Medical Student Education Research Articles

Introduction to Treating Patients Exposed to Chemical, Biological, Radiological, and Nuclear (CBRN) Threats: A Military Medical Case-Based Curriculum.

Ensuring proficiency in responding to, evaluating, and treating chemical, biological, radiological, and nuclear (CBRN) casualties is a critical component of military medical student education. To meet this objective, we developed a case-based CBRN curriculum that can serve as a model to address potential curricular gaps for civilian prehospital, UME, and GME programs. The curriculum was administered in two sessions, 1 month apart, each with individual student preparation, including an optional asynchronous online module and a review of clinical practice guidelines. Session one consisted of a 2-hour introductory lecture, followed by a student reflection. Session two consisted of a 1-hour small-group case study, designed as a multimodal exercise with a corresponding computer-based worksheet and knowledge check. Forty-five teams consisting of three to four second-year medical students (N = 170) completed the sessions and course survey. Sixty-four percent of student teams were extremely or quite satisfied with what they learned, 62% found the materials very or quite relevant to their needs, and 69% rated the instructional materials as extremely or quite understandable. Student feedback included designating additional time for worksheet completion. A case-based training on CBRN patient care earned positive ratings for the clarity of instruction, the impact on students as learners, and the feasibility of the training. Future training evolutions could track student completion of prework, extend the allotted time for activity completion, and evaluate curricular effectiveness through pre-post measurement of students' confidence in their ability to care for a CBRN patient.

Hubungan Antara Tingkat Stres, Kualitas Tidur dan Tekanan Darah Pada Mahasiswa Pendidikan Dokter Fakultas Kedokteran Universitas Mataram

Most of the medical students experienced mental disorders, such as anxiety disorders, stress, and sleep disorders. Poor sleep quality due to prolonged sleep disturbances will increase blood pressure. This study aimed to determine the relationship between level of stress, sleep quality, and blood pressure in students of Medical Education of Medicine faculty at University of Mataram. This study used a cross-sectional analytical method. The population in this study is the students of Medical Education, Faculty of Medicine, Mataram University year of 2019, 2020, and 2021. Samples were selected using the consecutive sampling method. Data collection of sleep quality using a PSQI questionnaire and blood pressure measurement using a sphygmomanometer. Data analysis in this study used the spearman correlation test and ordinal regression test. Total of 99 students selected in this study showed that most of the students have moderate level of stress (84.8%), experienced poor sleep quality (66.7%), and had normal blood pressure (68.7%). Results on the relationship between level of stress with sleep quality and blood pressure obtained a respectively significant correlation (p value 0.029) and not significant correlation (p value 0.540). There was no significant correlation between sleep quality and blood pressure (p-value 0.762). Ordinal regression test also showed that there was no relationship between level of stress and sleep quality with blood pressure in students of the Medical Education, Faculty of Medicine, at Mataram University (p value 0.271). There was no relationship between level of stress and sleep quality with blood pressure in students of the Medical Education, Faculty of Medicine, at Mataram University.

АНАЛИЗ СОСТОЯНИЯ ЗДОРОВЬЯ ОБУЧАЮЩИХСЯ ПРЕДПРОФЕССИОНАЛЬНОГО МЕДИЦИНСКОГО ОБРАЗОВАНИЯ

The article monitors the health of students in specialized medical education. The results of the study showed that student health parameters decrease from 9th to 11th grade. The health index for 9th grade students is 73%, in 10th grades it is 69%, and in 11th grades the indicator drops to 61%. Most students in grades 9 and 10 belong to health groups I and II; they attend physical education classes and meet standards. In the 11th grade, the number of students in health group III who are diagnosed with several chronic diseases is increasing, so they study in rehabilitation groups. Health group IV includes more than 10 children who exhibit an acute course of the disease during certain periods. All classes have 2-4 disabled children. The work carried out allows us to carry out a system of work aimed at developing the health savings of schoolchildren.

