Medical School Curriculum Research Articles

Demonstrating the importance of interprofessional health education through an interactive case competition at Queen's Faculty of Health Sciences.

On March 4, 2021, OSLER Kingston and KHealth, student-run organizations at Queen's Faculty of Health Sciences, hosted a two-hour-long virtual interprofessional case competition called "OSLER x KHealth IPR Case Competition: Homelessness," focusing on housing insecurity and homelessness. This event demonstrated that integrating interprofessional education (IPE) competencies into educational experiences of health professional students is feasible to organize and implement while also being valuable. Students who participated found IPE to be helpful for their learning. Consequently, we encourage medical school curriculum leaders and student-led groups to prioritize IPE in their preclerkship curricular and extracurricular offerings.

How influential are medical school curriculum and other medical school characteristics in students' selecting pathology as a specialty?

There has been a significant decline in the number of United States allopathic medical students matching to pathology residency programs. Data acquired from the American Association of Medical Colleges (AAMC) show sustained variation in the medical school production of students who go on to pathology residency. When divided into groups based on the medical school's historical volume of graduates entering pathology, the schools in groups labeled Group 1 and Group 2 produced significantly higher and lower proportions of pathology residents, respectively. This study aimed to identify what medical school curriculum elements and other medical school characteristics might explain the differences observed in the AAMC data. The Dean or another undergraduate medical education contact from the Group 1 and Group 2 schools was invited to participate in an interview. Pathology Program Directors and Pathology Department Chairs were also included in communications. Thirty interviews were completed with equal numbers from each group. Interview questions probed pathology experiences, existence, and structure of a pathology interest group, options for post-sophomore fellowships, recent curriculum changes, and the extent of mentoring programs. Surprisingly, the curriculum does not appear to be a predictor of a medical school's production of students who enter pathology residency. A significantly greater percentage of Group 1 schools are public institutions compared to Group 2 schools. Other factors that may increase the number of students who go into pathology include mentoring, active learning versus observation, and post-sophomore fellowships or other opportunities to work in the capacity of a new pathology resident.

Education and training in radiation protection in Europe: results from the EURAMED Rocc-n-Roll project survey

PurposeTo analyse the existing radiation protection (RP) education and training (E&T) capabilities in the European Union and identify associated needs, problems and challenges.MethodAn online survey was disseminated via the EURAMED Rocc-n-Roll consortium network and prominent medical societies in the field of radiological research. The survey sections analyse the RP E&T during undergraduate, residency/internship and continuous professional development; RP E&T problems and legal implementation. Differences were analysed by European geographic regions, profession, years of professional experience and main area of practice/research.ResultsThe majority of the 550 respondents indicated that RP topics are part of undergraduate curricula in all courses for their profession and country (55%); however, hands-on practical training is not included according to 30% of the respondents. The lack of E&T, practical aspects in current E&T, and mandatory continuing E&T were considered the major problems. The legal requirement that obtained higher implementation score was the inclusion of the practical aspects of medical radiological procedures on education (86%), and lower score was obtained for the inclusion of RP E&T on medical and dental school curriculums (61%).ConclusionsA heterogeneity in RP E&T during undergraduate, residency/internship and continuous professional development is evident across Europe. Differences were noted per area of practice/research, profession, and European geographic region. A large variation in RP E&T problem rating was also obtained.

Health anxiety and academic performance among undergraduate medical students: A correlational study

Introduction: Health anxiety is commonly overlooked as a distinct issue and a component of anxiety. Its impact on academic performance in university students has not been examined. The purpose of this study was to determine the relationship between anxiety and academic performance among medical students. Methods: A correlational study involving 600 medical undergraduate students was conducted. Results: Of the 510 students involved in the study results indicate females experienced higher levels of health anxiety than males. The prevalence of health anxiety was 13.34%. A significant association (r = -.157; p=0.002) between anxiety (M=15.31; SD=9.86) and academic performance (M=64.87; SD=7.48) was found. Conclusion: The prevalence of health anxiety among study participants was 13.34% and it was negatively associated with academic performance. Based on the study findings, it is recommended that policies and interventions aimed at educating and managing health anxiety among medical students be incorporated into medical school curriculum.

