Medical Education Practice Research Articles

Looking at Social Interactions in Medical Education with Dual Eye-Tracking Technology: A Scoping Review

Purpose Social interactions are fundamental to effective medical practice, yet assessing these complex dynamics in educational settings remains challenging. This review critically examines the emerging use of dual eye-tracking technology as a novel method to quantify, analyze, and enhance social interactions within medical education contexts. Materials and Methods We performed a scoping review of the literature, focusing on studies that utilized dual eye-tracking within medical education contexts. Our search included multiple databases and journals. We extracted information on technical setups, areas of application, participant characteristics, dual eye-tracking metrics, and main findings. Results Ten studies published between 2012 and 2021 met the inclusion criteria, with 90% utilizing dual screen-based- and 10% dual mobile eye-tracking. All studies were conducted in the context of surgical training, primarily focusing on laparoscopic surgery. We identified two main applications of dual eye-tracking: (1) as an educational intervention to improve collaboration, (2) as a diagnostic tool to identify interaction pattern that were associated with learning. Key metrics included joint visual attention, gaze delay and joint mental effort. Conclusion Dual eye-tracking offers a promising technology for enhancing medical education by providing high-resolution, real-time data on social interactions. However, current research is limited by small sample sizes, outdated technology, and a narrow focus on surgical contexts. We discuss the broader implications and potential for medical education research and practice.

Accommodating Learners: An Adaptive Approach to Surgical Hand Preparation With Crutches

Accommodations for injured and disabled surgical providers have to balance an individual's needs with measures that ensure sterility requirements, patient and provider safety. The highly specialized nature of the surgical environment poses challenges when implementing changes in the operating room and literature is limited on adaptive surgical hand preparation techniques necessary to maximize a disabled medical student's active participation in their surgical clerkship. This paper presents a detailed account of the development and implementation of an adaptive surgical hand preparation designed to address mobility needs, enabling a student's active participation and education in the surgical curriculum. This offers a framework for adapting traditional surgical hand preparation techniques for crutches consisting of essential requirements in terms of equipment and personnel, step-by-step guide for implementation, discussion of potential risks related to contamination and safety, and a discussion on future directions for further innovation. An adaptive surgical hand preparation technique was necessary to sterilize forearm crutches for a third-year medical student with a physical disability to ensure accessibility in the operating room and equity in surgical clerkship and medical education. Successful use of this protocol, in over 40 surgical cases throughout an 8-week surgical clerkship, created opportunity for a disabled medical student to access the sterile operating table through collaboration and innovation in the operating room. The adaptive hand preparation and sterile crutch cover solution was necessary for the student to assist in open, laparoscopic, and surgical procedures resulting in high clinical performance marks in the surgical clerkship. Beyond the individual benefit, this protocol promotes the importance of equity in medication education and encourages diversity through adaptive measures in the surgical field. Designing an adaptive sterilization protocol for use of crutches in the operating room serves as an example of educational engineering and adaptable accessibility. The entire collaborative effort involving the medical student, university, surgical providers and operating room staff demonstrates the importance of teamwork in creating access in healthcare settings. Through learned experience, the authors provide insights for future directions for innovation, aiming to enhance access and inclusivity in medical education and surgical practice. This paper reflects on the broader implications of educational engineering and inclusive practices in healthcare.

QuPath Edu and OpenMicroanatomy: Open‐source virtual microscopy tools for medical education

AbstractVirtual microscopy is becoming increasingly common in both medical education and routine clinical practice. Virtual microscopy software is typically designed either for (1) training students in anatomy, histology, and histopathology, or (2) quantitative analysis—but not both simultaneously. QuPath is one of the most widely used software applications for histopathology image analysis in research and provides a comprehensive set of computational tools to evaluate histology slides. We have enhanced QuPath by developing a new extension, QuPath Edu, which adapts the software to function as an intuitive microanatomy learning environment. Additionally, we have created an entirely new, complementary software platform called OpenMicroanatomy, which provides an alternative way to access QuPath Edu teaching content through a web interface. These tools have been used in teaching of first year medical and dentistry students at the University of Oulu Medical Faculty, and we conducted a user survey for the Class of 2023 to assess the usability and student experience. In general, the introduced annotation and quiz features were appreciated by the students and the system usability of OpenMicroanatomy was considered excellent (SUS score 84.8). Together, these freely available tools enable teachers to develop and deploy innovative training material for anatomy, histopathology, quantitative analysis, and artificial intelligence in a wide range of contexts. This unique combination can provide the next generation of students with essential multidisciplinary skills.

