Medical Education Programs Research Articles

A Homemade, Cost-Effective, Realistic Pelvic Exam Model.

This innovation is intended to instruct medical students, residents of all levels, and mid-level practitioners. Pelvic examinations are essential components to clinical practice but are challenging to teach, learn, and practice on live patients secondary to patient comfort because this is an invasive procedure.1 Resident physicians and medical students traditionally learn these methods through observation while actively working in their department or clinics.2 Simulation models can improve a provider's competency and confidence performing pelvic examinations which improve patient comfort and exam accuracy.3 One barrier to simulation training is the cost of the pelvic simulator models. A basic pelvic exam simulator costs $365.4 The cost is high, therefore limiting the availability of a simulation model accessible to residency programs across the country. This barrier to pelvic models was overcome by developing a homemade alternative for cervical examination and collection of screening swabs. The model created can be easily manufactured by students, residents, and faculty alike for less than $20 and approximately two hours of manufacturing time. A literature review was conducted to find similar products and other production methods for a pelvic examination model. No comparable models were found.This is a guide to utilizing supplies from a local dollar store combined with home recycling products and a few common crafting tools to create a realistic pelvic examination model. After utilizing this pelvic examination model, the learner will be able to: 1) demonstrate ability to perform a pelvic examination comfortably and safely, 2) demonstrate ability to obtain a cervical swab on female patients, and 3) show proficient understanding of female anatomy. The pelvic exam model is utilized to effectively teach proper technique for pelvic examinations. This model can be utilized to teach medical students, incoming residents, and new mid-levels. Senior residents, experienced mid-levels, or attendings who are experienced in completing pelvic examinations can easily utilize this model to teach proper technique. The data for this study was collected from a single graduate medical education program in Detroit, Michigan. This was designed as a single blind survey where the reviewer's identities were kept anonymous from the data collectors. Surveys were collected from attendings, residents, mid-level providers, and medical students across specialties of emergency medicine, family medicine, obstetrics and gynecology. A total of 77 individuals tested the homemade model and compared it to a pelvic exam on a live patient as well as a commercial pelvic exam model. Survey results showed the low-cost homemade model was just as effective as a commercially manufactured model, with some respondents saying the DIY model was more effective and more realistic. Comparing the commercial models to the homemade model, 54 of the 77 participants had experience with a commercial model. In the survey when compared to a commercial model, 57% of the participants felt the examination was the same, and 31% indicated the homemade model felt more realistic. Overall, the homemade cost-effective model is comparable if not more realistic to more expensive commercial models. The main take away of this innovation, to remember it is possible to create cost-effective models for realistic, educational learning. This model has one limitation because it is not suitable for a bimanual examination, but it can be expanded to allow for bimanual examination. Pelvic examination, cervical examination, creative simulation models.

Experience of practicing obstetrician-gynecologists in a surgical training program in total laparoscopic hysterectomy

Advanced surgical techniques, such as total laparoscopic hysterectomy, are often challenging to acquire beyond fellowship training programs for practicing obstetrician-gynecologists. A lack of formative data currently exist for continuing medical education programs, limiting our understanding of how improvement in surgical skills and training programs occur. This study aimed to investigate how practicing obstetrician-gynecologists acting as trainees experience a program that aims to teach them total laparoscopic hysterectomy, and to assess whether their surgical skills improve according to data from formative assessment tools and qualitative data from open-ended survey questions and in-depth interviews. We report a process analysis of formative data collected during a pilot implementation trial of a surgical training program targeting practicing obstetrician-gynecologists. Eleven consultant obstetrician-gynecologists and 4 experienced surgical mentors participated in 4 hospitals in Queensland, Australia. Total laparoscopic hysterectomy was performed in 700 patients over the course of the study. A total laparoscopic hysterectomy surgical mentorship training program of 10 training days with up to 3 total laparoscopic hysterectomy procedures per day was performed. Both the obstetrician-gynecologists and the surgical mentor completed a formative assessment questionnaire analyzing the trainee's performance after each surgical procedure. Mentors were formatively assessed by the Structured Training Trainer Assessment Report (STTAR) and at the completion of the study by the mini-STTAR, a summative assessment of quality of mentorship. Obstetrician-gynecologists, mentors, hospital leaders, and surgical administrative staff participated in qualitative interviews about the training program. Over time, there was a demonstrated improvement in trainee performance reported by both mentors and trainees in all competency assessment tool domains as the case number increased, with mentors consistently rating trainees' performance higher than the trainees themselves. Most trainees were satisfied with their mentor in all 31 areas during formative assessment, and at the end of the training, structure, attributes, and role modeling were all rated high (average score >4.5; range, 3.79-5.00), whereas training behavior was rated slightly lower at 4.1 (range, 3.79-4.45). Qualitative interviews demonstrated that the trainees found the training to be a beneficial, hands-on experience. Formative assessment clearly documented improvement in surgical skills during a total laparoscopic hysterectomy training program for consultant obstetrician-gynecologists.

