Medical School Curriculum Research Articles

Determination of Attitudes and Knowledge Levels of Pediatricians about Pediatric Medicolegal Problems in Turkey

Objective: In recent years, allegations of medical errors in Turkey have been increasing. These allegations are generally concentrated on the issue of consent. Since most children are medically and legally incapable of making their own decisions on consent issues and the decision is made by the legal representative instead, various legal and ethical dilemmas arise. Pediatrics ranks first in lawsuits filed for medical errors. In our study, we aimed to evaluate the awareness of forensic legal issues among pediatricians. Materials and Methods: Our study is prospective and cross-sectional. Participants were asked 25 questions based on 14 possible case examples. They were asked to give a score between 1 and 5 points for each question about their feeling of adequacy regarding the information, consent, documents, and procedures that should be done according to these cases. Mann‒Whitney U and Kruskal‒Wallis tests were used statistically; p<0.05 was considered significant. Results: Two hundred nine pediatricians answered the questions. Sixty-six percent of the participants were working in tertiary care hospitals. Pediatricians were undecided about feeling adequate regarding the necessary information, consent, documents, and procedures to be performed for children (3.19/5) and felt inadequate when facing the refusal of treatment (2.77/5). There was no statistically significant difference between feeling competent in terms of title and professional seniority. Only 2% of the pediatricians stated that children under 12 years of age have the power of discernment, and only 7% stated that children over 15 years of age do not have the power of discernment. Conclusion: The general conclusion we reached in our study is that pediatricians do not feel adequate even concerning basic legal issues such as information, consent, and refusal of treatment. Therefore, they need to gain knowledge of these issues. For this reason, educational activities such as adding legal education to the medical school curriculum, legal training for pediatricians, and regular seminars effectively eliminate the lack of knowledge on this issue and prevent lawsuits.

Abstract 4138484: Exploring medical students’ clinical preparedness to provide cardiovascular care for sexual and gender minorities

Sexual and gender minorities (SGM) have unique risk factors for cardiovascular disease (CVD). A higher likelihood of tobacco use, inadequate exercise, diabetes, dyslipidemia, hypertension, and obesity have been found, driven by increased psychosocial stressors across the lifespan. Specific treatments, especially gender-affirming hormone therapy, can also increase the CVD risk. Even though SGM-related issues have been introduced into medical education, students’ expertise regarding cardiovascular care for SGM populations has not been studied. The present study examines the clinical preparedness, attitudes, and basic knowledge of medical students regarding cardiovascular care for SGM populations. Medical students from Germany were recruited to take part in an online survey. Additionally, medical students from the UK and the USA will be recruited in the future. We used a variety of channels for recruitment (e.g., mailing lists of student councils, social medical groups). The LGBT-DOCSS was used to assess SGM-related clinical competency. Based on prior work of our research group, we developed items to assess the knowledge of SGM-related cardiovascular care and educational needs. We calculated descriptive statistics to describe the outcomes of interest. Currently, 217 medical students (20% final-year) from 5 German medical schools participated in the study. Regarding general SGM-related clinical competency, participants scored below average on clinical preparedness (3.4/7.0), above average on basic knowledge about SGM-specific healthcare (5.1/7.0), and low on explicit bias and prejudice towards SGM individuals (6.4/7.0). 84 % of the participants reported not feeling appropriately prepared to deliver cardiovascular care for SGM populations. Most participants (72 %) only knew about one or two SGM-specific CVD risk factors. There was a high interest in learning about cardiovascular care for SGM populations (96%) and a preference to implement the issue in medical school curricula (93%). Additional data from Germany, the USA, and the UK will be presented at the time of the conference presentation. The present study provides insights into the clinical preparedness of medical students regarding cardiovascular care for SGM populations. Despite showing a high interest in learning about SGM-specific cardiovascular care, most medical students feel underprepared on the issue. Implementing SGM-specific cardiovascular health into medical school curricula could close this gap.

Reflection and self-efficacy for clinical skills.

