Medicine Education Research Articles

The Influence of Saudi Board of Emergency Medicine Residency Educators on Residents' Academic and Clinical Performance in Riyadh, Saudi Arabia.

The Saudi Board of Emergency Medicine (SBEM) is required to assign educators including program directors to supervise their residents. These educators may impact the residents' academic and clinical performances. After thorough review, we noticed that the current literature lacks information about the direct influence of emergency medicine educators on their residents' academic and clinical performances. The main purpose of this study is to assess the residents' confidence level, and to measure the program directors' satisfaction of the residents' performances during their SBEM training yearsin Riyadh hospitals. This concurrent mixed-methods study was conducted in nine training hospitals in Riyadh, Saudi Arabia, during the 2021-2022 academic year. For the quantitative aspect, a cross-sectional survey was used, based on a questionnaire administered to postgraduate year (PGY)-2 to PGY-4 SBEM residents (n=120) using a nonprobability convenient sampling technique. The survey aimed to assess residents' confidence in their academic and clinical performance, influenced by their educators. A Likert scale with a total of 25 items, covering the seven roles of the CANMEDs framework, was employed. This assessment utilized a published tool called the In-Training Evaluation Report. For the qualitative aspect, program directors' perspectives were gathered through one-on-one unstructured interviews (n=9), guided by theoretical saturation. A purposive sampling technique was employed to select program directors. The interview tool collected demographic data, including gender, years of experience, and training hospital, and included 17 open-ended questions to explore program directors' opinions. The result of mixed methods showed that both quantitative and qualitative data sets were divergent with all independent variables (resident's age, gender, and training level) with the exception of the training hospital which was convergent. Thus, the residents' confidence toward their academic and clinical performances induced by their institutional educators was high. However, the program directors indicated changes that related to residents' training level. The residents' confidence toward their academic and clinical performance induced by their institutional educators was high.The educators had a great deal of influence over the academic and clinical performance of the residents. However,the program directors thought there were some issues with the performance of the residents.Most of the program directors also believed that several influential factors that may have affected the residents' overall performance includestress and receiptof constructive feedback.

Use of audio-visual aids and case studies to enhance understanding of family medicine among medical students.

Teaching family medicine to medical students is primarily intended to aid in their understanding of the distinctive and significant role that the speciality performs within the healthcare system. Improving medical students' comprehension of family medicine may have an impact on their decision to pursue family medicine as a speciality. It is important to use innovative evidence-based teaching and learning strategies and ensure that medical students receive extra learning opportunities in family medicine. This is a short report highlighting the use of audio-visual aids and case studies to enhance the understanding of family medicine principles among undergraduate medical students attending a private university in Ghana.Contribution:This short report offers family medicine teachers and educators at the undergraduate level an example of how to apply audio-visual aids and case studies to enhance the understanding of family medicine principles among students. The report contributes to the growth of family medicine as a speciality within the African context.

Caring for racially minoritized patients in oral medicine education: An interactive e-resource.

Caring for racially minoritized patients in oral medicine education: An interactive e-resource.

Evidence-based practice education in physical medicine and rehabilitation residency programs: A Canadian national survey.

The current extent and quality of evidence based practice (EBP) training for physiatrists is unclear at this time. Training of EBP is also available to residents in Canada. The extent, quality and impact of the training was explored. Cohort study Results: about half of the Canadian programs reported a formal EBP curriculum. The most frequently reported method of providing EBP education were resident participation in journal club. Despite the increasing integration of EBP into residency program education, there remains a critical lack of knowledge and skills for implementation of EBP into clinical practice among Canadian PM&R residency programs.

Proposing a Principle-Based Approach for Teaching AI Ethics in Medical Education.

