Medical School Education Research Articles

From books to the bedside: post-graduation impact of 'Week On the Wards' on medical education

BackgroundThe transition between preclinical and clinical years during medical school has been shown to be challenging. Cooper Medical School of Rowan University (CMSRU) implements one required two-week-long shadowing program for first and one one-week-long shadowing program for second-year medical students called Week On the Wards (WOW). The goal of this study is to ascertain whether students who completed the WOW curriculum found it beneficial over the long-term. Specifically, we want to evaluate alumni’s impression of the program’s influence on career, specialty choice, professional development, personal development, and confidence.MethodsTo evaluate our program, we developed, validated, and distributed a survey via email in the autumn of 2023. Our population included alumni from the classes of 2019–2022, irrespective of race and gender. After following steps for survey development, it was validated via focus group using qualitative methods. The survey consisted of 19 questions answerable on a 5-point Likert scale, a “Yes/No/Unsure/Maybe” section, and an optional open-ended response question. Descriptive analysis was done to report the percent responses.ResultsThe survey was emailed to 353 alumni, with 72 completed responses returned. Majority of respondents agreed or strongly agreed that the WOW program showcased the importance of teamwork in medicine (80.6%), helped them learn to apply medical knowledge (77.8%), influenced their decision regarding which residency/specialty they chose (72.2%), provided an example of how teamwork in medicine is necessary for patient safety and effective care (66.6%), and increased their confidence in their networking skills (66.6%). Alumni nearly unanimously agreed that the WOW program was a useful part of their medical school education (93.1%) and that it should be continued for future classes (94.4%).ConclusionOur results highlight the sustained importance of early preclinical exposure to clinical environments in students’ future career decisions, in their understanding of the clinical applications of learned preclinical topics, and the importance of teamwork in medicine.

Language Barriers in Studying Medicine in English: Concerns and Attitudes of Clinical Phase Medical Students at the University of Tripoli

Despite being a foreign language, English is the medium of instruction in many Arab medical schools, creating language barriers and difficulties for students. The aim of this study was to assess the concerns and attitudes of students towards English as a medium of instruction (EMI) and to explore the barriers as well as opinions of students. This was a cross-sectional descriptive study that targeted students enrolled at the clinical phase at the faculty of medicine in the University of Tripoli using a self-administered questionnaire during the period from the 10th of March 2024 to the 24th of March, 2024. About 61 (36.1%) medical students were moderately comfortable with the English language, followed by 45 (26.6%) who were comfortable as opposed to 10 (5.9%) who were very uncomfortable. The majority 102 (60.4%) recommended changes to address the language concerns in the curriculum. Among the 66 participants who responded to this section, 33.3% recommended that the university should provide free English language courses and 161 (95.3%) stated they would choose to study medicine in English again. The study revealed that the majority of the participants did not feel that English is a significant barrier in their studies with 62.7% disagreeing with the existence of language barriers.

What are future doctors learning about sex? An assessment of sexual health curricula across medical schools in the Northeastern United States.

Sexual health is an imperative area of study in medical school education, yet many medical schools do not offer a comprehensive curriculum nor is it standardized across the United States (US). This study aims to assess written curriculum materials from sexual health curricula in medical schools across the northeast region of the US and compare the current teachings to suggested standards. A compilation of academic resources including lecture materials and syllabi were systematically reviewed utilizing a standardized and validated rubric with variables assessed including: 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. We analyzed our data from the document analysis to look at the frequency of inclusion and exclusion of the sexual health topics included in our rubric. The outcomes of our data set were in line with our hypothesis that there is significant variance between sexual health curricula across institutions as well as an overall lack in material covering sexual health topics. The data show significant sex specific differences such that male-specific topics were covered more frequently than female-specific information. Additionally, only one of the 10 schools examined taught about vulvar conditions. There was also a paucity of information about sexuality in the post-partum period. The clinical implications of this study aim to highlight the discrepancy between an ideal sexual health curriculum and what is actually being taught in medical schools and help to guide future work of creating a comprehensive and standardized sexual medicine education in US. medical schools. The validity of this study was strengthened by analyzing direct curricula materials as opposed to previous use of subjective, self-reported questionnaires. However, the sample location being restricted to the Northeast was a limitation to generalize findings across the country. Future studies would aim to analyze medical school curricula across different regions in the US. This study shows that there is a lack of comprehensive and standardized sexual health curriculum in medical schools in the Northeastern US and serves as initial evidence for further investigation of this topic across American medical schools.