Clinical skills are fundamental to medical school curriculums and typically introduced within the preclinical years. In their experiential learning, students' self-efficacy, or the belief in their ability to succeed, is an important factor in influencing clinical skill mastery. Reflection is thought to affect self-efficacy; however, its exact impacts remain largely unexplored within published literature. This mixed methods study investigated whether preclinical students' engagement with reflection affected self-efficacy for clinical skills. Two hundred seventy-three of the 289 preclinical medical students who were invited to participate responded to this 2022 study. We used validated questionnaires to measure engagement with reflection and perceived self-efficacy for clinical skills, conducting hierarchical multiple linear regression for analysis. Thirteen students participated in semi-structured interviews and focus groups, which were analysed via thematic analysis. While statistical analysis showed no significant effects of engaging with reflection on clinical skill self-efficacy, thematic analysis suggested that students perceived the opposite. The themes through which reflection affected self-efficacy were by 'evaluation of performances' against expected outcomes, 'familiarisation and understanding of skills', by 'transforming personal mindsets' and allowing students to 'connect to their emotions'. This study suggests that engaging with reflection can positively or negatively affect self-efficacy for clinical skills, depending on students' attitudes towards reflective practice. Solely engaging with reflection is insufficient to alter self-efficacy beliefs and should be considered alongside personal factors including the individual's mindset and perceived need for reflection. The medical educator's role in facilitating reflection is important, enabling students to reap the benefits of this practice.

The Business of Healing: Medical Students’ Opinions on the Need for Formal Business Training in the Medical School Curriculum

Mounting evidence suggests physicians struggle with the increasing corporatization of healthcare. Currently, most medical programs offer only an MBA program for students interested in business of medicine principles, resulting in more debt or independent information search. A brief survey of a sampling of U.S. first-through fourth-year medical students (MD/DO) revealed that 90% indicated having either “no,” “minimal,” or “basic” perceived knowledge in the field of the business of medicine; 21.5% of students indicated they were “somewhat likely” or “very likely” to pursue an MBA. Furthermore, 58.2% of respondents indicated they were “very likely” or “somewhat likely” to take a business and medicine course during medical school if offered. Despite the limitations of the study, the results indicate that medical students would be interested in a dedicated business and medicine course and believe it necessary to learn the basic principles of business.

Climate change and its health effects - an optional subject for medical students

Abstract The Standing Committee of European Doctors urged to include training on the impact of climate change on health for health professionals. Currently, in the curriculum of most medical schools, the health-related impacts of climate change represent a peripheral part. The teaching of health effects of climate change should be made part of the training of health professionals and should be introduced in the curriculum of medical schools. ClimateMed is an Erasmus project that improves the curriculum and expands knowledge about the health effects of climate change at medical universities. The World Café method, based on round table discussions, was applied to assess the needs, summarize the proposals, and develop the necessary strategy. At the same time, a questionnaire was applied to those medical students from UMFST Targu Mureș who chose this subject as an optional subject. Students related the importance of understanding the diseases caused directly or indirectly by climate change, and reported what kind of topics should be included in a new course, in which semester/module and in what format it would be appropriate to teach it. The most frequently reported topics were: excessive heat and heat-related illnesses, extreme weather, vector-borne diseases, food safety, air pollution, and mental health. According to the goals of the project and students’ opinions, since 2023 medical students can choose Climate Change and Health Effects as an elective course. Based on the demand for medical universities to include in their curriculum knowledge related to the health effects of climate change, ClimateMed project can facilitate this integration and can promote the increase of teacher motivation and the development of methodological guidelines for university teachers. The project contributes to the preparation of some educational materials and the introduction of an optional subject in the training curriculum of the students of the Faculty of Medicine, UMFST Targu Mureș. Key messages • There must be made efforts to include training on the impact of climate change on health for health professionals, to introduce this subject in the curriculum of medical schools. • ClimateMed project can facilitate the integration of knowledge about the health effects of climate change into curriculum and can promote the practical use.

The effect of health literacy course on the level of health literacy in medical students

Abstract Health literacy (HL) concerns not only individuals but also health systems and health professionals. Most of the literature on HL has focused on patient factors, with little emphasis on the communication skills and practices of health professionals. Training is needed at all levels to understand the concept of HL and its impact on health inequalities. This study is an intervention study. Data were collected from 29 students taking the third year elective course at the Faculty of Medicine through an online survey. The survey consists of 40 questions aimed at assessing the demographic characteristics of the participants, the TSOY-32 Scale and some factors affecting HL. During the training period, role-play scenarios were played to teach the importance of HL, sample videos were watched to evaluate physician-patient communication, and case studies were conducted. The mean pre-test TSOY-32 scale score of the participants was 32.8±5.8. The mean post-test TSOY-32 scale score was 36.4±7.1. There was a significant difference between pretest and posttest groups in terms of TSOY-32 scale score (p = 0.033). Health professionals often overestimate patients’ HL levels and do not have sufficient competence to effectively manage limited HL. These gaps need to be addressed through the curricula of medical schools and specialties. Key messages • Training on health literacy improves medical students’ communication skills, bridging gaps in patient care. • Addressing health literacy in medical training enhances patient-doctor communication, vital for quality care.

