Medical Education Curriculum Research Articles

Clinical Clerkships in General Medicine Enable Students to Acquire Basic Medical Competencies and Experience in Community-Based Integrated Care: A Descriptive Questionnaire-Based Study.

Background No previous research has targeted educators regarding educational practice and the achievements of students in terms of the learning objectives of clinical clerkships in university general medicine departments of Japan. We aimed to clarify the characteristics of clinical clerkships in Japanese general medicine departments using a questionnaire administered to chairpersons of university general medicine departments. Methods This was a descriptive questionnaire-based study using Google Forms (Google, Inc., Mountain View, CA, USA). We asked the chairpersons of general medicine departments in Japanese universities the following questions, with responses given on a 5-point Likert scale: Question 1: How well are primary symptoms in the national model core curriculum for undergraduate medical education taught in clinical clerkships in university general medicine departments? Question 2: How successfully can students achieve the learning objectives of the national model core curriculum for undergraduate medical education through clinical clerkships in general medicine departments of university hospitals? Question 3: How successfully can students achieve the learning objectives of the national model core curriculum for undergraduate medical education through clinical clerkships in other community clinics or hospitals?The results of the questionnaire responses are described as mean±standard deviation. Results Of the 71 Japanese universities with general medicine departments, 43 were included in the analysis. For Question 1, the symptoms and pathophysiologies with a mean score of 4 points or higher were fever, general malaise, anorexia, weight loss or gain, edema, abdominal pain, lymphadenopathy, and headache. All those symptoms require basic medical competencies. For Questions 2 and 3, the intramural clinical clerkship of general medicine departments had a higher mean score than the extramural clinical clerkship for diagnostic reasoning that emphasizes medical history and physical examination and a comprehensive approach to patients with multiple health problems.In contrast, the extramural clinical clerkship, in which medical students can build experience with community-integrated care, had a mean score of 3 points or higher for all items. Conclusions The clinical clerkship in general medicine departments of Japanese universities provides students with chances to acquire clinical competencies regarding primary symptoms and pathophysiologies. Additionally, the extramural clinical clerkship provides experience in community-based integrated care, including home medical care, collaboration, health and welfare, and long-term care.

Impact of Experiential Learning of Nutrition Therapy on Medical Students.

Despite the recognition that nutrition is a critical component of health and disease, many medical schools struggle to incorporate nutrition education into their dense curriculum. We designed this study to determine whether a brief, experiential learning project would be an effective option for teaching this content. Medical students voluntarily enrolled in the study, agreeing to (1) attempt a 2-week "medically prescribed" diet and (2) participate in small group lunch discussions related to their diet experience. Data on student perception of nutrition in medicine was collected through validated surveys. Custom surveys were designed to capture student confidence in using nutrition counseling, while qualitative analysis of lunch discussions revealed themes of experiential learning. Participants reported an overall positive sentiment and named the most impactful learning component as actively attempting the diet. Student participants showed a variety of adherence to their assigned diet, yet as a cohort demonstrated increased confidence over their non-participant peers in the use of nutrition counseling in a clinical setting. In addition, diet participants demonstrated an increased perception of the importance of physician efficacy and the physician-patient relationship in the broader landscape of nutrition in patient care (compared to the control group). This study demonstrates the educational value of a short, immersive, extracurricular opportunity in bolstering an already demanding undergraduate medical education curriculum.

Keep thinking about unanswered questions in primary care: Cultivating negative capability.

Negative capability or tolerance for uncertainty is important for primary care physicians. The 2022 edition of the Model Core Curriculum for Medical Education also states that the content of professionalism is to "keep thinking about unanswerable questions."

Assessing the Capability of ChatGPT in Answering First- and Second-Order Knowledge Questions on Microbiology as per Competency-Based Medical Education Curriculum.