In search of a modern character of a doctor: what examples to learn from the greats? Part I

At present, additional courses are increasingly being introduced into the postgraduate medical education program, which contain discussions on the personal qualities of a doctor and the functions of the medical profession. To that end, certain moral and ethical reference points are selected from the biographies of physicians of the "past", which are elevated to an ideal and repeated in every biographical article without proper professional evaluation. There is a mythologization of the image of a doctor among the professional community and the reason for this trend, in part, lies in the false idea that the history of medicine can be written without specialized knowledge and without the tools that historians use when analyzing biographical information.The article provides a general overview of the development of medical knowledge, which was influenced not only by political and economic, but also by religious factors. A specialized approach used by historians in the analysis of biographical information is considered. A different view is offered on the potential of interpreting the image of a doctor, evaluating the activities of physicians of the past and forming examples for doctors of the future that would be in demand in modern professional education.

Characterizing the Variety of Call Structures Across Canadian Diagnostic Radiology Postgraduate Medical Education Programs.

Characterizing the Variety of Call Structures Across Canadian Diagnostic Radiology Postgraduate Medical Education Programs.

Knowledge level of medical students about ionising radiation used for diagnostic purpose in radiology: a survey study.

People exposed to ionising radiation may develop harmful somatic and genetic effects in their anatomical structures. Technological advancements, particularly in radiological devices, research and examinations result in a significant increase in the number of radiological investigations. This large number of radiological examinations increased the number of patients affected by ionising radiation. This study aims to evaluate the medical students' knowledge of ionising radiation and, examine the level of knowledge of medical students on the awareness and safety of ionising radiation exposure, emphasises the importance of radiation curricula internship programmes. This study is a survey application. The chi-square test is used. As a result, the intern's knowledge of ionising radiation increased significantly after the internship in a radiology unit. Although it has been significantly increased, it is still insufficient. This gap can be filled by incorporating radiology unit internship programmes into the curriculum of medical faculty education programmes.

Medical education program implementation experience in an elective course: a case study in South Korea.

This study was conducted to examine the results of designing and implementing a teaching program for medical education as the elective course for 4th-year students of medical course. In order to design the teaching program for medical education as an elective course, we conducted literature review, five medical education experts were interviewed, and the literature required in the design process was reviewed. A developing teaching program was implemented as an elective course in a medical school of Korea, and 4th-year students of medical course participated in the program. In the elective course, the medical education program process competencies were derived into three categories: theoretical educational knowledge, teaching competency, and research competency for education. Moreover, instructional materials were developed to help students achieve these competencies. And project-based learning strategy was selected and implemented for 4th-year students in medical course, and positive satisfaction was confirmed. As a study designed and implemented in a medical education program in a medical school in Korea, it is expected to be helpful when introducing medical education to undergraduate students or developing a medical education program to strengthen the teaching capacity of residents.

Financial Leadership Skills Training: Can a Hybrid Didactic/Interactive Exercise Model Fill a Gap in Graduate Medical Education?

