Undergraduate Medical Education Curriculum Research Articles

12 Tips for Including Disability Awareness within Undergraduate Medical Education Curricula

Disability is extremely common, and there is a need for high quality medical school curricula on working with persons with disabilities. The goal of disability training is to provide the proper knowledge and skills to address the unique needs of PWD, mitigate health disparities, and help shape more compassionate and informed physicians. This article presents 12 tips to incorporate disability training into undergraduate medical education. These tips emphasize the inclusion of PWD in all stages of the curriculum, interprofessional education, experiential learning, and exposure to a range of disability types. By leveraging these tips, educators will be able to create effective learning opportunities and improve the future healthcare of PWD.

Sexual and gender minority health: a roadmap for developing evidence-based medical school curricula

Background: Educating future physicians about sexual and gender minority (SGM) patients and their health care needs is an important way to mitigate discrimination and health disparities faced by this community. Canada, across its 17 medical schools, lacks a national standard for teaching this essential topic. This paper aims to review the best practices for teaching an SGM curriculum in undergraduate medical education and synthesize this information into actionable propositions for curriculum development. Methods: A scoping literature review was conducted to identify best practices for SGM teaching. The review elicited peer-reviewed and grey literature on best practices for SGM teaching, policy documents, and opinion pieces from medical education authorities and SGM advocacy groups. Through an iterative process with all authors, the Canadian Queer Medical Students Association (CQMSA), and the Association of Faculties of Medicine of Canada (AFMC), a set of propositions was developed. Results: The search yielded 1347 papers, of which 89 were kept for data extraction. The main outcomes of these papers were sorted along five repeating themes, which formed the basis for six propositions; two more propositions were then added after discussion with all authors. Conclusion: We present eight propositions for the development of a national standard for SGM education at the undergraduate medical level. These include standardizing learning objectives across all schools, using established curricular models to guide curriculum development, interweaving concepts across all levels of training, diversifying teaching modalities, providing faculty training, ensuring a safe space for SGM students and faculty, using OSCEs as a teaching tool, and involving the local SGM community in curriculum development and delivery.

Effect of simulation-based emergency airway management education on the knowledge, skills and perceived confidence of medical interns.

An effective airway management education program is a crucial part of the undergraduate medical education curriculum. Theoretical instructions and practical demonstrations are the major modalities of medical education in Nepal. Simulation-based education (SBE) programs have not yet been implemented effectively. The authors aimed to determine the effects of an SBE program on the knowledge, skills, and perceived confidence of medical interns regarding emergency airway management. This mixed methods study comprised both quantitative and qualitative components. The study participants were 47 medical interns who had participated in the SBE program. The mean age of the 47 participants was 24.74 years. There were 33 (70.21%) male and 14 (29.79%) female participants. The knowledge, skills, and perceived confidence scores of the participants for airway management preparation, basic airway management, endotracheal intubation, and laryngeal mask airway (LMA) insertion improved significantly following the SBE program (P<0.001). Analysis of the participants' feedback indicated that they largely approved of the SBE program. The majority of students and faculty expressed a willingness to include similar programs in the undergraduate medical education curriculum. This study demonstrated through quantitative and qualitative metrics that SBE can enhance the knowledge, skills, and perceived confidence in performing emergency airway management among medical interns. The authors recommend measures to include and effectively implement SBE in the undergraduate medical education curriculum of Nepal.

Structured Online Systematic Review Training for Medical Students: An Elective Module in Physiology.

