Teaching In Medical Education Research Articles

Lung ultrasound teaching in medical education: a pilot study at a Brazilian medical school

Lung ultrasound teaching in medical education: a pilot study at a Brazilian medical school

Digital content on YouTube channels: A boon or bane to teaching and learning in medical education

Digital content on YouTube channels: A boon or bane to teaching and learning in medical education

Simulation-based interprofessional education for teaching evidence-based medical practice.

Objective: To achieve consensus on opinions of expert medical educationist on utilization of simulation-based interprofessional education as teaching strategy for evidence based practice teaching in undergraduate medical education. Study Design: Qualitative Case study. Setting: Bahria University Health Sciences Campus. Period: March 2023 to August 2023. Methods: Research using modified Delphi technique was done under ERC 16/2023-BUMDC. Communities of practice and transformative learning theory were used for guiding research design. Non-probability, snow-ball sampling technique was used to select expert panel as participants. Inclusion criteria were medical educationist with masters in health professional education and ten year of experience in department of medical education. Content analysis was used for analyzing data and atlas ti-9 was used for organizing data collected through online email interviews. Results: Final consensus of participants was attained on, third year, Simulation-based interprofessional education/ Assignments/ Journal Clubs/Case-based discussions, Fourth year, Simulation-based interprofessional education/ Journal Clubs/Case-based discussions, Content: Final year, Simulation-based interprofessional education/ Clinical setting/ Journal Clubs. Conclusion: Expert showed ninety percent consensus that simulation-based interprofessional education is good teaching strategies for teaching evidence –based practice in undergraduate medical.

Validation of the Learner Engagement Instrument for Continuing Professional Development.

Learner engagement is the energy learners exert to remain focused and motivated to learn. The Learner Engagement Instrument (LEI) was developed to measure learner engagement in a short continuing professional development (CPD) activity. The authors validated LEI scores using validity evidence of internal structure and relationships with other variables. Participants attended 1 of 4 CPD courses (1 in-person, 2 online livestreamed, and 1 either in-person or online) in 2018, 2020, 2021, and 2022. Confirmatory factor analysis was used to examine model fit for several alternative structural models, separately for each course. The authors also conducted a generalizability study to estimate score reliability. Associations were evaluated between LEI scores and Continuing Medical Education Teaching Effectiveness (CMETE) scores and participant demographics. All statistical methods accounted for repeated measures by participants. 415 unique participants attended 203 different CPD presentations and completed the LEI 11,567 times. The originally hypothesized 4-domain model of learner engagement (domains: emotional, behavioral, cognitive in-class, cognitive out-of-class) demonstrated best model fit in all 4 courses, with Comparative Fit Index ≥0.99, Standardized Root Mean Square Residual ≤0.031, and Root Mean Square Error of Approximation ≤0.047. The reliability for overall scores and domain scores were all acceptable (50-rater G-coefficient ≥ 0.74) except for the cognitive-in-class domain (50-rater G-coefficient 0.55 to 0.66). All findings were similar for both in-person and online delivery modalities. Correlation of LEI scores with teaching effectiveness was confirmed (rho 0.58), and a small correlation was found with participant age (rho 0.19); other associations were small and not statistically significant. Using these findings, we generated a shortened 4-item instrument, the LEI Short Form. This study confirms a 4-domain model of learner engagement, and provides validity evidence that supports using LEI scores to measure learner engagement in both in-person and livestreamed CPD activities.

Fostering Empathy: Nurturing Compassionate Healers through Innovative Teaching and Insightful Assessment in Medical Education

Abstract: The significance of empathy in the realm of medical education cannot be undermined, as once a student embarks on their journey to serve and heal mankind, cultivating empathetic skills becomes an indispensable part of their training. Empathy plays a significant role in healthcare delivery in the domains of patient outcomes and doctor-patient relationships. This article provides a brief review of empathy education and assessment techniques in the field of medicine. Upon realizing the merits that can be attributed to empathy, it is of paramount importance that medical students must be trained in empathy to transform them into patient-centered healthcare professionals. Only training medical students in empathy will not serve the purpose, and we must complement the training component with assessment. In conclusion, empathy is one of the key components of compassionate and patient-centered medical care. This calls for the need to train and assess medical students during their training period to improve their empathetic abilities and support the process of producing competent and compassionate future medical doctors.

