Medical Education Activity Research Articles

Primary care physicians' attitudes, practices, and perceived barriers toward depression screening in older people in the Kingdom of Bahrain

PurposeThis study aimed to explore attitudes, practices, and perceived barriers of primary care physicians (PCPs) toward depression screening in older people.MethodsThis cross-sectional study enrolled PCPs from randomly selected representative primary care centers in Bahrain. A self-administered piloted semi-structured questionnaire was used for data collection.ResultsWe enrolled 248 PCPs in the study (82.3% females, and the mean age = 40 ± 8.7 years). More than half of the participants (54.4%) had a positive attitude toward depression screening in older people. However, only 10.9% of the participants reported systematically screening for this condition without using specific tools for screening in 45.5%. The most reported barriers toward this service are short consultation time (95%), the presence of multiple co-morbidities in this age group (90%), and the absence of guidelines or appropriate training in around 30%. Positive attitudes were significantly higher among older PCPs (p = 0.039), family physician consultants (p = 0.008), those with more than 10 years of work experience (p = 0.024), and those who participated in related educational activities (p = 0.007). Under-screening practice is associated with perceived short consultation time (p = 0.002), insufficient continuous medical education (CME) activities attendance in older people's mental health (p = 0.048) as well as having a general physician's title (p = 0.049). Only the PCPs' job title, Adjusted Odds Ratio (OR) = 3.513, 95 C.I [1.225-10.074] and attendance of CME activities, OR = 1.278, 95 C.I [1.098 – 3.192] remained significant when controlled for age and experience.ConclusionMore training on older people's mental health and provision of screening and management guidelines are priorities to promote older people's mental health in primary care settings.

Entrustable Professional Activities in Medical Education: SELECT Leadership, Values-Based Patient-Centered Care, Health Systems, and Scholarly Excellence

Entrustable Professional Activities (EPAs) represent a concept in medical education that has gained significant traction over the last few years, particularly in the context of competency-based medical education. An EPA refers to a specific task or responsibility that can be entrusted to a trainee once they have demonstrated the necessary competence. EPAs provide concrete tasks that a trainee should be able to complete at various stages of training in order to clarify expectations and responsibilities they should master. The University of South Florida Morsani College of Medicine (USFMCOM), Scholarly Excellence, Leadership Experiences, Collaborative Training (SELECT) MD program pairs a unique four-year longitudinal leadership program including the domains of leadership, values-based patient-centered care, health systems, and scholarly excellence with an innovative medical degree program. Students in the SELECT program spend the first two years on the campus in Tampa, Florida, and the clinical years on the regional campus in Allentown, Pennsylvania. These additional threads of curriculum call for a unique set of EPAs. A working group of faculty, students, and administrators within the college from both the main and regional campus developed EPAs for each of the above listed areas of focus within the curriculum. In this paper, the authors describe how Entrustable Professional Activities were developed at MCOM to assess the SELECT curriculum in the areas of leadership, values-based patient-centered care, health systems, and scholarly excellence.

Training to Increase Minority Enrollment in Lupus Clinical Trials With Community Engagement: Enhancing Lupus Clinical Trial Recruitment Through Provider and Community Health Worker Engagement.