The use of artificial intelligence (AI) in medicine, potentially leading to substantial advancements such as improved diagnostics, has been of increasing scientific and societal interest in recent years. However, the use of AI raises new ethical challenges, such as an increased risk of bias and potential discrimination against patients, as well as misdiagnoses potentially leading to over- or underdiagnosis with substantial consequences for patients. Recognizing these challenges, current research underscores the importance of integrating AI ethics into medical education. This viewpoint paper aims to introduce a comprehensive set of ethical principles for teaching AI ethics in medical education. This dynamic and principle-based approach is designed to be adaptive and comprehensive, addressing not only the current but also emerging ethical challenges associated with the use of AI in medicine. This study conducts a theoretical analysis of the current academic discourse on AI ethics in medical education, identifying potential gaps and limitations. The inherent interconnectivity and interdisciplinary nature of these anticipated challenges are illustrated through a focused discussion on "informed consent" in the context of AI in medicine and medical education. This paper proposes a principle-based approach to AI ethics education, building on the 4 principles of medical ethics-autonomy, beneficence, nonmaleficence, and justice-and extending them by integrating 3 public health ethics principles-efficiency, common good orientation, and proportionality. The principle-based approach to teaching AI ethics in medical education proposed in this study offers a foundational framework for addressing the anticipated ethical challenges of using AI in medicine, recommended in the current academic discourse. By incorporating the 3 principles of public health ethics, this principle-based approach ensures that medical ethics education remains relevant and responsive to the dynamic landscape of AI integration in medicine. As the advancement of AI technologies in medicine is expected to increase, medical ethics education must adapt and evolve accordingly. The proposed principle-based approach for teaching AI ethics in medical education provides an important foundation to ensure that future medical professionals are not only aware of the ethical dimensions of AI in medicine but also equipped to make informed ethical decisions in their practice. Future research is required to develop problem-based and competency-oriented learning objectives and educational content for the proposed principle-based approach to teaching AI ethics in medical education.

Making assessment a team sport: a qualitative study of facilitated group feedback in internal medicine residency.

Competency-based medical education relies on feedback from workplace-based assessment (WBA) to direct learning. Unfortunately, WBAs often lack rich narrative feedback and show bias towards Medical Expert aspects of care. Building on research examining interactive assessment approaches, the Queen's University Internal Medicine residency program introduced a facilitated, team-based assessment initiative ("Feedback Fridays") in July 2017, aimed at improving holistic assessment of resident performance on the inpatient medicine teaching units. In this study, we aim to explore how Feedback Fridays contributed to formative assessment of Internal Medicine residents within our current model of competency-based training. A total of 53 residents participated in facilitated, biweekly group assessment sessions during the 2017 and 2018 academic year. Each session was a 30-minute facilitated assessment discussion done with one inpatient team, which included medical students, residents, and their supervising attending. Feedback from the discussion was collected, summarized, and documented in narrative form in electronic WBA forms by the program's assessment officer for the residents. For research purposes, verbatim transcripts of feedback sessions were analyzed thematically. The researchers identified four major themes for feedback: communication, intra- and inter-personal awareness, leadership and teamwork, and learning opportunities. Although feedback related to a broad range of activities, it showed strong emphasis on competencies within the intrinsic CanMEDS roles. Additionally, a clear formative focus in the feedback was another important finding. The introduction of facilitated team-based assessment in the Queen's Internal Medicine program filled an important gap in WBA by providing learners with detailed feedback across all CanMEDS roles and by providing constructive recommendations for identified areas for improvement.

Multidimensional formats of surgical anatomy in otorhinolaryngology student teaching-acomparison of effectivity

Technological change in healthcare and the digital transformation of teaching require innovations in student teaching in medicine. New technologies are needed to enable the delivery and use of diverse teaching and learning formats by educational institutions independent of time and place. The aim of this study is to analyze the effectiveness of different multidimensional formats in student teaching in surgical ENT medical anatomy. During the summer semester 2022 and winter semester 2022/2023, the digital teaching and learning program was expanded by testing different visualization formats (3D glasses, cardboards, or VR glasses) with students in the context of ahighly standardized surgical procedure, namely cochlear implantation. Apre- and post-intervention knowledge assessment was carried out in all groups, followed by an evaluation. Of 183 students, 91students fully participated in the study. The post-intervention knowledge assessment showed asignificant increase in correct answers regardless of visualization format. In adirect comparison, the operating room (OR) group answered correctly significantly more often than the cardboard group (p = 0.0424). The majority of students would like to see 3D teaching as an integral part of the teaching program (87.9%) and more streaming of live surgeries (93.4%). They see the use of the various technologies as avery good addition to conventional surgical teaching (72.5%), as good visualization (89%) increases retention (74.7%) and motivation (81.3%). Application and use of new visualization technologies in everyday clinical practice is apromising approach to expanding student training. Mobile, interactive, and personalized technical formats can be adapted to the learning behavior of students. Last but not least, the use of new media influences learning motivation. An expansion of digital teaching and learning formats can be expressly recommended on the basis of this study.

Implicit Bias and Health Disparities Education in the Neonatal Intensive Care Unit.