Virtual reality: The bridge between medical education and clinical practice.

After perusing the paper by Kim et al, I discovered that this is an interesting manuscript and a successful study. Virtual reality (VR) is an emerging and promising technology employed in the domain of medical practice and medical education over the past decade. In the era of big data, VR is constantly progressing in the fields of medical education and clinical diagnosis and treatment. As a novel scientific and technological tool, VR not only overcomes multiple limitations of the traditional medical teaching mode but also reduces the reliance on personnel and equipment. VR can simulate the real clinical situation, stimulate the enthusiasm of young doctors and nurses for clinical study, and simultaneously safeguard and promote medical safety and doctor-patient harmony. Favorable outcomes have been attained in clinical teaching and diagnosis and treatment activities. While enhancing the training conditions of medical cosmetics and elevating the level of clinical practice and teaching, the risks resulting from improper clinical diagnosis and treatment have been circumvented. All of this is evident and comprehensible.

Exploring links between visuospatial ability and anatomy learning in education: A bibliometric analysis and scientific mapping

The field of medical education faces a significant challenge in teaching human anatomy, a fundamental aspect of medical science that is often perceived as complex and demanding. Understanding the shapes and anatomical structure locations is crucial for students to master the intricacies of anatomy. Visuospatial ability, which involves comprehending three-dimensional structures and their spatial relationships, plays a pivotal role in anatomy learning. The aim of this study was to examine keywords, territories/countries, the number of publications, institutions, authors, and associated journals related to visuospatial ability in anatomy learning through extensive bibliometric analysis. Data were gathered from the Scopus database, and VOSviewer was employed to conduct a bibliometric analysis. Approximately 552 eligible articles were examined in their entirety. The findings indicated that the most significant research growth occurred in 2012, with the United States of America emerging as the leading country in the field. Furthermore, Anatomical Science Education was recognized as the most esteemed journal in this field, with Wilson, T.D. being credited as the most influential author. The bibliometric data also demonstrated various approaches to improve visuospatial capacity in anatomy learning, such as utilizing virtual reality or other computer-assisted learning modalities and their integration into medical education practice. In conclusion, these findings highlight the critical role of visuospatial ability in facilitating the acquisition of anatomical knowledge and offer direction for future research in this area.

EXPERIENCE OF IMPLEMENTING THE DISTANCE E-COURSE “STATISTICAL METHODS IN PHARMACY” IN THE MATHEMATICAL TRAINING OF FUTURE PHARMACEUTICAL SPECIALISTS

The article is dedicated to the issue of distance and online learning in higher pharmaceutical education. In the paper, the main principles and characteristic features of the concept of distance learning are outlined, the main advantages and disadvantages of using distance and e-learning in pharmaceutical and medical higher education are discussed. Considerable attention is paid to the use of distance learning technology in the process of math training for students pursuing higher education in the field of pharmacy. In addition to technical means and the structural-methodological component of the distance course development process, special attention is given to psycho-pedagogical aspects, which includes a focus on increasing the motivation of this group of education seekers to master disciplines related to exact sciences. It is demonstrated, using the example of the developed by the authors distance course “Statistical Methods in Pharmacy”, implemented with the LMS Moodle, that a successful combination of methodological approaches and innovative teaching methods, aimed at implementing a competency-based approach in education, along with modern information technology providing online access to educational content, including tools for feedback support, practical skills development, and automated self-assessment, ensures the effectiveness of achieving educational goals by learners and the formation of professional competencies defined by the educational program. The course was tested, certified, and implemented in the fundamental training of future pharmaceutical professionals at the National University of Pharmacy. It is concluded, that the implementation of distance learning technology in the practice of Ukrainian higher pharmaceutical and medical education is necessary not only due to the current conditions that make it impossible to organize full-fledged offline education but also because of the efficiency of these technologies, primarily for organizing independent students’ work, that ensures the development of learners’ autonomy, contributes to the development of information culture, general digital competence, and a range of soft skills, including communication, interaction, collaboration in a digital environment, and the rational use of study time.

