Medical Education Research Articles

Analysis of the Effectiveness of Using Digital Technologies in Teaching 1st Year Medical Students

In the modern world, the amount of knowledge has increased significantly, and therefore, there is a constant need to acquire and update it. Medicine is a rapidly developing field, and it is important for the future and working doctor to constantly improve their professional skills using modern technologies. The purpose of this study is to determine the most effective modern information technologies and the level of their effectiveness in the study of the subject "Medical Biology," as well as the attitude of students to their use and the impact on the ability to perceive educational material. Methodology. The study employed a complex set of research methods, including theoretical (such as analysis of scientific sources, pedagogical and teaching materials, and comparison) and empirical (such as summarizing teaching experience and interviewing) methods. First-year students (130) of the medical university were involved in the survey. Results. From our experience, using problem lecture technology in the learning process is more appropriate. It is based on a problematic presentation of the material in the form of contradictions, certain contradictions, the discussion of which makes it possible to keep students active, encourage them to dialogue or even debate. Problem presentation of the material stimulates the mental abilities of students and develops critical thinking, scientific, and cognitive activity. For data visualization, in addition to presentations and videos, mind maps were created, which made it possible to direct students not to memorization, but to reflection and awareness of cause-and-effect relationships and connections. The most effective way to create a mental map is to use the "brainstorming" technology. Students offer several variants of ideas for solving a specific problem; everyone expresses their own opinion and then combines the information into one collective solution and depicts it in the form of a diagram. To combine theoretical training and practical skills (simulating biological processes), we used the Labster platform covering different topics in biology, such as genetics, ecology, and cell biology. When studying Medical Biology, the most popular platform used by students was edX (53.1%). Regarding the forms of education, 37.9% of respondents chose the form, 38.6% the mixed form, and the rest were undecided. Conclusions. Modern information technology has become an integral part of the learning process in medical higher education, improving the quality of students' preparation for the requirements of modern medicine. The most effective methods for teaching "Medical Biology" include problem-based lectures with presentations, electronic resources, videos, virtual labs, websites, and mind maps. A blended approach that combines multiple technologies enhances the learning process and helps develop essential professional skills in future doctors.

Challenges and opportunities for strengthening palliative care services in primary healthcare facilities: perspectives of health facilities in-charges in Dar es Salaam, Tanzania

BackgroundWith the rise of non-communicable diseases in Tanzania, palliative care (PC) is increasingly needed to improve the quality of life for these patients through pain and symptom management and providing...

57 Resident education in the NICU: A curriculum innovation project

Abstract Background For paediatrics residents, much of newborn care is learned during Neonatal Intensive Care Unit (NICU) rotations. However, the NICU is a high-stress and specialized learning environment. Today’s residents often have less NICU exposure during their training than in the past, leading to concerns from trainees that they are inadequately prepared for neonatal care and resuscitation upon graduation. Objectives We aimed to develop, implement and evaluate a paediatric residency NICU curriculum aimed to augment and improve learning on rotation. Design/Methods We utilized Kern’s Six Step Approach for Curriculum Development. Step 1: We identified that our paediatric residents consistently expressed dissatisfaction with the quality and quantity of learning opportunities on their NICU rotations. Step 2: A collaborative working group of residents, paediatricians, and neonatologists identified learning needs. Step 3: Needs were mapped to specific general paediatrics educational objectives within the Royal College Competency Based Medical Education (CBME) curriculum. Step 4: Suitable learning strategies were selected including simulation, procedural skill training, embedded time with the neonatal resuscitation team, and lunch and learn seminars. Steps 5 and 6: The curriculum was piloted during the 2021-2022 academic year and resident reactions evaluated. Results The detailed curriculum is shown in Table 1. At the start of each NICU rotation, all paediatrics residents on rotation attended a half-day simulation based “boot-camp” consisting of a didactic Neonatal Resuscitation Program (NRP) refresher course, relevant procedural skills stations (intubation, UVC placement, needle thoracocentesis), and simulated neonatal resuscitation scenarios. Junior residents were scheduled for protected time to attend deliveries with a dedicated multidisciplinary resuscitation team to ensure familiarity and begin to solidify skills. Learning was further augmented by weekly, resident-led lunch and learn sessions on topics mapped to level of training. To evaluate this curriculum, resident satisfaction was assessed using surveys post bootcamp and at the end of their rotation. Overall, the curriculum was well received. Bootcamp was the highest rated element; 96% of residents agreed or strongly agreed that the session was useful for their education (Figure 1). Post curriculum implementation, there was significant improvement in resident NICU rotation feedback; residents expressed that the NICU learning environment and resident experience has improved. Conclusion We successfully implemented a NICU curriculum for paediatrics residents, with high satisfaction ratings and improved overall rotation feedback. This program shows promise in addressing a long standing educational gap. More research is needed to investigate whether it leads to improved competency in practice.