Global health education in Europe: an insight into the student’s perspective

Abstract Background As the world grows ever connected, more importance is placed on aptness in Global Health. For medical students, incorporating social, environmental, cultural, and global issues in the curriculum is pivotal to their success as future medical professionals. In spite of this, students are dissatisfied with ongoing pedagogy. In review of existing evidence, we discovered that there is no set standard for European medical schools to follow in Global Health teaching. This is evidenced by variation in the course requirement and in the topical content covered. Consequently, students have self-perceived and actual gaps in their Global Health knowledge. Another point highlighted in our research was that despite the importance students have placed on Global Health education, they have viewed it as less relevant in comparison to other aspects of Medicine. To improve this lack of engagement, students have made suggestions that could potentially have a positive impact on teaching methods if they were to be implemented. Objectives Our background review and evidence gaps inspired us to conduct an online survey in our university. Examining this, together with reviewing existing evidence on student opinions and experiences from all over Europe, will give us the opportunity to uncover student sentiment towards Global Health education. Results Our survey is underway; its results will be discussed in our presentation. Conclusions In analysing existing survey results and in executing a survey in our medical school, we have gained some insight and understanding into the perspectives, knowledge gaps, and suggestions of medical students as concerns their Global Health education in Europe. These should be considered in forming and refining the Global Health curriculum of European medical schools. Key messages • Explore the attitudes and opinions of European students towards Global Health education. • The medical student’s perspective should be considered to guide a better-suited education in Global Health across Europe; this is of the utmost importance in a now globalised world.

Natural frequency tree- versus conditional probability formula-based training for medical students’ estimation of screening test predictive values: a randomized controlled trial

BackgroundMedical students and professionals often struggle to understand medical test results, which can lead to poor medical decisions. Natural frequency tree-based training (NF-TT) has been suggested to help people correctly estimate the predictive value of medical tests. We aimed to compare the effectiveness of NF-TT with conventional conditional probability formula-based training (CP-FT) and investigate student variables that may influence NF-TT’s effectiveness.MethodsWe conducted a parallel group randomized controlled trial of NF-TT vs. CP-FT in two medical schools in South Korea (a 1:1 allocation ratio). Participants were randomly assigned to watch either NF-TT or CP-FT video at individual computer stations. NF-TT video showed how to translate relevant probabilistic information into natural frequencies using a tree structure to estimate the predictive values of screening tests. CP-FT video showed how to plug the same information into a mathematical formula to calculate predictive values. Both videos were 15 min long. The primary outcome was the accuracy in estimating the predictive value of screening tests assessed using multiple-choice questions at baseline, post-intervention (i.e., immediately after training), and one-month follow-up. The secondary outcome was the accuracy of conditional probabilistic reasoning in non-medical contexts, also assessed using multiple-choice questions, but only at follow-up as a measure of transfer of learning. 231 medical students completed their participation.ResultsOverall, NF-TT was not more effective than CP-FT in improving the predictive value estimation accuracy at post-intervention (NF-TT: 87.13%, CP-FT: 86.03%, p = .86) and follow-up (NF-TT: 72.39%, CP-FT: 68.10%, p = .40) and facilitating transfer of training (NF-TT: 75.54%, CP-FT: 71.43%, p = .41). However, for participants without relevant prior training, NF-TT was more effective than CP-FT in improving estimation accuracy at follow-up (NF-TT: 74.86%, CP-FT: 58.71%, p = .02) and facilitating transfer of learning (NF-TT: 82.86%, CP-FT: 66.13%, p = .04).ConclusionsIntroducing NF-TT early in the medical school curriculum, before students are exposed to a pervasive conditional probability formula-based approach, would offer the greatest benefit.Trial registrationKorea Disease Control and Prevention Agency Clinical Research Information Service KCT0004246 (the date of first trial registration: 27/08/2019). The full trial protocol can be accessed at https://cris.nih.go.kr/cris/search/detailSearch.do?seq=15616&search_page=L.