This study evaluates the effectiveness of the Training to Increase Minority Enrollment in Lupus Clinical Trials with Community Engagement (TIMELY) program on enhancing referrals of underrepresented patients to lupus clinical trials. TIMELY leverages two existing American College of Rheumatology online educational initiatives: Materials to Increase Minority Involvement in Clinical Trials (MIMICT), a continuing medical education activity for health care providers, and the community health worker (CHW) Lupus Clinical Trials Training (LuCTT). TIMELY introduced a unique roundtable meeting format to build on the existing online educational programs and facilitate discussions between local clinical trial sites and provider and CHW participants. This study used an online pretest and posttest design to assess changes in theory-based behavioral predictors of lupus clinical trial referrals and engagement (ie, knowledge, attitudes, self-efficacy, and intentions) among providers and CHWs. Participants completed MIMICT or LuCTT and then were eligible to participate in roundtable meetings. Paired t-tests were used to assess changes in composite scores before and after the intervention for each of the outcomes. The final sample included 40 providers and 18 CHWs. Knowledge scores increased significantly for both providers (P < 0.01) and CHWs (P < 0.001) on completion of MIMICT and LuCTT, respectively. After participating in the TIMELY roundtable, providers' composite scores for self-efficacy and intentions significantly increased (P < 0.001). Provider self-efficacy gains were sustained at three months' follow-up (P < 0.001). These promising findings highlight the potential and opportunities for the TIMELY program to improve behavioral predictors of trial referrals, including CHW knowledge and providers' knowledge, self-efficacy, and intentions to refer underrepresented patients to lupus clinical trials.

Considering the Cost-Effectiveness of Accredited Continuing Medical Education: A Landscape Analysis of Economic Concepts in Continuing Medical Education Research.

In health care, cost-effectiveness analysis evaluates changes in health outcomes as a function of costs. The cost-effectiveness of continuing professional development for health care providers has not been historically well characterized despite substantial investment. This literature review identified publications considering the costs and cost-effectiveness of accredited continuing medical education activities. Searches were conducted for English language records in PubMed and the gray literature using a 10-year lookback period from March 10, 2023. Search terms included concepts related to continuing medical education, cost, effect, and utilization. One reviewer conducted title/abstract screening, full-text review, and data extraction, with direction and adjudication of search and screening concepts provided by the lead advisor. Publications were categorized as related to costs of an educational intervention (Concept 1) and/or the impact of education on health care costs (Concept 2). Results were summarized using descriptive statistics. A total of 668 database records were screened, 125 (19%) underwent full-text review, and 25 of 125 (20%) were accepted; 7 of 351 (2%) gray literature sources were accepted for a total of 32 included records. The most common reason for rejection was not being an accredited activity. Of the 32 records, 27 (84%) were related to Concept 1 only, 3 (9%) to Concept 2 only, and 2 (6%) to both Concepts 1 and 2. Approximately half (n = 19, 59%) mentioned costs without supporting data. These findings show that considerations of cost and cost-effectiveness are rare in the accredited continuing medical education literature, which may limit how the value of continuing medical education is characterized.

Entrustable professional activities in medical education and their importance

The Article Abstract is not available.

The impact of online CME on clinicians’ ability to utilize immunotherapy in unique populations of patients with NSCLC.

e21004 Background: Immunotherapy (IO) has become a standard of care in the management of advanced non-small cell lung cancer (NSCLC). However, treatment with IO-based regimens may not always be straightforward, particularly in unique clinical scenarios and patient populations. As such, members of the multidisciplinary care team, including oncologists and pulmonologists, may lack experience in utilizing IO in these instances. The objective of this study was to assess the educational impact of a series of continuing medical education (CME) activities on the knowledge, competence, and confidence of oncologists and pulmonologists with respect to recognizing strategies that facilitate the safe and effective use of IO in patients with advanced NSCLC. Methods: The educational analysis consisted of 2 online, CME-certified activities. Educational impact was assessed with repeated pre-/post-education including multiple choice knowledge/competence questions and 5-point Likert scale confidence questions. Data from all oncologists and pulmonologists who completed pre- and/or post-education assessments were aggregated across activities and stratified by learning theme. Relative changes in percentage of correct responses and clinicians who were confident (value of 4 or 5) were used to measure improvement in knowledge, competence, and confidence. A McNemar’s test assessed significant levels of changes reported with P values &lt;.05 considered statistically significant. The first activity in the analysis launched October 2023 and the last launched November 2023; data were collected until January 2024. Results: The educational series resulted in improvements in oncologists’ (N=119) and pulmonologists’ (N=49) knowledge, competence, and confidence after education. Conclusions: This analysis demonstrates that oncologists’ and pulmonologists’ knowledge, competence, and confidence regarding the safe and effective use of IO in patients with advanced NSCLC improved after education. Despite these improvements, additional educational activities are needed to address residual gaps and further increase clinicians’ ability in these dynamic and challenging clinical settings. [Table: see text]

