Research Articles

Undergraduate general medicine education in Japan: A nationwide cross‐sectional survey of medical trainees' perspectives

AbstractBackgroundThe 2022 revised version of the Model Core Curriculum (MCC) for Medical Education in Japan includes “generalism” as a new expertise quality and ability, based on the results of surveys of experts in health professions education. However, the perspectives of medical trainees under the pre‐2022 MCC revision were under‐examined. Here, we investigated what these trainees felt they had learned about general medicine (GM)‐related topics.MethodsWe performed a nationwide cross‐sectional study using an anonymous online questionnaire, which was developed with reference to the 2022 revised MCC. The questionnaire consisted of 14 items. For all items, we asked, “Did you learn enough during medical school?” Respondents were asked to respond on a 5‐point Likert scale (from 1 = strongly disagree to 5 = strongly agree).ResultsThree hundred and eighty‐six participants (response rate 55.4%) were included in the analysis. For the item “Behavioral science,” the number of participants who chose “3 = neither agree nor disagree” was highest, at 171 (44.3%) and with an average of 3.28, indicating that this item was perceived as insufficiently studied. Approximately half of the participants chose “4 = agree” for all items other than “Behavioral science.”ConclusionsThe study suggested that behavioral science may be underlearned among medical trainees of the pre‐2022 MCC generation. Medical educators in Japan should formulate curricula in accordance with the 2022 revision MCC and improve curricula regarding behavioral science. Future research should survey the generation of trainees who receive 2022 revision MCC‐compliant medical education; comparison of results with those of this study would be valuable in examining the effects of the revised guideline and inform international medical educators.

"Understanding dementia together": The design, delivery and evaluation of a collaborative, inter-professional dementia workshop for healthcare students.

A collaborative, multi-disciplinary team input is crucial for the optimal management of the older adult with complex care needs such as dementia. Interprofessional learning (IPL) at undergraduate level can lead to improved collaborative knowledge and skills. The aim of this study was to develop, deliver and evaluate an IPL dementia workshop for healthcare students across 11 disciplines. A secondary aim was to determine whether there is a clinical application of learned knowledge in students who completed the workshop and subsequently underwent clinical placement. The design of the IPL workshop aligned with Kern's map for the development of a curriculum in medical education. The Alzheimer's Disease Knowledge Scale (ADKS) was used to assess students' knowledge of dementia pre-and-post workshop, as well as opened-ended questions on role recognition and communication. A total of 102 students completed the workshop questionnaire, with a follow up of 47 students on clinical placement. There was a statistically significant increase in students' knowledge and confidence levels in communication with a person with dementia. Students reported positively on the workshop format, the collaborative nature of the workshop, as well as the role of the patient advocate. The follow up of students on clinical placement showed a perceived behavioural change in communication modification. Our study demonstrates the benefits of an IPL initiative across multiple disciplines, with perceived behavioural change on clinical placement.

Is it Necessary to Incorporate Traumatic Dental Injury Course into the Medical Education Curriculum: A Systematic Review

Is it Necessary to Incorporate Traumatic Dental Injury Course into the Medical Education Curriculum: A Systematic Review

57 Resident education in the NICU: A curriculum innovation project

Abstract Background For paediatrics residents, much of newborn care is learned during Neonatal Intensive Care Unit (NICU) rotations. However, the NICU is a high-stress and specialized learning environment. Today’s residents often have less NICU exposure during their training than in the past, leading to concerns from trainees that they are inadequately prepared for neonatal care and resuscitation upon graduation. Objectives We aimed to develop, implement and evaluate a paediatric residency NICU curriculum aimed to augment and improve learning on rotation. Design/Methods We utilized Kern’s Six Step Approach for Curriculum Development. Step 1: We identified that our paediatric residents consistently expressed dissatisfaction with the quality and quantity of learning opportunities on their NICU rotations. Step 2: A collaborative working group of residents, paediatricians, and neonatologists identified learning needs. Step 3: Needs were mapped to specific general paediatrics educational objectives within the Royal College Competency Based Medical Education (CBME) curriculum. Step 4: Suitable learning strategies were selected including simulation, procedural skill training, embedded time with the neonatal resuscitation team, and lunch and learn seminars. Steps 5 and 6: The curriculum was piloted during the 2021-2022 academic year and resident reactions evaluated. Results The detailed curriculum is shown in Table 1. At the start of each NICU rotation, all paediatrics residents on rotation attended a half-day simulation based “boot-camp” consisting of a didactic Neonatal Resuscitation Program (NRP) refresher course, relevant procedural skills stations (intubation, UVC placement, needle thoracocentesis), and simulated neonatal resuscitation scenarios. Junior residents were scheduled for protected time to attend deliveries with a dedicated multidisciplinary resuscitation team to ensure familiarity and begin to solidify skills. Learning was further augmented by weekly, resident-led lunch and learn sessions on topics mapped to level of training. To evaluate this curriculum, resident satisfaction was assessed using surveys post bootcamp and at the end of their rotation. Overall, the curriculum was well received. Bootcamp was the highest rated element; 96% of residents agreed or strongly agreed that the session was useful for their education (Figure 1). Post curriculum implementation, there was significant improvement in resident NICU rotation feedback; residents expressed that the NICU learning environment and resident experience has improved. Conclusion We successfully implemented a NICU curriculum for paediatrics residents, with high satisfaction ratings and improved overall rotation feedback. This program shows promise in addressing a long standing educational gap. More research is needed to investigate whether it leads to improved competency in practice.