Informing factors and outcomes of self-assessment practices in medical education: a systematic review

Background Self-assessment (SA) is increasingly recognized not only as an assessment method but also as a vital learning activity that enables learners to identify their strengths and limitations, fostering a crucial skill for lifelong learning. Despite its acknowledged significance, there remains a gap in understanding SA for and as learning, rather than merely of learning. This review, therefore, explores two primary questions: (1) What factors inform the implementation of medical students’ SA practices? (2) How does SA practices contribute to various educational outcomes? Methods A systematic review was conducted across five databases, employing a combination of keywords pertinent to SA and medical education. Our selection criteria deliberately excluded articles that solely focused on the accuracy of SA or used SA exclusively as a measure for other outcome variables. As a result, 39 studies met our inclusion criteria and were analyzed for this review. Qualitative narrative synthesis was used to summarize the informing factors. Furthermore, Kirkpatrick’s model was employed to categorize and summarize the effects of SA activities across various educational outcome levels, including reactions, learning, and behavioral changes. Results Our review reveals that key factors influencing students’ SA includes feedback from various stakeholders, peer assessment, the format of SA, and both learner and teacher training. Among the 39 studies examined, the majority demonstrated positive effects of SA on aspects such as attitudes and skills. However, a minority found no significant associations, with these outcomes frequently linked to contextual variables and how SA was implemented. Conclusions Our review does not focus on SA accuracy or its role as an assessment method; instead it delves into the role of SA as an integral learning practice. We explored its influencing factors and its impact across various outcomes. The findings indicate that for SA to effectively enhance student learning outcomes, it must be implemented with ample support, clear guidelines, and within contexts that encourage feedback and reflection.

From Scalpel to Simulation: Reviewing the Future of Cadaveric Dissection in the Upcoming Era of Virtual and Augmented Reality and Artificial Intelligence.

Cadaveric dissection (CD) has been a foundational practice in medical education for centuries, offering indispensable insights into human anatomy. However, the advent of artificial intelligence (AI) and related technologies is revolutionizing the way anatomy is taught and learned. CD has long been regarded as a cornerstone of medical education, playing a critical role in providing hands-on experience and a deep understanding of human anatomy. It has allowed medical students and professionals to explore the intricacies of the human body in a way that textbooks and other educational resources could not fully replicate. By physically examining and dissecting cadavers, students gain invaluable insights into the complexity of human tissues, organ systems, and anatomical relationships, laying the foundation for their clinical knowledge and practice. This review explores the enduring significance of human cadaveric dissection in contemporary medical education and examines the impact of AI-driven tools and virtual simulations on traditional dissection practices. It also discusses the potential integration of these technologies to enhance medical training. Through an analysis of recent studies and emerging trends, this article provides a concise overview of how CD and AI can complement each other in the education of future healthcare professionals. As technology has advanced, traditional methods of teaching and learning anatomy are undergoing a transformation. AI-powered tools, virtual reality (VR), augmented reality (AR), and 3D simulations are increasingly being integrated into medical curricula, offering new ways to visualize and interact with anatomical structures. These technologies can simulate complex procedures, provide real-time feedback, and offer repeatable, risk-free learning experiences. As a result, many educators and institutions are rethinking the role of CD in the modern medical classroom, questioning whether it remains indispensable or if AI-based alternatives can adequately replace or supplement it. We analyze how AI and virtual simulations are being utilized to complement cadaver-based learning, potentially enhancing the educational experience through innovative, interactive methods. It also will highlight the unique value that CD still provides, including the tactile and spatial understanding of the human body that digital tools may not fully replicate. We also discuss the potential benefits of integrating these technologies into anatomy education, such as increased accessibility, personalized learning, and improved retention of knowledge. Ultimately, the review will consider how the combination of traditional dissection methods and cutting-edge AI technologies can create a more dynamic and effective approach to medical education, preparing students better for the complexities of clinical practice. A consensus has to be reached on how CD and AI can coexist and complement one another in the training of future healthcare professionals.