Tracking the information-seeking patterns and preferences of US-based medical oncologists (MOs): A 2-year longitudinal assessment.

e21012 Background: The rapid pace of scientific advancement demands that community-based MOs continually access new information and effectively apply it in their clinical practices to improve long-term patient outcomes. A variety of dissemination vehicles are currently available to facilitate the transfer of knowledge, including continuing medical education (CME) activities. Despite the significant resources allocated for the development of these modalities, little definitive data is available documenting MOs’ preference for, utilization of and perspectives on the benefits and limitations of CME. This longitudinal assessment sought to establish a baseline understanding of MOs’ patterns of engagement with CME activities following the upheaval caused by COVID, and gauge if and/or how this has shifted as the pandemic has subsided further. Methods: In April 2022 a 56-question online survey was distributed to 4,623 US-based MOs from a proprietary database. A small honorarium was offered for participation. Responses were collected from 83 MOs. A 2-year follow up assessment is planned for April 2024 to track changes in preferences and participation. Results: 83% of MOs “agree” or “strongly agree” that the pace of oncology advancements is quicker now than it was in the past yet only 25% spend more time accessing CME. On average, MOs dedicate 6 hours a week to seeking oncology-related information, in which utilization of CME activities is included. MOs believe CME activities are useful for helping to stay up to date with advances in oncology (3.5 on a 1-5 scale) and 55% believe the application of new and emerging therapies within oncology would be slower if CME was no longer available. MOs are most interested in CME activities featuring practically oriented topics including recently presented clinical trial findings , molecular testing and analysis and treatment sequencing . Notably, the highest-ranking MO consideration for participation in a CME program was the topic, followed by faculty and then the length of the activity. In terms of length, MOs preferred 30-to-60-minute programs rather than shorter (15 minutes or less). All surveyed MOs utilize some form of CME with preferences varying for different virtual, live in-person and enduring formats. Despite its wide-scale proliferation, only 34% of MOs use social media for professional purposes including accessing oncology education. Conclusions: MOs value CME activities and utilize both in-person and virtual programs on a regular basis. As concerns over COVID have diminished, it is predicted that established interest in asynchronous forms of education will wane with an increased shift toward in-person meetings. The results of this longitudinal study are critical to ensure that oncology CME resources are designed to effectively convey needed information and in turn positively affect patient care.

Barriers to implementing clinical cancer genetics in sub-Saharan Africa: Perspectives of participants of a virtual cancer genetics course.

10597 Background: While clinical cancer genetics remains underutilized in sub-Saharan Africa (SSA) and many low-middle income countries, there are few empiric studies assessing knowledge gaps and perspectives of healthcare providers. We conducted a survey of participants of a virtual short course ( https://www.africanoncogenetics.org/home ). Methods: The comprehensive survey, partly adapted from other published instruments, included multiple-choice knowledge and practice questions on cancer genetics, Likert-scale questions on perspectives, and open-ended questions on barriers. Cancer genetics experts reviewed the survey to ensure face-content validity. The online course was given between October and November 2021; participants were invited through snowball circulation on global oncology listservs. Data were summarized with descriptive analysis. Results: There were 370 participant responses included in this analysis. Participants represented 40 countries, with largest representation from Nigeria (n=106, 29%), South Africa (n=50, 14%), and Uganda (n=39, 13%). Participants represented various medical specialties and research domains: laboratory medicine (15%), medical genetics (14%), biomedical science (10%), general practice (9%), and oncology (8%) were the most common. Participants also represented a spectrum of practice settings, with the highest proportions from national hospitals (29%) and private hospitals (8%). Most of the participants 223 (71%) had some genetics lectures during medical/nursing school or other training, but only 116 (37%) had attended any continuing medical education (CME) activities in cancer genetics since starting practice. Moreover, the overwhelming majority 95% expressed interest and willingness to attend a future CME course. Many participants, 148 (47.2%) rated their knowledge of cancer genetics as poor or very poor, 150 (48%) as fair, while only 15 (5%) rated as good or very good. Most participants 196 (62%) considered themselves not qualified to interpret results of clinical cancer genetics testing, 100 (32%) were somewhat qualified, and 19 (6%) very qualified. Many participants 93 (30%) noted cancer genetics testing was not available to their patients; another 67 (22%) noted testing was only available outside the country; and only 47 (15%) had testing available within their primary institutions. In aggregate, the most common listed perceived barriers to implementing cancer genetics testing were costs (18%), lack of testing infrastructure (17%), lack of personnel (17%), and lack of provider knowledge (16%). Conclusions: Our survey demonstrates several perceived gaps limiting clinical cancer genetics testing implementation in SSA. A multi-pronged approach that addresses testing costs, testing infrastructure, and patient and provider education is urgently needed.