Background Recently, elective posting has been introduced by the National Medical Commission (NMC) of India in the undergraduate competency-based medical education (CBME) curriculum. To successfully implement it in medical colleges, facilitators (medical teachers) need to commit extra time. Hence, this study aimed to evaluate the impact of online teaching-learning methods for implementing an elective module for undergraduate medical students at Burdwan Medical College and Hospital, West Bengal, India. Methods An online module for systematic review methods was developed using the Delphi method. This module was used to train 30 medical students divided into six groups. One resident and one facultyfacilitated each group. After the elective program of 15 days, program feedback and evaluation using the Kirkpatrick model were obtained from the students. Results A total of 30 undergraduate medical students with a mean age of 22.7±0.95 years participated in the study. All of them successfully conducted a systematic review per group. The students' feedback was 86.33% positive, and the project evaluation showed an 84% positive opinion. The highest score was for understanding, facilitators' knowledge, and experience. The lowest score was for the immediate applicability of the knowledge. Conclusion An online systematic review training module can be used for elective teaching-learning for final-year medical students, particularly within limited time and resource constraints. Students appreciated the module's clear objectives, appropriate complexity, and facilitators' expertise, leading to improved communication, engagement, and critical-thinking skills. Despite some limitations, these findings suggest that online learning can complement traditional methods and address logistical challenges in medical education, warranting further research on its long-term impact and broader applicability.

Practice makes perfect: the development of a medical student-led crowdsourced question bank for self-study in undergraduate medical education

Implication Statement The development of multiple-choice questions (MCQs) for undergraduate medical education study purposes is resource intensive. Commercially available question banks are typically expensive, only available in English, and may not be aligned with medical school learning objectives. Here, we introduce The Ottawa Question Bank: a student-led, bilingual study resource curated to a Canadian undergraduate medicine curriculum (www.theottawaquestionbank.ca). In total, 205 medical students wrote and edited 4438 original MCQs linked to objectives from the University of Ottawa undergraduate medical education curriculum. The project has received positive feedback from both developers and users. Our experience suggests that involving medical students in MCQ development is feasible and can result in the rapid creation of a low-cost, high-quality study resource curated to a program’s learning objectives. The platform outlined here can be used as a model for other medical schools and professional degree programs to develop their own question banks, including pharmacy, dentistry, nursing, and physiotherapy. Interested programs are encouraged to contact our team for collaborative opportunities.

Operationalizing a 3-year standalone, accelerated medical school curriculum to nurture physicians to become primary care and health system leaders

The United States faces a shortage of primary care physicians. To address this, there have been pioneering efforts to develop accelerated pathways with a primary care focused curriculum for undergraduate medical education. The New York University Grossman Long Island School of Medicine (NYU GLISOM) was conceptualized as the first standalone, accelerated, tuition-free program in the US in over 100 years, with mission-centered curriculum on primary care and health system leadership. The aim of this article is to map the process for the development of a three-year integrated curriculum, describe the pedagogical approach that guided the design of the longitudinal courses, share the student and faculty’s perspective about the curriculum, and describe the early outcomes of the first two graduate classes. A major key driver for curricular design is integrating longitudinal courses of Clinical Ambulatory Practice Experience (CAPE), Health Systems Science (HSS), and Learning Community - Social Sciences, Humanities, Ethics and Professionalism (LC-SHEP) over three years and active learning through Problem Based Learning (PBL). We have successfully operationalized an accelerated, standalone, integrated medical school curriculum mission-centered on primary care and health system leadership. Our outcomes reveal a higher percentage (76% N =45) of NYU GLISOM students entering primary care compared to national benchmarks. The integration of the longitudinal courses of HSS, LC-SHEP, and CAPE is a key pillar to reinforce the tenants of primary care and health system leadership. Focused interview of graduates from the pioneer cohort consistently stated that the longitudinal courses prepared them well for residency in primary care and as a health systems’ change agent. Despite the challenges of an accelerated program, NYU GLISOM successfully integrated the longitudinal courses with optimal performance and achievement of educational program objectives. Our experience can serve as a model for innovation and design of an accelerated three-year primary care curriculum.

The tip of the iceberg: Generalism in undergraduate medical education, a systems thinking analysis.