Teaching Medical Students Rapid Ultrasound for shock and hypotension (RUSH): learning outcomes and clinical performance in a proof-of-concept study

BackgroundPoint-of-care ultrasound (POCUS) is a critical diagnostic tool in various medical settings, yet its instruction in medical education is inconsistent. The Rapid Ultrasound for Shock and Hypotension (RUSH) protocol is a comprehensive diagnostic tool, but its complexity poses challenges for teaching and learning. This study evaluates the effectiveness of a single-day training in RUSH for medical students by assessing their performance in clinical scenarios.MethodsIn this prospective single-center observational proof-of-concept study, 16 medical students from Saarland University Medical Center underwent a single-day training in RUSH, followed by evaluations in clinical settings and on a high-fidelity simulator. Performance was assessed using a standardized scoring tool and time to complete the RUSH exam. Knowledge gain was measured with pre- and post-training written exams, and diagnostic performance was evaluated with an objective structured clinical examination (OSCE).ResultsStudents demonstrated high performance in RUSH exam views across patients (median performance: 85–87%) and improved scanning times, although not statistically significant. They performed better on simulators than on live patients. Written exam scores significantly improved post-training, suggesting a gain in theoretical knowledge. However, more than a third of students could not complete the RUSH exam within five minutes on live patients.ConclusionsSingle-day RUSH training improved medical students’ theoretical knowledge and simulator performance but translating these skills to clinical settings proved challenging. The findings suggest that while short-term training can be beneficial, it may not suffice for clinical proficiency. This study underscores the need for structured and possibly longitudinal training programs to ensure skill retention and clinical applicability.

Should Medicine be Taught in Leading Medical Languages or the Mother Tongue?

Abstract In non-English speaking developing countries, several debates have arisen over choosing the language of instruction in medical education, whether it should be one of the leading medical languages, such as English, or the mother tongue. In this article, we discuss this debate and provide a brief review of the pedagogical evidence supporting the superiority of the mother tongue as a language of instruction. We also highlight the academic challenges associated with second-language-based medical education and emphasize the impact of language of instruction on the doctor–patient relationship and health care. Finally, we examine the reasons or arguments for not including the mother tongue in medical education. In conclusion, the importance of English as a leading scientific and medical language should not overshadow the crucial role of the native language as the language of instruction in non-English speaking countries. Each country should develop strategies to include the mother tongue in medical education, following the example of developed countries.

Secondary Level Students’ Experiences in English as a Medium of Instruction: A Nepalese Context

This study explores the secondary-level students’ experiences in English as a medium of instruction in education. It aimed at identifying the challenges in English as a medium of instruction for the students in the Nepalese educational settings. It used narrative inquiry as a research method in order to explore the living experiences of the students regarding the practice of using the English language as a language of classroom instruction in the context where English is used as a non-native language. Semi-structured interview has been used as a research process for data collection and the interview guidelines have been used as research tools while collecting data from purposely selected seven student participants studying in the secondary level. This study has revealed that the students experience English as a medium of instruction as a practice to boost up their confidence personally as well as academically despite their EMI hardships in and outside their educational settings.

A comparative study on the effectiveness of online and in-class team-based learning on student performance and perceptions in virtual simulation experiments

BackgroundThe swift transition to online teaching in medical education has presented the challenge of replicating in-class engagement and interaction essential for active learning. Despite online team-based learning (TBL) offering potential solutions through structured cooperative activities, its efficacy in virtual simulation experiment courses remains scantily researched. This study investigates the effectiveness of online TBL for teaching virtual patient experiments in a basic medical laboratory course and contrasts it with traditional offline teaching in terms of student performance and perceptions.MethodsA comparative analysis involved 179 Year 3 medical students using online TBL, face-to-face TBL (FTF-TBL), and the flipped classroom (FC) approach. The learning outcomes were assessed based on experiment reports, IRAT scores, TRAT scores, and final exam performance. Students’ perceptions of both online and in-class TBL methodologies were also surveyed.ResultsBoth online and in-class TBL groups demonstrated comparable academic outcomes and surpassed the FC group in academic performance. Students displayed a marked preference for the TBL format (whether online or in-class), valuing its enhancement of learning interest and practical knowledge application. Nevertheless, refinements in discussion efficiency, platform convenience, and student-instructor interaction were indicated as potential areas of improvement in the online setting.ConclusionsOnline TBL, along with its in-class counterpart, showed superior academic performance and a more positive learning experience compared to the FC group. These findings underscore the potential of online TBL in adapting to modern pedagogical challenges and enriching medical education through virtual simulation experiments.