Integration of social determinant of health in patient’s history-taking in medical education: an educational scholarship and action research study: phase I

Background and objectiveOne of the most important aspects of health is social health. Addressing social health and social accountability is possible by education of social determinants of health (SDH) to medical students. The aim of current study is to integrate the SDH variables to patient’s history-taking in medical education during clerkship stage as an action research and scholarship in education. Pediatric patients were selected as the target population for this study.MethodsThe present study is an action-research including three phases of the program's design, implementation, and evaluation. The present paper reports the results of phase I including the following steps; rapid scoping review and expert panel for development of history-taking form. The goal of this phase was to prepare an SDH checklist for history-taking in the Pediatrics Ward of Firoozabadi Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran. The checklist of history-taking was evaluated in terms of measurability, feasibility, priority, and clarity using a 5-choice Likert scale.ResultsAccording to the results of the scoping review and consensus-based methods, the preliminary version of the program was prepared including the SDH history-taking checklist. A total of 21 items were selected after two expert panel rounds. The overall absolute agreement was 0.704 (95% CI: 0.587 – 0.793) which was significantly higher than 0.5 (P < 0.001). The range of scores was 3.5 – 4.83 (out of five).ConclusionWe developed a SDH history-taking form including nine domains and 21 items. This form should be piloted and evaluated by an expert panel in the next phases. The present phase of the project proposed a consensus-based program for the imputation of SDH education in the education program of medical students. The reason for the importance of choosing children is that social factors in the group of children can have a greater impact considering the long life ahead and being in the growing age. After the implementation and evaluation phases, this program may be imputed in the medical education curriculum.

Integrating a Longitudinal Course on the Principles of Research in an Outcomes-Based Undergraduate Medical Education Curriculum.

Teaching and learning approaches can support medical students in developing the research skills necessary to be adept consumers of scientific research. Despite various influencing factors, existing literature on effective strategies in undergraduate medical education remains limited. Using a spiraled curriculum, we created and evaluated a longitudinal course to enhance medical students' research abilities. During a recent curriculum renewal at one medical school, a three-year longitudinal course on the principles of research was developed and implemented. The innovation of this course includes the sequential nature and deliberate redundancy of curriculum content, how new knowledge is linked to prior learning, and the progressive level of difficulty in knowledge application and skill development. The authors analysed faculty members' and students' satisfaction and their perceptions of each session of the course using program evaluation data collected between 2019 and 2021. Both faculty members and students recognized the benefits of revisiting concepts and highlighted learning outcomes like improved synthesis of information, explaining findings to patients, and enhanced critical thinking. The adoption of a spiraled curriculum in undergraduate medical education offers a systematic approach for developing students' research skills. The positive reception of this innovation underscores its potential to help future health professionals form a professional identity as adept researchers. However, its implications demand careful consideration and ongoing evaluation to ensure that the desired outcomes are sustained.