There is a shortage of generalist physicians globally impacting health equity and access to care. An important way in which medical schools can demonstrate social accountability is by graduating learners interested in careers in generalism. While generalism is endorsed as a matter of principle in medical education, how this translates into curricula is less clear. The aim of this study was to identify how generalism is understood and supported by family physician educational leaders in undergraduate medical education (UME) in Canada. We conducted a qualitative study, interviewing 38 family medicine leaders in UME across all 17 Canadian medical schools. We examined the data with template analysis, informed by the iceberg model of systems thinking. Four themes were identified: (1) Teaching and learning strategies in support of generalism-a consistent range existed across UME curricula; (2) Curriculum patterns-changes in leadership and curriculum reform created positive or negative feedback loops that promoted or hindered initiatives to support generalism; (3) Curriculum structures-organ-system-based curricula and availability of generalist faculty presented particular challenges to teaching generalist approaches; (4) Mental models and ways of knowing-the preponderance of biomedical frameworks of thinking in curricula unconsciously undermined generalist approaches to patient care. UME programmes promoted generalism through a range of teaching activities and strategies, but these efforts were countered by curriculum structures and mental models that perpetuate epistemic inequity between biomedical approaches to medical education and generalist models of care. Novel curricular frameworks are needed to align undergraduate programmes' commitment to social accountability with community-based need.

Nothing About Us Without Us: Improving Representation of Disability in Medical School Curriculum Through Explicit Inclusion.

Medical school curricula across the United States fail to adequately prepare students to provide high-quality care to and advocate for patients with disabilities. To address this shortcoming at one large, urban medical school, the Curriculum Committee at Sidney Kimmel Medical College (SKMC) formed a taskforce of students and faculty to evaluate the degree and quality of disability representation in its undergraduate medical education (UME) curriculum. Taskforce members solicited input from five community members in various fields of disability advocacy to craft recommendations that reflected this community's vision for disability education in UME. Community partners suggested areas of focus including clinical skills, accessibility of healthcare facilities, awareness of intersectionality with other identities, acknowledgment of bias, and respect for the patient's autonomy via their "right to risk." The taskforce report to the Curriculum Committee included 9 recommendations for curricular revision based on community partner suggestions, 6 of which were accepted and are being implemented into the curricular content for the class of 2026 and beyond. This novel approach to implementing curricular change could encourage other medical schools to evaluate their own curricula through the lens of disability and prompt curricular revision with the input of community partners with disabilities, students, and, faculty.

A Working Framework to Address Diversity, Equity, and Inclusion in Undergraduate Medical Education

AbstractHealth disparities exist among groups that are based on race, ethnicity, gender, socioeconomic status, and geography. Often, interventions directed at addressing these disparities are episodically incorporated into health professions education as opposed to a more uniform integration throughout a curriculum. Thus, a working framework for integrating and assessing diversity, equity, and inclusion (DEI) specifically into foundational science teaching in health professions’ education is needed. Current frameworks are theoretically based and often bereft of practical examples that basic science and clinical educators would find useful in educational settings. Here we analyzed examples in pharmacology, therapeutics, and clinical medicine to create a tool aimed at identifying and remediating biases and disparities across the undergraduate medical education (UME) curriculum. We initially focused on pharmacology examples and performed a literature search followed by an in-depth analysis of the literature together with our experiences teaching topics with a DEI component. It became clear that, in addition to pure pharmacology topics, there are many pharmacology- and therapeutics-related topics that also involve race, gender, and sexual orientation. These include clinical guidelines and clinical screening criteria. Further analysis of all of the examples derived from our multi-faceted analysis revealed common themes that we, in turn, compiled into a framework. This framework can be used by foundational science and clinical educators to help both students and faculty understand how to navigate DEI-associated foundational science content.