#1306 Online medical education advances physicians’ understanding of the clinical benefits of SGLT 2 inhibition in chronic kidney disease management

Abstract Background and Aims Patients with chronic kidney disease (CKD) have a substantially impaired cardio-renal health prognosis and a reduced life expectancy. Several recent cardio-renal outcomes trials have demonstrated the clinical benefits conveyed by Sodium-Glucose Cotransporter 2 (SGLT2) inhibitors with respect to improved cardiovascular (CV) risk and reduced decline in kidney function. The goal of this online medical education activity was for learners to be better able to detect CKD early in clinical practice and integrate reno-protective therapies, such as SGLT2 inhibitors, into their management of suitable patients with CKD. Method Five nephrology experts participated in a 30-min online video program with synchronized slides and written transcript. Educational effect was assessed using a repeated-pair design with pre-/post-assessment. 3 multiple choice questions assessed knowledge/competence, 1 question rated on a Likert-type scale assessed confidence. A paired samples t-test was conducted on overall average number of correct responses and for confidence rating, a McNemar's test was conducted at the question level (5% significance level). Cohen's d with correction for paired samples estimated the effect size of the education on number of correct responses. Data collection from 28 December 2022 to 1 March 2023. Results Conclusion Participation of PCP in an online video expert program improved their understanding of the close association between metabolic, renal, and cardiovascular diseases, the latest results of CKD outcome trials with SGLT2 inhibition in CKD management, as well as their competence in the practical use of these reno-protective medications in suitable patients with CKD.

#1309 Case-based online medical education improves physicians’ knowledge and competence in the healthcare of patients with type 2 diabetes and CKD

Abstract Background and Aims Kidney disease, including chronic kidney disease (CKD), affects more than 850 million people globally. At least 40% of people with diabetes develop CKD, and many progress to end-stage kidney disease (ESKD) and kidney failure. Globally, diabetes is the leading cause of kidney failure requiring transplantation or dialysis. The risk of both progression to kidney failure and cardiovascular (CV) events is significantly elevated in patients with type 2 diabetes (T2D) and CKD. Both T2D and CKD are CV disease (CVD) risk multipliers. Patients at early stages of CKD are more likely to die of CVD than they are to progress to ESKD. The goal of this online medical education activity was for learners to better acknowledge serious health risks associated with CKD in patients with T2D and have greater awareness of the availability of novel treatment options shown to reduce the risk of associated complications. Method An interactive text-based educational program including two detailed patient cases challenges clinicians to apply most recent evidence-based guideline recommendations. Detailed scenarios prompt learners to determine the correct treatment and follow-up for the patient with expert commentaries providing in-depth advice at each stage and a conclusion at the end of the program. Educational effect was assessed using a repeated-pair design with pre-/post-assessment. 3 multiple choice questions assessed knowledge/competence, 1 question rated on a Likert-type scale assessed confidence. A paired samples t-test was conducted on overall average number of correct responses and for confidence rating, a McNemar's test was conducted at the question level (5% significance level). Cohen's d with correction for paired samples estimated the effect size of the education on number of correct responses. Data collection from 24 February 2023 to 20 April 2023. Results Conclusion Participation of PCP and NEPH in an interactive case-based online medical educational program improved their knowledge, competence and confidence in the management of patients with T2D and CKD.