Learning abnormal physical examination signs: an introductory course.

The acquisition of clinical skills is an essential part of the osteopathic medical school curriculum. Preclinical medical students, especially at osteopathic medical schools, have limited exposure to abnormal physical examination (PE) findings that are not typically seen in a student's peers or in a standardized patient (SP). The early exposure of first-year medical students (MS1s) to normal and abnormal findings in the simulation settings better equips them to identify abnormalities when they encounter them in a clinical setting. The aim of this project was to develop and implement the introductory course on learning abnormal PE signs and pathophysiology of abnormal clinical findings to address the educational needs of MS1s. The didactic part of the course consisted of PowerPoint presentations and lecture on the topics related to the simulation. The practical skill session was 60min, during which time students first practiced PE signs and then were assessed on their ability to accurately identify abnormal PE signs on a high-fidelity (HF) mannequin. Faculty instructors guided students through clinical cases and challenged them with probing questions in clinically relevant content. Before- and after-simulation evaluations were created to assess students' skills and confidence. Student satisfaction levels after the training course were also assessed. This study demonstrated significant improvements in five PE skills (p<0.0001) after the introductory course of abnormal PE clinical signs. The average score for five clinical skills increased from 63.1 to 88.74% (before to after simulation). The confidence of students in performing clinical skills and their understanding of the pathophysiology of abnormal clinical findings also increased significantly (p<0.0001) after simulation activity and educational instruction. The average confidence score increased from 3.3 to 4.5% (before to after simulation) on a 5-point Likert scale. Survey results demonstrated high satisfaction with the course among learners with mean satisfaction score 4.7±0.4 on 5-point Likert scale. The introductory course was well received by MS1s and they left positive feedback. This introductory course offered MS1s with novice PE skills the ability to learn a variety of abnormal PE signs, including heart murmurs and rhythms, lung sounds, measurement of blood pressure (BP), and palpation of the femoral pulse. This course also allowed abnormal PE findings to be taught in a time-efficient and faculty-resource-efficient manner.

Establishing a baseline for multilingual capabilities of medical students at the Michigan State University College of Osteopathic Medicine.

The language proficiencies of Michigan State University College of Osteopathic Medicine (MSUCOM) medical students are unknown. As of 2015, approximately 8% (or roughly 25 million) of the US population over the ageof five were considered "limited English proficient". Research indicates, however, that it is valuable to patients to be able to communicate in their primary language with their primary care physician. If medical students' language proficiencies were known, the medical school curriculum could be adapted to leverage or enhance a student's language proficiencies, preparing students to serve in communities where their patients language proficiencies align. The aim of this pilot study was to survey MSUCOM medical students in order to assess their language proficiencies with two goals in mind: first, to develop medical school curriculum that would leverage student's language proficiencies, and second, to encourage student placement within diverse communities throughout the state of Michigan where these physicians-in-training speak or understand the primary language of the local community to better serve patients. For this cross-sectional descriptive pilot study, a short, author-created survey was sent to 1,226 osteopathic medical students (OMS-I to OMS-IV) at MSUCOM. Participants were asked questions pertaining to language proficiency, number of languages spoken, prior exposure to education abroad, and demographic information. All participant data were only reported in grouped, collective, de-identified terms. Descriptive statistical analyses (frequencies, percentages) were calculated utilizing SPSS Version 25 software. Over the course of several months, 698 (58.7%) current MSUCOM medical students participated in the study. Of those students, 382 (54.7%) responded that they were multilingual. The top three second languages reported spoken were: English 332 (47.6%), Spanish 169 (24.2%), and Arabic 64 (9.2%). In addition, 249 (37.2%) said they had prior exposure to education abroad, and 177 (26.4%) said they had lived in another country for more than 6months. The majority, 382 (54.7%), of the MSUCOM students who participated in the survey have some degree of multilingual capabilities. The student population at MSUCOM may benefit from completing primary care rotations in diverse communities within the state of Michigan. Likewise, the communities throughout Michigan may benefit from having bilingual and multilingual medical students serve in their medical facilities. Further research on the efficacy of leveraging language skills in various communities, as well as broadening the population sample, is warranted to refine and validate the observed pilot study results.