Background With recent healthcare changes, competition for financial resources is increasing. Graduate medical education (GME) programs do not routinely prepare residents to understand the complexity of financial decisions that affect their practice. At our institution, we designed new sessions to explore personal and departmental financial education in our yearly Radiation Oncology (RO) leadership course. Methods Over the past five years, we have been piloting a longitudinal leadership course for our RO medical and physics residents, integrating a hybrid didactic/interactive exercise approach. The core RO faculty consists of the course director, the residency directors, and department leadership. The course structure includes an introduction to understanding how resource allocation is determined at the institutional level as well as a personal finance component. We recruited the RO Vice Chair, RO Department Administrator, and the MD, MBA Chair of the Vacancy Review Committee at our institution to teach these concepts over three sessions. The first was a didactic introduction to departmental finance by our Vice Chair to prepare attendees for the second interactive session, in which residents worked through a pro forma to determine the feasibility of hiring a new departmental faculty member. The final session was led by our MD, MBA colleague who taught residents how hiring decisions are made and explained what happens to the pro forma at the institutional level. The third session integrated an interactive exercise focusing on personal finance skills. Results At the end of the series, the ten resident attendees were informally surveyed regarding how effective and worthwhile the three finance sessions were. The verbal feedback regarding the curriculum was uniformly positive. All ten residents, including the physics resident, indicated that these classes were helpful and filled a gap in the current GME curriculum. Further feedback analysis noted that additional interactive exercises should be prioritized to reinforce understanding of these financial concepts. Discussion Financial education is lacking in most GME training programs. Targeted instruction for both personal and departmental financial decisions was well received in this novel course at our institution. Further studies are needed to determine effectiveness and optimal integration of financial leadership skill development in the GME setting. Future directions could be to determine the best balance of didactic instruction and interactive exercises to enhance resident understanding of these financial topics. With recent healthcare changes, competition for financial resources is increasing. Graduate medical education (GME) programs do not routinely prepare residents to understand the complexity of financial decisions that affect their practice. At our institution, we designed new sessions to explore personal and departmental financial education in our yearly Radiation Oncology (RO) leadership course. Over the past five years, we have been piloting a longitudinal leadership course for our RO medical and physics residents, integrating a hybrid didactic/interactive exercise approach. The core RO faculty consists of the course director, the residency directors, and department leadership. The course structure includes an introduction to understanding how resource allocation is determined at the institutional level as well as a personal finance component. We recruited the RO Vice Chair, RO Department Administrator, and the MD, MBA Chair of the Vacancy Review Committee at our institution to teach these concepts over three sessions. The first was a didactic introduction to departmental finance by our Vice Chair to prepare attendees for the second interactive session, in which residents worked through a pro forma to determine the feasibility of hiring a new departmental faculty member. The final session was led by our MD, MBA colleague who taught residents how hiring decisions are made and explained what happens to the pro forma at the institutional level. The third session integrated an interactive exercise focusing on personal finance skills. At the end of the series, the ten resident attendees were informally surveyed regarding how effective and worthwhile the three finance sessions were. The verbal feedback regarding the curriculum was uniformly positive. All ten residents, including the physics resident, indicated that these classes were helpful and filled a gap in the current GME curriculum. Further feedback analysis noted that additional interactive exercises should be prioritized to reinforce understanding of these financial concepts. Financial education is lacking in most GME training programs. Targeted instruction for both personal and departmental financial decisions was well received in this novel course at our institution. Further studies are needed to determine effectiveness and optimal integration of financial leadership skill development in the GME setting. Future directions could be to determine the best balance of didactic instruction and interactive exercises to enhance resident understanding of these financial topics.

Designing a User-Friendly Context-Specific Assessment Tool for Community-Based Teachers.