Evaluation of a basic-clinical integrated pharmacology case-based learning program from a student perspective using the CIPP model.

This study aimed to systematically evaluate the effectiveness of case-based learning (CBL) within a basic-clinical integrated educational program using the Context, Input, Process, and Product (CIPP) evaluation model. The CBL program was integrated into the Pharmacology-Clinical Case Practice component of the pharmacology course, a mandatory course for first-year medical students. To evaluate the program, a CIPP model-based questionnaire was developed, assessing needs, goals, resources, educational management, and outcomes. To ensure the reliability and validity of the variables, factor analysis was performed, reducing an initial set of 28 items to 18 final observation variables distributed across four factors. The survey, designed to measure learner satisfaction, was administered to 37 students who participated in the Pharmacology-Clinical Case Practice course during the first semester of 2022. Participants rated their satisfaction with the CBL program based on the CIPP model (on a 5-point scale), giving an average score of 4.17. This suggests that learners who followed the CBL program combining basic and clinical components generally found the program operationally effective with positive outcomes. The teaching model and evaluation model applied in this study can be utilized in various majors when operating CBL classes that link basic and clinical education in medical schools in the future.

Effectiveness of a report writing training program using peer review: evidence from first- year medical students

BackgroundReport writing in class provides basic training for academic writing. However, report writing education in medical schools in Japan has rarely been reported and no teaching strategy has been established for it.MethodsThis study developed a report writing program using peer review for first-year medical students consisting of two 120-minute classes. The goal of being able to write reports appropriately was established and presented to students at the beginning of the program. In session 1, students decided on a topic, gathered information, and structured their report. In session 2, students’ written reports were peer reviewed. The reports were improved based on the peer reviews. The responses of the pre- and post-program questionnaires were evaluated to determine the program’s effectiveness. The other reports that were assigned one month after the program were used as comparison with the reports of students who did not participate. Furthermore, the long-term effects of the program were also evaluated by comparing the results of students from the previous year who did not participate in the program with those of program participants six months after the program.ResultsA total of 106 students completed the questionnaire evaluation. The program was rated as being acceptable for the students. Self-assessment of report writing significantly improved after the program. The report scores of program participants (n = 99) were significantly higher overall and in all domains than were those of non-participants (n = 99). The self-assessment of students who participated (n = 96) was significantly higher than that of non-participants (n = 109). No difference was observed for students’ sense of burden in report writing.ConclusionsThe report writing skills of medical students can be improved by clearly establishing the goals of report writing and practicing the basic skills of report writing step-by-step. Moreover, the use of peer review may enhance the effectiveness of learning opportunities for report writing.

Not taught in medical school but needed for the clinical job – leadership, communication and career management skills for final year medical students

BackgroundStarting the first job as a young physician is a demanding challenge. Certain skills are important to master this transformation that go beyond the theoretical knowledge and practical skills taught in medical school. Competencies such as communication, leadership and career management skills are important to develop as a young physician but are usually not sufficiently taught in medical school in a structured and comprehensive way.MethodsWe performed an online survey among final year medical students regarding how they perceive their current competency level in communication, leadership and career management skills. We also assessed how they rate the importance to acquire these competencies and the current emphasis during their medical school education regarding these topics.ResultsOf 450 final year medical students 80 took part in the voluntary survey and 75 complete datasets were returned (16.7%). The majority of respondents rated different communication skills, leadership skills and career management skills as important or very important for their later clinical work. However, most students felt to be poorly or very poorly prepared by the current medical school curriculum, especially for certain leadership and career management skills. Overall, 90.7% of participants expressed interest in an additional educational course that covers subjects of communication, leadership and career management skills during the later stage of medical school, preferably as a hybrid in-person session that also offers synchronous online participation.ConclusionsThe results of the survey express the need to address communication, leadership and career management skills in the medical curriculum to be better prepare students for the demands of residency and their further course as physicians. An educational format during the final year of medical school may be suitable to address mentioned topics in the framework of clinical practical exposure.