Emergency burn education: Evaluating a surgical simulation-based intervention

Medical simulation has provided favorable outcomes in the improvement of clinical competence at both the undergraduate and postgraduate levels. The recall of information demonstrably increases when it has been taught in environments similar to the workplace. This study aimed to evaluate the role of a one-day burn simulation session in improving students' knowledge of burn management and interest in plastic surgery as a specialty. A one-day course was designed to deliver multiple lectures covering surgical topics such as the classification and management of burns, followed by a series of practical workshops. Participants were instructed to undergo a pre-course knowledge assessment and a survey focusing on interest in plastic surgery. Students were subsequently instructed to complete a post-course assessment and a survey of knowledge and confidence in managing burns as well as interest in plastic surgery both immediately and 6 weeks post-course. The students' knowledge demonstrated a 54.2% increase in the post-course assessment (p<0.01). 27% of participants (n=14) participated in a 6-week post-course quiz. The knowledge assessment of these participants at 6 weeks post-course also demonstrated a sustained increase of 61.0% (p<0.01). Interest in plastic surgery was increased by 31.4% post-course (p<0.01). At 6 weeks post-course, a sustained increase of 14.7% was demonstrated in comparison to pre-course data (p=0.03). Simulation teaching provides good outcomes in both information retention and interest in plastic surgery as a specialty. Therefore, medical school curriculums may benefit from including burn simulations.

The current status of “spirituality and health” teaching in Brazilian medical schools: a nationwide survey

BackgroundRecent data on the teaching of “spirituality and health” (S/H) in medical schools are needed. In this study, we aimed to investigate the current status of S/H teaching in Brazilian medical schools, the opinions of medical directors/deans on this topic and the factors associated with its incorporation into the curriculum.MethodsA nationwide cross-sectional survey was carried out in 2021. Information concerning the S/H content in the curricula of medical schools was obtained through medical school representatives and other sources. Medical school representatives were asked about their opinions of and barriers to S/H teaching. Regression models were used to evaluate the factors associated with the incorporation of such content into the curriculum.ResultsInformation on the incorporation of S/H content in medical curricula was retrieved from different sources for all 342 (100%) Brazilian medical schools. Among the representatives, 150 (43.9%) completed the online form. An increase in the S/H content in Brazilian medical schools was observed (from 40% to 2011 to 65.5% in 2021). Most medical school representatives agreed that this issue is important in medical training and that more space in the curriculum is needed. However, they also observed several barriers, such as a lack of knowledge of medical teachers/faculty, a lack of time, and the topic not being included in teaching plans. The most important factors that influenced the incorporation of S/H teaching in medical schools and representatives’ opinions were a lack of time and knowledge, professor preparedness and standardized national competency requirements.ConclusionThese results could help medical educators rethink the incorporation of S/H content into their curricula.

Integrating Public Health Into Undergraduate Medicine in North America: A Systematic Review.

The coronavirus disease 2019 (COVID-19)pandemic has served as a stark reminder of the importance of foundational public health training for all physicians. However, the most effective way to incorporate these concepts into undergraduate medical education remains unclear. Here, we characterize the literature regarding the effectiveness of public health integration into undergraduate medical education in North America. We systematically searched MEDLINE, Embase, Cochrane Central, and Education Resources Information Center (ERIC) in accordance with preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines for North American peer-reviewed literature, published from 01/01/2000 to 30/08/2021, that described outcomes of integrating public health training within an undergraduate medical curriculum. Results were qualitatively synthesized into key themes. A total of 38 studies, involving interventions across 43 medical schools, were included. Studies reported on a combination of public (n=13), global (n=9), population (n=9), community (n=6), and epidemiological (n=1) health interventions, and either implemented one-off workshops, electives, or international experiences (n=19); a longitudinal theme or long-term enrichment pathway (n=14); or a case-based learning curriculum (n=8). The majority (81.5%, 31/38) of integrations were self-described as successful and, of studies reporting on feasibility, most (94.1%, 16/17) were indicated as feasible. The definition of what constituted such success, however, was unclear. Innovative examples included the use of simulation workshops and mobile-optimized media content. Key challenges were noted, however, in securing adequate funding and buy-in from administrative leadership. Robust community partnerships and iterative cycles of implementation of the intervention were critical factors to success. In summary, foundational public health components can be effectively integrated into medical school curricula and would benefit from adequate resourcing, innovation, community partnerships, and continuous improvement.