The contextual interview: a cross-cutting patient-interviewing approach for social context

ABSTRACT Patient interviewing pedagogy in medical education has not evolved to comprehensively capture the biopsychosocial model of healthcare delivery. While gathering a patient’s social history targets important aspects of social context it does not adequately capture and account for the real-time reassessment required to understand evolving factors that influence exposure to drivers of health inequities, social determinants of health, and access to supports that promote health. The authors offer a patient interviewing approach called the Contextual Interview (CI) that specifically targets dynamic and ever-changing social context information. To substantiate the use of the CI in medical education, the authors conducted a qualitative review of the Accreditation Council for Graduate Medical Education Milestones for primary care specialties (Family Medicine, Internal Medicine, and Pediatrics). Milestones were coded to the extent to which they reflected the learner’s need to acknowledge, assess, synthesize and/or apply patient contextual data in real-time patient encounters. Approximately 1 in 5 milestones met the context-related and patient-facing criteria. This milestone review further highlights the need for more intentional training in eliciting meaningful social context data during patient interviewing. The CI as a cross-cutting, practical, time-conscious, and semi-structured patient interviewing approach that deliberately elicits information to improve the clinician’s sense and understanding of a patient’s social context. The authors reviewed future directions in researching adapted versions of the CI for undergraduate and graduate medical education.

Online versus in-person surgical near-peer teaching in undergraduate medical education during the COVID-19 pandemic: A mixed-methods study.

The coronavirus disease 2019 (COVID-19) pandemic stimulated a paradigm shift in medical and surgical education from in-person teaching to online teaching. It is unclear whether an in-person or online approach to surgical teaching for medical students is superior. We aim to compare the outcomes of in-person versus online surgical teaching in generating interest in and improving knowledge of surgery in medical students. We also aim the quantify the impact of a peer-run surgical teaching course. A six-session course was developed by medical students and covered various introductory surgical topics. The first iteration was offered online to 70 UK medical students in March 2021, and the second iteration was in-person for 20 students in November 2021. Objective and subjective knowledge was assessed through questionnaires before and after each session, and also for the entire course. Data were analyzed from this mixed-methods study to compare the impact of online versus in-person teaching on surgical knowledge and engagement. Students in both iterations showed significant improvement of 33%-282% across the six sessions in knowledge and confidence after completing the course (p < 0.001). There was no significant difference in the level of objective knowledge, enjoyment, or organization of the course between online and in-person groups, although the in-person course was rated as more engaging (mean Likert score 9.1 vs. 9.7, p = 0.033). Similar objective and subjective surgical teaching outcomes were achieved in both iterations, including in "hands-on"topics such as suturing, gowning, and gloving. Students who completed the online course did not have any lower knowledge or confidence in their surgical skills;however, the in-person course was reported to be more engaging. Surgical teaching online and in-person may be similarly effectiveand can be delivered according to what is most convenient for the circumstances, such as in COVID-19.

The Application of Cognitive Teaching and Learning Strategies to Instruction in Medical Education

This study aimed to explore how cognitive learning theory can be utilized in medical education by examining teaching strategies and providing practical applications. The main findings are as follows. First, there are seven teaching strategies and specific sample activities that instructors can use based on learning processes in medical schools. These strategies include promoting the perception of sensory stimuli, maintaining divided or selective attention, reducing the cognitive load, implementing encoding strategies, facilitating information retrieval, incorporating distributed learning for retention, and utilizing metacognitive strategies. Second, this study discusses nine instructional events to which cognitive learning strategies have been applied. These events encompass gaining attention, informing learners of goals, stimulating recall of prior learning, presenting new content, providing learning guidance, offering exercises and learning activities, giving feedback, assessing performance, and improving retention and transfer. Third, principles of curriculum design have been implemented from a cognitive perspective. Fourth, case studies of instruction employing cognitive teaching strategies are discussed. Cognitive learning theory has two implications: first, if instructors in medical schools apply the results of the study to design classes and curricula, they would be able to minimize learners’ cognitive load due to ineffective teaching strategies or curricula; second, cognitive teaching strategies that aim to elicit improvements in thinking skills could provide useful teaching strategies for medical education, which aims to train experts with high-level thinking processes. In this sense, cognitive learning theory can be effectively applied in current medical education.