Medical students’ knowledge on palliative care – a survey of teaching in Finland

Background Most studies on palliative medicine (PM) undergraduate education have focused on contents and organizational issues but not the outcome. Students’ learning outcomes should be studied to improve teaching in medical schools. Methods A questionnaire about perceived PM education and attitudes on palliative care (PC) was sent to 543 last year students in all five Finnish medical schools in 2018–2019. In total, 175 (32 %) responses were received from four universities. The students evaluated both the quantity and quality of their PM teaching, implementation of European Association for Palliative Care (EAPC) guidelines and their satisfaction to the training. There were two palliative case scenarios, and the students were asked to find the best treatment option. In addition, students´ attitudes towards end-of-life (EOL) care issues were examined. Results In the Finnish universities, PM education was available mainly integrated with oncology, geriatrics, and general medicine. A total of two universities also offered a specific PM course. In average, 50–70% of the EAPC curriculum was covered by lectures, small-group teaching, seminars, and bedside teaching with significant differences between faculties. Only 30–60 % of students were satisfied with the education received. The highest rankings were given in the universities with a special PM course. Students from these universities expressed less anxiety in facing EOL issues. Conclusions In Finland, the coverage of EAPC curriculum is satisfactory, but the PM education is mainly given integrated with other specialties. The dedicated course on PM was associated with increased perceived knowledge and satisfaction of PM education. However, PM training was not associated with students’ attitudes on PC.

A Student Call for Gun Violence Education in Medical Schools

This Viewpoint discusses the lack of gun violence education in medical school curricula despite the high prevalence of firearm-related deaths and injuries in the US.

Heeding a Student Call for Gun Violence Education in Medical Schools

Heeding a Student Call for Gun Violence Education in Medical Schools

Comparing fourth-year medical students’ procedural surgical skill learning outcomes between third-person point-of-view video lectures and first-person point-of-view immersive virtual reality: a pilot study of surgically implanting a subdermal drain on cadavers

The use of virtual reality (VR) training in medical school education has increased over the last decade partly due to coronavirus-19 (COVID-19) and due to technology advancements in this integrative area. As medical students are being trained in new pedagogical interventions, it is important to drill-down and focus on the areas of most translational concern for assessing their competency and proficiency. Thus, the present pilot study sought to evaluate a group of fourth-year medical students’ ability to learn a modified medical school curriculum on implementing a subdermal drain by first learning how to stitch on a silicone model (i.e., proper stitching only) and then being randomly assigned to either a third-person point-of-view (TP-POV) or first-person point-of-view (FP-POV) immersive VR group to learn how to conduct the surgical procedure (i.e., conceptually and procedurally). Then, the participants’ surgical procedural motor skills were assessed on a single attempt to demonstrate their competency and proficiency on a cadaver. The results showed that the pedagogical learning differences in FP-POV immersive VR improved the cleanliness and accuracy of the surgical dissection movement and drain placement with 100% proficiency in the first attempt at implementing this surgical technique on a cadaver. Additionally, there was statistically significant improvement in the dissection movement (p < 0.05*) and the tension test (p < 0.01**) in the FP-POV group compared to the TP-POV group, even with a small sample size in the present pilot study. These findings offer unique training opportunities to be considered when designing future VR curriculum with the suggested use of repeated-measures designs on the surgical procedural motor skills to assess learning curves and their potential translations in reducing operating room errors, costs, planning and scheduling times, and surgery overlaps, thereby positively contributing to a more efficient and safer OR surgical experience by staff and patients in the near future.