This study aimed to characterize implicit bias (IB) and health disparities (HD) education in neonatal-perinatal medicine (NPM), including current educational opportunities, resources, and barriers. A national web-based survey was sent to NPM fellows, neonatologists, and frontline providers after iterative review by education experts from the National Neonatology Curriculum Committee. Quantitative data were analyzed with chi-square and Fisher's exact tests. Qualitative data were evaluated using thematic analysis. Of the 452 NPM survey respondents, most desired additional IB (76%) and HD (83%) education. A greater proportion of neonatologists than fellows received IB (83 vs. 57%) and HD (87 vs. 74%) education. Only 41% of neonatologists reported that their institution requires IB training. A greater proportion of fellows than neonatologists expressed dissatisfaction with the current approaches for IB (51 vs. 25%, p < 0.001) and HD (43 vs. 25%, p = 0.015) education. The leading drivers of dissatisfaction included insufficient time spent on the topics, lack of specificity to NPM, inadequate curricular scope or depth, and lack of local educator expertise. A minority of faculty who were tasked to educate others have received specific educator training on IB (21%) and HD (16%). Thematic analysis of survey free-text responses identified three main themes on the facilitators and barriers to successful IB and HD education: individual, environmental, and curricular design variables. NPM trainees and neonatologists desire tailored, active, and expert-guided IB and HD education. Identified barriers are important to address in developing an effective IB/HD curriculum for the NPM community. · There is a gap between the current delivery of IB/HD education and the needs of the NPM community.. · NPM trainees and neonatologists desire tailored, active, and expert-guided IB and HD education.. · A successful curriculum should be widely accessible, NPM-specific, and include facilitator training..

The Making of a Health Profession: How Chinese Medicine Became a Nationally Registered Allied Health Profession in Australia

Abstract In 2012, traditional Chinese medicine (TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herbal medicine dispenser. Australia was the first Western country to introduce national registration for Chinese medicine, followed by Portugal and, recently, New Zealand. The practice of TCM in Australia can be traced back to the beginning of Chinese immigration to Australia during the Victorian Gold Rush which began in the 1850s. The process which led to national registration commenced in the early 1970s with the establishment of the first acupuncture courses. Decades of gradual development of courses from unaccredited part-time diplomas to accredited bachelor degrees, and the development, by the profession, of national consensus on educational standards were essential elements in the process which led to registration. Professional associations, such as the Australian Acupuncture and Chinese Medicine Association Ltd. (AACMA), also developed a framework of professional self-regulation, including Codes of Ethics, Codes of Conduct, ongoing professional development requirements and Infection Control Guidelines, and provided leadership in the development of the profession. After decades of tribalism and division within the TCM profession, the National Academic Standards Committee brought almost all stakeholders together to reach a consensus on the Australian Guidelines for Traditional Chinese Medicine Education which were published by AACMA in 2001. Professional associations also collaborated on joint submissions to the government in support of registration, which was introduced first in the state of Victoria in 2000, and subsequently became national in 2012. Despite national registration, some barriers still remain, and professional associations continue to lobby the federal government for inclusion in Medicare, chronic disease management scheme, and Veterans Affairs.

(027) Assessment of Sexual Medicine Curriculum Across Northeast Medical Schools

Abstract Introduction Sexual health is an imperative area of study in medical school education. However, many medical schools do not offer a comprehensive curriculum nor is it standardized across the US. The history of sexual health as an academic area was introduced in the 1970s but minimal work has been done to assess the validity and accuracy of teachings. While previous work has evaluated the full, mandatory, sexual health course in year 1 medicine at a large state university, the relationship between curricula across different institutions has not been considered (Ross, Bayer, 2021). Objective The sexual medicine curriculum across U.S. medical schools has not been well documented or standardized. This study aims to assess the current guidelines and recommendations for sexual health curriculums in medical schools across the northeast region and compare the current teachings to suggested standards. Methods A compilation of academic resources including lecture material and syllabus will be systematically reviewed utilizing a standardized and validated rubric. The variables assessed include: biological and psychological aspects of human sexual development, anatomy and physiology of the human sexual response cycle, sexual health in relation to human reproduction, and contraceptive options. Results Statistical analyses will include a chi-squared to determine whether rubric ratings differ by region, type of school and degree awarded as well as a four-way ANOVA to explore whether geographic region, school control, degree awarded, and research activity levels influence the quantity and quality of sexual health curricula. Conclusions The goal of this study is to determine the areas of discrepancies between guidelines of sexual health curricula and the current teachings with the aim to improve sexual medicine education in U.S. medical schools. Disclosure No.

Mandating Disability Education in Medicine: A Call to Action

Mandating Disability Education in Medicine: A Call to Action

Internal Medicine Resident Addiction Training at the Veteran's Health Administration: A Qualitative Evaluation of Site Directors' Response to the 2022 ACGME Requirements.

