Generative artificial intelligence (GAI) is anticipated to transform medical education, and many studies have already been published reporting its effectiveness, accuracy, and feasibility as a "tutor" to help medical students learn in different didactic contexts. This perspective reviews this literature and highlights an understudied use-case for GAI: helping medical students to prepare for context-specific intraoperative learning during surgical clerkships. We propose a "librarian," rather than tutor, method for GAI deployment in undergraduate medical education, where students dictate their learning objectives and receive specific direction to guide their individualized preparation, instead of the passive reception of didactic information which defines tutor-GAI use. We describe the librarian-GAI model in practical terms, providing template queries and prompt-engineering guidance for learners.

Application of a Systematic Approach to Curriculum Development Within Oncology Education: The Oncology National Course for Advocacy, Research, and Education.

Anatomical photographs are essential in medical education and research as they document fine details of human anatomy. which may support visualization of dissection material. This study investigated the feasibility of an artificial intelligence (AI)-based image enhancement system for anatomical dissection photographs and explored whether subtle visual differences could be detected under magnification. A dataset of 50 anatomical photographs taken between 2001 and 2024 with four different digital cameras was processed using Upscayl (v2.11.5) with the preset "16× REAL-ESRGAN." Processing was performed on a Casper Excalibur G770 laptop, requiring approximately 3-5 min per image. Original and enhanced images were compared at magnifications of 1×, 5×, 10×, 15×, and 20× on a 55-in. Full HD display. Forty experts, including neuroanatomists and neurosurgeons, qualitatively assessed the images with respect to anatomical accuracy, noise reduction, edge definition, and training value. The visual differences between the original and enhanced images were generally subtle. However, subtle improvements in edge definition and noise reduction became more apparent in deep anatomical regions, such as ventricular cavities, particularly at higher magnification levels. High-resolution images showed limited observable differences, whereas lower-resolution images exhibited slightly more noticeable changes under magnification. The enhancement process did not introduce distortions of anatomical structures. A key limitation was the substantial increase in file size after enhancement. AI-based image enhancement appears feasible for anatomical dissection photographs and may provide modest visual benefits in selected settings, especially for older or lower-resolution images viewed at higher magnification. Further optimization is required to reduce file size and processing time before routine educational or publication use.

A concise review investigating simulation modalities' effects on team efficiency, provider wellbeing, education & clinical outcomes.

Virtual reality (VR) devices are increasingly being utilized within operating theaters and intensive care units where appropriate sanitation is vital to ensure that patients do not unnecessarily acquire hospital-associated infections. The morphology of VR devices in conjunction with the variety of materials and internal components provides challenges to their repurposing. This study aimed to evaluate the microorganisms remaining on VR headsets following sanitation by laboratory staff in a medical education anatomy teaching facility. The external components and internal facial interface were swabbed and separately cultured on four AGAR plates (Horse Blood, Nutrient, bile Esculin, and Mannitol Salt). Colonies were counted, sampled, pooled and subsequently processed for shotgun metagenomic sequencing. A higher number of colonies were present on surfaces closest to the eyes and facial interface compared to the external components. Metagenomic analysis identified 27 pathogenic bacteria including 4 "ESKAPE" pathogens (Enterobacter sp., Staphylococcus aureus, Klebsiella spp. and, Escherichia coli) and numerous organisms associated with ocular infections. A broad range of antimicrobial resistance genes were identified conveying resistance to Methicillin, Aminoglycosides, Macrolides, Tetracyclines, and Polymixins. Further research is required to ensure that current sanitization practices of VR head mounted displays are appropriate within high-risk hospital settings.

Rethinking Competency-Based Medical Education in Radiation Oncology: Early Lessons and Future Directions.

Investigating narrative styles in animated patient stories to increase public awareness and genetic literacy in a multiethnic Asian population.

The importance of young surgeons in surgical health policy advocacy engagement.