Training an infectious disease unit in palliative care during and post COVID-19: a qualitative longitudinal study.

To understand palliative care needs and their changes perceived by health professionals (HPs) of the Infectious Diseases Unit who participated in palliative care (PC) intensive training during the pandemic and behind/during the pandemic and one year after the outbreak. A longitudinal qualitative study. Thematic analysis and meaning shift were two months after training to one year. This specific thematic approach enabled the researchers to fully understand the experiences of the HPs after they participated in the intensive PC training program during the pandemic. Participant validation meeting with the ward's staff one year after the end of the course was performed. The two last validation meetings were used as a triangulation source to plan the new education projects. From March 9 to 28, 2020, the Palliative Care Services (PCS) developed intensive experiential training. Thirty-one HPs of the Infectious Diseases Unit (physicians and nurses) who were facing the COVID-19 emergency participated in the training. We conducted eight semi-structured interviews with HPs who participated in intensive training during the first wave of the pandemic (T0), two months (T1) after training and after one year (T2), during the second wave. Two validation meetings were performed as suggested by the best practices in medical education. Twenty-two infectious disease staff members participated, 8 physicians and 14 nurses. Our data show a meaning shift on five overarching themes (defined within the sub-themes): (1) Recognizing patients' palliative care needs; (2) Responses to palliative care needs; (3) Increasing attention to intervention and care choices; (4) The suffering of health professionals; (5) Training evaluations and future expectations. At the end of Pandemic period, new training needs and acquisition have emerged. Palliative care needs changed over time: the COVID-19 themes are now far from their perception, and somehow the skills acquired during the intensive training are less present. The pandemic led to a rapid acquisition of competencies and changes in the professionals' behaviors, maintenance of professionals' knowledge and competencies at two months and one year. COVID has improved relationships and increased interactions with the infectious world but that it has not been enough. The integration between PC and Infectious world needs models of integration to implement.

Holistic Review in Applicant Selection: A Scoping Review.

To avoid overreliance on metrics and better identify candidates who add value to the learning environment, some medical schools and residency programs have begun using holistic review for screening and selection, but limited data support or refute this use. This scoping review examines holistic review definitions and practice in medical education, summarizes research findings, and identifies gaps for future research. The authors searched 7 databases using the keywords holistic, attributes, mission-based, mission-centric, and socially accountable for articles on holistic review within undergraduate medical education (UME) and graduate medical education (GME) published from database inception through July 5, 2024. Author pairs independently screened articles for inclusion and extracted data. Discrepancies were resolved via discussion. Quantitative and qualitative synthesis was performed. A total of 6,511 articles were identified, with 33 included in this review. Twenty-five studies (76%) focused exclusively on GME, with only a few assessing holistic review in UME. Holistic review was implemented at 3 main stages: screening, interviewing, and ranking. Common rationales included service patterns, patient-physician identity concordance, enhancing patient trust, professional advocacy, and educational benefits. Holistic review elements varied, with most falling within the Association of American Medical Colleges experiences, attributes, and metrics framework. Nearly all studies reported an increase in the percentage of underrepresented in medicine trainees interviewed or selected. Several studies also demonstrated increases in other groups (e.g., women, lower socioeconomic status). Many studies included additional interventions to promote diversity, limiting the ability to assess holistic review in isolation. This scoping review summarizes the literature on rationale, development and implementation process, structure and components, outcomes assessed, barriers, and strategies for success for holistic review. This work can inform institutions and departments seeking to develop or refine their own holistic review systems and serve as a nidus for future research.