Graduate medical education (GME) programs must ensure that they are able to collect accurate information about resident competence through assessment tools that are fit for purpose. An assessment form or process is called “fit for purpose” when there is good alignment between the tool (how something is assessed) and the intent (the specific knowledge, skill, or attitude/belief that is being assessed).In our family medicine GME program, we identified that the generic workplace-based summative assessment tool provided to community-based family medicine obstetrics (FMOB) clinical teachers was not fit for purpose. As a result, these teachers were uncertain about program expectations regarding competence, the assessment form was challenging and frustrating to complete, and our program struggled to extract useful assessment data from completed assessment forms. To address this issue, we took a systematic approach to develop a workplace-based assessment tool that was specific to the clinical context of FMOB and user-friendly for clinical teachers.Our goals were to develop: (1) a fit-for-purpose workplace-based assessment tool for community-based FMOB teachers that could be used for accurate assessment without the need for faculty development, and (2) an evidence-guided process for designing similar context-specific tools in the future. We met our first goal through designing the FMOB competence rubric (FMOB-CR) tool. The FMOB-CR is comprised of 2 elements. The first is a rubric containing specific statements and examples of resident performance. The rubric clearly outlines the expected level of competence on a 3-point rating scale (“cause for concern,” “acceptable competence,” “exemplary competence”), organized by the 6 Skill Dimensions of Family Medicine (similar to CanMEDS roles).1 The second element is a simple online assessment form in which FMOB teachers specify their resident's level of competence in each Skill Dimension, guided by the statements and examples in the rubric.The FMOB-CR uses plain language and context-specific clinical examples along with a simple online assessment form to clearly communicate expectations of competence to teachers (and residents) without additional faculty development. This user-friendly tool should make it easier for FMOB clinical teachers to better identify residents who are underperforming, which will allow the program to be more effective in intervening and supporting residents in difficulty.To meet our second goal, we developed an evidence-guided process for designing workplace-based assessment tools that are fit for purpose for specific clinical contexts. Our design process included: assembling a tool development team with relevant expertise, including a resident; consultations with FMOB teachers and residents; environmental scan and review of local assessment forms and assessments used by other FMOB GME programs; a modified Delphi process with local GME program faculty to develop and refine the table of competence statements; a consensus-building process within the research team to revise the statements for the rating scale; and implementation of the assessment rubric with concurrent collection of validity evidence. For both the FMOB-CR and the development process, we collected validity evidence according to Messick's unified concept of validity.2The Table details the validity evidence collected to date. Fifteen FMOB teachers surveyed showed strong agreement across 5 items about the utility of the rubric in allowing them to accurately assess residents (overall M=3.25/4, Likert scale 1=strongly disagree to 4=strongly agree), and across 3 items about the usefulness of the rubrics in helping them to understand program expectations of resident competence (overall M=3.36/4); 14 of 15 teachers preferred the new form to the old one.We hope that the worked example of the FMOB-CR and its development process may serve as a blueprint for other institutions to develop context-specific assessment tools.

The Value of Signaling an Orthopaedic Surgery Program: A Survey to Orthopaedic Surgery Programs.

A new system was implemented by the Association of American Medical Colleges called the preference signaling program for the 2022 to 2023 orthopaedic surgery residency match. Applicants were able to signal 30 orthopaedic surgery programs to indicate high interest in a specific program. The purpose of this study was to address how important signaling was to an orthopaedic surgery program this 2022 to 2023 application cycle. A five-question survey was sent to orthopaedic surgery residency programs participating in the Electronic Residency Application Service this application cycle. Contact information was gathered through the Accreditation Council for Graduate Medical Education residency website and program websites. Responses were obtained from 69 of the 151 programs (46%) contacted. The average number of applicants per program was 727 (range, 372 to 1031, SD 155). Thirty-four of 61 respondents (56%) stated that 100% of their interviewees signaled their program. Fifty-five of 61 respondents (90%) indicated that their interviewee pool consisted of 75% or more applicants who signaled. Applicants who signaled had a 24.4% (range, 12.77 to 47.41, SD 8.04) chance of receiving an interview. Applicants who did not signal had just a 0.92% (range, 0 to 13.10, SD 2.08) chance of receiving an interview. Fifty-four of the 63 applicants (86%) answered that signaling played an important role in considering an applicant for an interview. Over half of the responding programs only interviewed applicants who signaled their program, and over 90% of programs' interview lists consisted of at least 75% of signaling applicants. Eighty-six percent of programs indicated that signaling played an important role in considering an applicant for an interview. Applicants who signaled were 26.5 times more likely to receive an interview than those who did not (P < 0.0001). With this information, applicants can narrow down their list of programs to apply to, knowing that their signal to a program will give them a better chance at receiving an interview.

A Program of Assessment Model for Point-of-Care Ultrasound Training for Pediatric Critical Care Providers: A Comprehensive Approach to Enhance Competency-Based Point-of-Care Ultrasound Training.

Point-of-care ultrasound (POCUS) is increasingly accepted in pediatric critical care medicine as a tool for guiding the evaluation and treatment of patients. POCUS is a complex skill that requires user competency to ensure accuracy, reliability, and patient safety. A robust competency-based medical education (CBME) program ensures user competency and mitigates patient safety concerns. A programmatic assessment model provides a longitudinal, holistic, and multimodal approach to teaching, assessing, and evaluating learners. The authors propose a fit-for-purpose and modifiable CBME model that is adaptable for different institutions' resources and needs for any intended competency level. This educational model drives and supports learning, ensures competency attainment, and creates a clear pathway for POCUS education while enhancing patient care and safety.