Developing Competencies and Milestones: Putting the Pieces Together for Student Success

Abstract Competency-based medical education has become a means in physician assistant (PA) education to ensure learner readiness for practice; align educational expectations; and assess knowledge, skills, and attitudes. Competency-based education may also serve to meet accreditation requirements. Creating program-defined competencies and associated milestones can help a PA program align with their mission and vision, developmentally guide learners through the curriculum, and ensure program assessments measure the tasks required of practice-ready graduates. This review provides an overview of a single program's process for developing program-defined competencies and associated milestones. Beginning with a literature search, the program was able to develop a working list of competencies that was then further refined into competencies with building block milestones that support the development of competency in various domains. Involving faculty in defining a program's competencies is an Accreditation Review Commission on Education for the Physician Assistant requirement that can be done from the ground up or by using previously published competencies that are refined and tailored for the program. The process of creating the competencies provides significant insight into a program's curriculum, goals and expectations for students, and assessment methods.

How COVID-19 pandemic and Ukrainian crisis shaped mental health services for medical students in Poland?

The mental health of medical students is a crucial concern in contemporary medical education. This manuscript reports the availability and shape of psychological support for medical students in Poland in the backdrop of the COVID-19 pandemic and the Ukrainian crisis. A survey comprising 10 questions was distributed to 22 medical schools in Poland, with a 59% response rate. The findings reveal that psychological support programs are predominantly managed by internal university units. Funding sources vary, with some universities utilizing internal budgets and others leveraging European funds or external projects. The support modalities are primarily hybrid, catering to student preferences. Limitations exist in the number of consultations, although some universities provide extended support based on student needs. Assistance is offered in multiple languages, with additional programs like stress-reduction workshops and mindfulness training being available in several universities. A notable increase in demand for psychological support post-COVID-19 was reported, with some universities establishing their programs during or after the pandemic. The commentary highlights the rising need for mental health services among medical students and underscores the importance of flexible, inclusive, and well-funded support. The effective functioning of these programs aligns with the broader objective of fostering a resilient and emotionally balanced healthcare workforce.

A breath of fresh air: a pilot flipped classroom approach to airway management skills training

ObjectivesWhile flipped classroom instruction has repeatedly shown efficacy in undergraduate medical education, evidence for its utility in procedural domains remains sparse. This holds particular significance for surgical subspecialties such as otolaryngology, which have limited time in undergraduate medical curricula. We designed a novel airway management skills simulation course with a flipped classroom approach and evaluated its efficacy in a pilot study.MethodsA simulation course was designed to provide instruction in seven airway management skills: bag valve mask ventilation, laryngoscopy, intubation, cricothyroidotomy, tracheotomy, and tracheostomy care. Publicly available YouTube videos were selected as pre-learning materials. Participating students completed surveys before the pre-learning assignment and after completion of the simulation center workshop.ResultsSixteen students participated in the workshop, and data was collected from 14 participants. Learners reported significant improvements in knowledge regarding all covered skills except tracheotomy; mean self-rated knowledge improved from 2.9 to 5.8 (p < 0.001) on a scale from 0 to 10. Significant increases in self-reported confidence in performing all seven skills were also observed, with an overall increase from 1.1 to 5.7 (p < 0.001). Students also rated all elements of the workshop highly, including a prevailing belief that the pre-learning materials markedly enhanced their learning.ConclusionOur novel framework for skills-based education using a flipped classroom approach demonstrated remarkable efficacy in improving learner knowledge and self-reported confidence regarding airway management skills. This educational design, including the use of high-quality, publicly available pre-learning videos, has significant implications for undergraduate medical education in surgical subspecialties.