83 What is social paediatrics and how do we teach it? A scoping review of social medicine curricula in the child and youth health context across health disciplines

Abstract Background Social paediatrics is a field that focuses on addressing social and environmental factors that affect children’s health and wellbeing1. Over recent years in medical education, social paediatrics has become increasingly recognized as foundational to undergraduate and postgraduate paediatrics curricula. Paediatric residency programs worldwide have been developing and offering social paediatrics curricula, yet we lack understanding of effective strategies for teaching it to medical trainees. 1. Spencer N, Colomer C, Alperstein G, et al. Social paediatrics. J Epidemiol Community Health. 2005;59(2):106-108. doi:10.1136/jech.2003.017681 Objectives We conducted a scoping review to describe the various educational interventions used to teach content and practice related to social paediatrics. Design/Methods We conducted a scoping review to describe the various educational interventions used to teach content and practice related to social paediatrics. Our literature search first drew upon Ovid MEDLINE and MedEd PORTAL, with subsequent studies identified through reference searching in relevant articles. We included studies that described and/or evaluated educational interventions aimed to teach elements of social paediatrics. We excluded studies published before 2000. We extracted data from the selected articles and conducted thematic analysis. Results Our search yielded 443 articles. Initial screen by title and/or abstract and subsequent screen by abstract and/or full text yielded 28 papers. Where it was unclear if studies met inclusion criteria, two additional researchers reviewed the full text. With the addition of articles found in references of the provisional articles, a total of 36 papers were included in the review. Of those, 17 (47%) described curricular interventions at the level of paediatric residency, 7 (19%) described medical school curricula, and 8 (22%) included non-medicine fields such as dentistry, nursing, research, and others. Fifty percent of curricula required self-directed learning, while a different 50% subset had a formal reflection process as part of learning consolidation. We organized the literature thematically into the following themes: interdisciplinary collaboration, community partnership, advocacy training, and experiential learning. Conclusion Our scoping review describes a variety of curricular interventions aimed to teach elements of social paediatrics, with a large focus on social determinants of health, primarily poverty, and a relative lack of focus on the underlying structural, systemic, and social justice issues underpinning these health determinants. We need to consider how the pedagogical strategies on offer can be purposed towards the development of more robust social paediatrics curricula at the postgraduate level.

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.

What are future doctors learning about sex? An assessment of sexual health curricula across medical schools in the Northeastern United States.

Sexual health is an imperative area of study in medical school education, yet many medical schools do not offer a comprehensive curriculum nor is it standardized across the United States (US). This study aims to assess written curriculum materials from sexual health curricula in medical schools across the northeast region of the US and compare the current teachings to suggested standards. A compilation of academic resources including lecture materials and syllabi were systematically reviewed utilizing a standardized and validated rubric with variables assessed including: biological and psychological aspects of human sexual development, anatomy and physiology of the human sexual response cycle, sexual health in relation to human reproduction, and contraceptive options. We analyzed our data from the document analysis to look at the frequency of inclusion and exclusion of the sexual health topics included in our rubric. The outcomes of our data set were in line with our hypothesis that there is significant variance between sexual health curricula across institutions as well as an overall lack in material covering sexual health topics. The data show significant sex specific differences such that male-specific topics were covered more frequently than female-specific information. Additionally, only one of the 10 schools examined taught about vulvar conditions. There was also a paucity of information about sexuality in the post-partum period. The clinical implications of this study aim to highlight the discrepancy between an ideal sexual health curriculum and what is actually being taught in medical schools and help to guide future work of creating a comprehensive and standardized sexual medicine education in US. medical schools. The validity of this study was strengthened by analyzing direct curricula materials as opposed to previous use of subjective, self-reported questionnaires. However, the sample location being restricted to the Northeast was a limitation to generalize findings across the country. Future studies would aim to analyze medical school curricula across different regions in the US. This study shows that there is a lack of comprehensive and standardized sexual health curriculum in medical schools in the Northeastern US and serves as initial evidence for further investigation of this topic across American medical schools.

Cultivating Leadership and Teamwork in Medical Students Through Rowing: A Phenomenological Study.