Introduction: Anatomy is considered a difficult subject with a broad curriculum, and many students encounter difficulty in understanding it effectively. Modern-day learning involves the integration and use of new technologies and resources. Aim: To examine the perceptions of medical students regarding various teaching, learning, and assessment methods. Materials and Methods: This cross-sectional survey was conducted among undergraduate medical students (n=266) of the American International Institute of Medical Sciences, Udaipur, Rajasthan, India, after obtaining ethical clearance. A structured questionnaire consisting of 28 questions encompassing the current teaching, learning, and assessment methods in anatomy was used for the study. The data obtained were analysed and represented as percentages. Results: More than half of the participants, 164 (61.65%), believed that a one-year duration is adequate for proper understanding of the subject. About 82 (30.83%) of the participants felt that classical large-group lectures were the best teaching method. Students appreciated problem-based teaching, small-group demonstrations, and the use of advanced teaching-learning methodologies. A total of 248 (93.23%) of the participants enjoyed teaching at the dissection table. The majority of participants found difficulty in learning embryology 190 (71.43%) and histology 140 (52.63%). They expressed difficulty in comprehending the sequence of events, inability to visualise structures, and inadequate time allocation in embryology, as well as difficulty in identifying structures under the microscope and insufficient lecture and practical time in histology. Participants were satisfied with continuous assessment methods such as weekly assessments and part-ending tests. Conclusion: The survey received a mixed response from the participants. They were satisfied with the existing oneyear anatomy curriculum. Participants appreciated classical chalkboard teaching and cadaveric dissection even in the age of multimedia and artificial intelligence. Problem-Based Learning (PBL) and clinical case discussions as part of CompetencyBased Medical Education (CBME) encouraged critical thinking and application of knowledge among the participants. Students expressed anxiety regarding embryology and histology but appreciated continuous assessment strategies, as these aided ongoing learning and improved performance.

Holopath-VR360-degree virtual reality videos in pathology education: The Holopath-VR experience.

Emergency medicine (EM) board certification pass rates have been declining amid a rise in new residency programs-many affiliated with for-profit hospitals or lacking Council of Teaching Hospital (COTH) designation. This study examines how founding year, COTH-status, program length, and hospital ownership relate to board examination performance. We conducted an observational cross-sectional analysis of 234 EM residency programs using American Board of Emergency Medicine, Accredidation Council for Graduate MEdical Education, and American Hospital Association data. The primary outcomes were program-level first-time Qualifying Exam (QE) and Oral Certifying Exam (OCE) median pass rates from 2021 to 2023. We examined the associations of pass rates with founding year, primary hospital COTH-status, program length (3 vs. 4 years), and primary hospital ownership. Linear regression models assessed relationships between program characteristics and pass rates. Recently-founded programs (post-2015) had significantly lower board performance, with an 11-percentage point reduction in QE pass rates (p < 0.001) and a 2.6-percentage point reduction in OCE pass rates (p = 0.001). Programs affiliated with COTH hospitals had higher pass rates (QE + 6.1 percentage points, p < 0.001; OCE + 1.6 percentage points, p = 0.001). Three- and four-year programs demonstrated similar board pass rates. In comparison to programs with a for-profit affiliation, EM residency programs with nonprofit and government affiliations were associated with nonsignificantly higher QE pass rates (+ 2.0 percentage points, p = 0.40 and + 4.6 percentage points, p = 0.061, respectively). Nonprofit affiliation was associated with nonsignificantly higher OCE pass rates(+ 2.0 percentage points, p = 0.11). Government affiliation was associated with significantly higher OCE pass rates (+ 2.9 percentage points, p = 0.026). Program characteristics significantly affect board examination outcomes for EM residents. Recently founded programs, those lacking COTH designation, or those affiliated with for-profit hospitals may lack essential resources and experience for optimal training. Identifying and supporting the institutional factors that contribute to resident success will be vital to maximizing programs' learning environments.