Trainee growth vs. fixed mindset in clinical learning environments: enhancing, hindering and goldilocks factors

BackgroundDoctors in training (trainees) have higher rates of burnout, anxiety and depression than other professionals. An important psychological tool to combat this crisis is promotion of a growth mindset, which increases resilience and improves mental health outcomes. How growth mindset might be promoted within the clinical learning environment is underexplored. This study aimed to explore the factors promoting a growth mindset versus fixed mindset in trainees from the perspective of the trainees.MethodsThis constructivist study employed a novel method of encouraging trainees’ reflections on mindset adoption in the clinical learning environment. Trainees played Mindset, a tabletop simulation board game that included challenges encountered within training. This was followed by a facilitated debriefing, focusing on factors that promoted growth or fixed mindset adoption in the clinical learning environment. Debriefing transcripts were analysed using template analysis.ResultsThree groups of oncology trainees and one group of medical education fellows participated (16 participants in total). Factors promoting growth mindset adoption included passion, collaboration, diverse career and role modelling. Factors promoting fixed mindset adoption included burnout and competition. Some factors, such as grit, previous success experience and singular training location promoted a fixed mindset when too much or too little were present, and promoted a growth mindset when they were in balance (the Goldilocks principle).ConclusionsThe importance of balance versus excess of certain factors, and the ubiquitous competitive culture in medicine promoting a fixed mindset, were compelling reflections. This study may aid invested parties to reflect on what factors they can upregulate and down regulate to optimise trainees’ adoption of a growth mindset.

Transformational learning and professional identity formation in postgraduate competency-based medical education.

Residency programmes are in transition to a framework for competency-based medical education (CBME). The intersection of CBME with transformational learning (TL) experiences and professional identity formation (PIF) - particularly within senior learners in transitional states - is unknown but important to understand in order to develop and implement strategies to support trainees' professional development. Through inductive qualitative methods, we conducted semi-structured interviews (n= 22) of current trainees and recent graduates from adult cardiology residency training programmes within Canada to explore the impact of TL experiences on residents' professional growth and identity formation. Interviews were analysed using thematic analysis informed by TL theory. CBME did not appear to influence trainees' experiences of disorienting dilemmas and TL. Important clinical encounters and interpersonal relationships - in particular, those between mentor and mentee - shaped trainees' professional development as cardiologists ('enabling factors' for TL and PIF). 'Imposter phenomenon' was widely prevalent in our sample study population even among graduates who had already completed their training. Requisite elements for transformation (disorienting dilemmas, critical reflection, discourse and action) also contributed to PIF. TL experiences influenced PIF in senior learners but infrequently intersected with CBME; these experiences were more commonly prompted by disorienting dilemmas relating to clinical outcomes or interpersonal interactions independent of CBME-specific architecture.

Prevalence and Extent of Industry Funding to Program Directors Across Pediatric Surgical Specialties

IntroductionIndustry funding in surgical education offers benefits but presents conflicts of interest. This study defines the prevalence and extent of industry funding to fellowship program directors (FPDs) across pediatric surgical specialties. Materials and methodsThis was a retrospective cross-sectional analysis of FPDs in pediatric surgical specialties. Data were amalgamated from the Centers for Medicare and Medicaid Services and the Accreditation Council for Graduate Medical Education. Characteristics of FPDs were obtained from academic websites and medical licensing boards. Personal industry payments from 2016 to 2022 were analyzed, and temporal trends were elucidated. Comparisons were made by year, surgical specialty, and control groups with nonparametric tests. ResultsA total of 241 FPDs were identified, with 206 (85%) receiving industry payments over the study period. The specialties with the highest prevalence of industry funding to FPDs were pediatric orthopedic surgery (100%), pediatric urology (96%), and pediatric surgery (85%). Total industry payments aggregated to $7.3 million dollars with the majority awarded to pediatric orthopedic surgery (91%). Most industry payments were for royalties or licensing (57%) and consulting fees (31%). Median total industry payments per FPD differed between subspecialties (P < 0.001) and was highest in pediatric orthopedic surgery ($7009, interquartile range [IQR], $1771-$50,239) and lowest in pediatric otolaryngology ($116, IQR, $75-$1626). Male FPDs had higher median total industry payments than female FPDs ($1643, IQR, $172-$8731 versus $193, IQR, $84-$712, P < 0.001). ConclusionsIndustry payments to FPDs in pediatric surgical specialties are highly prevalent, but the magnitude varies by specialty. Future work is needed to establish mechanisms that promote equitable partnerships between academia and industry for pediatric surgery training.