Вплив тривоги і депресії на психічний стан здобувачів медичної освіти під час воєнного стану

Actuality. Long-term exposure to stressors associated with martial law hurts the mental state of the country's population. One of the risk groups is education seekers, for whom it is possible to sum up the stressful impact of education and other zonal factors. Earlier, in the example of countries in Africa, the Middle East and Kosovo, it was proven that the symptoms of anxiety and depressive disorders increased during military conflicts, particularly among medical students. The work aimed to study the symptoms of anxiety and depression in students of higher medical education at the Dnipro State Medical University and to determine their impact on the mental component of quality of life. Materials and methods: a four-fold one-moment cross-sectional survey questionnaire was conducted on the Google Forms platform. We interviewed 193 medical students of the Dnipro State Medical University. Data were collected after one, three, ten months and one year from the beginning of martial law. The level of anxiety was assessed using the generalized anxiety disorder scale (GAD-7), depression was assessed using the Patient Health Questionnaire (PHQ-9), and the mental component of quality of life was assessed using a self-administered questionnaire based on the VAS. Results. The median level of anxiety symptoms according to GAD-7 at the first stage of the study was 8 [5; 14] points with further reduction in the fourth stage to 5.5 [3.5; 7.5] points. The median level of depressive symptoms determined by PHQ-9 varies from 11 [6; 14] points after 1 month to 7.5 [4; 10] points 1 year after the start of martial law. Subjective assessment of working capacity in the subjects was 4 [3; 7] points for VAS with dynamics from 6 [4; 8] after 1 month of martial law, to 4.5 [4; 6] points after 1 year. According to the results of the correlation analysis, a relationship between indicators of anxiety, depression and the mental component of the quality of life was revealed. The correlation between anxiety and depression persisted as the duration of martial law increased, as did the relationship between anxiety and the mental component of quality of life at 1, 3, and 10 months of martial law. But after 12 months of martial law, anxiety ceases to affect the quality of life of the surveyed education seekers. Conclusions. Univariate and multiple logistic analyses were used to explore the psychometric characteristics that correlated with achieving a sufficient level of the mental component of quality of life. The combination of GAD-7 ≥ 10 and PHQ-9 ≥ 10 had the best predictive ability among the constructed models, for which the AUC was 0.777 (95% CI 0.711 – 0.834). By incorporating the ability to work into the model, we enhance its predictive power, resulting in an AUC of 0.844 (95% CI 0.785 – 0.892), which signifies its exceptional predictive capabilities. Thus, the presence of anxiety for GAD-7 more than 10 points increases the chances of not achieving quality of life by 2.885 (95% CI 1.167 – 7.133) times, the presence of depression for PHQ-9 more than 10 points – by 2.689 (95% CI 1.182 – 6.117) times, and subjectively reduced ability to work – 1.434 (95% CI 1.193 – 1.725) times.

The discipline of Medical Psychology in the ethical-humanistic education of medical students

Objective: To describe the current situation of ethical-humanistic training through the discipline Medical Psychology at the Faculty of Medical Sciences of Sancti Spíritus “Dr. Faustino Pérez Hernández.”Methods: Non-experimental, descriptive, cross-sectional study with a mixed-methods approach. The sample was stratified and non-probabilistic, consisting of 10 professors, 8 administrators, and 60 students. Results: The diagnosis found the following strengths: the discipline Medical Psychology is integrated into the cross-curricular ethical-humanistic formation within the Medicine curriculum; humanistic values education is established as a priority methodology; the medical-legal curricular strategy is developed; the faculty serves as an example of what is taught in the discipline; students recognize the importance of the formative process. On the other hand, the following deficiencies were found: weaknesses in the direction of ethical-humanistic training in the discipline Medical Psychology; professors need more training to meet the requirements of the medical training model; there are still no comprehensive assessments that emphasize skills and behavior, as well as the interrelation with the main integrating discipline. Conclusions: The discipline Medical Psychology has the potential to enhance the ethical-humanistic education of medical students. Both administrators and students recognize the importance of improving this educational process. However, it was observed that there is no relevant methodology adapted to the formative needs of professors and students

Headache Education in Canadian Medical Schools.

This study aims to gain a better understanding of the current scope of headache education received in Canadian medical schools. The Women's College Hospital Centre for Headache at the University of Toronto, Canada, distributed a questionnaire to administrators and physicians involved in medical student education at Canadian medical schools and gathered information surrounding headache education. Overall, the degree of headache education varied between schools in regard to the hours of training that occurred and year the training took place. This survey provides an initial insight into the current standards of headache-specific education in Canadian medical schools.