P.016 Re-norming medical education: centering patient experience and diverse bodies in Lumbar Puncture (LP) instruction

Background: Medical curricula are often created with limited patient and student input and underrepresent certain body types. Traditional medical education often prepares learners to perform procedures, such as lumbar punctures (LPs), on a young white able-bodied 70kg male. When approaching diverse patients, this educational gap can lead to medical learners’ lack of confidence, skill, and knowledge, resulting in poor patient experiences. Methods: This co-design project involves patient and student input. We interviewed five patients who underwent LPs and explored their experience through a trauma-informed approach. To visualize landmarking across body types, we recruited nine volunteers of diverse body sizes, ages, tattoos, and skin colour (Fitzpatrick Scale). Incorporating patient narratives, as well as videos and photographs showing landmarking on diverse bodies, we crafted an online LP instructional module. Focus groups of 6-10 students will be held to collect student perception of the effectiveness of the module. Results: Our learning module and related media will be built into Western University’s Undergraduate Medical Education curriculum, available under a Creative Commons license through the Western Health Education Media Library. Conclusions: Integrating patient experience and student feedback, we are developing a comprehensive educational tool to better equip medical learners to deliver patient-centered LPs across diverse body types.

12 Tips for Including Disability Awareness within Undergraduate Medical Education Curricula

Persons with disabilities (PWD) make up the largest minority group in the U.S. and experience significant health care disparities. Effective training for physicians who will inevitably encounter these patients is warranted; however, as low as 23% of American medical schools have a disability curriculum, which has resulted in a sense of unpreparedness and discomfort among physicians when caring for PWD. The goal of disability training is to provide the proper knowledge and skills to address the unique needs of PWD, mitigate health disparities, and help shape more compassionate and informed physicians. This article presents 12 tips to incorporate disability training into undergraduate medical education. These tips emphasize the inclusion of PWD in all stages of the curriculum, interprofessional education, experiential learning, and exposure to a range of disability types. By leveraging these tips, educators will be able to create effective learning opportunities and improve the future healthcare of PWD.

Use of Social Learning Tools Improves Engagement and Performance in Undergraduate Medical Physiology Education

Objective: We sought to increase engagement, reduce cognitive load, and foster self-directed learning while potentially improving exam performance by incorporating a social annotation tool (SAT) into a flipped classroom setting in an undergraduate medical education curriculum. Hypothesis: We hypothesized that using the SAT (Perusall) as preparatory material for a flipped classroom would increase engagement and academic performance compared to using a pre-recorded lecture video when teaching cardiovascular physiology. Methods: Within a first-year undergraduate medical physiology course, students (n=125) used the SAT to annotate assigned cardiovascular physiology readings before a flipped classroom session. This strategy was compared to the common practice of providing students with a pre-recorded lecture. Students took an assessment before and after to assess knowledge acquisition and engagement with both formats. Results: The SAT intervention identified an average time spent engaged with the material of 142.1 minutes ( n=125), with a pre- and post-assessment score improvement of approximately 20.25% (61.5% vs 82%; n=81). The pre-recorded one-hour lecture found that students engaged with the material, on average, for 51.45 minutes, corresponding to an average of 91% video completion. Findings from this lecture intervention showed the pre- and post-assessment scores improved by an average of 5% (71% vs. 76%; n=80). A paired sample t-test identified a significant difference between the percent improvement between quizzes for SAT (M=19.71, SD=26.374) and percent improvement for recorded lecture (M=6.57, SD=26.369); [t(69)=3.450, p=0.001]. The use of SAT enhanced academic performance in midterm and final exams. The average performance in questions that mapped back to the flipped classroom utilizing SAT text was 91% (n=6) , as compared to an average performance of 73% to those questions that mapped back to the online pre-recorded lecture (n=11 ). Conclusions: Incorporating SATs into a flipped classroom model increased engagement and academic performance versus passive lectures when teaching medical physiology. Our study provides support to the use of social learning tools to enhance active learning in undergraduate medical education. none. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Bioethics curriculum for undergraduate medical students: an evaluation study utilizing mixed methods approach