Open educational resources for medical community

The study reveals the great importance of open educational resources (OER) in the field of medical education and scientific activity. Objective. To develop an “OER navigator for medical community”, containing metadata of information resources with open free access. These resources are intended for use in curricula at all stages of medical education, in scientific activities and self-education. At the present stage, the social significance of education in terms of the world concept of “sustainable development” is defined as the most important component and means of survival for civilization (UNESCO). In medicine, with its special mission to preserve the health of the population, the urgent task consists in the training of highly qualified personnel. Close connection of the future of mankind with the processes of digitalization determines the availability of information resources and the use of modern technologies as key aspects of the organization of educational processes. The analysis of the scientific literature and the study of the experience of OER application revealed that OER represent an important tool in the information support of the scientific and educational sphere. OER contribute to forming a personal educational environment, learning continuously and improving skills worldwide, in perpetuity and regardless of financial capabilities. The amount of data presented on the Internet is huge, therefore, the search for necessary information takes a significant amount of time. The developed Navigator (http://lib-os.ru/obrazovatelnye-resursy/navigator-oor-medicinskogo-soobshhestva/) provides meta-data of information resources with open free access, thereby allowing representatives of the medical community at all levels of education and research to quickly and effectively find reliable scientific data and peer-reviewed sources of information.

Impact of COVID-19 pandemic on teaching learning process in pre clinical medical education in selective medical college in Bangladesh

Background: The corona virus disease (COVID-19) pandemic has caused major disruption in educational sector including medical education. This disease outbreak has changed the medical education curriculum from traditional platform to elearning for students including Bangladesh. Objective: To observe the impact of COVID-19 pandemic on teaching learning process in medical education in Bangladesh. Methods: This qualitative survey was done among the 68 pre-clinical students aged 19 to 23years, of a non-government medical college in Bangladesh, from march to December 2021. All study participants were first year undergraduate MBBS students from anatomy, biochemistry and physiology. Data was collected by administering pre-tested questionnaires through Google form. Results: About 75% of the participants agreed that online classes were helpful during the home stay period of COVID pandemic, but about 92.2% of them were skeptical about the success of this online system for their future medical education. About 80.9% had difficulty in keeping their concentration during online class. About 94% found difficulty to follow online practical classes. Majority of the students (82.4%) feel anxious whether they were capable of doing their job properly since this method needs technical knowledge. About 50% students had limited access to internet, there were technical issues like power cut (76.5%), and poor network of internet (69.1%) also reduced the effectiveness of online education. Online class also disrupt teacher-student relationship. Conclusion: The internet based classes served the purpose of continuation of academic activity in medical education during adverse condition of COVID . But due to uneven use of technology it had some obstacles also. Student’s ability to learning in medical education was also hampered in the absence of physical classes. This online method of education system needs much improvement to be effective in medical education. J Bangladesh Soc Physiol 2022;17(2): 64-71

In-Hospital Continuous Medical Education during the COVID-19 Pandemic

Background: The coronavirus disease 2019 (COVID-19) is a highly contagious disease as it is spread by contact with infected surfaces and inhalation of droplets. Several measures have been put in place to prevent the COVID-19 infection one of which is social distancing and physical distancing. Some in-hospital continuous medical education was suspended during the pandemic. Objective of Study: The objective of the study is to investigate the impact of social distancing on In-hospital continuous professional development during the COVID-19 pandemic. Research methodology: This is a cross-sectional study conducted among doctors working in Nigeria irrespective of their cadre or location. A self-administered online questionnaire was used to generate data for this study. There was no risk of participating in the study. Results: The respondents in this study were 62. The majority 51(82.3%) had different in-hospital continuous medical education (CME) activities during the first wave of the COVID-19 pandemic when there was a ban in Nigeria on the gathering of more than 20 persons; the CME activities were via Zoom video conferencing 44 (71%) App. The majority of the respondents however preferred a face-to-face (physical) meeting [40(74.2%)] and also learnt better during a face-to-face meeting [46(74.2%)]. Conclusion: CME is very important in healthcare so COVID-19 did not stop it although it went through a lot of transformation in the mode it was delivered.