This study was conducted to allow us to understand the subjective experiences of medical students participating in rowing exercise classes at a medical school in South Korea and to derive implications for medical education. Accordingly, we analyzed their reflective journals, focusing on leadership and teamwork development. The study involved 40 second-year premedical students, and Colaizzi's analysis was employed to understand and structure their experiences. The comprehensive analysis revealed 149 meaningful statements expressing students' thoughts and experiences regarding the rowing exercise. From these statements, 13 meanings were synthesized, resulting in nine themes and four overarching categories, which provided a multilayered understanding of students' experiences. The factors that enhanced teamwork included communication, trust, respect among team members, and a sense of responsibility. By contrast, the hindering factors were competitiveness, impatience, and avoidance of responsibility. Before the class, a mix of anticipation, excitement, and dissatisfaction regarding the rowing exercise course was observed. However, after the class, students realized that the role of the entire team, rather than individual ability, is crucial, and collaboration with peers is key-the concept of shared leadership. This study is significant in that it demonstrates rowing's potential as a team sport to serve as an effective program for fostering collaboration and leadership within the medical school curriculum.

Communicating with Deaf Patients in the Clinical Environment: Lessons Learned from a Virtual Patient Panel

Background Communication and cultural differences predispose Deaf patients to suboptimal healthcare. Despite this disparity, health professionals have historically received little to no training in caring for Deaf patients. Patient panels are an effective tool in medical education to model communication strategies. Objective In this paper, we describe the design, implementation, and results of a virtual patient panel focused on communicating with Deaf patients in clinical contexts. We offer practical suggestions for incorporating similar educational interventions in health professions education to prepare trainees to effectively navigate these conversations with their patients. Methods The panel consisted of a one-hour question and answer discussion facilitated by the authors with Deaf patients and Certified Deaf Interpreters (CDI). The panel was presented to 271 second-year medical students at our institution in November of 2023. Following this discussion, students were encouraged to share one or two key takeaways from the session through a survey link. These results were analyzed using pile-sorting qualitative analysis to identify main themes. Results There were 73 respondents, with a response rate of 27%. After the panel, the most popular takeaway points from student reflections included communication (n=56, 77%) and access to care (n=47, 64%), followed by autonomy (n=17, 23%), the doctor-patient relationship (n=15, 21%), and culture (n=11, 15%). Based on this initiative, we identified and offer twelve tips for developing similar exercises. These tips are thematically presented under three groupings: Planning Considerations, Patient Panelist Considerations, In-Session Considerations, and Post-Session Considerations. Conclusion This patient panel was the first of its kind in our medical school curriculum. Important considerations in panel design and implementation should focus on delivery time constraints with live-interpreting and further exploring the role of trust and communication in the physician-patient relationship.

Not taught in medical school but needed for the clinical job – leadership, communication and career management skills for final year medical students

BackgroundStarting the first job as a young physician is a demanding challenge. Certain skills are important to master this transformation that go beyond the theoretical knowledge and practical skills taught in medical school. Competencies such as communication, leadership and career management skills are important to develop as a young physician but are usually not sufficiently taught in medical school in a structured and comprehensive way.MethodsWe performed an online survey among final year medical students regarding how they perceive their current competency level in communication, leadership and career management skills. We also assessed how they rate the importance to acquire these competencies and the current emphasis during their medical school education regarding these topics.ResultsOf 450 final year medical students 80 took part in the voluntary survey and 75 complete datasets were returned (16.7%). The majority of respondents rated different communication skills, leadership skills and career management skills as important or very important for their later clinical work. However, most students felt to be poorly or very poorly prepared by the current medical school curriculum, especially for certain leadership and career management skills. Overall, 90.7% of participants expressed interest in an additional educational course that covers subjects of communication, leadership and career management skills during the later stage of medical school, preferably as a hybrid in-person session that also offers synchronous online participation.ConclusionsThe results of the survey express the need to address communication, leadership and career management skills in the medical curriculum to be better prepare students for the demands of residency and their further course as physicians. An educational format during the final year of medical school may be suitable to address mentioned topics in the framework of clinical practical exposure.

Gender and Sexuality Awareness in Medical Education and Practice: Mixed Methods Study.