Precision surgical education

Information and data are accelerating the implementation of competency-based medical education. The adoption of precision education can contribute to this purpose. This article discusses the extent to which precision surgical education can be used in assessing the minimum reliability standards of future surgeons — given the advent of Entrustable Professional Activities — and as an option to strengthen the career trajectory of residents.

The show must go on: fostering residents’ sustainable employability in medical education – a qualitative exploration of the Resident Leadership Program

BackgroundResidents’ sustainable employability (SE) is threatened by high burn-out rates, sleep deficits, and career dissatisfaction. Medical education may contribute to residents’ SE by providing them with opportunities to influence their employment contexts and to develop conscious self-regulation. This paper explores how residents, participating in the Resident Leadership Program (RLP), are enabled to work on, and learn about, their SE.MethodsThe RLP took place between February and July 2021 and consisted of lectures on, and practice in, quality improvement (QI) work. SE was the theme that governed residents’ QI projects. In this study, residents were interviewed individually before the program (n = 8), were observed while participating in the program (45 h) and were interviewed in three groups after the program (n = 8). The data were analysed in accordance with the ‘flexible-coding’ method.ResultsThe findings are presented in four ‘acts’ mirroring an unfolding play as a metaphor to show how residents’ understanding of context, self-regulations, and quality improvement work—relevant to their SE—changed in the RLP. The acts include ‘setting the stage’, describing how residents experienced the context of medicine; ‘acting the part’, depicting how residents managed their employment contexts using self-regulation; ‘changing the décor’, elaborating on residents’ QI projects; and ‘growing one’s role’, presenting residents’ take-aways from participating in the RLP that may benefit their SE. These take-aways encompassed awareness of the importance of SE, a reconsideration and/or adjustment of self-regulation, feeling better equipped to navigate employment contexts, and increased joy in work because of contributing to peers’ SE through QI work.ConclusionsOur results indicate that medical education is a fruitful environment for providing important lessons and tools for residents to work on and learn about their SE, likely benefiting their SE throughout their careers.

Attitudes and perceptions of Thai medical students regarding artificial intelligence in radiology and medicine

IntroductionArtificial Intelligence (AI) has made a profound impact on the medical sector, particularly in radiology. The integration of AI knowledge into medical education is essential to equip future healthcare professionals with the skills needed to effectively leverage these advancements in their practices. Despite its significance, many medical schools have yet to incorporate AI into their curricula. This study aims to assess the attitudes of medical students in Thailand toward AI and its application in radiology, with the objective of better planning for its inclusion.MethodsBetween February and June 2022, we conducted a survey in two Thai medical schools: Chiang Mai University in Northern Thailand and Prince of Songkla University in Southern Thailand. We employed 5-point Likert scale questions (ranging from strongly agree to strongly disagree) to evaluate students’ opinions on three main aspects: (1) their understanding of AI, (2) the inclusion of AI in their medical education, and (3) the potential impact of AI on medicine and radiology.ResultsOur findings revealed that merely 31% of medical students perceived to have a basic understanding of AI. Nevertheless, nearly all students (93.6%) recognized the value of AI training for their careers and strongly advocated for its inclusion in the medical school curriculum. Furthermore, those students who had a better understanding of AI were more likely to believe that AI would revolutionize the field of radiology (p = 0.02), making it more captivating and impactful (p = 0.04).ConclusionOur study highlights a noticeable gap in the understanding of AI among medical students in Thailand and its practical applications in healthcare. However, the overwhelming consensus among these students is their readiness to embrace the incorporation of AI training into their medical education. This enthusiasm holds the promise of enhancing AI adoption, ultimately leading to an improvement in the standard of healthcare services in Thailand, aligning with the country’s healthcare vision.

Development of Leadership Skills in Medical Education: Protocol for a Scoping Review.