Parkinson's Disease Psychosis and the Marketing of Pimavanserin.

In 2016, Nuplazid (pimavanserin) became the first FDA-approved treatment for Parkinson's Disease Psychosis (PDP). We explored the possibility that PDP was a term created to market Nuplazid. We examined trends in perceptions of psychosis in Parkinson's disease from the 1990s to 2020 through MEDLINE search term frequency, neurology textbooks, guidance from professional societies, Acadia annual reports, sponsored websites, and a sponsored meeting held by the National Institutes of Health (NIH). We analyzed continuing medical education (CME) activities on PDP and analyzed the connection between payments by the manufacturer of pimavanserin and prescriptions. Our analysis of nine sponsored CME activities reveals misleading themes, including: PDP is common, progressive, and not always drug-induced; there is no such thing as a benign hallucination, and psychotic symptoms always worsen; PDP increases mortality; and competing treatments are ineffective or dangerous while pimavanserin is safe and effective for treating PDP. Industry-sponsored CME was used to disseminate inaccurate and misleading marketing messages on psychosis related to Parkinson's disease. Some professional societies and some textbooks also resisted the PDP label. Reframing PDP as a unique condition is a typical example of condition branding. The establishment of PDP expanded the use of pimavanserin and is likely to have resulted in many avoidable deaths.

Faculty’s perception of their role as a tutor during Problem-Based Learning activity in undergraduate medical education

Introduction: The study aimed to ascertain how the faculty at the Faculty of Medicine, Hasanuddin University perceived their role as a tutor during a problem-based learning activity during the academic phase of medical education, based on the length of time they acted as a tutor. Methods: This was prospective observational research with an explanatory sequential mixed-method design, which was performed at the Undergraduate Medical Study Program, Faculty of Medicine, Hasanuddin University, from January 2023 until May 2023. Research subjects were divided into two groups: a) the Novice group and b) the Expert group. Quantitative data were collected by giving a questionnaire containing six categories with 35 questions and distributed by Google form. An independent t-test was used to compare the faculty’s perception, with a p-value &lt;.05 significant. Followed by Focus Group Discussion (FGD) for qualitative data, which then were analysed by thematic analysis. The last stage is integrating quantitative and qualitative data. Results: There were statistically significant differences in seven issues between the two groups. Most of the tutors in both groups had favorable opinions, except for the expert group's disagreement with the passive role of the tutor in the tutorial group. Eight positive and twelve negative perceptions were found in the FGD. Conclusion: Most tutors positively perceived their role in PBL, with the expert group having more dependable opinions and well-reasoned suggestions. Keywords: Problem-Based Learning, Undergraduate Medical Education, Focus Group Discussion

Current status and continuing medical education need for general practitioners in Tibet, China: a cross-sectional study