BackgroundThe undergraduate bioethics curriculum introduced in a private medical college in Pakistan in 1988 and revised in 2009 has evolved over time to incorporate globally relevant innovations, including integration of bioethics spirally within an existing problem-based learning curricular framework. The present evaluation study shares the results of this integrated bioethics curriculum delivered for 10 years across the five-year undergraduate medical curriculum. The study assessed the effectiveness of the curriculum in terms of student achievement, appropriateness of course contents and efficiency of instructional methods.MethodsThe study utilized a mixed method sequential explanatory design. The quantitative method was used in the first phase to gather data by utilizing a structured online questionnaire. This was followed by the second phase of qualitative methods to explain the findings of the first phase and enrich the data gathered. This phase was based on focus group discussions and document review.ResultsStudent and faculty responses showed the curriculum contents to be relevant, informative, and appropriate as per learning objectives and student achievement. Multi-modal instructional methods used were stated to be effective and engaging; small group teaching and shorter sessions suggested to be preferable for fostering discussion and maintaining student engagement and attention. Large class formats were stated to be less effective. Students affirmed the contribution of bioethics education to their personal and professional development and ethical positioning. The majority of students agreed that the curriculum contributed to their knowledge acquisition (60.3—71.2%), skill development (59.41—60.30%) and demonstration of ethical/professional behavior (62.54—67.65%). The ranges indicate agreement with related sets of questions.Participants suggested that the curriculum could be further strengthened by better integration in clinical years, role modelling and providing opportunities for application in clinical health care settings. Moreover, topics like ethical issues related to the use of social media, public health ethics and ethics and law were suggested as additions to the existing curriculum. These findings have regional and global relevance for the development and assessment of effective bioethics curricula.ConclusionAn effective bioethics curriculum for undergraduate medical education should run longitudinally across the 5 year curriculum and be integrated in the modules and clerkships. Basic acquisition of knowledge and skills takes place in Years 1 & 2 with reinforcement and application in Years 3–5. Learning embedded in an integrated curriculum can help students recognize, critically analyze and address ethical dilemmas. Involvement and commitment of the clinical faculty is essential for reinforcing the ethical principles and concepts learnt in the earlier years.

Integrating Choosing Wisely, Value-Based Care Principles, Into Undergraduate Medical Education: A Pilot Study.

Healthcare spending represents a large portion of the GDP of the United States. Value-based care (VBC) seeks to decrease waste in health care spending, yet this concept is insufficiently taught to medical students. The Choosing WiselyStudents and Trainees Advocating for Resource Stewardship (STARS) campaign promotes initiatives that integrate knowledge of VBC into undergraduate medical education (UME). This study sought to determine the most effective strategy to educate medical students on key principles of VBC as taught by the STARS campaign. Choosing Wiselyprinciples were incorporated into the UME curriculum of an academic medical institution via the creation of eight new learning objectives (LOs) for case-based learning (CBL) sessions and lectures. Medical students completed an annual 10-question survey from 2019 to 2022 and 10 formal examination questions during the preclinical (years 1 and 2) curriculum after exposure to varying quantities of LOs. Pearson correlation, chi-square, and logistic regression were employed to determine the association between increased LOs in the curriculum and (1) campaign awareness and (2) knowledge of VBC principles. A total of 700 survey responses over a four-year period (2019 to 2022) were analyzed. Student awareness of the campaign and knowledge of VBC principles increased year over year during the survey period (39% to 92% and 64% to 74%, respectively). There were significant associations between increased LOs in the curriculum and (1) campaign awareness (0.828, p<0.0001) and (2) knowledge of VBC principles (0.934, p<0.001). Students also performed well on formal examination questions related to VBC principles (mean: 81.5% and mean discrimination index: 0.18). Integration of VBC-focused LOs is significantly associated with awareness of the Choosing WiselySTARS campaign and knowledge of VBC principles taught by the campaign. Collaborative initiatives to increase exposure to VBC education may improve students' knowledge of these principles during medical school.