From classroom to bedside: The role of point‐of‐care ultrasound in undergraduate medical education

AbstractIntroductionPoint‐of‐Care Ultrasound (POCUS) has become an indispensable tool for diagnosis, monitoring, and procedure guidance in various medical specialties. Structured POCUS training is essential to provide users with the knowledge and skills needed for clinical practice. Many medical schools have integrated POCUS into their curriculum to familiarize their students with this technology early on in their medical careers.ObjectiveThis review aims to explore the integration of POCUS into the undergraduate medical education curriculum, discussing its benefits, challenges, barriers, and strategies for effective implementation.DiscussionThe POCUS educational framework uses various methods that combine the delivery of theoretical knowledge with practical skills training. It is highly recommended that medical schools include the fundamentals of ultrasound physics and knobology, structural anatomy, physiology, basic pathology of various organs, and basic instructions on ultrasound needle guidance for procedures in their POCUS curriculum. Importantly, the curriculum should include a comprehensive plan for assessing competency. The integration of POCUS into undergraduate medical education offers several benefits, including facilitating the teaching of basic sciences, enhancing physical examination skills, improving clinical problem‐solving abilities, preparing students for future clinical work, and enhancing the overall educational experience. However, there are challenges associated with this integration, such as a limited availability of qualified instructors, the high financial and logistical investment required, and the complexities of incorporating POCUS into an already compact medical curriculum. With the advancements in ultrasound technology and the integration of artificial intelligence, future research studies are needed to assess how these developments influence the integration of POCUS in undergraduate medical education.

Special Issue on Informatics Education A Longitudinal Graduate Medical Education Curriculum in Clinical Informatics: Function, Structure, and Evaluation.

There is a need to integrate informatics education into medical training programs given the rise in demand for health informaticians and the call on the Accreditation Council for Graduate Medical Education (ACGME) and the body of undergraduate medical education (UGME) for implementation of informatics curricula. This report outlines a 2-year longitudinal informatics curriculum now currently in its seventh year of implementation. This report is intended to inform United States (US) Graduate Medical Education (GME) program leaders of the necessary requirements for implementation of a similar program at their institution. The curriculum aligns with the core content for the subspecialty of clinical informatics (CI) and is led by a multidisciplinary team with both informatics and clinical expertise. This educational pathway has a low direct cost and is a practical example of the academic learning health system (aLHS) in action. The pathway is housed within an internal medicine department at a large tertiary academic medical center. The curriculum has yielded 13 graduates from both internal medicine (11, 85%) and pediatrics (2, 15%) whose projects have spanned acute and ambulatory care and multiple specialties. Projects have included Clinical Decision Support (CDS) tools, of which some will be leveraged as substrate in applications seeking extramural funding. Graduates have gone on to CI board certification and fellowship, as well as several other specialties, creating a distributed network of clinicians with specialized experience in applied CI. An informatics curriculum at the GME level may increase matriculation to CI fellowship and more broadly increase development of the CI workforce through building a cadre of physicians with HIT expertise across specialties without formal CI board certification. We offer an example of a longitudinal pathway which is rooted in aLHS principles. The pathway requires a dedicated multidisciplinary team and departmental and IT leadership support.

Remote Online-exam Dishonesty in Medical School during COVID-19 Pandemic: A Real-world Case with a Multi-method Approach

AbstractThe COVID-19 pandemic significantly impacted medical education, causing a shift towards online learning. However, this transition posed challenges in administering online assessments, particularly in proctoring and detecting academic misconduct. This study aimed to investigate the prevalence of academic misconduct among medical students during remote online examinations using hierarchical clustering and comparing self-reported confessions and recorded video reviews. The results of the study confirmed the existence of academic misconduct in remote online examinations, as evidenced by both self-report and video footage review. Hierarchical clustering was able to predict academic misconduct with an accuracy rate of approximately 55%. These findings highlight the need for medical educators to develop and implement ethics and morality-focused courses to address the issues of dishonesty among medical students in online assessments. In conclusion, this study shed light on the challenges of remote online assessments in medical education, particularly in detecting academic misconduct. Using a data-driven approach to analyse the prevalence of academic misconduct, this work provided insights into the need for ethical and moral education in medical curricula, which can help address the dishonesty among medical students during online assessments.

Curriculum and program evaluation in medical education: a short systematic literature review.