A review on modern teaching and learning techniques in medical education

Education is an ever-evolving and active process that requires periodic refinement. The absence of innovative teaching techniques in academics leaves medical curricula inadequate to take significant strides towards the future. The objective of this review is to define and evaluate alternative methods of teaching and learning that can supplement or serve as alternatives to didactic lectures. These methods aim to promote active student involvement and expedite a smooth flow of information. A literature review was conducted using PubMed, OVID and EBSCO, utilizing keywords such as "learning," "didactic lectures," "alternative techniques of learning," "modern learning techniques," and "medical education." Database searches identified 300 studies, with 250 selected for further screening based on inclusion and exclusion criteria. Articles were surveyed for relevance and significance to our study objectives, encompassing both qualitative and quantitative studies. Various modern learning methodologies were identified, including Case-Based Learning, Evidence-Based Medicine, Problem-Based Learning, Simulation-Based Learning, e-learning, Peer-Assisted Learning, Observational Learning, Flipped Classroom, and Team-Based Learning. These methods address individual learning differences, allowing students to broaden their thinking and professional knowledge. Early introduction of integrative approaches develops student competency and leadership, preparing them for a seamless transition into clinical practice. This study emphasizes the significance and challenges of modern learning systems. Given technological advancements and the broader implications of medical information, students require innovative skills through inter-professional learning. It is imperative to introduce and implement flexible medical curricula that accommodate distinct modern teaching methodologies to address the evolving needs of medical education.

Exploring Quality and Requirements in Faculty Development Related to Teaching.

Little is known about medical school requirements for faculty development related to teaching (FDT) in medical education. This study examined the national landscape and local faculty perceptions of their own institution's FDT requirement. An electronic survey was disseminated to Faculty Affairs Offices in US medical schools to assess FDT requirements. A second survey was distributed to faculty within one medical school to gauge faculty perceptions related to existing FDT requirements. Responses were received from approximately 33% of US medical schools and 36% of local faculty. Few responding medical schools had formal FDT requirements. There was a wide range variation of hours and activities necessary to satisfy existing requirements and consequences for noncompliance. For respondents from schools that did not have a requirement, many saw value in considering a future requirement. Many local faculty agreed that the FDT requirement improved their teaching skills. When asked to share other thoughts about the FDT requirement, several qualitative themes emerged. This study helps establish a national benchmark for the status of FDT requirements in medical education and revealed information on how to optimize and/or improve such requirements. The authors offer five recommendations for schools to consider regarding FDT.

Artificial Intelligence in Medicine: Cross-Sectional Study Among Medical Students on Application, Education, and Ethical Aspects.

The use of artificial intelligence (AI) in medicine not only directly impacts the medical profession but is also increasingly associated with various potential ethical aspects. In addition, the expanding use of AI and AI-based applications such as ChatGPT demands a corresponding shift in medical education to adequately prepare future practitioners for the effective use of these tools and address the associated ethical challenges they present. This study aims to explore how medical students from Germany, Austria, and Switzerland perceive the use of AI in medicine and the teaching of AI and AI ethics in medical education in accordance with their use of AI-based chat applications, such as ChatGPT. This cross-sectional study, conducted from June 15 to July 15, 2023, surveyed medical students across Germany, Austria, and Switzerland using a web-based survey. This study aimed to assess students' perceptions of AI in medicine and the integration of AI and AI ethics into medical education. The survey, which included 53 items across 6 sections, was developed and pretested. Data analysis used descriptive statistics (median, mode, IQR, total number, and percentages) and either the chi-square or Mann-Whitney U tests, as appropriate. Surveying 487 medical students across Germany, Austria, and Switzerland revealed limited formal education on AI or AI ethics within medical curricula, although 38.8% (189/487) had prior experience with AI-based chat applications, such as ChatGPT. Despite varied prior exposures, 71.7% (349/487) anticipated a positive impact of AI on medicine. There was widespread consensus (385/487, 74.9%) on the need for AI and AI ethics instruction in medical education, although the current offerings were deemed inadequate. Regarding the AI ethics education content, all proposed topics were rated as highly relevant. This study revealed a pronounced discrepancy between the use of AI-based (chat) applications, such as ChatGPT, among medical students in Germany, Austria, and Switzerland and the teaching of AI in medical education. To adequately prepare future medical professionals, there is an urgent need to integrate the teaching of AI and AI ethics into the medical curricula.

Integrating Research and Teaching in Medical Education: Challenges, Strategies, and Implications for Healthcare.

The integration of research and teaching in medical education offers numerous benefits, fostering critical thinking and analytical skills in students. Institutions worldwide have recognized the significance of this nexus and have implemented initiatives to link teaching with discipline-based research, promoting interdisciplinary collaboration. This article aims to explore the challenges and recommendations for integrating research and teaching in medical schools and provide recommendations to overcome these challenges. We conducted a comprehensive review of the literature to identify the common challenges faced by medical institutions in integrating research and teaching. PubMed, Scopus, Web of Science, ERIC, and Google Scholar databases were searched to assess the literature that met the study objectives with explicit inclusion and exclusion criteria. We also examined successful strategies employed by some institutions to promote research-teaching integration. The challenges identified include limited resources, the need to balance research and curriculum requirements, and the importance of cultivating a research-oriented institutional culture. Successful strategies involve curriculum updates, faculty motivation, and cross-disciplinary collaboration. Implementing strategies involve vertically and horizontally integrating research methodology throughout the undergraduate curriculum and cross-integrating traditional medical courses with other disciplines. Collaboration between universities, enterprises, and schools can enhance comprehensive cooperation. To create a research-oriented learning environment, medical institutions should address these challenges and implement effective strategies. This approach will not only nurture research-oriented healthcare professionals but also advance medical knowledge for the benefit of patient care. By addressing these challenges and implementing appropriate strategies, medical institutions can create a research-oriented learning environment, nurturing research-oriented healthcare professionals and advancing medical knowledge to improve patient care.