Creating a more equitable future: development, implementation, and evaluation of a novel surgical disparities curriculum for medical students

PurposeThe AAMC has expanded its focus on healthcare disparities training during undergraduate medical education (UME). Currently, no standardized published curriculum dedicated to surgical disparity training exists. Therefore, our purpose was to develop, implement, and evaluate a novel Surgical Disparities Curriculum to equip medical students to recognize peri-operative disparities.MethodsThe Surgical Disparities Curriculum was developed based on the Surgical Disparity Framework created by the NIH-American College of Surgeons Summit on Health Disparity using Kern’s Model of Curriculum Development. The curriculum includes four components which are illustrated in Fig. 1: (1) a pre-session review of a journal article and multimedia adjunct highlighting one category within the framework, (2) a didactic session highlighting key elements of the state of surgical disparities and teaching the NIH-ACS framework, (3) a review of a clinical vignette and articles highlighting a framework factor, and (4) a discussion session applying all elements of the framework to disparities identified in pre-session materials, clinical vignette, and personal clinical experiences. The curriculum was administered at a single large academic institution to 223 third-year medical students. Curriculum evaluation was performed using Kirkpatrick’s Model of Training Evaluation and included post-participation surveys to evaluate participant reaction to the curriculum as well as pre- and post-course assessments to evaluate learning. Results were pooled and a Fisher’s exact test or independent samples t test was used for relevant analysis with p < 0.05 considered significant. Thematic analysis, using common word groupings, was also performed on post-survey comments.Fig. 1Outline of novel Surgical Disparities Curriculum for Medical Students. Pre-session preparation includes a survey and a guided reading with a relevant journal article and a multimedia adjunct. Next is a didactic session that introduces a Surgical Disparities Framework established by the ACS in 2016 and gives students a background in the language of discussing disparities. Next is a clinical vignette that highlights a framework factor and several disparities of interest. This is followed by a guided discussion on the pre-session materials, the didactic component, and the clinical vignette within the framework accompanied by a discussion on how to apply the framework and identify and prevent disparities. This was followed by a post-session surveyResultsParticipants stated they had prior dedicated training in recognizing health disparities integrated throughout the UME curriculum during pre-clinical (83%) and clinical (89%) experiences. Only 31% of students agreed surgical disparities had been discussed during their rotation prior to curriculum implementation. After curriculum participation, 90% of students endorsed an improved understanding of surgical disparities in healthcare and there was a 20% improvement in self-reported identification of peri-operative disparities from 68 to 88% (20% [CI 12–28%], p < 0.0001). Participation in the curriculum also resulted in knowledge acquisition with students scoring better (78% v 59% at baseline; p < 0.0001) on post-participation assessment.ConclusionThe Surgical Disparities Curriculum provides a novel solution for bridging the gap in training medical students to recognize disparities in the care of surgical patients. Future work will be done to assess long-term retention and behavioral changes because of our intervention. In addition, we will be working on the translatability of our curriculum to other institutions with the goal of training clerkship students across the country to better recognize surgical disparities.

Integration of Disability Awareness Improves Medical Students’ Attitudes Toward People with Disabilities

Persons with disabilities (PWD) often require special accommodations and more comprehensive healthcare yet frequently have encounters with physicians who are unprepared to provide tailored and complete care. A multipronged disability awareness curriculum for second-year medical students was implemented, including content on disability etiquette, patient-centered and interprofessional learning sessions for individuals with physical disabilities and intellectual and developmental disabilities, and a debriefing session with physiatrists. The objective of this study was to utilize a mixed methods approach to evaluate the disability awareness curriculum in undergraduate medical education (UME). Assessment was conducted using course evaluations, pre- and post-surveys including the Attitudes and Perspectives Towards Persons with Disabilities (APPD) scale and Multidimensional Attitudes Scale Toward Persons with Disabilities (MAS), and student focus groups. The mean scores from both the APPD (2.11 ± 0.43 pre-score vs. 1.7 ± 0.39 post-score) and MAS (2.45 ± 0.43 pre-score vs. 2.25 ± 0.55 post-score) indicate the curriculum improved medical students’ attitudes toward PWD (p < 0.05), with lower numbers representing more favorable attitudes. After completing the curriculum, medical students’ attitudes were comparable to those of doctor of physical therapy (DPT) students. Qualitative analysis from focus groups highlighted four major themes: education, comfort level, impact on future practice, and disability differences. This curriculum has potential as a valuable framework for delivering effective disability education to medical students to prepare future physicians to serve PWD and their unique needs. It meets core competencies, provides an opportunity to learn in interprofessional environments, and integrates PWD into the educational process.