Background and objective ChatGPT is anartificial intelligence (AI) language model that has been trained to process and respond to questions across a wide range of topics. It is also capable of solving problems in medical educational topics. However, the capability of ChatGPT to accurately answer first- and second-order knowledge questions in the field of microbiology has not been explored so far. Hence, in this study, we aimed to analyze the capability of ChatGPT in answering first- and second-order questions on the subject of microbiology. Materials and methods Based on the competency-based medical education (CBME) curriculum of the subject of microbiology, we prepared a set of first-order and second-order questions. For the total of eight modules in the CBME curriculum for microbiology, we prepared six first-order and six second-order knowledge questions according to the National Medical Commission-recommended CBME curriculum, amounting to a total of (8 x 12) 96 questions. The questions were checked for content validity by three expert microbiologists. These questions were used to converse with ChatGPT by a single user and responses were recorded for further analysis. The answers were scored by three microbiologists on a rating scale of 0-5. The average of three scores was taken as the final score for analysis. As the data were not normally distributed, we used a non-parametric statistical test. The overall scores were tested by a one-sample median test withhypothetical values of 4 and 5. The scores of answers to first-order and second-order questions were compared by the Mann-Whitney U test. Module-wise responses were tested by the Kruskall-Wallis test followed by the post hoc test for pairwise comparisons. Results The overall score of 96 answers was 4.04 ±0.37 (median: 4.17, Q1-Q3: 3.88-4.33) with the mean score ofanswers to first-order knowledge questions being 4.07 ±0.32 (median: 4.17, Q1-Q3: 4-4.33) and that of answers to second-order knowledge questions being 3.99 ±0.43 (median: 4, Q1-Q3: 3.67-4.33) (Mann-Whitney p=0.4). The score was significantly below the score of 5 (one-sample median test p<0.0001) and similar to 4 (one-sample median test p=0.09). Overall, there was a variation in median scores obtained in eight categories of topics in microbiology, indicating inconsistent performance in different topics. Conclusion The results of the study indicate that ChatGPT is capable of answering both first- and second-order knowledge questions related to the subject of microbiology. The model achieved an accuracy of approximately 80% and there was no difference between the model's capability of answering first-order questions and second-order knowledge questions. The findings of this study suggest that ChatGPT has the potential to be an effective tool for automated question-answering in the field of microbiology. However, continued improvement in the training and development of language models is necessary to enhance their performance and make them suitable for academic use.

Rembrandt’s Anatomy Lesson of Dr. Tulp Revisited: Advancements in Teaching Anatomy and Neurobiology in an Integrated Medical Curriculum in the 21st Century.

The recent challenges in anatomy and neurobiology education in medical curricula have imposed a curricular redevelopment in delivery and content, incorporating modules in virtual anatomy and neurobiology, didactic lecture and enhanced cadaveric dissection in a state-of-the-art teaching and learning environment. The combined approach engaged active student participation at each phase of the course, incorporated clinical perspectives, emphasized valuable diagnostic and surgical techniques and procedures, and minimized noxious exposure to formaldehyde by using unembalmed cadavers in a laminar airflow environment. Finally, the objectives of emphasizing the importance of proficiency in anatomy knowledge in clinical medicine were accomplished well within the allocated one semester time frame, in a timely, cost and resource effective manner, and with demonstration of competency to standard during post laboratory examinations.

Medical Students' Views and Attitudes toward Vaccine Refusal during the COVID-19 Pandemic: A Multicenter Study