Current application of ChatGPT in undergraduate nuclear medicine education: Taking Chongqing Medical University as an example

Background Nuclear Medicine(NM), as an inherently interdisciplinary field, integrates diverse scientific principles and advanced imaging techniques. The advent of ChatGPT, a large language model, opens new avenues for medical educational innovation. With its advanced natural language processing abilities and complex algorithms, ChatGPT holds the potential to substantially enrich medical education, particularly in NM. Objective To investigate the current application of ChatGPT in undergraduate Nuclear Medicine Education(NME). Methods Employing a mixed-methods sequential explanatory design, the research investigates the current status of NME, the use of ChatGPT and the attitude towards ChatGPT among teachers and students in the Second Clinical College of Chongqing Medical University. Results The investigation yields several salient findings: (1) Students and educators in NM face numerous challenges in the learning process; (2) ChatGPT is found to possess significant applicability and potential benefits in NME; (3) There is a pronounced inclination among respondents to adopt ChatGPT, with a keen interest in its diverse applications within the educational sphere. Conclusion ChatGPT has been utilized to address the difficulties faced by undergraduates at Chongqing Medical University in NME, and has been applied in various aspects to assist learning. The findings of this survey may offer some insights into how ChatGPT can be integrated into practical medical education.

Exploring the Impact and Prospects of Social Media in Advancing Pediatric Pathology.

Social media has been recently highlighted as a unique and modern virtual force that allows for worldwide connection, collaboration, communication, and engagement between pathologists, trainees, and medical students. Much literature has been focused on the role of social media in recruitment and medical education practices of different pathology subspecialties, such as dermatopathology and hematopathology. However, current literature on pathology social media's status and potential future roles in promoting pediatric pathology is sparse. Herein, this review intends to narrow this knowledge gap by reviewing how social media has been utilized in different pediatric subspecialties, the current use of social media in pathology, and how the future of pediatric pathology social media use may look moving forward regarding education, research, and recruitment. Specific tips and related online resources are provided.

Challenges in teacher-student communication during family medicine residency: A qualitative study.

Deficiencies in communication among healthcare professionals, recognized by medical educators and healthcare institutions, can negatively impact medical education and clinical practice. Analyzing teacher-resident communication difficulties shed light on this issue and propose practical strategies for its mitigation. To identify common communication challenges between teacher and residents during Family Medicine residency and to analyze their impact on interactions with peers, the work team, and patients. Qualitative study, the critical incident technique was used to collect information of interest. Seventy teachers, and fifty third-year residents from the Mexican Republic described critical incidents related to their communication experiences during Family Medicine residency. 192 critical incidents were collected (several participants reported more than one incident), comprising 127 reports from teachers, and 65 from residents. Four themes were identified: 1) asymmetric communication, 2) assertive communication, 3) organizational communication, and 4) effective communication. The main challenges identified were abuse of power in communication, lack of communication skills, and the absence of institutional communication channels. These issues significantly impacted learning, work environment, interpersonal relationships, and medical care. This study highlights communication issues within Family Medicine residency in Mexico. The issues detected hindered learning and effective collaboration and negatively impacted the work environment, interpersonal relationships, and the quality of medical care. These findings underscore the urgent need to reorient the medical specialty curriculum towards an approach that includes communication skills.

A Content Analysis of Health Library Support for Australian Medical Training Programs