A Role for Live-Animal Models in Undergraduate Surgical Education During the Cadaver Shortage.

A Role for Live-Animal Models in Undergraduate Surgical Education During the Cadaver Shortage.

The Everlasting Effects of the Covid-19 Pandemic on Oral and Maxillofacial Surgery Residency Match

The Everlasting Effects of the Covid-19 Pandemic on Oral and Maxillofacial Surgery Residency Match

National Pediatric Subspecialty Recruitment Sessions Increase Program Visibility and Impact Candidate Application Choices.

While the pediatric subspecialty applicant pool is increasing, so is the number of open positions, with an overall 1:1 ratio of applicant to position. Unfortunately, there is a wide disparity in this ratio dependent upon subspecialty, leaving many programs unfilled.1 Since 2020, recruitment has shifted to virtual, and while the impact on programs and applicants is not fully understood, some program leadership feel disadvantaged without the opportunity to showcase their programs in person. To satisfy the growing desire for pediatric subspecialty programs to be more visible to the applicant pool, a national virtual recruitment session was piloted for pediatric subspecialties using the virtual format created by FuturePedsRes.Individual subspecialty recruitment sessions were held during July 2022 from 8:00-9:30 pm ET featuring 2 to 3 subspecialties on 4 different dates. Prior to the evening, programs were given the option to post a slide on the Association of Pediatric Program Directors website describing their fellowship training program for applicant review. A representative for each participating subspecialty, identified through the Council of Pediatric Subspecialties, served as the communication director between programs and session organizers to coordinate logistics prior to the event. Each subspecialty had a unique virtual link on the night of their session, and each fellowship program within that subspecialty had an individual breakout room. Applicants rotated freely between program breakout rooms, with a suggestion to rotate every 10 minutes. A post-participation survey was sent to all participants.Eleven pediatric subspecialties participated, including 701 live participants representing programs and applicants (Table). Of the participating program leadership, 158 completed a post-participation survey, with half indicating the session increased the visibility of their program, several citing an appreciation of the intimate relationship with the applicants, and a majority wanting to participate again. Of the 49 applicants who responded to the survey, 100% felt the evening was a good use of their time, highlighting the face time with leadership and trainees and the opportunity to meet many programs in one setting as positives. Importantly, 92% (45 of 49) of applicants visited programs outside their current geographic location, 51% (25 of 49) visited programs they were not originally planning to apply to, and 42% (18 of 43) applied to new programs as a result of participating in the session. Challenges identified included: some programs having no applicants visit their breakout rooms, the late timing of sessions in this recruitment season, and some logistical issues during the sessions.The inaugural national pediatric subspecialty recruitment sessions were successful, resulting in increased visibility for programs and in applicants applying to programs they had not considered prior to the session. Applicants thought the accessibility of all programs on one platform simultaneously was helpful, and many visited programs they otherwise would not have had the opportunity to explore. In response to feedback, several logistical changes will be applied to subsequent sessions for the 2023 appointment year, including a shift to earlier in the year, prior to the submission of applications. This will allow for increased time for advertising the sessions and improved promotion of individual program information in advance. This model of training program informational sessions is applicable across graduate medical education programs and may serve to not only provide enhanced individual program visibility but also increase awareness about careers in subspecialities in general and potentially expand the applicant pool.

Power/knowledge: A sociomaterial perspective on a new accreditation process during COVID-19.