The integration of gender and sexuality awareness in health care is increasingly recognized as vital for patient outcomes. Despite this, there is a notable lack of comprehensive data on the current state of physicians' training and perceptions in these areas, leading to a gap in targeted educational interventions and optimal health care delivery. The study's aim was to explore the experiences and perceptions of attending and resident physicians regarding the inclusion of gender and sexuality content in medical school curricula and professional practice in Israel. This cross-sectional survey targeted a diverse group of physicians across various specializations and experience levels. Distributed through Israeli Medical Associations and professional networks, it included sections on experiences with gender and sexuality content, perceptions of knowledge, the impact of medical school curricula on professional capabilities, and views on integrating gender medicine in medical education. Descriptive and correlational analyses, along with gender-based and medical status-based comparisons, were used, complemented, and enhanced by qualitative analysis of participants' replies. The survey, encompassing 189 respondents, revealed low-to-moderate exposure to gender and sexuality content in medical school curricula, with a similar perception of preparedness. A need for more comprehensive training was widely recognized. The majority valued training in these areas for enhancing professional capabilities, identifying 10 essential gender-related knowledge areas. The preference for integrating gender medicine throughout medical education was significant. Gender-based analysis indicated variations in exposure and perceptions. The study highlights a crucial need for the inclusion of gender and sexuality awareness in medical education and practice. It suggests the necessity for curriculum development, targeted training programs, policy advocacy, mentorship initiatives, and research to evaluate the effectiveness of these interventions. The findings serve as a foundation for future directions in medical education, aiming for a more inclusive, aware, and prepared medical workforce.

A Student Call for Gun Violence Education in Medical Schools

This Viewpoint discusses the lack of gun violence education in medical school curricula despite the high prevalence of firearm-related deaths and injuries in the US.

The Impact of a Study Trip to Auschwitz: Place-based Learning for Bioethics Education and Professional Identity Formation.

There are increasing calls for coverage of medicine during the Holocaust in medical school curricula. This article describes outcomes from a Holocaust and medicine educational program featuring a study trip to Poland, which focused on physician complicity during the Holocaust, as well as moral courage in health professionals who demonstrated various forms of resistance in the ghettos and concentration camps. The trip included tours of key sites in Krakow, Oswiecim, and the Auschwitz-Birkenau concentration camps, as well as meeting with survivors, lectures, reflective writings, and discussions. In-depth interviews and reflective writings were qualitatively analyzed. Resulting themes centered on greater understanding of the relationship between bioethics and the Holocaust, recognizing the need for moral courage and social awareness, deeper appreciation for the historical roles played by dehumanization and medical power and their contemporary manifestations, and the power of presence and experiential learning for bioethics education and professional identity formation. These findings evidence the significant impact of the experience and suggest broader adoption of pedagogies that include place-based and experiential learning coupled with critical reflection can amplify the impact of bioethics and humanism education as well as the process of professional identity formation of medical students.

Exploring Bias in Health Care: Using Art to Facilitate a Narrative Medicine Approach among Third-Year Medical Students.

Teaching medical students about biases in health care poses challenges due to the complexity of modifying preexisting beliefs and the possibility of triggering strong emotional reactions. Narrative medicine fosters reflection and discussion among healthcare providers, and visual thinking strategies (VTS) enable providers to improve diagnostic ability through close and methodical examination of art. This study investigated the effectiveness of a session integrating narrative medicine and VTS to enhance third-year medical students' understanding of bias in health care. A 90-minute "Narrative Medicine Rounds" session was implemented in the Family Medicine clerkship for all third-year medical students in the Florida International University Herbert Wertheim College of Medicine class of 2024. The session included a faculty-facilitated discussion of Robert Colescott's painting Emergency Room, an overview of narrative medicine principles, and a sharing of student narratives related to bias experienced in the healthcare setting. After the session, students wrote and submitted their narrative essays. Students also completed an anonymous, optional, computer-based evaluation with Likert-type and free-response questions. Likert questions were analyzed using descriptive statistics. For the short-answer questions, teams of two researchers (D.G. and S.E.S., E.E. and M.S.) analyzed responses for themes and subthemes, met to reach consensus on a codebook through discussion, and recoded data as needed until frequencies of themes were mutually determined. Of 101 students, 87 (86%) provided responses to the Likert questions. Seventy percent of respondents agreed that Robert Colescott's Emergency Room was a useful tool for discussing bias in medicine, whereas 25% were neutral. Fifty-one percent of respondents agreed that the session enhanced their understanding of bias in patient care, with 33% being neutral. Forty-seven percent of respondents agreed that the session made them more familiar with narrative medicine as a tool that they can use in patient care, with 28% being neutral. Students identified five themes for recognizing bias: empathy (16%), self-reflection (60%), active listening (17%), communication (13%), and education (7%). When addressing bias, students outlined five strategies: drawing from personal experiences (1%), self-reflection (64%), communication (29%), education (15%), and advocacy (26%). Combining narrative medicine and VTS in a single session offers a promising approach for discussing bias in healthcare education. Through reflective experiences and art interpretation, students demonstrated an awareness of often interconnected strategies to identify and mitigate bias while caring for patients. Future next steps for this study involve exploring longitudinal impacts and integrating narrative medicine strategies throughout the medical school curriculum.