ABSTRACT Health libraries play a critical role in supporting medical training in Australia. Accreditation is an important means of ensuring a program of study and the education provider suitably equips trainees with the knowledge, skills and professional attributes necessary to practice in the profession. This study identifies a lack of consistency and specificity in Australian medical colleges accreditation requirements as they pertain to health libraries. The recommended accreditation standard developed in this study provides a benchmark for training providers that will ensure consistency of access to high-quality library collections, services and spaces for all medical trainees. Accreditation standards from 52 medical colleges and associations supporting Australian medical training programs were reviewed. Information extracted from accreditation documents was entered into a working text spreadsheet. Data was organized under three key categories: Collections, Services and Space. Additional categories were added to record the use of the noun Library and expectations for journal access. A data extraction tool was created in Microsoft Excel to note the requirements of each provider for libraries and collections, services and spaces. The results of the content analysis highlight a lack of consistency in accreditation providers’ expectations for library collections, services and spaces. Most providers (87% n = 45) required host organizations to provide access to collections. Requirements for library space were mandated by 54% of providers (n = 28). Less than 50% of providers (n = 22) specified library services as requirements. This content analysis highlights the role of health libraries in supporting medical education, research and evidence-based practice. It also reinforces the need for improved specificity, consistency and clarity in accreditation requirements for health libraries in post-graduate medical training. The recommended benchmark accreditation standard developed in this study is a step toward addressing these issues and ensuring equity of access to library services and facilities for all medical trainees in Australia.

Perceptions of ChatGPT in healthcare: usefulness, trust, and risk.

This study explores the perceptions of ChatGPT in healthcare settings in Taiwan, focusing on its usefulness, trust, and associated risks. As AI technologies like ChatGPT increasingly influence various sectors, their potential in public health education, promotion, medical education, and clinical practice is significant but not without challenges. The study aims to assess how individuals with and without healthcare-related education perceive and adopt ChatGPT, contributing to a deeper understanding of AI's role in enhancing public health outcomes. An online survey was conducted among 659 university and graduate students, all of whom had prior experience using ChatGPT. The survey measured perceptions of ChatGPT's ease of use, novelty, usefulness, trust, and risk, particularly within clinical practice, medical education, and research settings. Multiple linear regression models were used to analyze how these factors influence perception in healthcare applications, comparing responses between healthcare majors and non-healthcare majors. The study revealed that both healthcare and non-healthcare majors find ChatGPT more useful in medical education and research than in clinical practice. Regression analysis revealed that for healthcare majors, general trust is crucial for ChatGPT's adoption in clinical practice and influences its use in medical education and research. For non-healthcare majors, novelty, perceived general usefulness, and trust are key predictors. Interestingly, while healthcare majors were cautious about ease of use, fearing it might increase risk, non-healthcare majors associated increased complexity with greater trust. This study highlights the varying expectations between healthcare and non-healthcare majors regarding ChatGPT's role in healthcare. The findings suggest the need for AI applications to be tailored to address specific user needs, particularly in clinical practice, where trust and reliability are paramount. Additionally, the potential of AI tools like ChatGPT to contribute to public health education and promotion is significant, as these technologies can enhance health literacy and encourage behavior change. These insights can inform future healthcare practices and policies by guiding the thoughtful and effective integration of AI tools like ChatGPT, ensuring they complement clinical judgment, enhance educational outcomes, support research integrity, and ultimately contribute to improved public health outcomes.

The Viennese dissection course-Amodel for Habsburg medical teaching (1787-1848).

This article delves into the beginnings of the dissection course, ateaching practice which today is still in place in Vienna and continues to shape future medical practitioners. Based on acomparison of different historical sources the article shows that the Viennese tradition of adissection course dates back to the 1780s and the initiative of the anatomist Joseph Barth to build adissection institute and to implement adissection course, two endeavors that coincided with JosephII's reform ideas regarding apractically orientated medical and surgical education and aEurope-wide practice turn. Additionally, this paper shows the role of the Viennese dissection course as model for other Habsburg universities and, thus, explains the similarities of today's dissection courses in different former Habsburg universities.

Influence of Model Evolution and System Roles on ChatGPT's Performance in Chinese Medical Licensing Exams: Comparative Study.