BackgroundThe Tibetan area is one of China’s minority regions with a shortage of general practice personnel, which requires further training and staffing. This research helps to understand the current condition and demand for general practitioner (GP) training in Tibetan areas and to provide a reference for promoting GP education and training.MethodsWe conducted a cross-sectional survey using stratified sampling targeting 854 GPs in seven cities within the Tibetan Autonomous Region, utilizing an online questionnaire. Achieving a high response rate of 95.1%, 812 GPs provided invaluable insights. Our meticulously developed self-designed questionnaire, available in both Chinese and Tibetan versions, aimed to capture a wide array of data encompassing basic demographics, clinical skills, and specific training needs of GPs in the Tibetan areas. Prior to deployment, the questionnaire underwent rigorous development and refinement processes, including expert consultation and pilot testing, to ensure its content validity and reliability. In our analysis, we employed descriptive statistics to present the characteristics and current training needs of GPs in the Tibetan areas. Additionally, chi-square tests were utilized to examine discrepancies in training needs across various demographic groups, such as age, job positions, and educational backgrounds of the participating GPs.ResultsThe study was completed by 812 (812/854, 95.1%) GPs, of whom 62.4% (507/812) were female. The top three training needs were hypertension (81.4%, 661/812), pregnancy management (80.7%, 655/812), and treatment of related patient conditions and events (80.5%, 654/812). Further research shows that the training required by GPs of different ages in “puncturing, catheterization, and indwelling gastric tube use” (64.6% vs. 54.8%, p = 9.5 × 10− 6) varies statistically. GPs in various positions have different training needs in “community-based chronic disease prevention and management” (76.6% vs. 63.9%, p = 0.009). The training needs of GPs with different educational backgrounds in “debridement, suturing, and fracture fixation” (65.6% vs. 73.2%, p = 0.027) were also statistically significant.ConclusionsThis study suggests the need for targeted continuing medical education activities and for updating training topics and content. Course developers must consider the needs of GPs, as well as the age, job positions, and educational backgrounds of GPs practicing in the Tibetan Plateau region.Trial registrationNot applicable.

Analysis of the implementation of the medical boarding school in a medical course derived from the mais médicos program

The mandatory curriculum internship corresponds to an essential period for medical education in which the apprentice, through supervised training in the health service, develops and improves competencies and knowledge of medical practice. In 2014, the new National Curriculum Guidelines (DCN) were instituted that guide medical education activities according to the scenario observed in the Unified Health System (SUS), aiming to qualify professionals so that the demands of citizens, families and communities are served. In this context, through the Mais Médicos Program (PMM) and the initiatives for the expansion of medical schools in Brazil, the medical course analyzed in this study, started its activities in 2015, starting to compose the set of courses guided by the new DCN. This article proposed to analyze the process of implementing the medical boarding school of the course, from the perspective of the students. This is a qualitative study, in which the data were collected through a questionnaire sent to the students of the course, with a total of 29 participants. The analysis of the data produced was performed by the dialectical hermeneutic technique. The categories of analysis were health care, health management and health education, which addressed topics about a) operational techniques, such as the correct filling of medical records, learning maneuvers and physical examination techniques and the communication of established hypotheses and sharing the therapeutic process with the patient; b) Integration between service, teaching and community, discussing the adaptation of the structure of health services to receive academics, perceptions about the number and quality of practice scenarios, students' performance in the health service and incentive to contribute actions in the context SUS; c) Structuring the boarding school, discussing the total workload of the stages, pointing out which casters demonstrated the largest and lower organization and what their evaluative methods were; d) Preceptoria, deepening about the performance of preceptors in the practical scenarios, the quality of preceptoria and communication between preceptors and students. It was concluded that the process of implementation of the medical boarding school analyzed is in line with the new DCN, but it demands improvements to fully achieve the learning objectives specified in the course regulation.

Awareness of smoking cessation amongst German vascular surgeons.

Background: Smoking represents the well-known enemy of vascular well-being. Numerous previous studies emphasised the important role of smoking on the development and progression of atherosclerotic cardiovascular disease. The current study aimed to identify hurdles and barriers for an insufficient implementation of secondary prevention in the treatment of lower extremity peripheral arterial disease (PAD). Methods: All members of the German Society for Vascular Surgery and Vascular Medicine (DGG) with valid email addresses were invited to participate in an electronic survey on smoking. Results are descriptively presented. Results: Amongst 2716 invited participants, 327 (12%) submitted complete responses, thereof 33% women and 80% between 30 and 59 years old (87% board certified specialists). 83% were employed by hospitals (56% teaching hospital, 14% university, 13% non-academic) and 16% by outpatient facilities. 6% are active smokers (63% never) while a mean of five medical education activities on smoking cessation were completed during the past five years of practice. Only 27% of the institutions offered smoking cessation programs and 28% of the respondents were aware of local programs while a mean of 46% of their patients were deemed eligible for participation. 63% of the respondents deemed outpatient physicians primarily responsible for smoking cessation, followed by medical insurance (26%). Conclusions: The current nationwide survey of one scientific medical society involved in the care of patients with vascular disease revealed that smoking cessation, although being commonly accepted as important pillar of comprehensive holistic care, is not sufficiently implemented in everyday clinical practice.