A surge of interest: Analysing the increased public interest in lipedema using google trends.

This study aimed to monitor public interest in information related to Lipedema and examine potential temporal, seasonal, and income-related trends that may impact public interest. A dataset was created using the Google Trends tool by inputting the keyword "Lipedema" to obtain the relative search volume (RSV) from 2004 to the present in the United States (US). To examine potential income-related disparities in public interest in Lipedema across the US, RSV values were recorded in the five states with the highest and the lowest median income (Maryland, New Hampshire, New Jersey, Utah, and Washington and Mississippi, West Virginia, Arkansas, New Mexico, Kentucky, respectively). Public interest in Lipedema increased significantly over time (R2 = 0.693, p < .001 for the linear trend; R2 = 0.880, p < .001 for the quadratic trend). There were no significant differences between the RSV values between the month of the year and the season of the year (p = 1.000 and p = .859, respectively). RSV values of the five highest-income and low-income states showed significant increases (R2 = 0.333, p < .001, and R2 = 0.195, p < .001, respectively) More rapid growth in interest in Lipedema in states with high income compared to the states with low income (p < .001). Public interest in Lipedema is increasing in both high-income and low-income states. States with higher incomes are more interested. Searches for lipedema are expected to become more frequent, leading to a rising demand for comprehensive education in medical schools and clinician training programs. In addition, there will also be a need for easily accessible, high-quality information resources.

EP525 - A Survey of Medical Students’ Attitudes Towards Sustainable Healthcare

Abstract Aims As the climate crisis becomes increasingly prevalent, so does emphasis on environmental sustainability. The healthcare sector (a significant contributor to environmental impact) is particularly of interest: sustainable healthcare and awareness within the NHS is crucial. However, few medical schools include environmental teaching in their curricula. We undertook this survey to assess environmental awareness and perspectives amongst medical students. Methods An online questionnaire was distributed to London medical students. Participants were asked demographic data, questions concerning the environmental impact of products and practices in the NHS, and methods to reduce healthcare’s environmental impact. Results 87% of students stated that healthcare’s environmental impact is of concern to them, 97% agreed that the environmental impact of products should be considered during development. 65% agreed that the environmental impact of a product should influence its use, but 95% agreed that a device being recyclable/reusable would influence their practice. Students felt the factor most negatively impacting the environmental burden of healthcare was ‘disposable plastic items’, in 57% of responses, and ‘general waste’ in 44%. Conclusions Most medical students found healthcare's environmental impact concerning, expressing a desire to choose the most sustainable options. Whilst the distribution of academic year and the London demographic limited this study, we believe it is the first of its kind assessing medical student's attitudes towards the environmental impact of healthcare. With this initial benchmark, we hope future surveys will assess and improve the environmental awareness of doctors in training, as well as the inclusion of environmental teaching in medical school.

Disability health in medical education: development, implementation, and evaluation of a pilot curriculum at Stanford School of Medicine.

People with disabilities face significant healthcare disparities due to barriers to accessing care, negative attitudes of providers, and lack of education on disabilities for healthcare professionals. Physicians report discomfort when interacting with patients with disabilities, adding to the disparity, warranting research on medical school education. Two educational interventions were structured: (1) a brief 2-h intervention in the mandatory curriculum and (2) a 9-week elective course which included interactions with individuals with disabilities through workshops and partner programs. We predicted that both of these interventions would result in improvements in attitude and empathy toward individuals with disabilities and reduce student anxiety. During the 2018-2019 academic year, 54 students completed the surveys for the 2-h intervention and 8 students completed the 2-h intervention and elective course. Pre-, post-, and delayed post-intervention surveys (3 months after post survey) measured students' attitudes, using validated surveys on attitudes, empathy and anxiety toward individuals with disabilities. Both educational interventions resulted in improved attitudes toward individuals with disabilities. However, students reported only feeling prepared to care for patients with disabilities after the elective course. The elective course, but not the 2-h course, significantly decreased student anxiety levels, likely due to more individual time working with individuals with disabilities. Delayed analysis after 3 months showed that both interventions had a lasting impact on attitudes and behavior change when caring for individuals with disabilities. Medical education is effective at improving medical students' attitudes and behaviors toward individuals with disabilities. A 2-h session can lead to a modest improvement in attitudes. However, more dedicated time and exposure to persons with disabilities results in a greater improvement in students' attitudes, anxiety and preparedness.