Continuing education is critical for oncology nurses to enable the delivery of safe, efficient, specialist care based on current evidence-based guidelines. Accessing training opportunities can be challenging in the face of work and staffing pressures. Asynchronous online education can circumvent this barrier but despite growth in popularity, evidence of its effectiveness on practice outcomes is weak. To evaluate and synthesise evidence for the impact of asynchronous online cancer education for nurses on practice outcomes. A systematic approach was used to identify primary studies in the following databases: CINAHL, MEDLINE, APA, PsychInfo, ERIC, EMBASE, PubMed and Web of Science. Critical appraisal was guided by the Medical Education Research Quality Instrument (MERSQI) and Effective Public Health Practice Project (EPHPP) tools for quantitative studies, and the Critical Appraisal Skills Programme (CASP) checklist for qualitative studies. The Kirkpatrick Four Level Model of training evaluation and a modified effect direct plot were used to facilitate synthesis of the evidence. Thirty studies of varying research design were included in the review. Vast heterogeneity was apparent in research designs, participants, intervention design and duration, and outcome measures. Due to this heterogeneity, it was difficult to establish that one design of education was more effective than another. Patient outcomes were not measured in any of the thirty studies reviewed. Behavioural change was objectively measured in two (7%) studies, evaluating screening rates and pain assessments, and self-reported in eleven (37%) studies regarding changes such as adapting to patients' language needs, cytotoxic drug handling, and discussing reproductive health. At least one educational outcome (nurses' knowledge, skills, attitudes, beliefs, confidence or self-efficacy) was measured in all thirty papers, however, improvements in these did not necessarily translate to evidence of changing practice outcomes. The overall quality of evidence was weak, particularly with respect to research design and validity of outcome measures. The need for more rigorous research in this field continues as there were limited evidence available to evaluate the direct impact of online cancer education on practice outcomes. Practice outcome evaluation could be enhanced by using measurements that are less subject to bias.

The Surgical Objective Structured Clinical Examination: A Literature Review.

One of the most important components of medical education is attitude education, where a central element of attitude education is the teaching of medical ethics and professional values. An educational approache used for this purpose is the examination of the Hippocratic (Historical) Oath and the Current Physician’s Oath (the Declaration of Geneva, 1948). The aim of this study is to analyze the Original Hippocratic Oath and the Current Physician’s Oath in terms of their thematic content and to demonstrate their relationship with medical ethical principles and professional values. A literature review was conducted to identify the ethical principles and core professional values in medicine. Ethical principles were addressed beyond the traditional four-principle framework, adopting a more comprehensive ethical perspective. With respect to professional values, the analysis considered humanistic values commonly emphasized in both European and U.S. medical curricula. Subsequently, the Hippocratic Oath and the Current Physician’s Oath were examined to determine which ethical principles and professional values they reflect. The findings indicate that both the original and current oath texts are closely associated with numerous medical ethical principles and professional values and continue to maintain their relevance in modern medicine. Therefore, a detailed examination of both texts and their association with ethical and professional values should constitute a core component of attitude education throughout medical education. We believe that embracing and upholding the ethical and professional values articulated in these oath texts is essential for all physicians throughout their professional lives. Keywords: Hippocratic Oath, Physician’s Oath, Geneva Declaration, Ethical Principles, Professional Values, Medical Education.

Climate change in Ecuadorian undergraduate medical education programs: curricular assessment and the role of medical students' associations, 2019-2024.

ABSTRACT Background To create a workforce fit for 21st century healthcare, the importance of integrating more primary care teaching into the medical undergraduate curriculum has been repeatedly highlighted; yet has been slow to realise. Aim To explore the lived experience of educators working together to integrate teaching at the primary-secondary care (PSC) interface and identify facilitators and barriers to achieving change. Method A constructivist research philosophy using qualitative methodology explored the experiences of educators involved in integrating general practice teaching into the undergraduate curriculum. Purposive sampling identified suitable primary, secondary care and pre-clinical educators who consented to semi-structured interviews remotely via Microsoft Teams. Transcripts were coded using qualitative data analysis software and themes generated through iterative and inductive analysis. Results Ten educators (5 General Practitioners, 3 Hospital Consultants, 2 Pre-Clinical) took part. Four main themes emerged: (i) The sociocultural context, (ii) Understanding the interface, (iii) Tensions at the primary/secondary care interface, (iv) Challenges in managing educational change. Although supporting the rational for change, a strong sense of loss of traditional teaching formats, lack of communication, and misunderstandings related to clinical work and differentiating between generalist and specialist roles were found. Conclusion This study is unique in revealing a complex educational landscape, with many interconnected factors to consider if general practice is to be better integrated into the undergraduate curriculum. Hidden medical education sociocultural themes require further exploratory study in terms of both interface working and curriculum development.