The COVID-19 pandemic had significant impacts on many aspects of health care and education, including the accreditation of medical education programmes. As a community of international educators, it is important that we study changes that resulted from the pandemic to help us understand educational processes more broadly. As COVID-19 unfolded in Canada, a revised format of undergraduate medical accreditation was implemented, including a shift to virtual site visits, a two-stage visit schedule, a focused approach to reviewing standards and the addition of a field secretary to the visit team. Our case study research aimed to evaluate the sociomaterial implications of these changes in format on the process of accreditation at two schools. We interviewed key informants to understand the impacts, strengths and limitations of changes made to the accreditation format. We used an abductive approach to analyse transcripts and applied a sociomaterial lens in looking for interconnections between the material and social changes that were experienced within the accreditation system. Stakeholders within the accreditation system did not anticipate that changes to the accreditation format would have significant impacts on how accreditation functioned or on its overall outcomes. However, key informants described how the revised format of accreditation reconstructed how power was distributed and how knowledge was produced. The revised format contributed to changes in who held power within each of the programmes, within each of the visiting teams and between site members and visiting team members. As power shifted across stakeholders in response to material changes to the accreditation format, key informants described changes in how knowledge was produced. Our findings suggest that the most powerful knowledge about any given programme might best be obtained through individualised tools, technologies and voices that are most meaningful to the unique context of each programme. Deliberate attention to how knowledge and power are influenced by the interactions between material and social processes within accreditation may help educators and leaders see the effects of change.

The influence of new nurses’ knowledge, nursing performance, and educational needs of chemotherapy medication on chemotherapy medication errors

Purpose: This study aimed to identify the factors affecting the chemotherapy medication errors made by new nurses and to use the results as basic data for the development of a chemotherapy medication nursing education program for new nurses.Methods: This cross-sectional study was conducted with 189 new nurses working at a general hospital and a tertiary general hospital in Korea. The data collection period was from January 11 to February 7, 2021. The data collected during this study were analyzed using the IBM SPSS statistics version 25.0 program. Data analysis included descriptive statistics, independent t-test, ANOVA, and logistic regression analysis.Results: One factor influencing chemotherapy medication errors was new nurses’ educational needs (odds ratio=.18, &lt;i&gt;p&lt;/i&gt;=.005). As educational needs increased, the probability of making errors in medication was reduced by .18.Conclusion: It is necessary to develop a chemotherapy medication education program tailored to the educational needs of new nurses by considering the education period, method, and content, with a focus on the content with high demand from new nurses.

Guidelines for the use and reuse of animals for teaching within veterinary medical education programs

Use and reuse of animals for educational purposes could adversely affect animal welfare. Guidelines for quantifying, monitoring, and planning the use and reuse of animals have been developed. Within this framework, animals are assigned points for usage, with more points being allocated to procedures that may have a greater adverse effect on animal welfare. Usage of individual animals is limited to a maximum of 8 points in a calendar week, 24 points in a month, or 60 points within a 16-week study period and any associated examination period. Advantages and disadvantages of the system are discussed, while modifications are expected as knowledge emerges on the impacts of procedures on animal welfare.

Developing and validating a national set of standards for undergraduate medical education using the WFME framework: the experience of an accreditation system in Iran

BackgroundDefining standards is the first step toward quality assurance and improvement of educational programs. This study aimed at developing and validating a set of national standards for the Undergraduate Medical Education (UME) program through an accreditation system in Iran using the World Federation for Medical Education (WFME) framework.MethodsThe first draft of standards was prepared through consultative workshops with the participation of different UME program stakeholders. Subsequently, standards were sent to medical schools and UME directors were asked to complete a web-based survey. The content validity index at the item level (I-CVI) was computed using criteria including clarity, relevance, optimization and evaluability for each standard. Afterward, a full-day consultative workshop was held and a wide range of UME stakeholders across the country (n = 150) discussed the survey results and made corrections to standards.ResultsAnalysis of survey results showed that relevance criteria had the best CVI as only 15 (13%) standards demonstrated CVI < 0.78. More than two-thirds (71%) and a half (55%) of standards showed CVI < 0.78 for optimization and evaluability criteria. The final set of UME national standards was structured in 9 areas, 24 sub-areas, 82 basic and 40 quality development standards, and 84 annotations.ConclusionsWe developed and validated national standards as a framework to ensure the quality of UME training with input from UME stakeholders. We used WFME standards as a benchmark while addressing local requirements. The standards and participatory approach to developing standards may guide relevant institutions.

Addressing HPSP Learner Needs: A Pilot Study of a "Fundamentals of Military Medicine" Course.