The Value of Food: A Necessary Rhetoric

Food is a basic necessity of life. It provides nutrients, which in turn provide energy, required not only for daily activity through various physiological functions, but for growth, repair and immunity. It follows logically that with optimal nutrition, health is granted and ill-health distanced. This, however, is not the premise from which the general populace, the medical and pharmaceutical establishments, and governments discuss health. The populace eats to taste and satisfaction; the healthcare apparatus exists to attend to the sick; and the health budget is on hospitals, equipment, drugs and emoluments of the health work force. The attention given to the content of food by the community, the space occupied by food and nutrition in medical school curricula, and policies on food and nutrition by governments are testaments to this. In this write-up, the value of food is illustrated with a clinical case, and recommendation to raise the attention paid to food and nutrition from the current level is made.

Where in the world: Mapping medical student learning using the Social and Structural Determinants of Health Curriculum Assessment Tool (SSDH CAT)

ABSTRACT Introduction Addressing the Social and Structural Determinants of Health (SSDH) is a primary strategy for attaining health equity. Teaching and learning about SSDH has increased across medical schools throughout the world; however, the published literature describing these efforts continues to be limited and many unknowns persist including what should be taught and by whom, what teaching methods and settings should be used, and how medical learners should be assessed. Materials and Methods Based on published studies, input from experts in the field, and elements from the framework developed by the National Academy of Medicine, we created a universal Social and Structural Determinants of Health Curriculum Assessment Tool (SSDH CAT) to assist medical educators to assess existing SSDH curricular content, ascertain critical gaps, and categorize educational methods, delivery, and assessment techniques and tools that could help inform curricular enhancements to advance the goal of training a health care workforce focused on taking action to achieve health equity. To test the usefulness of the tool, we applied the SSDH CAT to map SSDH-related curriculum at a US-based medical school. Results By applying the SSDH CAT to our undergraduate medical school curriculum, we recognized that our SSDH curriculum relied too heavily on lectures, emphasized knowledge without sufficient skill building, and lacked objective assessment measures. As a result of our curricular review, we added more skill-based activities such as using evidence-based tools for screening patients for social needs, and created and implemented a universal, longitudinal, experiential community health curriculum. Discussion We created a universal SSDH CAT and applied it to assess and improve our medical school’s SSDH curriculum. The SSDH CAT provides a starting point for other medical schools to assess their SSDH content as a strategy to improve teaching and learning about health equity, and to inspire students to act on the SSDH.

Virtual objective structured clinical examinations — a novel approach to teaching and evaluating leadership skills in medical students

The objective structured clinical examination (OSCE) is a simulation-based method of learning and assessment that allows for mistakes and feedback. Its uniformity, objectivity, and reproducibility are among its greatest strengths. Unfortunately, OSCEs rarely directly assess non-clinical skills or focus on leadership skills, such as conflict management. Leadership training is an underrepresented component of the medical school curriculum. Although OSCEs cannot evaluate leadership in its entirety, we have demonstrated the feasibility of using OSCEs to simulate realistic scenarios for students to apply and practise communication, collaboration and professional skills associated with leadership.

Virtual peer teaching in the gross anatomy lab: a format of peer teaching and learning during the COVID-19 pandemic.