Academic hospital medicine faculty possess diverse interests and pursue a variety of career pathways. Faculty development programs are essential for career advancement; however, a lack of alignment between individual faculty needs and development activities can impede career development efforts. To our knowledge, there are no studies that have examined whether clusters of faculty exist with similar development needs, for which tailored faculty development "packages" can be offered. To determine whether distinct clusters of faculty with shared development needs can be identified and to explore faculty-level factors associated with these clusters. We conducted a survey study among hospitalists at seven academic institutions from November 2023 to September 2024. We generated a comprehensive list of 33 potential faculty development topics and asked survey respondents to indicate whether each topic was important to them, choosing as many as applied. We used latent class analysis (LCA) to classify faculty into distinct clusters based on their selection of desired development topics. A total of 136 faculty (median age 38 years) participated in the study. LCA identified five distinct groups as the optimal solution: (1) Master clinician (29%), (2) medical education scholar (11%), (3) clinical investigator (24%), (4) educational leader (22%), and (5) operational leader (14%). In a representative sample of academic hospitalists, we identified five distinct latent classes of faculty based on their preference for faculty development topics. These results can be leveraged to curate specific packages to optimally align faculty development offerings with diverse faculty interests and career trajectories.

Bridging theory and practice in generative artificial intelligence for medical education: insights from clinical teaching experience.

Large language models (LLMs) have gained increasing popularity in medical education, with evidence supporting their educational value when framed through the lens of Cognitive Load Theory (CLT). Source-based LLMs, which explicitly ground responses in user-uploaded material via retrieval-augmented generation (RAG) algorithms, may offer additional educational value by using student-developed materials to conceptualize new areas of learning in a familiar framework. This has applications for areas like medical education in dermatology, which could benefit from inclusive sources and enhanced education to alleviate healthcare gaps. However, no prior studies have examined whether the inclusion of student-authored notes alters the response characteristics of a source-based LLM when responding to medical questions. To conduct an observational, comparative performance evaluation study assessing the accuracy, response reproducibility, and intermodel response similarity of freely available LLMs on text-only Step 1 dermatology questions, and to explore whether providing extensive student-generated notes to a source-based LLM alters these performance characteristics. In December 2024, four LLMs were evaluated: NotebookLM (NLM) with uploaded pre-clerkship study guides (NLM w/ Notes), NLM with an uploaded blank sheet of paper (NLM w/o Notes), ChatGPT-4o mini, and Google Gemini 1.5 Flash. Each model completed three trials of 121 text-based USMLE Step 1 dermatology questions from the AMBOSS question bank. They were evaluated for overall majority-consensus accuracy, accuracy by question difficulty, intertrial reproducibility, and agreement in answer choice selection between models. Differences were analyzed through a Cochran's Q omnibus test and subsequent pairwise McNemar tests with Benjamini-Hochberg correction. Response reproducibility and intermodel agreement were analyzed through Fleiss's Kappa statistics with 95% confidence intervals. ChatGPT-4o mini achieved the highest overall majority-consensus accuracy (84.3%). NLM w/ Notes demonstrated the highest intertrial reproducibility (Fleiss's κ = 0.927, 95% CI [0.875-0.978]) and strong performance on lower-difficulty questions, but comparatively reduced accuracy on higher-difficulty items. NLM w/o Notes exhibited significantly higher omission rates (10.5% vs ≤1.65% for other models) than other tested LLMs. Sensitivity analysis excluding omissions increased NLM w/o Notes' accuracy from 66.9% to 77.8%, matching NLM w/ Notes' performance. Intermodel agreement was significantly higher between NLM w/ Notes and ChatGPT-4o mini compared to NLM w/o Notes and Gemini 1.5 Flash. Provision of student-generated notes substantially increased response reproducibility in a source-based LLM, likely reflecting consistent retrieval of similar source excerpts across trials. However, note-grounding appeared to constrain performance on higher-difficulty questions, suggesting a RAG algorithm retrieval error when question stems excluded characteristic 'key words' present in lower-difficulty items. The results highlight potential challenges of a student-level, CLT-grounded educational LLM that must deal with non-expert-curated notes, balance source utilization and internal reasoning, and meaningfully appraise uploaded sources to assess a student's individual learning gaps.

Integrating indigenous methodologies into medical education in the west: a conceptual framework for the Hybrid Relational Clerkship Model (HRCM).