(Re)Development of pain target competencies in a contemporary, multi-centre undergraduate medical curriculum: The importance of local cultural requirements

Pain is the most common reason to seek healthcare, however pain teaching is often not prominent in medical school curricula. This project reviewed an existing medical curriculum to develop a comprehensive pain curriculum that consolidated pain learning across a medical degree delivered on geographically-distinct campuses, looking to provide contemporary pain learning that was culturally appropriate in a local context. A cross-campus, interdisciplinary pain working group (PWG) was established to work across the two program stages (pre-clinical, clinical) and three clinical campuses. The PWG undertook a three-phase project to i) develop a range of potential target competencies based on expert input and international pain curricula, ii) identify and review existing pain competencies, and iii) undertake iterative review of information, consult with stakeholders, and propose revised competencies. Eight pain competencies were identified within the extant curriculum. Recommendations included two existing competencies remained unchanged, four be modified, two merged, and 26 new competencies adopted including some specific to local Indigenous Māori and Pacific Island communities. The 33 pain target competencies were structured across different teaching domains: science, research, and scholarship (n = 5); population health and epidemiology (n = 3); clinical skills (n = 5); and diagnostics and therapeutics (n = 20). Contemporary pain learning, including around Indigenous health, was not adequately represented. New target competencies were adopted to ensure pain learning is appropriate for medical practice in Aotearoa New Zealand, containing competencies specific to Māori and Pacific Island communities. Curricula review needs to consider local cultural requirements while integrating international best practice to ensure pain learning is appropriate. PerspectiveA comprehensive pain curriculum was developed across a multi-campus medical school setting. Through a three-phase project, existing pain competencies were reviewed and new target competencies developed, including those specific to local Indigenous communities. Findings highlight the importance of ensuring contemporary curricula include pain learning that is culturally focused and relevant.

Medical students' knowledge and attitudes towards breast cancer screening strategies for the transgender population.

179 Background: Transgender patients (TP) are less likely to seek medical attention, including breast cancer screening (BCS) . Approximately half of TP perceive healthcare workers as uneducated, and face intersecting disparities when accessing healthcare. Despite an increased risk of BC while hormonal gender reassignment treatment, only 0.6% adhere to BCS recommendations. Most medical schools do not include transgender health training in their curricula, leading to an inadequacy in preparing professionals to deliver comprehensive high-quality care. Our group previously demonstrated an important gap in knowledge from specialists on BCS in TP (Barragan-Carrillo et. al. ASCO, 2022). We seek to evaluate the state of knowledge of BCS in TP in Medical Students. Methods: We conducted a validated 14-item online survey exploring the knowledge and attitudes of medical students regarding BCS strategies in TP. 6 questions assessed attitudes and 8 knowledge. Participants were invited in July 2022 through social media to complete the survey. Descriptive statistics were employed for data analysis and chi square was used to asses for associations between demographic data with knowledge. Results: 104 participants completed the survey, 75 (72.1%) identified as female, 28 (26.9%) as men, and 1 (1%) as transgender. 17 (16.3%) self-identified as a sexual minority. Median age was 22 (range 18-30) years. 69 (66.3%) were enrolled in private institutions, and 35 (33.7%) in public. Most (65%) were 4 th -7 th year, and 36 (35%) 1 st -3 rd year students. 32 (30.7%) expressed confidence in their knowledge to address BCS needs for TP. 15% considered medical schools provide good understanding of transgender health needs,86%) believe understanding these needs should be mandatory in in the medical school curricula, and 103 (99.0%) stated they would benefit from more training the subject. Regarding knowledge evaluation, the average score was 46.7% (SD 19.3), with only 11.5% identifying the correct age to start BCS and only 22% the correct interval for it. Only 9 students (8.6%) had a score higher than 75%, and 0 participants got a score of 100%. On chi-square testing we did not find any associations between demographics and knowledge. Conclusions: Most medical students believe they lack capacity to address transgender health issues and would benefit from additional education and training. Our findings support that the current medical school curricular do not support sufficient training on this subject, and bolster the need for a more inclusive curricula. The described deficiencies in future physicians’ knowledge emphasize the importance of incorporating these topics into academia.