Knowledge, attitude, and perception of Arabmedical students towards artificial intelligence in medicine and radiology: Amulti-national cross-sectional study

ObjectivesWe aimed to assess undergraduate medical students’ knowledge,attitude, and perception regarding artificial intelligence (AI) inmedicine.MethodsA multi-national, multi-center cross-sectional study was conductedfrom March to April 2022, targeting undergraduate medical students in nine Arabcountries. The study utilized a web-based questionnaire, with data collectioncarried out with the help of national leaders and local collaborators. Logisticregression analysis was performed to identify predictors of knowledge, attitude,and perception among the participants. Additionally, cluster analysis wasemployed to identify shared patterns within their responses.ResultsOf the 4492 students surveyed, 92.4% had not received formal AItraining. Regarding AI and deep learning (DL), 87.1% exhibited a low level ofknowledge. Most students (84.9%) believed AI would revolutionize medicine andradiology, with 48.9% agreeing that it could reduce the need for radiologists.Students with high/moderate AI knowledge and training had higher odds ofagreeing to endorse AI replacing radiologists, reducing their numbers, and beingless likely to consider radiology as a career compared to those with lowknowledge/no AI training. Additionally, the majority agreed that AI would aid inthe automated detection and diagnosis of pathologies.ConclusionsArab medical students exhibit a notable deficit in their knowledgeand training pertaining to AI. Despite this, they hold a positive perception ofAI implementation in medicine and radiology, demonstrating a clear understandingof its significance for the healthcare system and medical curriculum.Clinical relevance statementThis study highlights the need for widespread education and trainingin artificial intelligence for Arab medical students, indicating itssignificance for healthcare systems and medical curricula.Key Points• Arab medical students demonstrate asignificant knowledge and training gap when it comes to using AI in thefields of medicine and radiology.• Arab medical students recognize theimportance of integrating AI into the medical curriculum. Students with adeeper understanding of AI were more likely to agree that all medicalstudents should receive AI education. However, those with previous AItraining were less supportive of this idea.• Students with moderate/high AI knowledgeand training displayed increased odds of agreeing that AI has the potentialto replace radiologists, reduce the demand for their services, and were lessinclined to pursue a career in radiology, when compared to students with lowknowledge/no AI training.

INCONSISTENT AND UNPREPARED: HOW FAMILY CAREGIVERS AND OLDER ADULTS EXPERIENCE HOSPITAL DISCHARGE

Abstract Family caregivers and older adult patients report confusion, inconsistency, and a lack of preparation for post-discharge activities after a hospital stay, leading to hospital readmissions. This multi-disciplinary research project investigated how family caregivers, older adult patients, and hospital clinical and administrative staff experienced the hospital discharge process at a midwestern hospital system. The research team brought together expertise in community-engaged research and bridged multiple specializations, including personal family caregiver experience, community service expertise, community engaged research leadership, and instruction of medical students and social work students. Together, we conducted semi-structured interviews with family caregiver, older adult patients, and hospital personnel via video conference and telephone. We analyzed the data using open coding strategies and principles of thematic analysis. Themes included the importance of the timing of discharge planning, communication between all systems and individuals included in the discharge process, a lack of clarity regarding the roles in the process, inconsistent identification of the family caregiver, conflicting priorities, and the impact of medication errors. Implications are (1) each organization within the older adult/family caregiver system must determine their role in the post discharge process including the type of services and resources that support older adults and family caregivers and (2) the current system of healthcare, public sector, and community must determine how to adapt and change to support older adults and their family caregivers during the post-discharge period.