Background: Peer teaching is a powerful educational tool utilized in medical school curricula. Previously, first year medical students taught their peers about the gross anatomical structures they had dissected in the anatomy lab. While this strategy provided an opportunity for students to learn from one another, there were unintended outcomes including difficulty engaging all students. Considering these observations, along with needing to limit student numbers in the lab due to the coronavirus disease 2019 (COVID-19) pandemic, a strategy was developed where students could conduct their anatomy peer teaching in a virtual environment. The goal was to establish an effective and efficient means for students to teach and learn from one another virtually. Methods: Students, working in groups of four, were tasked to: 1) Find and label 4-5 assigned structures on cadaver-based images; 2) Provide a rationale for labeling; 3) Discuss something relevant about the structure; 4) Prepare a 5-minute video presentation of steps 1-3; and 5) Review and provide meaningful feedback on another group's presentation. Student performance on virtual peer teaching assignments was evaluated using a structured rubric and grades were weighted based on two separate faculty assessments. Student feedback was obtained via discussions with the course director, a semi-structured 1-hour virtual focus interview and from course evaluation data. Results: While students performed well on these assignments, feedback from students indicated several drawbacks such as excess time editing their videos, concerns about the validity of information provided by their peers, and the timing of peer teaching to be non-conducive to learning. Conclusions: Although the students viewed the virtual peer teaching negatively, we were successful in developing a platform in which students participated more equally in peer teaching. Recommendations to those considering this platform include careful consideration of timing of peer teaching activities and faculty feedback as well as technology used.

Shift in Format of Medical School Education During COVID-19 in India, Portugal, and the U.S.

Since March 2020, when COVID-19 was declared a pandemic by the World Health Organization, medical schools across the globe have had to adapt medical student curriculums due to the burden of the pandemic on the healthcare system, social distancing measures, and limitation of health resources. The pandemic has pressured medical schools to shift from traditional in-person teaching to other formats to minimize in-person interaction. The purpose of this study was to explore the extent that COVID-19 initially impacted the format of medical school curriculums in different parts of the world. From June 12, 2020, to August 13, 2020, a survey was distributed to international medical student listservs, medical student social medial forums, and national medical student associations through Qualtrics. Currently enrolled medical students were asked to complete the questionnaire. For statistical analysis, chi-square and t-test were used at p &lt; 0.05. The survey was completed by 112 medical students from India, Portugal, and the U.S. Medical school classes shifted from in-person to online learning after the start of the pandemic. In all three countries, over 97% of respondents reported that classes became exclusively online after the pandemic. Compared to before the pandemic, medical students had less patient interaction after the start of the pandemic in India and the U.S. However, in Portugal, there was an increase in patient interaction among medical students. The COVID-19 pandemic led to new modes of learning for medical students and required medical schools to re-design traditional class formats.

Opinion & Special Articles: Examining the Hidden Curriculum of Medical School From a First-Generation Student Perspective.

With the incorporation of pass/fail outcomes into the curricula of many medical schools, a greater premium is being placed on leadership, research, and other extracurricular pursuits. These activities, as well as the cultivation of social capital, represent a "hidden curriculum" which offers significant benefits to career development that are not often explicitly stated. The hidden curriculum benefits students with generational knowledge of the medical school infrastructure and harms first-generation and/or low-income (FGLI) students, who take longer to integrate into the professional environment and experience more challenges along the way. FGLI students show increased persistence, and they offer diverse perspectives, but poor representation and lack of a clear pathway narrow their entry into several medical specialties, including neurology. As neurologists and educators, we play a role during a critical time of medical student professional development and can help bring the hidden curriculum into the light. Recognition of student backgrounds should guide policies to arm all students with knowledge to make the most of the limited timeframe of medical school. To reduce the lag phase of less enfranchised students, several effective practices can be instituted with minimal modification to existing medical school infrastructure. Efforts to support FGLI students by increasing transparency of the hidden curriculum, formalizing FGLI mentorship groups, and centralizing key information and resources will pay dividends with greater realization of promise and increased diversity and inclusion across more specialties.

Near-Peer-Teaching Revision Series During the COVID-19 Recovery Phase: An Experience From a UK Medical School.