Leadership is recognized as an essential competency in health care and science, being central for professionals to face health challenges. Few physicians feel prepared to serve as leaders in the health care environment, and few receive training in the leadership skills needed to be successful. Teaching leadership skills together with extensive, longitudinal, clinical education in an authentic and nurturing environment can effectively develop students for leadership in medicine. Studies on the subject still do not show the best way to implement it in medical education, and an updated review is necessary. The aim of this study is to identify the types of available evidence on the teaching of leadership skills in undergraduate courses in the health area, analyze them, determine knowledge gaps, and disseminate the research results. This is a scoping review that will consider studies on leadership skills in medical and health undergraduate courses. Primary studies published in English, Spanish, and Portuguese since 2019 will be considered. The search will be performed in 8 databases, and reference lists will be searched for additional studies. Duplicates will be removed, and 2 independent reviewers will examine the titles, abstracts, and full texts of the selected studies. Data extraction will be performed using a tool developed by the researchers. The scoping review is currently in progress. The preliminary database search has been completed, yielding a total of 1213 articles across multiple databases. The next stages, including deduplication, title and abstract screening, and full-text review, are scheduled to be completed by December 2024. Data extraction and analysis are expected to be finalized by March 2025, with the final report anticipated to be ready for submission by June 2025. This scoping review on leadership in the medical curriculum can significantly contribute to the literature by organizing and synthesizing the available evidence on teaching leadership skills in undergraduate courses in the health area. Furthermore, by analyzing evidence and identifying knowledge gaps, the study can provide valuable insights to develop more efficient and comprehensive medical education programs, thus preparing students to take on leadership roles in the complex environment of health care. Open Science Framework YEXKB; https://osf.io/yexkb. PRR1-10.2196/62810.

Social Media Usage for Medical Education and Smartphone Addiction Among Medical Students: National Web-Based Survey.

Social media (SoMe) have taken a major place in the medical field, and younger generations are increasingly using them as their primary source to find information. This study aimed to describe the use of SoMe for medical education among French medical students and assess the prevalence of smartphone addiction in this population. A cross-sectional web-based survey was conducted among French medical students (second to sixth year of study). The questionnaire collected information on SoMe use for medical education and professional behavior. Smartphone addiction was assessed using the Smartphone Addiction Scale Short-Version (SAS-SV) score. A total of 762 medical students responded to the survey. Of these, 762 (100%) were SoMe users, spending a median of 120 (IQR 60-150) minutes per day on SoMe; 656 (86.1%) used SoMe for medical education, with YouTube, Instagram, and Facebook being the most popular platforms. The misuse of SoMe in a professional context was also identified; 27.2% (207/762) of students posted hospital internship content, and 10.8% (82/762) searched for a patient's name on SoMe. Smartphone addiction was prevalent among 29.1% (222/762) of respondents, with a significant correlation between increased SoMe use and SAS-SV score (r=0.39, 95% CI 0.33-0.45; P<.001). Smartphone-addicted students reported a higher impact on study time (211/222, 95% vs 344/540, 63.6%; P<.001) and a greater tendency to share hospital internship content on social networks (78/222, 35.1% vs 129/540, 23.8%; P=.002). Our findings reveal the extensive use of SoMe for medical education among French medical students, alongside a notable prevalence of smartphone addiction. These results highlight the need for medical schools and educators to address the responsible use of SoMe and develop strategies to mitigate the risks associated with excessive use and addiction.

A Quantitative Cross-Sectional Study on the Behavioral Intentions of Polish Medical and Healthcare Students Regarding Interprofessional Collaboration in Their Future Clinical Practice

Background/Objectives: Since the importance of robust theory-driven research is emphasized in medical education and little data are available on the intentions of medical and healthcare students regarding interprofessional collaboration, this study aimed to analyze the behavioral intentions of Polish medical and healthcare students to undertake interprofessional collaboration in their future work. This study follows the assumptions of the theory of planned behavior, including analysis of the students’ attitudes, subjective norms, and perceived behavioral control in this regard. Methods: Data were collected from March to July 2023 on the population of students at Poznan University of Medical Sciences (Poland) using a questionnaire developed using dedicated manuals on the theory. Results: The students demonstrated generally positive behavioral intentions and attitudes, with a mean total attitude score of 103.13 ± 33.31 in a possible range of −231 to 231. Their sense of social pressure to engage in interprofessional collaboration was weak to moderate positive, as indicated by their total subjective norm score equal on average to 57.01 ± 42.98 in a possible range of −189 to 189, or mixed when evaluated directly. Furthermore, even though they presented a neutral or moderately positive direct assessment of their perceived behavioral control, its indirect measure was weak to moderately negative, with a mean total perceived behavioral control of −80.78 ± 59.21 in a possible range of −231 to 231. Conclusions: The findings suggest that students’ perceptions of mixed social pressure and the presence of barriers or obstacles to collaboration may negatively impact their perceived ease and willingness to collaborate, even despite their initially positive attitudes towards it.