DEATH AND DYING EDUCATION IN US MEDICAL SCHOOLS: A SCOPING REVIEW

Abstract With an aging population, knowledge about death, dying, loss, grief, and end-of-life (EOL) care is an essential skill for most physicians. However, EOL education has been minimally incorporated into medical school curricula in the United States (U.S.); there is a significant need to better prepare medical students for the unique challenges of improving patient wellbeing at end-of-life. To understand how death and dying topics have been incorporated into U.S. medical school education, we conducted a systematic scoping review, using PRISMA guidelines, of published research on death education for medical students between 2010 through 2022. An initial search in EMBASE and PubMed yielded 3,443 citations; 265 articles met the initial inclusion criteria (e.g., research-based, EOL education specific), with 97 articles selected for full-text review. Overall, we found significant variation in the type and content of EOL training in U.S. medical schools. Using a competency-based medical education framework that reflects tangible knowledge, skills, and attitudes as a guide to ensure proper EOL training, a deductive coding approach yielded several themes including: reliance on brief, skills-based workshop interventions and limited longitudinal integration into curricula; general research on student attitudes and wellbeing; and an emphasis on needs assessments highlighting gaps in evidence-based EOL training interventions. Using these findings, we offer applied considerations for teaching EOL related skills in U.S. medical schools. In turn, this work contributes to the enhancement of health across the lifespan and might ultimately lead to a society where a “good death” is not an exception, but a reality.

GERIATRICS IN HEALTH PROFESSIONS EDUCATION: A BIBLIOMETRIC ANALYSIS OF 70 YEARS OF RESEARCH

Abstract To move forward in the field of Geriatrics in Health professions education (HPE), we must understand its conception and recognize current trends and future directions. Therefore, we conducted a bibliometric and network analysis of all studies indexed in the Scopus Database related to Geriatrics and HPE from 1953 to 2022. We retrieved 2940 studies comprising 7344 authors and 618 journals; these were imported to bibliometrics (RStudio) and Vos Viewer. To understand the intellectual structure, we employed a co-citation analysis; we identified 5 clusters that described fundamentals in geriatrics, nursing education, needs assessment, and interprofessional education (IPE). Furthermore, six topics were placed in the keyword co-occurrence, ranging from medical, nursing, dental, social workers, and interprofessional education. Consequently, we identified geriatrics education for medical students and interprofessional education between 2004 and 2016; furthermore, clinical competence was the most recent trending topic, accompanied by end-of-life care and geriatric psychiatry. In the evolution map, three topics emerged in the last ten years: IPE, online learning, and geriatric dentistry. These findings were confirmed in the bibliographic coupling analysis. Four major themes emerged among 13 clusters: IPE, Attitudes and career orientation to geriatrics, innovative educational methods such as gamification, and geriatric undergraduate education. Although we identified several studies, this barely represents the 1% of production in HPE. Furthermore, we identified a trend toward IPE, undergraduate medical education, career orientation, and innovative education. However, there is a lack of themes such as simulation and entrustable professional activities, with an underrepresentation of the developing world.

CHALLENGES AND OPPORTUNITIES IN DEVELOPING ENGLISH-LANGUAGE EDUCATIONAL ENVIRONMENT IN MEDICAL EDUCATION DURING CRISIS SITUATIONS

The article deals with the role of English as a language of medical academic instruction in modern conditions that is gaining a particular relevance both in Ukraine and around the world. Knowledge of professional English facilitates the integration into the global scientific and educational space, opens up new opportunities for both students and teachers. Ensuring the quality of education in the context of the coronavirus infection pandemic, time of uncertainty, and military operations is of particular importance. After all, the quality of education depends not only on the scientific and methodological support of academic disciplines, but also on the use of the latest forms and methods of teaching, the relevance of the content to current trends and events in the world, which is impossible without the use of English as a language of international medical communication.
 The purpose of the study is to reveal the characteristic features of the creation of the English-language educational environment in medical education and to determine their role in the perception and assimilation of educational material by students of higher medical education in crisis situations. Poltava State Medical University is diligently striving to establish and maintain a thriving and supportive English-language educational environment.
 The creation of English-language educational environment in medical education and its role in ensuring the professional development of students and teachers of higher medical education is of global importance for further use in professional activities. In crisis situations, its preservation and development is an important area of work of a higher education institution, in particular Poltava state medical university. Hence, it can be stated that the creation of the English-language educational environment at Poltava State Medical University fosters the professional and personal development of both students and teachers, enabling all participants in the educational process to unleash their full potential.

Potential Rheumatological Heart Disease Causing Triple Valve Replacement: A Case Report

INTRODUCTION: Mechanical valves were identified in the aortic, mitral, and tricuspid valves of an 88-year-old donor. The presence of these valves along with the donor's past medical history and body habitus indicate a triple valve replacement surgery was performed. CASE PRESENTATION: Here we describe our 88-year-old donor’s body habitus during routine anatomical dissection. DISCUSSION: Evidence of a rare triple valve surgery is discussed along with how this type of case report acts as a useful exercise contributing towards medical student education. CONCLUSION: A rare triple valve replacement appears to have been performed on our donor.