The Importance of Discussing the History of Racism in Medical Student Education.

Racial health disparities are tightly linked to the longstanding and pervasive institution of racism. Efforts to reverse disparities begin with awareness and accountability through education. The health care workforce must be formally educated about racist practices, tools, and ideologies that perpetuate poor health outcomes. This article explores prior efforts to integrate race didactics into medical school education, addresses current legislation, and illuminates lessons learned from a single institution pilot curriculum exploring the history of racism in the field of obstetrics and gynecology. Educating medical school students about the history of racism is an important and necessary tool for positive change.

Nutrition and Physical Activity Education in Medical School: A Narrative Review.

This review explores the diverse landscape of integrating nutrition and physical activity education into medical school curricula, focusing on the imperative role of physicians in promoting health through lifestyle changes. By examining global medical education structures, we uncovered disparities in nutrition and physical activity training, and highlighted the need for a shared framework to address international and regional challenges. Despite acknowledging the importance of both nutrition and physical activity, studies have consistently uncovered deficiencies in medical school curricula, especially in skills related to providing lifestyle advice and behavioral counseling. Survey studies among medical students have illuminated various perceptions and knowledge gaps, emphasizing the need for more comprehensive and mandatory nutrition and physical activity training. While acknowledging progress, challenges, such as time constraints, resource availability, and faculty expertise, persist. Integrating lifestyle education results in resistance, a demand for strategic communication, and faculty buy-ins. These findings underscore the importance of a holistic approach that balances theoretical knowledge, practical skills, and confidence that medical students need to promote effective nutrition and physical activity in healthcare.

Paws for thought: advocating for the disabled population through service dog education in medical school

Service dogs are essential companions for approximately 500,000 disabled individuals in the United States. They provide daily assistance with a diverse range of impairments by performing trained tasks. Despite the studied benefits of owning a service dog, physicians often lack knowledge and education regarding their utility. This widespread ignorance among healthcare providers has left many disabled individuals unaware of the life-changing support service dogs can provide, exacerbating existing healthcare disparities for the disabled community. Integrating service dog education into medical curricula is crucial to enhancing care for disabled patients. By equipping future physicians with this knowledge, the medical community can better advocate for and support disabled patients, ensuring they receive comprehensive and informed care.

Undergraduate occupational medicine education in European Medical Schools: better training to meet today’s challenges

BackgroundOccupational medicine (OM) faces considerable challenges today, one of them related to the university training of future physicians considered suboptimal at a global level as it has been pointed out in many studies. The aim of this study is to update the state of OM medical education in European universities.MethodsBetween March and August 2022, an e-mail survey regarding OM training to undergraduate medical students was conducted among OM professors at European universities in 28 countries (n = 347).ResultsOf the 347 universities, 53 medical schools from 19 countries responded (response rate = 15.3%). In 89% of cases, OM was taught. The average number of hours per academic year was 24.3, with significant variation within the same country. Lectures were the most popular teaching technique (98%), with a considerable use of modern approaches such as problem-based learning (61%), and e-learning (57%). While occupational diseases and principles of prevention were covered, other subjects such as the environmental impact or collaboration with an OM physician were poorly represented in the educational program.ConclusionAccording to data, several European medical schools may provide insufficient OM education and training to their students. The education of undergraduate occupational medicine students in European medical schools should be designed to equip them with the knowledge and skills required to meet today’s challenges. It is critical that undergraduate OM education in European medical schools be enhanced, harmonized, and standardized.