Background The COVID-19 pandemicled to a significant disruption in clinical attachments for final-year medical students which can result in gaps in clinical knowledge and lower confidence levels. We developed a targeted near-peer-teaching (NPT) revision series to bridge this gap. Method A one-week virtual revision series was developed by the postgraduate doctors (PD and AT) and supervised by the final year written paper lead (NS) as per curriculum requirements. The series focused on eight key common clinical presentations. It was delivered via Leicester Medical School's virtual platform by PD and AT a week before the finals.Multiple-choice surveys were sent out prior to the commencement of the seriesto gauge participation and baseline confidence. Surveys were also sent out before and after each session evaluating teaching, confidence levels, and improvement points. Results This NPT experience was the first comprehensive revision series during the COVID-19 recovery phase. Between 30 and 120 students attended each session. From the pre-series survey (n=63), almost all students indicated that their clinical attachments had been affected by the pandemic and that they (100%) would be interested in participating in the NPT series. From the post-session surveys, 93% of students reported that the session enhanced their confidence in recognizing and managing the clinical presentation, and 100% considered the quality of teaching to be good to excellent. From the post-series survey, a significant improvement was seen in confidence based on the Likert scale (from a combined 35% to 83%, pre, and post-series, respectively). Conclusion The series evaluation demonstrates that students found it a valuable experience and benefited from the social and cognitive congruence afforded by near-peer teachers. Furthermore, the results support the continued use and development of a virtual pre-exam revision series within the medical school curriculumas an adjunct to normal teaching.

Protocol Development for Digisection: Making a Case for Standardizing Educational Technology Use for Digital Dissection and Anatomical Studies.

The changes that have characterized advancements in anatomical sciences and medical education have significantly influenced pedagogies and the mode of delivery of teaching and training in the context of medical education. Another reality is the impact of educational technology (EdTech) penetration and integration into medical sciences and education. These events have undoubtedly influenced certain traditional practices and pedagogies including dissection. For example, EdTech and innovations have introduced virtual human images and three-dimensional (3D) human body representations for the purposes of teaching and dissection. Another instance includes the fact that the old dissection guides for gross anatomy, which follow the traditional regional anatomy approach, are often challenging to adapt to the relatively modern medical school curriculum that has embraced the integration philosophy. It is apparent that one practical and realistic way to provide an adapted and effective guide for anatomical dissections under various curricular philosophies and contexts would be to develop de novo protocols or adapt existing ones. Protocol development would be a vital component of the modern anatomist toolkit. This article presents the basic considerations and practical approach, including underpinning principles, to developing virtual dissection protocols using a digital 3D dissection facility, the Anatomage table (Anatomage Inc., California, United States of America), as a case study.

Vertical Integration and Reinforcement of BasicScience Concepts in an Engaging Clinically Oriented Physiology Pharmacology Session (COPPS).

Medical educators are finding it challenging to ensure strong basic sciences knowledge is built in the allocated time assigned in the innovative medical school curriculum. In this article, we introduce a novel method to vertically integrate basic sciences knowledge during clinical training.

Virtual Reality for Emergency Medicine Training in Medical School: Prospective, Large-Cohort Implementation Study.