No knowledge gap in human physiology after remote teaching for second year medical students throughout the Covid-19 pandemic

The COVID-19 pandemic had a disruptive effect on higher education. A critical question is whether these changes affected students’ learning outcomes. Knowledge gaps have consequences for future learning and may—in health professionals' education—also pose a threat to patient safety. Current research has shortcomings and does not allow for clear-cut interpretation. Our context is instruction in human physiology in an undergraduate medical program from high stakes end of term examinations. The sequence of imposed measures to slow the COVID-19 pandemic created a natural experiment, allowing for comparisons in performance during in-person versus remote instruction.In a two-factorial design, mode of instruction (in-person vs. remote) and mode of assessment (in-person vs. remote) were analyzed using both basic (non-parametric statistics, T-tests) and advanced statistical methods (linear mixed-effects model; resampling techniques). Test results from a total of N = 1095 s-year medical students were included in the study.We did not find empirical evidence of knowledge gaps; rather, students received comparable or higher scores during remote teaching. We interpret these findings as empirical evidence that both students and teachers adapted to pandemic disruption in a way that did not lead to knowledge gaps.We conclude that highly motivated students had no reduction in academic achievement. Moreover, we have developed an accessible digital exam system for secure, fair, and effective assessments which is sufficiently defensible for making pass/fail decisions.

Orthopaedic Surgery in the Metaverse: Current Data on Virtual-Reality Based Training

BACKGROUND: Immersive, realistic, and low-risk training has long been ideal for skill-based disciplines such as surgery. Recent advances in virtual reality technology have led to development of surgical training software with the goal to provide experience without risk. The aim of this review is to summarize the current data for virtual reality-based orthopaedic surgery training to evaluate how beneficial the technology may become in educational circumstances. METHODS: A literature review was completed analyzing eight randomized controlled trials completed between 2019 to 2022 to evaluate the effect of virtual reality on orthopaedic surgery education for medical students and residents. Each trial included groups of learners that were trained on a specific procedure with standard methods (“control”) or virtual reality software (“VR group”). Subjects were then evaluated on completion of procedures with real-life models. Procedures included total hip arthroplasty (n=2), tibial intramedullary nail (n=2), slipped capital femoral epiphysis pinning (n=2), and unicompartmental knee arthroplasty (n=2). The primary metrics assessed were time to complete procedure and objective assessment scores. Secondarily survey results were evaluated regarding subjects’ perceived utility of virtual reality in orthopaedic surgery training. RESULTS: 168 subjects (medical students n=68, residents n=100) were included across the 8 different trials. All trials included at least one objective assessment and it was found that overall, the VR group performed 19.9% better than control group on average (19.875 ± 18.324, 95% CI). Seven of the trials reported time to complete procedure, in which it was found that overall VR group completed the procedures 12% faster than control group on average (12 ± 10.988, 95% CI). Subjective measures showed that over 70% of subjects found the VR learning to be at least “helpful” or “useful”. CONCLUSION: Early studies of the emerging field of virtual reality in surgical training are promising. When looking at objective measures and time to complete procedures, VR trained learners perform as well, if not better, than standard method learners. Inclusion of virtual reality-based practice in medical school curricula and residency training may lead to less surgical errors, increased knowledge of procedures, and more efficient learning in real-life scenarios. This potential impact extends beyond well-resourced institutions, as VR technology can provide a cost-effective and accessible alternative for surgical training in low-income and low-resource areas of the world, democratizing access to high-quality medical education. Continued research on translation into clinical practice is warranted, with the potential to bridge educational disparities and improve surgical outcomes on a global scale.