Medical education is constantly evolving worldwide and facing various challenges. To cope with these, continuous and fruitful evaluation of an educational program is the need of the day. This study aims to know the purpose of evaluation, various theories related to program evaluation, and different models of curriculum and program evaluation. This will help educationists evaluate their programs fruitfully and effectively according to their needs and objectives. Different search engines including Medline's PubMed interface, Google Scholar, and Cochrane Review databases using keywords, curriculum evaluation, evaluation models, and evaluation strategies in education, were searched without any date restrictions, and 20 full-text articles were selected for review and data extraction. While reviewing the literature it was found that most of the modern educational program and curriculum evaluation models are based on the reductionist, system, and complexity theories of evaluation. The experimental/quasi-experimental model is based majorly on the linear approach and reductionism, but its drawback is that it is impractical for the whole curriculum and sometimes ethically unfavorable. Kirkpatrick's model, Philips' model, the CIPP model, and the logic model are based on the system and complexity theory and are more practical in medical education. Each of these models has its advantages and limitations. In this review, the authors discussed the important distinctive features of these evaluation theories and models and their applicability and usefulness in evaluating different programs and curricula.

“Understanding Dementia Together”: The Design, Delivery and Evaluation of a Collaborative Inter-professional Dementia Workshop for Healthcare Students

Abstract Background A collaborative, multi-disciplinary team input is crucial for the optimal management of a person with dementia. Interprofessional learning (IPL) has benefits at undergraduate level. Allowing students to engage in IPL pre-qualification enables them to understand the value of a collaborative approach in improving patient care, and this insight may cultivate future collaboration. The aim of this study was to develop, deliver and evaluate an IPL dementia workshop for healthcare students across a broad range of relevant disciplines. A secondary aim was to determine the extent of perceived clinical application of learned knowledge in students who completed the workshop and subsequently underwent clinical placement. Methods This study adopted a social constructivist pedagogical approach. A steering group was formed which included faculty members from 11 healthcare disciplines. Disciplines represented included medicine, nursing, dentistry, physiotherapy, radiography, radiation therapy, audiology, speech and language therapy, pharmacy, occupational therapy and paramedicine. Kern's map for the development of a curriculum in medical education informed the development of the intervention. The Alzheimer's Disease Knowledge Scale questionnaire was used to assess students’ knowledge. Results 102 students completed the pre and post workshop surveys. There was a statistically significant increase in student's knowledge (t (11) = -5.251, p≤0.001) and communication scores (Z=-7.792, p≤0.001) post workshop. The follow up of students on clinical placement showed a perceived behavioural change in communication modification, with 79% of students stating that they have changed the way they communicate with a person with dementia. Conclusion The findings of this study provide insight into the optimum modes of design and delivery of an IPL dementia workshop, state of knowledge, confidence, and role recognition across a broad spectrum of healthcare students. The longitudinal follow up of students on clinical placement established perceived behavioural change due to the training.

Closing the Trauma Performance Improvement Loop With In-situ Simulation

IntroductionContinuous performance improvement (PI) programs are essential for excellent trauma care. We incorporated PI identified from trauma cases into an in-situ simulation-based medical education curriculum. This is a proof-of-concept study exploring the efficacy of high-fidelity pediatric trauma simulations in improving self-reported provider comfort and knowledge for identified trauma PI issues. MethodsThis study was performed at an American College of Surgeons-verified Level I Pediatric Trauma Center. Several clinical issues were identified during the trauma PI process, including management of elevated intracranial pressure in traumatic brain injury and the use of massive transfusion protocol. These issues were incorporated into a simulation-based medical education curriculum and high-fidelity in-situ trauma mock codes were held. In-depth debriefing sessions were led by a senior faculty member after the simulations. The study participants completed pre- and postsimulation surveys. Univariate statistics are presented. ResultsTwenty three providers completed surveys for the pediatric trauma simulations. Self-reported provider confidence Likert scale improved from pre- to postsimulation (P = 0.02) and trauma experience and knowledge scores improved from 82% presimulation to 93% postsimulation (P = 0.02). ConclusionsHigh-fidelity pediatric trauma simulations enhance provider comfort, knowledge, and experience in trauma scenarios. By integrating high-fidelity trauma simulations to address clinical issues identified in the trauma PI process, provider education can be reinforced and practiced in a controlled environment to improve trauma care. Future studies evaluating the implementation of clinical pathways and patient outcomes are needed to demonstrate the effectiveness of simulations in PI pathways.

Dr. Vasant Ramji Khanolkar: A Revolutionary Pathologist in India.