Substance use disorders (SUDs) are prevalent in the USA yet remain dramatically undertreated. To address this care gap, the Accreditation Council for Graduate Medical Education (ACGME) approved revisions to the Program Requirements for Graduate Medical Education (GME) in Internal Medicine, effective July 1, 2022, requiring addiction medicine training for all internal medicine (IM) residents. The Veterans Health Administration (VHA) is a clinical training site for many academic institutions that sponsor IM residencies. This focus group project evaluated VHA IM residency site directors' perspectives about providing addiction medical education within VHA IM training sites. To better understand the current state, barriers to, and facilitators of IM resident addiction medicine training at VHA sites. This was a qualitative evaluation based on semi-structured video-based focus groups. Participants were VHA IM site directors based at a VHA hospital or clinic throughout the USA. Focus groups were conducted using a semi-structured group interview guide. Two investigators coded each focus group independently, then met to create a final adjudicated coding scheme. Thematic analysis was used to identify key themes. Forty-three participants from 38 VHA sites participated in four focus groups (average size: 11 participants). Six themes were identified within four pre-defined categories. Current state of training: most VHA sites offered no formal training in addiction medicine for IM residents. Barriers: addiction experts are often located outside of IM settings, and ACGME requirements were non-specific. Facilitators: clinical champions help support addiction training. Desired next steps: participants desired incentives to train or hire local champions and a pre-packaged didactic curriculum. Developing competent clinical champions and leveraging VHA addiction specialists from non-IM settings would create more addiction training opportunities for IM trainees at VHA sites. These insights can likely be applied to IM training at non-VHA sites.

Status of education, research opportunities and clinical care in sleep medicine across developing countries. A multinational questionnaire-based analysis

Status of education, research opportunities and clinical care in sleep medicine across developing countries. A multinational questionnaire-based analysis

Pediatric disaster preparedness curriculum across emergency medicine residencies.

To assess pediatric disaster medicine (PDM) instruction in emergency medicine (EM) residency programs and to identify barriers to integrating these skills into EM training. National survey study of United States EM Residency Program Directors (PDs) and Assistant PDs during the 2021-2022 academic year. Of the 186 EM residency programs identified, a total of 24 responses were recorded with a response rate of 12.9 percent. Importance of training was rated 5.79 (standard deviation 2.51) using the Likert scale ranging from 1 to 10. Out of 24 programs, 17 (70.8 percent) do not have any PDM training as part of residency training. Live drill, simulation, and tabletop were identified as most effective methods to deliver PDM training with the Likert scale score of 4.78, 4.6, and 4.47, respectively. Senior trainees' level of -knowledge/skills with family reunification (Likert 2.09/5; chemical-biological-radiological-nuclear explosive 2.95/5) and mass casualty preparation of the emergency department (3.3/5) as assessed by the respondents. The main barrier to education included logistics, eg, space and costs (Likert 3.7/5), lack of didactic time (3.7/5), and limited faculty knowledge, skill, or experience (3.3/5). PDM training is lacking and requires standardization. This study highlights the opportunity for the creation of a model for EM resident education in PDM.

Diabetes Health Supervision and Treatment Strategy Based on Data Management and Analysis on eKTANG Platform.

The management of diabetes-related risk factors could effectively reduce the occurrence of its complications, improve the quality of life of patients, and reduce the mortality of patients. Data analysis based on the eKTANG platform could greatly improve the efficiency of communication between patients and doctors, and strengthen the treatment and management of diabetes. We created eKTANG to monitor patient health effectively. The eKTANG health management system aims to extensively intervene in blood glucose monitoring, nutrition, exercise, medicine, and health education to enable diabetes patients to achieve optimal treatment results. Diabetes patients diagnosed by Henan University Medical School included through the eKTANG platform were randomly divided into three groups: member service package group, discharge/ outpatient follow-up group, and out-of-hospital care group. We conducted intensive out-ofhospital interventions for three groups of patients for three months to help patients formulate precise blood glucose control plans and conduct training. The traditional group was compared with the eKTANG platform group, and the physiological indicators and patient compliance of the four groups were observed 6 months later. In the eKTANG platform management group, the average blood glucose compliance rate increased significantly, and the percentage of average blood glucose in the range of 3.9-10.0 showed an upward trend. Fasting blood glucose and postprandial blood glucose showed a downward trend. At the same time, the number of patients per capita blood glucose monitoring showed a significant increase compared with the control group. The establishment of the eKTANG platform can improve the efficiency of patient's medical treatment, improve their lifestyles, reduce the incidence of patient complications, and build a virtuous circle gradually. This research has strengthened the health management and autonomy of diabetic patients and improved the efficiency of treatment. It is worthy of promotion.