Background: The rapid development and production of COVID-19 vaccines have raised concerns about their safety and efficacy, which have contributed to vaccine hesitancy among some people. Objectives: This study aimed to determine the opinions and attitudes of medical students about COVID-19 vaccines and vaccine hesitancy. Methods: Nine hundred seventy-seven volunteer students from three medical faculties participated in this study, and data were collected via an online survey. A questionnaire consisting of 40 items and four parts, including sociodemographic information, COVID-19 vaccines, vaccine rejection, and vaccine hesitancy was used for data collection. In the questionnaire, the students were asked about their desire to be vaccinated, whether they want to be vaccinated for their families, vaccination indecision or rejection, and the reasons for not wanting to be vaccinated. Results: Among the students, the rate of vaccine rejection was 15.4% (n=150), and the rate of vaccine hesitancy was 18.9% (n=185). While 65.7% (n=642) wanted to be vaccinated against COVID-19, the rate of those who wanted their families to be vaccinated was 54.1% (n=529). Age and being in the preclinical period positively affected the vaccination decision, while a history of COVID-19 and being affected by vaccine technology negatively influenced the decision to be vaccinated. The vaccine acceptance rate was significantly higher in men than in women (P=0.002), in preclinical students than in clinical year students (P=0.049), and in those without a history of COVID-19 than in those who had COVID-19 (P&lt;0.001). Conclusion: The attitudes of medical students toward COVID-19 vaccines were positive. However, considering that some students were hesitant to be vaccinated or against vaccination, we think it would be beneficial to integrate positive attitude development programs into the medical education curriculum.

Mapping academic practice: a Latourian inquiry into a set of lecture slides

ABSTRACT How is academic work accomplished within a curriculum that has been established through a digital education infrastructure, and what, exactly, does an academic member of staff do within this digital context? Reflecting on the empirical findings of a three-year ethnography of a distributed medical education curriculum delivered across two university campuses in Canada, this paper demonstrates that the ways in which work that has typically been characterized as academic is enacted within this curriculum, positioned as a socio-technological network, through a heterogeneous network of people and materials. Drawing on the philosophical anthropology of Bruno Latour, An Inquiry into Modes of Existence, this paper positions the individual academic member of staff as one amongst many network elements within the digital platform across which academic work is generated and circulated. The paper argues that studies of digitally-mediated higher education can equally rest on small and localized instances of practice as well as on cross-boundary or institutional explorations, and offers ways of thinking that are informed by Latour's philosophical anthropology.

Chatbots for future docs: exploring medical students’ attitudes and knowledge towards artificial intelligence and medical chatbots

ABSTRACT Artificial intelligence (AI) in medicine and digital assistance systems such as chatbots will play an increasingly important role in future doctor – patient communication. To benefit from the potential of this technical innovation and ensure optimal patient care, future physicians should be equipped with the appropriate skills. Accordingly, a suitable place for the management and adaptation of digital assistance systems must be found in the medical education curriculum. To determine the existing levels of knowledge of medical students about AI chatbots in particular in the healthcare setting, this study surveyed medical students of the University of Luebeck and the University Hospital of Tuebingen. Using standardized quantitative questionnaires and qualitative analysis of group discussions, the attitudes of medical students toward AI and chatbots in medicine were investigated. From this, relevant requirements for the future integration of AI into the medical curriculum could be identified. The aim was to establish a basic understanding of the opportunities, limitations, and risks, as well as potential areas of application of the technology. The participants (N = 12) were able to develop an understanding of how AI and chatbots will affect their future daily work. Although basic attitudes toward the use of AI were positive, the students also expressed concerns. There were high levels of agreement regarding the use of AI in administrative settings (83.3%) and research with health-related data (91.7%). However, participants expressed concerns that data protection may be insufficiently guaranteed (33.3%) and that they might be increasingly monitored at work in the future (58.3%). The evaluations indicated that future physicians want to engage more intensively with AI in medicine. In view of future developments, AI and data competencies should be taught in a structured way during the medical curriculum and integrated into curricular teaching.