Integrating a self-directed ultrasound curriculum for the internal medicine clerkship

BackgroundIncorporating ultrasound into the clinical curriculum of undergraduate medical education has been limited by a need for faculty support. Without integration into the clinical learning environment, ultrasound skills become a stand-alone skill and may decline by the time of matriculation into residency. A less time intensive ultrasound curriculum is needed to preserve skills acquired in preclinical years. We aimed to create a self-directed ultrasound curriculum to support and assess students’ ability to acquire ultrasound images and to utilize ultrasound to inform clinical decision-making.MethodsThird year students completed the self-directed ultrasound curriculum during their required internal medicine clerkship. Students used Butterfly iQ+ portable ultrasound probes. The curriculum included online modules that focused on clinical application of ultrasound as well as image acquisition technique. Students were graded on image acquisition quality and setting, a patient write-up focused on clinical decision-making, and a multiple-choice quiz. Student feedback was gathered with an end-of-course survey. Faculty time was tracked.ResultsOne hundred and ten students participated. Students averaged 1.79 (scale 0–2; SD = 0.21) on image acquisition, 78% (SD = 15%) on the quiz, and all students passed the patient write-up. Most reported the curriculum improved their clinical reasoning (72%), learning of pathophysiology (69%), and patient care (55%). Faculty time to create the curriculum was approximately 45 h. Faculty time to grade student assignments was 38.5 h per year.ConclusionsStudents were able to demonstrate adequate image acquisition, use of ultrasound to aid in clinical decision-making, and interpretation of ultrasound pathology with no in-person faculty instruction. Additionally, students reported improved learning of pathophysiology, clinical reasoning, and rapport with patients. The self-directed curriculum required less faculty time than prior descriptions of ultrasound curricula in the clinical years and could be considered at institutions that have limited faculty support.

Undergraduate Medical Education Curriculum Reforms in Pakistan: A Mixed Methods Study of Academic Leadership Perspectives.

Periodic revision of undergraduate medical education (UGME) curricula is an essential part of evidence-based educational practices. Pakistan's national UGME curriculum, last updated in 2005, was reviewed, and recommended updates were made in 2022. The authors explore academic medical school leaders' perspectives about the proposed reforms, gaps within the existing curriculum, and how to ensure the reform implementation is effective, collaborative, and feedback-driven. Using a mixed methods approach, data were collected from April to July 2022. Academic leadership (principals, who could designate vice principals or medical educators) at all medical schools across Pakistan (n = 117) were invited. Agreement with each of 20 proposed reforms was measured via a survey employing a Likert scale. A semistructured interview guide expanded on the survey questions with probes. Eighty-eight survey responses, from private (59; 67.0%) and public (29; 33.0%) institutions, were obtained (75.2% response rate). Participants recommended most of the proposed reforms. The 3 reforms that received the highest agreement were teaching professionalism as an integral part of the curriculum (83; 94.3%), mandating bedside procedural skills training (80; 90.9%), and including patient safety in the UGME curriculum (79; 89.8%). Including multidisciplinary tumor boards and surgical oncology had the lowest agreement (26; 29.5%). Fifteen interviews were conducted, which revealed 3 major themes: perceptions about changes to the curricular content, limitation of human and financial resources as barriers to reform implementation, and recommendations for effective implementation of an updated curriculum. The findings reflect an overall positive attitude of academic medical school leadership toward the 20 proposed UGME curriculum reforms, which could aid with on-the-ground implementation. However, major limitations, such as a lack of trained faculty and financial resources, must be addressed. The authors propose future research on the resources required for implementing UGME reforms and the reforms' impact after national implementation.