Virtual reality (VR)-based simulation is being increasingly used to train medical students in emergency medicine. However, because the usefulness of VR may depend on various factors, the best practices for implementing this technology in the medical school curriculum are yet to be determined. The overall objective of our study was to assess the perceptions of a large cohort of students toward VR-based training and to identify the associations between these attitudes and individual factors, such as gender and age. The authors implemented a voluntary, VR-based teaching session in the emergency medicine course at the Medical Faculty in Tübingen, Germany. Fourth-year medical students were invited to participate on a voluntary basis. Afterward, we asked the students about their perceptions, collected data on individual factors, and assessed the test scores achieved by them in the VR-based assessment scenarios. We used ordinal regression analysis and linear mixed-effects analysis to detect the impact of individual factors on the questionnaire answers. A total of 129 students participated in our study (mean age 24.7, SD 2.9 years; n=51, 39.8% male; n=77, 60.2% female). No student had previously used VR for learning, and only 4.7% (n=6) of the students had prior experience with VR. Most of the students agreed that VR can convey complex issues quickly (n=117, 91%), that VR is a useful addition to mannequin-based courses (n=114, 88%) or could even replace them (n=93, 72%), and that VR simulations should also be used for examinations (n=103, 80%). However, female students showed significantly less agreement with these statements. Most students perceived the VR scenario as realistic (n=69, 53%) and intuitive (n=62, 48%), with a relatively lower agreement for the latter among female respondents. We found high agreement among all participants (n=88, 69%) for immersion but strong disagreement (n=69, 54%) for empathy with the virtual patient. Only 3% (n=4) of the students felt confident regarding the medical content. Responses for the linguistic aspects of the scenario were largely mixed; however, most of the students were confident with the English language (not native) scenarios and disagreed that the scenario should be offered in their native language (female students agreed more strongly than male students). Most of the students would not have felt confident with the scenarios in a real-world context (n=69, 53%). Although physical symptoms during VR sessions were reported by 16% (n=21) of the respondents, this did not lead to the termination of the simulation. The regression analysis revealed that the final test scores were not influenced by gender, age, or prior experience in emergency medicine or with virtual reality. In this study, we observed a strong positive attitude in medical students toward VR-based teaching and assessment. However, this positivity was comparatively lower among female students, potentially indicating that gender differences need to be addressed when VR is implemented in the curriculum. Interestingly, gender, age, or prior experience did not influence the final test scores. Furthermore, confidence regarding the medical content was low, which suggests that the students may need further training in emergency medicine.

Implementation of a Student-Teacher-Based Blended Curriculum for the Training of Medical Students for Nasopharyngeal Swab and Intramuscular Injection: Mixed Methods Pre-Post and Satisfaction Surveys.

The COVID-19 pandemic caused a major disruption in the health care sector with increased workload and the need for new staff to assist with screening and vaccination tasks. Within this context, teaching medical students to perform intramuscular injections and nasal swabs could help address workforce needs. Although several recent studies discuss medical students' role and integration in clinical activities during the pandemic, knowledge gaps exist concerning their role and potential benefit in designing and leading teaching activities during this period. The aim of our study was to prospectively assess the impact in terms of confidence, cognitive knowledge, and perceived satisfaction of a student-teacher-designed educational activity consisting of nasopharyngeal swabs and intramuscular injections for the training of second-year medical students in the Faculty of Medicine, University of Geneva, Switzerland. This was a mixed methods pre-post surveys and satisfaction survey study. Activities were designed using evidence-based teaching methodologies based on the SMART (specific, measurable, achievable, realistic, and timely) criteria. All second-year medical students who did not participate in the activity's old format were recruited unless they explicitly stated that they wanted to opt out. Pre-post activity surveys were designed to assess perception of confidence and cognitive knowledge. An additional survey was designed to assess satisfaction in the mentioned activities. Instructional design was blended with a presession e-learning activity and a 2-hour practice session with simulators. Between December 13, 2021, and January 25, 2022, a total of 108 second-year medical students were recruited; 82 (75.9%) students participated in the preactivity survey and 73 (67.6%) in the postactivity survey. Students' confidence in performing intramuscular injections and nasal swabs significantly increased on a 5-point Likert scale for both procedures-from 3.31 (SD 1.23) and 3.59 (SD 1.13) before the activity to 4.45 (SD 0.62) and 4.32 (SD 0.76) after the activity (P<.001), respectively. Perceptions of cognitive knowledge acquisition also significantly increased for both activities. For the nasopharyngeal swab, knowledge acquisition concerning indications increased from 2.7 (SD 1.24) to 4.15 (SD 0.83), and for the intramuscular injection, knowledge acquisition concerning indications increased from 2.64 (SD 1.1) to 4.34 (SD 0.65) (P<.001). Knowledge of contraindications for both activities increased from 2.43 (SD 1.1) to 3.71 (SD 1.12) and from 2.49 (SD 1.13) to 4.19 (SD 0.63), respectively (P<.001). High satisfaction rates were reported for both activities. Student-teacher-based blended activities for training novice medical students in commonly performed procedural skills seem effective for increasing their confidence and cognitive knowledge and should be further integrated within a medical school curriculum. Blended learning instructional design increases students' satisfaction about clinical competency activities. Future research should elucidate the impact of student-teacher-designed and student-teacher-led educational activities.