Modern challenges of medical education and their reflection in the curriculum

Medical education in the 21st century is at a crossroads. Faced with the challenges posed by science and technology, as well as social change, the curriculum is increasingly out of step with the new needs for teaching and medical practice. The road to major curriculum reform is challenging due to a variety of factors, including deep-rooted values, natural resistance to change, and the accreditation process. In fact, even the very understanding of what it means to be a professional is changing, which has a profound impact on the future role of the physician in society and the relationship that develops in the course of medical practice between physician and patient. In this article, the author considers the problems facing medical education in the modern era. To solve these problems, the author recommends paying special attention to the 21st century medical education curriculum – knowledge acquisition and storage, cooperation with and management of artificial intelligence applications, a deep understanding of probabilistic reasoning, and the development of empathy and compassion in accordance with ethical norms and standards. Given these needs, it is essential, in the author's opinion, to undertake a significant reform of the curricula and, at the same time, strives to introduce such changes that will help prepare practitioners in the rapidly changing 21st century. The author of the article suggests the first steps that a higher education institution can take to solve the problems considered in this study.

Assessment of students’ perception on self-directed learning, alignment and integration in competency-based medical education curriculum among first year medical undergraduate students

Background: The introduction of competency-based medical education curriculum in India has endorsed many new concepts, like foundation course, self-directed learning, early clinical exposure, etc. There has been paradigm shift from teacher centered to student centered learning. Integration of the curriculum has been evolved as an important strategy in the current system of Competency based medical education and SDL is essential to enable medical students to develop independent learning skills, increased responsibility, assertiveness and accountability which are key attributes to a medical professional’s career. Literature search could not retrieve many studies in Indian context, hence this study was conducted to determine the perception of students’ on self-directed learning, alignment and integration in CBME curriculum among first year medical undergraduate students. Methods: It was a cross sectional study conducted among first year medical students. After obtaining informed consent, data was collected using a pre-validated questionnaire having SDL instrument and proforma to assess the students’ perception on alignment and integration. Students were asked to rate on a 5-point Likert scale. A total of 174 students completed the questionnaire. The data is expressed as means and percentages. Results: In the present study students opined that SDL helped them to establish their learning goals. Students also opined that alignment and integration is beneficial for in depth understanding of the subject and also to prepare for exams. Conclusions: Incorporation of SDL and aligning and integrated curriculum has helped students in better understanding and correlation of subjects across the phase. The joint efforts by the facilitators and students themselves may be helpful to make students independent and lifelong learners.

Restoring Trust in Science and Medicine: Empowering and Educating Future Physicians in Science Communication With the Public.

While the traditional medical school curriculum specializes in teaching doctor-patient communication at the individual patient level, the need to train physicians to communicate science and medicine effectively to the public at large is, for the most part, ignored. With the unchecked proliferation of misinformation and disinformation during the COVID-19 pandemic, it is critical that current and future medical professionals learn to engage in the public arena using multiple methods (written, oral, social media) across multimedia platforms to dispel misinformation and accurately educate the public. This article describes the authors' interdisciplinary approach at the University of Chicago Pritzker School of Medicine to teaching science communication to medical students, early experiences, and future directions in this vein. The authors' experiences show that medical students are viewed as trusted sources of health-related information, and thus, need the skills and training to tackle misinformation and that students across these learning experiences appreciated the opportunity to choose a topic of their interest according to what matters to them and their communities most. The feasibility of successfully teaching scientific communication in an undergraduate and medical education curriculum is confirmed. These early experiences support the feasibility and impact of training medical students to improve communication about science with the general public.

A medical student’s guide to the slit lamp examination

The slit lamp is an essential tool for the diagnosis of common eye pathology. Despite many eye conditions presenting initially to primary care, medical students do not typically receive formal training with the slit lamp in standard medical education curriculum. This guide provides a consistent, systematic framework that may be used by students and clinicians when approaching a slit lamp examination. Additionally, suggestions intended to optimize examination outcomes are described. It is our hope that this guide serves to enhance medical student comfort and proficiency with eye examinations, be it in an ophthalmology clinic, primary care, or emergency department setting.

Lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI+) healthcare in Singapore: perspectives of non-governmental organisations and clinical year medical students

ABSTRACT Purpose International studies document that lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI+) patients face significant health disparities. Studies exploring the attitudes, knowledge, preparedness and comfort levels of healthcare students towards LGBTQI+ health have been conducted in the United States, United Kingdom and Malaysia. This study aims to investigate stigma in healthcare for LGBTQI+ patients in Singapore, and possible upstream factors within medical education. Methods This mixed-methods study adopts a convergent parallel design. The Health Stigma and Discrimination Framework was referenced to devise in-depth interviews with representatives from 13 LGBTQI-affirming non-governmental organisations, analysed through thematic analysis. 320 clinical medical students were surveyed about attitudes, knowledge, comfort, preparedness, and perceived importance of/towards LGBTQI+ health, analysed via descriptive statistics and multivariate regression. Results Prevailing stigma in Singaporean society against LGBTQI+ individuals is exacerbated in healthcare settings. Doctors were cited as unfamiliar or uncomfortable with LGBTQI+ health, possibly from lack of training. Among medical students surveyed, the median composite attitudes, comfort and preparedness index was 3.30 (Interquartile Range (IQR) = 0.50), 3.17 (IQR = 0.83), 2.50 (IQR = 1.00) respectively. Only 12.19% of students answered all 11 true-false questions about LGBTQI+ health correctly. Conclusion Medical students in Singapore have scored sub-optimally in their knowledge and preparedness towards LGBTQI+ health, while interpersonal and structural stigma in healthcare towards LGBTQI+ people in Singapore negatively affects health and wellbeing. These findings are an impetus to improve medical training in this area. High scores among medical students in attitudes, comfort and perceived importance of LGBTQI+ topics demonstrate that there is space for LGBTQI+ health in the local medical education curriculum. Curricular interventions can prioritise content knowledge, communication skills and sensitivity.

Knowledge and Perception of Telemedicine among Medical Students of the University of Jos, Plateau State, Nigeria.

Telemedicine has promising potential to address the challenges faced by healthcare systems in developing countries, in providing equitable access to quality care. However, the practice of telemedicine is generally poor in these countries. The success of telemedicine like any technology depends on numerous factors including users' knowledge and perceptions. Hence, this study aimed to examine the knowledge and perceptions of telemedicine among medical students at the University of Jos. This was a cross-sectional study among 305 clinical medical students selected through a stratified sampling technique. A self-administered questionnaire consisting of a 28-item 5-point Likert response scale was used to collect data, comprising 13 items for knowledge, 8 for the perception of benefits, and 7 for the perception of ease of use of telemedicine. Data was analyzed using IBM-SPSS. One hundred and eleven (36.4%) participants had good knowledge of telemedicine, while 113 (37.1%) had a good perception of the benefits and 103 (33.8%) had a good perception of the ease of use. Respondents with a good knowledge of telemedicine were about five times more likely (OR = 5.24, 95% CI = 3.15 - 8.69) to have a good perception of the benefits and about eight times more likely (OR = 8.33, 95% CI = 4.57 - 14.26) to have a good perception of ease of use. Few medical students possess desirable levels of knowledge and perceptions of telemedicine which portrays a gap in the medical education curriculum. Therefore, training, and educational opportunities are recommended to improve their knowledge and perception of telemedicine.

Graduate medical education curriculum regarding the health and healthcare of older lesbian, gay, bisexual, transgender, and queer (LGBTQ+) adults

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) adults experience a wide variety of unique challenges accessing healthcare. These barriers may be exacerbated among older LGBTQ+ people due to intersecting, marginalized identities. To prepare physicians to address the healthcare needs of older LGBTQ+ adults, graduate medical education (GME) must include training about the specific needs of this population. Prior studies demonstrate a lack of LGBTQ+ training in GME curricula. Here, we investigated the presence of LGBTQ+ curricula in internal medicine residencies and geriatrics fellowships through a national survey. Over 62.0% of internal medicine (n = 49) and 65.6% (n = 21) of geriatric medicine fellowship program directors, responding to the survey, reported content relevant to the health of older LGBTQ+ adults. Education about LGBTQ+ health in internal medicine residencies and geriatrics fellowships is vital for the provision of culturally-competent healthcare and to create an inclusive environment for older LGBTQ+ patients.