Enhanced Scheduling to Improve Resident Continuity in a Family Medicine Teaching Clinic.

Continuity of care is a core concept at the heart of primary care practices. Increased patient-provider continuity of care is associated with better satisfaction scores, better clinical outcomes, decreased hospitalizations and emergency department utilization, improved completion of preventive health services, adherence to medical treatment plans, and improved show rates. Compared to traditional outpatient practices, resident teaching clinics traditionally have lower rates of continuity and face unique challenges in improving continuity given the curricular demands, complex scheduling, and high turnover of providers. The objective of our study was to assess the impact of front office training and new electronic medical record (EMR) scheduling protocols on resident continuity in a family medicine teaching clinic. From July 2021 through May 2022, optimized scheduling through a provider search function in the EMR was implemented in a family medicine teaching clinic. We compared the monthly continuity rates between corresponding months in the prior year and the intervention year. Over an 11-month implementation process, continuity for resident physicians increased from 36.4% to 64.6% (χ2=675.41, P&lt;.001) using EMR tools and scheduling search functions to improve and sustain continuity over the study period. This intervention to enhance continuity in a family medicine residency clinic led to rapid and sustained improvement in provider continuity. This result demonstrates that optimization of EMR scheduling with tools and protocols can improve overall continuity. This scheduling process can likely be applied to clinical sites for residency programs across disciplines.

Family Medicine Residency Program Directors' Perception of Curricular Elements Related to Autism: A CERA Study.

The family medicine (FM) approach to health care across the life span is well-suited to providing care for persons living with autism spectrum disorder (ASD). Little is known about ASD curricula in FM residency training and the characteristics of FM residency programs that prepare their residents to care for persons with this disorder. Our study questions were part of a larger omnibus survey by the Council of Academic Family Medicine Educational Research Alliance (CERA) with data collection from November 16 to December 18, 2022, from FM residency program directors (PDs). ASD curricula were investigated using 10 questions, with descriptive analyses and nonparametric comparisons between program variables and ASD curriculum. The response rate was 42.18%, with FM PDs reporting that their programs were preparing residents in the care of youth (71.53%) and adults (68.33%) with ASD, but to a lesser extent (58.89%) in facilitating transitions of care. Programs with faculty champions, access to published curricula, sufficient patients with ASD, and engagement of interprofessional faculty reported a higher proportion of resident preparedness. PDs of community-based programs were most confident in their ability to teach ASD care and transitions of care. Most FM PDs modestly agreed that they are preparing residents to provide care to patients with ASD and their families. PDs of programs with greater access to resources (ie, published curriculum, faculty champions, sufficient patients with ASD, interprofessional faculty experts) believed that their residents were more prepared. Community-based FM educators may help lead the way in providing models for care and education in this regard.

An overview of chronobiology and sleep medicine education in Brazil

An overview of chronobiology and sleep medicine education in Brazil

After the MATE Act: Integrating Buprenorphine Prescribing Into Mainstream Family Medicine Education and Practice.

After the MATE Act: Integrating Buprenorphine Prescribing Into Mainstream Family Medicine Education and Practice.

A Delphi Study to Validate the Patient-Centered Doctor’S Competency Framework in Korea

Defining a competent doctor is important for educating and training doctors. However, competency frameworks have rarely been validated during the process of their development in Korea. The purpose of this study was to validate the patient-centered doctor’s competency framework, which had been developed by our expert working group (EWG). Two rounds of Delphi questionnaire surveys were conducted among a panel of experts on medicine and medical education. The panel members were provided with six core competencies, 17 sub-competencies, and 53 enabling competencies, and were asked to rate the importance of these competencies on a 5-point Likert scale. Between April and July 2021, a total of 28 experts completed both rounds. The data of the Delphi study were analyzed for the mean, standard deviation, median, inter-rater agreement (IRA), and content validity ratio (CVR). A CVR &amp;gt;0.36 and IRA ≥0.75 were deemed to indicate validity and agreement. This study found that five enabling competencies were not valid, and agreement was not reached for three sub-competencies and two enabling competencies. In consideration of CVR and the individual opinions of panel members at each session, the final competencies were extracted through consensus meetings of the EWG. The competencies were modified into six core competencies, 16 sub-competencies, and 47 enabling competencies. This study is meaningful in that it proposes patient-centered doctor’s competencies enabling the development of residents’ milestone competencies, an assessment system, and educational programs.