Anti-racism curricula in undergraduate medical education: A scoping review

Purpose Medical educators have increasingly focused on the systemic effects of racism on health inequities in the United States (U.S.) and globally. There is a call for educators to teach students how to actively promote an anti-racist culture in healthcare. This scoping review assesses the existing undergraduate medical education (UME) literature of anti-racism curricula, implementation, and assessment. Methods The Ovid, Embase, ERIC, Web of Science, and MedEdPORTAL databases were queried on 7 April 2023. Keywords included anti-racism, medical education, and assessment. Inclusion criteria consisted of any UME anti-racism publication. Non-English articles with no UME anti-racism curriculum were excluded. Two independent reviewers screened the abstracts, followed by full-text appraisal. Data was extracted using a predetermined framework based on Kirkpatrick’s educational outcomes model, Miller’s pyramid for assessing clinical competence, and Sotto-Santiago’s theoretical framework for anti-racism curricula. Study characteristics and anti-racism curriculum components (instructional design, assessment, outcomes) were collected and synthesized. Results In total, 1064 articles were screened. Of these, 20 met the inclusion criteria, with 90% (n = 18) published in the past five years. Learners ranged from first-year to fourth-year medical students. Study designs included pre- and post-test evaluations (n = 10; 50%), post-test evaluations only (n = 7; 35%), and qualitative assessments (n = 3; 15%). Educational interventions included lectures (n = 10, 50%), multimedia (n = 6, 30%), small-group case discussions (n = 15, 75%), large-group discussions (n = 5, 25%), and reflections (n = 5, 25%). Evaluation tools for these curricula included surveys (n = 18; 90%), focus groups (n = 4; 20%), and direct observations (n = 1; 5%). Conclusions Our scoping review highlights the growing attention to anti-racism in UME curricula. We identified a gap in published assessments of behavior change in applying knowledge and skills to anti-racist action in UME training. We also provide considerations for developing UME anti-racism curricula. These include explicitly naming and defining anti-racism as well as incorporating longitudinal learning opportunities and assessments.

Mapping an undergraduate medical education curriculum against national and international palliative care reference learning objectives

BackgroundThe teaching of palliative care competencies is an essential component of undergraduate medical education. There is significant variance in the palliative care content delivered in undergraduate medical curricula, revealing the utility of reference standards to guide curricular development and assessment. To evaluate our university’s undergraduate palliative care teaching, we undertook a curriculum mapping exercise, comparing official learning objectives to the national Educating Future Physicians in Palliative and End-of-Life Care (EFPPEC) and the international Palliative Education Assessment Tool (PEAT) reference objectives.MethodsMultiple assessors independently compared our university’s UGME learning objectives with EFPPEC and PEAT reference objectives to determine the degree-of-coverage. Visual curriculum maps were created to depict in which part of the curriculum each objective is delivered and by which medical specialty.ResultsOf 122 EFPPEC objectives, 55 (45.1%) were covered fully, 42 (34.4%) were covered partially, and 25 (20.5%) were not covered by university objectives. Of 89 PEAT objectives, 40 (44.9%) were covered fully, 35 (39.3%) were covered partially, and 14 (15.7%) were not covered by university objectives.ConclusionsThe majority of EFPPEC and PEAT reference objectives are fully or partially covered in our university’s undergraduate medical curriculum. Our approach could serve as a guide for others who endeavour to review their universities’ specialty-specific medical education against reference objectives. Future curriculum development should target the elimination of identified gaps and evaluate the attainment of palliative care competencies by medical learners.