Design and Validation of Clinical Education Curriculum Pattern Based on Social Accountability for General Medicine Course: A Mixed Method Study

Introduction: In the social accountability of the curriculum, all medical education activities are aimed at training doctors who are able to meet the health needs of society. In Iran's medical education system, there is a weakness in responding to the needs of society, and the connection between students and society has gradually weakened. The purpose of this study was to design and validate a clinical education curriculum model based on social accountability for general medicine students. Methods: A sequential exploratory mixed-method approach was used to conduct this study at Tabriz University of Medical Sciences, combining qualitative and quantitative methods. The model was designed using the inductive content analysis method in the qualitative stage and validated through the descriptive-survey method in the quantitative stage. In order to collect data in the qualitative part, the method of studying previous documents, scientific texts and semi-structured interviews with experts and specialists was used, and in the quantitative part, a questionnaire prepared by the researcher was used. The model was developed using the views of 14 professors and 5 general practitioners, selected through purposive and sequential sampling until information saturation was reached. The model was validated by obtaining opinions from 15 experts using a purposeful and criteria-based method. The content validity ratio (CVR) was estimated using the Lawshe's formula. Results: In the qualitative phase, this study identified the characteristics of an ideal clinical education curriculum for a general medicine course based on a social responsibility approach. The characteristics identified were based on the four elements of Tyler's model. Based on the findings of this part of the research, the extracted codes in 114 subcategories and 13 main categories include goals: knowledge, attitude, and skills; Content: clinical sciences and skills, health sciences, behavioral sciences, social and professional ethics, communication and leadership skills, and content organization; Teaching-learning methods: educational strategies, and teaching-learning methods; Assessment methods: performance assessment in vivo, performance assessment in vitro, and essay assignments. In the quantitative phase, the designed model's components and elements underwent validation through expert agreement and received approval with a content validity ratio of CVR=0.81. Conclusion: In the proposed pattern, the clinical competencies required by general practitioners were the main focus of designing, explaining and describing curriculum elements. Also, this model is designed in such a way that it can meet the needs of society and medical students. It is suggested that medical school officials and curriculum planners use the proposed model in designing the curriculum of general medicine courses to enable medical students to respond to the needs of society.

Assessment of knowledge and prevalence of fibromyalgia among medical students and physicians in Riyadh region.

Fibromyalgia is a chronic condition that is characterized by widespread musculoskeletal pain and tenderness of soft tissue. The prevalence of FM in Saudi Arabia is not known. The diagnosis of FM is mainly clinical. The knowledge about fibromyalgia is poor, even among healthcare providers. To assess the knowledge and prevalence of fibromyalgia among medical students and physicians in the Riyadh region. A cross-sectional study was conducted at all medical colleges in Riyadh and Riyadh hospitals. The study was conducted on both medical students and physicians using a questionnaire. The SPSS program was used to analyze the data. A total of 556 participants were involved; 56.5% heard about fibromyalgia, and only 5.6% attended Continuing Medical Education (CME) activity. There were 31.5% had high knowledge, whereas 68.5% had low knowledge. The level of knowledge was associated with the year (P = 0.002), specialty (P = 0.013), hearing about fibromyalgia (P = 0.0001), attending lectures (P = 0.009), and being aware of diagnostic criteria (P = 0.0001). The prevalence of FM was high, and there was poor knowledge among medical students and physicians regarding fibromyalgia.