Assessing the current and desired levels of training and applied experiences in chronic disease prevention of students during medical school

IntroductionChronic diseases account for approximately 70% of deaths in the U.S. annually. Though physicians are uniquely positioned to provide behavior change counseling for chronic disease prevention, they often lack the necessary training and self-efficacy. This study examined medical student interest in receiving chronic disease prevention training as a formal part of their education as part of an effort to enhance their ability to provide guidance to patients in the future.MethodsA 23-question, online survey was sent to all undergraduate medical students enrolled in a large medical education program. The survey assessed medical student interest in receiving training related to chronic disease prevention. Survey topics included student awareness of primary prevention programs, perceived importance of receiving training and applied experience in chronic disease prevention, and preferences for how and when to receive this training. ResultsOf 793 eligible medical students, 432 completed the survey (54.5%). Overall, 92.4% of students reported receiving formal training in physical activity, public health, nutrition, obesity, smoking cessation, and chronic diseases was of “very high” or “high” importance. Despite this level of importance, students most frequently reported receiving no or 1–5 h of formal training in a number of topics, including physical activity (35.4% and 47.0%, respectively) and nutrition (16.9% and 56.3%, respectively). The level of importance given to public health training was significantly greater across degree type (p = 0.0001) and future specialty (p = 0.03) for MD/MPH students and those interested in primary care, respectively.ConclusionsWhile medical students perceive chronic disease prevention as an important topic, most reported receiving little to no formal training. To address the growing prevalence of chronic disease across our society, programs schools should place greater emphasis on integrating training in physical activity, nutrition, and obesity-related content into the medical education curriculum.

Experiential student study groups: perspectives on medical education in the post-COVID-19 period

BackgroundUndergraduate medical curricula often fail to integrate experiential learning methodologies. Thus, a pilot series of interactive pathology lessons was designed and implemented in an attempt to promote experiential learning.MethodsThirty pre-graduate medical students voluntarily participated in the interactive study groups at the First Department of Pathology of the National and Kapodistrian University of Athens, Medical School. A questionnaire was designed to investigate the satisfaction of students regarding their participation in pathology study groups and to identify the characteristics that shape students’ perceptions of the foundations of medical education. Descriptive statistics (mean values) were used to describe the students’ evaluations of the pathology study groups, and thematic analysis was conducted to investigate the data collected using open-ended questions.ResultsInteractions with the professor and the option of co-observing the slides using dual-view optical microscopes and virtual slides were each evaluated as “Excellent” by ≅ 95% of the students. Four overarching themes were identified regarding the core characteristics of medical education according to the students’ perspectives: 1) educational background in medical education, 2) interaction with educators in medical education, 3) educational material in medical education and 4) assessment in medical education.ConclusionsThe high rates of acceptance of the pathology study groups reflect the desire and need for active learning methodologies to be implemented in modern medical education. Nearly all the students mentioned the need for practical skill acquisition, the integration of theory into practice and ethics in medical education. The success of these optional pathology study groups highlights the need for similar modalities to be incorporated into the main medical education curriculum.

Evolving Abortion Laws Require Increased Integration of Legal Education Into Medical Education Curriculum.

Hickman, Kevin A. DMSc, MJ, MHA, PA-C, CHC; Brooks, Brandy A. EdD, MHS, PA-C; Cooper, Corey M. MHRT-CSP Author Information

Let food be thy knowledge gap: the lack of nutrition education in medical curricula.

Let food be thy knowledge gap: the lack of nutrition education in medical curricula.

Family adoption program in medical education curriculum

Family adoption program in medical education curriculum