Effects of the COVID-19 pandemic on the mental health of medical students and young physicians in Germany: Gender-specific results of an online survey

BackgroundHealthcare workers and medical students faced new challenges during the COVID-19 pandemic. Processes within many hospitals were completely disrupted. In addition, the face to face teaching of medical students was drastically reduced. Those at risk of developing mental health problems appear to be younger health care workers and women. ObjectiveTo investigate potential COVID-19 pandemic-related gender differences in psychological distress among medical students and physicians in their first years of practice. Design and settingAn anonymous survey was carried out online between December 1, 2021, and March 31, 2022, at the Mannheim Medical Faculty and the Würzburg Medical Faculty, Germany, after obtaining informed consent. Primary outcome measures were changes in anxiety and depression symptoms using the Hospital Anxiety and Depression Scale (HADS), and changes in participants' current quality of life using the WHO Quality of Life BREF. ResultsThe results show wave-like courses for perceived anxiety and burden overlapping with the course of the COVID-19 incidence. In comparison to men, women showed a significant higher increase in HADS (p = 0.005) and a reduced life quality (p = 0.007) after COVID-19. Both sexes showed different frequencies of the factors influencing quality of life, with the presence of a previous mental illness and mean anxiety having a significant higher negative impact in women. ConclusionFuture and young female physicians reported a disproportionate higher burden during COVID-19 compared to their male colleges. These observations suggest an increased need for support and prevention efforts especially in this vulnerable population.

Investigation on the Current Situation of Life Education and Reflection on the General Goal of Life Education for Contemporary Chinese Medical Students

Life education is an important subject of contemporary college education. The responsibility and pressure of contemporary college students are increasing rapidly, but the overall construction of psychological consultation and mental health courses in China is not mature, there still remaining the difficulty to solve psychological problems of college students from the source. At present, the importance of life education has been generally recognized all over the world, and amounts of increasingly perfect life education systems in schools, families, society and other aspects have been established, so as to effectively and permanently protect the mental health of college students. This article conducts an overall investigation on the current situation of life education in China and other countries, and discusses the overall goal of life education for contemporary Chinese medical students for reference.

Investigation on the Current Situation of Life Education and Reflection on the General Goal of Life Education for Contemporary Chinese Medical Students

Life education is an important subject of contemporary college education. The responsibility and pressure of contemporary college students are increasing rapidly, but the overall construction of psychological consultation and mental health courses in China is not mature, there still remaining the difficulty to solve psychological problems of college students from the source. At present, the importance of life education has been generally recognized all over the world, and amounts of increasingly perfect life education systems in schools, families, society and other aspects have been established, so as to effectively and permanently protect the mental health of college students. This article conducts an overall investigation on the current situation of life education in China and other countries, and discusses the overall goal of life education for contemporary Chinese medical students for reference.

A gap analysis of surgical simulation training in medical education for students with physical disabilities

A gap analysis of surgical simulation training in medical education for students with physical disabilities

A scoping review to identify and organize literature trends of bias research within medical student and resident education

BackgroundPhysician bias refers to the unconscious negative perceptions that physicians have of patients or their conditions. Medical schools and residency programs often incorporate training to reduce biases among their trainees. In order to assess trends and organize available literature, we conducted a scoping review with a goal to categorize different biases that are studied within medical student (MS), resident (Res) and mixed populations (MS and Res). We also characterized these studies based on their research goal as either documenting evidence of bias (EOB), bias intervention (BI) or both. These findings will provide data which can be used to identify gaps and inform future work across these criteria.MethodsOnline databases (PubMed, PsycINFO, WebofScience) were searched for articles published between 1980 and 2021. All references were imported into Covidence for independent screening against inclusion criteria. Conflicts were resolved by deliberation. Studies were sorted by goal: ‘evidence of bias’ and/or ‘bias intervention’, and by population (MS or Res or mixed) andinto descriptive categories of bias.ResultsOf the initial 806 unique papers identified, a total of 139 articles fit the inclusion criteria for data extraction. The included studies were sorted into 11 categories of bias and showed that bias against race/ethnicity, specific diseases/conditions, and weight were the most researched topics. Of the studies included, there was a higher ratio of EOB:BI studies at the MS level. While at the Res level, a lower ratio of EOB:BI was found.ConclusionsThis study will be of interest to institutions, program directors and medical educators who wish to specifically address a category of bias and identify where there is a dearth of research. This study also underscores the need to introduce bias interventions at the MS level.

Is the awarding gap at UK medical schools influenced by ethnicity and medical school attended? A retrospective cohort study

ObjectivesTo better characterise the Awarding Gap (AG) between black, Asian and other minority ethnic (BAME) and white students in UK undergraduate medical education by examining how it affects eight minority...