Voice‐over anatomy lectures created by AI‐voice cloning technology: A descriptive article

AbstractThe COVID‐19 pandemic revealed the pivotal role of digital learning and online lecture videos, leading a shift toward blended and flipped classrooms in the post‐pandemic era. This shift calls for development and (or) refreshment of novel online educational resources, such as Voice‐Over PowerPoint (VOPPT) presentations, specifically designed for asynchronous or synchronous learning methods. However, resource limitations often impede the timely delivery of high‐quality instructional materials. In this descriptive article, the use of AI‐voice cloning technology to automate the creation of VOPPT presentation has been explored. Descripts' Overdub tool, an AI‐voice cloning program, was trained on the 15‐min voice sample of an anatomy professor, and the synthesized voice was used to narrate presentations on inguinal canal and extrahepatic biliary anatomy. The educational use of this novel approach was evaluated based on the second‐year undergraduate medical students' qualitative feedback. Voice similarity analysis using Resemblyzer, an open‐source Python tool, showed a high similarity score of 0.92 between the cloned and original voices. Despite this, students raised concerns about the robotic voice, quick pace, punctuation problems, pronunciation difficulties, and expressed reservations about AI‐generated lecture narration. While the cloned voice closely matched the original, the AI‐generated narration fell short of capturing the nuanced details needed for an effective anatomy instruction. This uncovers AI's current limitations in the educational contexts but establishes a foundation for future progress in AI‐voice cloning technologies aimed at enhancing online educational resources for anatomy and medical education.

India's role in the odyssey of medical training in South Africa.

Apartheid had a devastating impact on medical education in South Africa. Until the development of the University of Natal Medical School in 1951, there were minimal opportunities for blacks (collectively Africans, Indians and so-called coloureds) to undertake undergraduate and postgraduate medical training in South Africa. At the height of apartheid (1968-1977), whites who had constituted 17% of the population, accounted for up to 87% of all medical graduates. The African majority, constituting 70% of the population had less than 5% of all medical graduates in South Africa. The global isolation of South Africa from the late 1940s further impacted negatively on the medical training for blacks in South Africa. During apartheid, the Government of India provided full scholarships to the marginalized in South Africa to study medicine in India. This initiative, coming at a time when India was grappling with its post-colonial challenges, was a remarkable yet seldom appreciated gesture.

Strategies to develop an efficient feedback system in medical education and its outcome – An interventional study

Objective The main aim of this study is to know the loopholes in the feedback system, strategies to remove these loopholes, and to measure the effects of an efficient feedback system in an institution. Methods This research has three stages. In the first stage, we tried to find out the flaws in the feedback system of the institution based on published benchmarks. Then we tried to remove these flaws with the collaboration of different stakeholders. In the last stage of the study, we tried to measure the effectiveness of these corrective procedures by certain key performance indicators (KPIs). Results After improvement strategies, there was a significant improvement in the KPIs like, the knowledge and attitude toward the feedback improved from 3.1 to 4.23 in students, and from 3.46 to 4.34 in faculty members, on a five-point scale, and the teaching standards improved as measured by students’ performance in different courses in terms of learning objectives achievement, for example in internal medicine from 70.8% to 75.3%. Similar improvement was recorded in other KPIs as well. Conclusion An efficient feedback system is the backbone of education and by adopting effective feedback, individuals and institutions can excel in the field of medical education.

Time-based versus competency-based medical education: Opportunities and challenges.

Time-based versus competency-based medical education: Opportunities and challenges.

Professionalitet: new horizons for the development of Tobolsk Medical College named after Volodya Soldatov

The article presents the experience of the Volodya Soldatov Tobolsk Medical College in implementing the Federal Project «Professionalitet» to solve the problems of a comprehensive reboot of the system of secondary vocational medical education.