With the increasing application of large language models like ChatGPT in various industries, its potential in the medical domain, especially in standardized examinations, has become a focal point of research. The aim of this study is to assess the clinical performance of ChatGPT, focusing on its accuracy and reliability in the Chinese National Medical Licensing Examination (CNMLE). The CNMLE 2022 question set, consisting of 500 single-answer multiple choices questions, were reclassified into 15 medical subspecialties. Each question was tested 8 to 12 times in Chinese on the OpenAI platform from April 24 to May 15, 2023. Three key factors were considered: the version of GPT-3.5 and 4.0, the prompt's designation of system roles tailored to medical subspecialties, and repetition for coherence. A passing accuracy threshold was established as 60%. The χ2 tests and κ values were employed to evaluate the model's accuracy and consistency. GPT-4.0 achieved a passing accuracy of 72.7%, which was significantly higher than that of GPT-3.5 (54%; P<.001). The variability rate of repeated responses from GPT-4.0 was lower than that of GPT-3.5 (9% vs 19.5%; P<.001). However, both models showed relatively good response coherence, with κ values of 0.778 and 0.610, respectively. System roles numerically increased accuracy for both GPT-4.0 (0.3%-3.7%) and GPT-3.5 (1.3%-4.5%), and reduced variability by 1.7% and 1.8%, respectively (P>.05). In subgroup analysis, ChatGPT achieved comparable accuracy among different question types (P>.05). GPT-4.0 surpassed the accuracy threshold in 14 of 15 subspecialties, while GPT-3.5 did so in 7 of 15 on the first response. GPT-4.0 passed the CNMLE and outperformed GPT-3.5 in key areas such as accuracy, consistency, and medical subspecialty expertise. Adding a system role insignificantly enhanced the model's reliability and answer coherence. GPT-4.0 showed promising potential in medical education and clinical practice, meriting further study.

Mobile applications for Medical Education and Clinical Practice

No abstract available

The social construction of time and its influence on medical education.

Few sociocultural constructs exist that are so deeply embedded in our daily lives and able to influence our thoughts, behaviours and interactions than time itself. Time spans all cultures, and yet many of us have not critically engaged with how time effects what we do, how we perceive and the ways in which we interact. As such, our relationship to time remains almost invisible running in the background nearly unnoticed until it is somehow brought into conscious awareness. In this paper, we draw on Levine's concepts of clock time and event time as different perspectives on time, demonstrating how they play out in medical education and clinical practice within the United States and Brazil. Clock time treats time as something external to our lives, fixed by the natural world and measured by clocks. Event time is conceptualised more flexibly, where the duration of activities depends on internal cues related to the flow and progression of events rather than strict schedules. By contrasting these differences, we hope to make visible the way that time influences our choices for educating physicians and provide a foundation for medical education to begin questioning how time is positioned, experienced and understood as a powerful force in the shaping of our profession. Additionally, we consider these perspectives within the concepts of Taylorism and Slow Medicine to better understand their links to medicine's formal and hidden curriculum in hopes of raising awareness and create new visions for medical education.

Adopting a pedagogy of connection for medical education.

In this article, we propose developing a "pedagogy of connection" based on the history and evolution of medical education in Brazil. This pedagogy emerged from the intersection of the healthcare and higher educational systems, both dedicated to the principles of social justice and universal access, in response to the country's efforts to address the enduring impacts of slavery and social inequality. Following the "Sanitary Reformation" movement-a foundational moment for Brazil's healthcare and medical education systems-Brazil established the Unified Public Healthcare System (Sistema Único de Saúde - SUS). SUS is founded on principles of universality, integrality, equity, community participation, political and administrative decentralisation, hierarchisation and regionalisation. Aligned with these core principles and inspired by critical pedagogy, Brazilian medical education has evolved with a profound commitment to social justice, critical consciousness, professional presence and compassion. This evolution has given rise to a "pedagogy of connection," which imbues medical education with a sense of purpose and joy, preparing future medical professionals to address the challenges of our ever-evolving society and healthcare systems. The connections fostered by this pedagogy occur in complementary dimensions: (a) healthcare system and society, (b) community, (c) profession, (d) patients, and (e) ourselves. This innovative pedagogy enhances medical education discourse and practice by emphasising the development of a professional identity grounded in social justice and patient-centred care, which remain challenges for current medical education systems. As the global medical education community embraces decolonisation, this pedagogy offers a framework that can be adapted and enriched in various contexts worldwide, fostering opportunities for mutual learning from diverse educational systems in a dialogical and democratic manner.