What Might It Mean to Embrace Emancipatory Pedagogy in Medical Education?

An emerging and important goal of professional health training and education is to develop a workforce that is equipped to address patients' social and structural determinants of health and to contribute to health equity. However, current medical education does not adequately achieve this vision. Emancipatory teaching, as described by scholars such as Paulo Freire and bell hooks, equips students with tools to identify and challenge oppressive systems. It helps students achieve freedom for themselves, thereby contributing to more emancipatory and humanistic patient care. Changing teaching in this way would help reverse implicit curricular values that tend to enshrine hierarchy and oppression. Humanities and bioethics scholars working within health professional schools thus should promote a more critical, emancipatory pedagogy in their institutions.

Orientation and application of gamification as teaching learning method by medical physiologists in India

Background: Gamification, the integration of game elements into non-gaming contexts, has gained significant attention in education, including medical education. Researches revealed that gamification elements such as points, badges, levels, and feedback are commonly used in higher education. Gamification is seen as a tool that can help millennial and Gen Z students, who prefer social learning ecosystems, in competency development and contextual learning. A review of gamification-based learning tools in both preclinical and clinical settings highlighted heightened student engagement and superior educational outcomes, but competitive gamification yielded unexpected results, with students spending limited time and resisting competitiveness. Aims and Objectives: This paper presents a cross-sectional study conducted in India to assess the orientation and application of gamification among faculty members of Medical Physiology. The study aimed to identify the advantages, challenges, and potential of gamification in enhancing the quality of medical education in India. Materials and Methods: The authors addressed the deficiency in the orientation and application of gamification tools in medical education by conducting a questionnaire-based cross-sectional study among medical physiologists in various Indian institutions and colleges. Results: Results showed that approximately 25% of the faculty members surveyed in India were oriented toward gamification, with slightly more orientation among junior faculties and those from northern India. There were regional variations in the use of specific gamification elements, such as points and badges, letterboards, and storyline elements. Conclusion: The study highlighted a promising trend of gamification adoption among medical physiologists, while also noting that a significant portion of faculty members remained unoriented and had yet to explore the benefits of gamification in medical education. The paper emphasized the need for proactive promotion and application of gamification tools to enhance teaching and learning methods in medical education.

Bachelor Level Students' Experiences Regarding English as a Medium of Instruction

This study explores the students’ experiences on English as a medium of instruction in education. This qualitative research used narrative inquiry as a research approach. The semi-structured interview was used as a data collection process and interview guidelines including open-ended questionnaires were used as research tools. The data were collected from the purposively selected two participants who were studying at bachelor level. This study revealed that the students account for the English medium of instruction as a supportive policy for them to be sold out in the global market; nevertheless, they experience their anxieties about this practice in and outside the educational setting.

Successful examples of asynchronous teaching in Polish interactive remote medical education

A thorough theoretical and practical preparation is crucial in the education of medical professionals. Present-day knowledge recipients expect a broad range of multimedia and interactive resources in the consumed media. The article discusses examples of such implementations for the nationwide education of a pharmacy technician, massage technician, medical sterilization technician, and occupational therapy technician. These examples were created for the Integrated Education Platform of the Ministry of Education and Science in Poland, as part of an EU-funded project. This study delineates the characteristics of e-materials, such as instructional and educational videos, film sequences, scenario-based learning games, interactive documentation, 3D animations, simulators and virtual tours. We prepared a learner benefit analysis based on the e-materials discussed. We aimed to formulate recommendations and guidelines for designing and developing multimedia and interactive resources, paying special attention to educational values and content for the medical industry. Regardless of the type of multimedia, profession and content, materials should prioritize realism, interactivity and detailed presentation of the situations/cases. The same multimedia rarely achieve different learning objectives and learning outcomes. To design and produce high-quality multimedia, it is necessary to know their characteristics and to work with a team of subject matter experts experienced in e-learning development.