Dr. Vasant Ramji Khanolkar is known as the Father of Pathology in India. His outstanding contributions include research on the epidemiology of cancer in India, leprosy, reproduction anatomy, and family planning practices in India. He had the lion's share in medical education in India and started the subjects of Biophysics and Applied Biology at Bombay University. He recognized the importance of basic science, experimental biology, biochemistry, biophysics, and numerology in medical education. He suggested many changes in the medical education curriculum of India and strengthened the research facilities in medical education. Dr. Vasant Ramji Khanolkar was honored with Padma Bhushan, a prestigious award by the Government of India.

176 Assessing the Hidden Curriculum in Medical Education: A Scoping Review and Residency Program’s Reflection

176 Assessing the Hidden Curriculum in Medical Education: A Scoping Review and Residency Program’s Reflection

An Evaluation of the First Clinical Posting in Psychiatry of the Competency-Based Medical Education (CBME) Curriculum for Undergraduate Medical Students in India.

The new competency-based medical education (CBME) curriculum presents an opportunity to address the many deficiencies in undergraduate (UG) psychiatry education in India. There are no published reports of such evaluations of psychiatry teaching programs based on the new CBME curriculum. We performed a cross-sectional evaluation of the first clinical posting in psychiatry of the new CBME curriculum using the following metrics: clinical skills, knowledge, attitudes towards psychiatry, self-efficacy in performing the specific learning objectives (SLOs), and satisfaction with specific teaching-learning and assessment methods implemented. The mean knowledge score after the posting was significantly higher compared to the mean knowledge score at baseline (7.79 vs 5.45, p<0.001). The mean clinical skills score after the posting was 13.77 (0-20 range). Improvement was noted in the mean scores on all three sub-scales of the attitudes toward psychiatry scale. However, the improvement in scores was statistically significant only on the 'Stigma of Psychiatry' sub-scale. The mean scores on the items of the self-efficacy scale were between 63.41 and 77.73 (0-100 range). The mean scores on all items of the satisfaction scale were between 4 (somewhat satisfied) and 5 (very satisfied). We have described an evaluation of the first clinical posting in psychiatry of the new CBME curriculum. The posting was effective in imparting knowledge and clinical skills and potentially bringing about favorable changes in the attitudes toward psychiatry among UG medical students. The students also perceived confidence in performing the SLOs and were satisfied with the teaching-learning methods and assessment methods implemented.

Incorporating Teaching of Intimate Partner Violence and Trauma- and Violence-Informed Care into Medical Education Curricula

Incorporating Teaching of Intimate Partner Violence and Trauma- and Violence-Informed Care into Medical Education Curricula

52116 Assessment of an Evidence-Based Dermatology Curriculum for Primary Care Medical Education

52116 Assessment of an Evidence-Based Dermatology Curriculum for Primary Care Medical Education

Exploring the impact of early exposure and mentorship on the neurosurgery career aspirations of medical students in low- and middle-income countries.

Early exposure to neurosurgery has been shown to have a positive influence on students' perceptions and attitudes towards the field of neurosurgery. This review delves into the problems faced by the neurosurgery workforce in LMICs, highlighting the necessity for local and international collaborative strategies and plans to enhance the medical education curriculum, training, and retention of neurosurgeons in their home countries. Mentorship also emerges as a crucial factor in neurosurgical career progress, narrowing the gap between theoretical knowledge and real-world practical skills, and providing guidelines in career pathways. Despite numerous benefits of early exposure and mentorship, limitations such as limited resources, inadequate elective opportunities, and negative cultural influences, hinder students' interest in neurosurgery. However, initiatives such as global outreach programs and collaborations between HICs and LMICs aim to address these challenges and improve access to mentorship and training opportunities and programs. This review recommends the integration of mentorship into career development strategies, establishing well-structured mentorship programs, and strengthening neurosurgery exposure in medical education. By implementing these recommendations, the next generation of neurosurgeons can be better equipped to address the complex challenges in LMICs, ultimately, enhancing easy access to neurosurgical care and strengthening healthcare systems.

A Spaced Repetition Approach to Presenting Autonomic Nervous System Pharmacology Curricula in Medical Education

A Spaced Repetition Approach to Presenting Autonomic Nervous System Pharmacology Curricula in Medical Education

Perspectives of Indian medical students regarding the competency based medical education curriculum – A qualitative, manual, theoretical thematic content analysis

Perspectives of Indian medical students regarding the competency based medical education curriculum – A qualitative, manual, theoretical thematic content analysis