Military medicine is uniquely different from civilian medicine, and military physicians in the USA are primarily recruited through the Health Professions Scholarship Program (HPSP) and the Uniformed Services University of the Health Sciences (USUHS). Medical students at the USUHS receive more than 650 hours of military-specific curriculum and spend 21 days engaged in field exercises. HPSP students complete two 4-week officer training sessions during their 4 years of medical school. There is a clear discrepancy in preparation for military medicine between HPSP and USUHS students. The USUHS School of Medicine undertook an initiative to develop a fully online self-paced course on the fundamentals of military medicine topics to help HPSP students bridge the gap in their preparation. This article will describe how the online self-paced course was designed and present feedback from the pilot offering of this course. As proof of concept of the effectiveness of an online self-paced course for teaching the fundamentals of military medicine to HPSP students, two chapters from the "Fundamentals of Military Medicine" published by the Borden Institute were transferred to an online format. Each chapter was offered as a module. In addition to the chapters, an introduction and closing module were added to the pilot course. The pilot course was offered over 6 weeks. Data for this study were obtained from module feedback surveys, pre- and post-course quizzes, participant focus groups, and course evaluation surveys. Pre- and post-test scores were analyzed to evaluate content knowledge. The open-ended survey questions on the feedback forms and focus group transcripts were collated and analyzed as textual data. Fifty-six volunteers enrolled in the study, and 42 completed the pre- and post-course quizzes. This participant pool included HPSP students (79%, n = 44) and military residents in civilian graduate medical education programs (21%, n = 12). The module feedback surveys showed that most participants spent 1 to 3 hours on each of the modules, which they rated as extremely or quite reasonable (Module 1: 64%, Module 2: 86%, Module 3: 83%). There was not much difference between the overall quality of the three modules. The participants found content on application to the military-specific context very valuable. Of the different course elements, video content was rated as the most effective. Participant feedback clearly highlighted that HPSP students want a course that informs them about the fundamentals of military medicine and demonstrates how the information would apply to their lives. Overall, the course was effective. HPSP students showed knowledge gains and self-reported satisfaction with the course's objectives. They were able to locate information easily and understand the course expectations. This pilot study has shown that there is a need for a course that provides the fundamentals of military medicine to HPSP students. A fully online self-paced course provides flexibility for the students and improves access.

Medical students and residents appreciate ebooks' convenience, but prefer the print book reading experience.

Increasingly, libraries buy medical monographs as ebooks, but that may not be what medical students and residents want. Some studies have shown that they prefer print books for some types of reading. On the other hand, for participants in distributed medical programs, ebooks are more accessible. To determine whether medical students and residents at an institution with a distributed medical education program prefer medical ebooks or print books. In February 2019, 844 medical students and residents were invited to complete an online questionnaire on their format preferences. Two hundred thirty-two students and residents responded. Most preferred electronic format for reading a few pages, but print for entire books. Respondents preferred ebooks because they were immediately available, searchable and could be used on the go, and print books because they strained users' eyes less, facilitated absorption of the text and could be held in users' hands. The location of respondents and year of study had little effect on responses. Libraries should consider buying quick reference and large, heavy textbooks as ebooks and pocket-sized or shorter, single-topic titles, in print format. Libraries have a responsibility to make both print and ebooks available to their users.

Neuromorphological Atlas of Human Prenatal Brain Development: White Paper.

Recent morphological data on human brain development are quite fragmentary. However, they are highly requested for a number of medical practices, educational programs, and fundamental research in the fields of embryology, cytology and histology, neurology, physiology, path anatomy, neonatology, and others. This paper provides the initial information on the new online Human Prenatal Brain Development Atlas (HBDA). The Atlas will start with forebrain annotated hemisphere maps, based on human fetal brain serial sections at the different stages of prenatal ontogenesis. Spatiotemporal changes in the regional-specific immunophenotype profiles will also be demonstrated on virtual serial sections. The HBDA can serve as a reference database for the neurological research, which provides opportunity to compare the data obtained by noninvasive techniques, such as neurosonography, X-ray computed tomography and magnetic resonance imaging, functional magnetic resonance imaging, 3D high-resolution phase-contrast computed tomography visualization techniques, as well as spatial transcriptomics data. It could also become a database for the qualitative and quantitative analysis of individual variability in the human brain. Systemized data on the mechanisms and pathways of prenatal human glio- and neurogenesis could also contribute to the search for new therapy methods for a large spectrum of neurological pathologies, including neurodegenerative and cancer diseases. The preliminary data are now accessible on the special HBDA website.