One Health in Medical Education: A Proposed Framework.

The One Health concept focuses on the interconnections between human health, animal health, and the environment, stressing the need for interdisciplinary collaborations to address complex issues such as the health challenges posed by climate change and global pandemics. One Health is a central part of the curriculum of veterinary schools, however, it is rarely incorporated into medical school education. Nationally, there are limited examples of formal One Health education and training for medical students. To incorporate One Health into its curriculum, John A. Burns School of Medicine developed a Dean's Certificate of Distinction in One Health that consists of a One Health foundational course, a clinical One Health elective course, participation in the One Health Interest Group, engagement in One Health educational and outreach activities, and a One Health research or curriculum development project. To the authors' knowledge, this is the first One Health certificate program developed and implemented in any Association of American Medical Colleges accredited medical school. Although introducing similar programs into medical curricula will continue to be challenging, we hope it will serve as a framework for other academic institutions.

Intimidating Attendings: The Importance of Near-Peer Mentorship During Third-Year Surgical Clerkship

IntroductionNear-peer instruction has grown in popularity in medical education; however, limited data exist to support its effectiveness. This study investigates the perceptions of near-peer style instruction in third-y medical students undergoing a surgical clinical clerkship. We hypothesized that near-peer instruction would provide a beneficial educational experience to third-y medical students during their surgical clinical clerkship. MethodsThe authors anonymously surveyed third-y medical students undergoing their clinical clerkship in surgery on their perception of the near-peer instruction and mentorship they received from fourth-y medical students at the beginning of the clerkship. Near-peer instruction included teaching suturing techniques, surgical procedures and anatomy, operating room literacy, and sharing anecdotal experiences. Surveys were distributed 24 h after receiving the formal instruction. ResultsA total of 85 students completed the survey (78% response rate). Students reported a similar or increase in value of learning from near-peer mentors compared to attending physicians (less valuable: 1.2%; just as valuable: 52.9%; more valuable: 45.9%). The majority of students indicated they would like to experience more near-peer style instruction in medical school as demonstrated in surgical clerkship training (absolutely no: 0%; probably not: 0%; on the fence: 4.7%; probably yes: 25.9%; absolutely yes: 69.4%). After experiencing near-peer instruction and mentoring, students were more interested in becoming near-peer mentors (less interested: 1.2%; just as interested: 29.4%; more interested: 69.4%). ConclusionsStudents appreciate and desire near-peer instruction, seeing it as an effective learning method. Mentees undergoing near-peer style instruction have an increased interest in becoming near-peer mentors.

Medical students’ knowledge on palliative care – a survey of teaching in Finland

Background Most studies on palliative medicine (PM) undergraduate education have focused on contents and organizational issues but not the outcome. Students’ learning outcomes should be studied to improve teaching in medical schools. Methods A questionnaire about perceived PM education and attitudes on palliative care (PC) was sent to 543 last year students in all five Finnish medical schools in 2018–2019. In total, 175 (32 %) responses were received from four universities. The students evaluated both the quantity and quality of their PM teaching, implementation of European Association for Palliative Care (EAPC) guidelines and their satisfaction to the training. There were two palliative case scenarios, and the students were asked to find the best treatment option. In addition, students´ attitudes towards end-of-life (EOL) care issues were examined. Results In the Finnish universities, PM education was available mainly integrated with oncology, geriatrics, and general medicine. A total of two universities also offered a specific PM course. In average, 50–70% of the EAPC curriculum was covered by lectures, small-group teaching, seminars, and bedside teaching with significant differences between faculties. Only 30–60 % of students were satisfied with the education received. The highest rankings were given in the universities with a special PM course. Students from these universities expressed less anxiety in facing EOL issues. Conclusions In Finland, the coverage of EAPC curriculum is satisfactory, but the PM education is mainly given integrated with other specialties. The dedicated course on PM was associated with increased perceived knowledge and satisfaction of PM education. However, PM training was not associated with students’ attitudes on PC.