Medical School Level Research Articles

Disorders of gut-brain interaction: Highly prevalent and burdensome yet under-taught within medical education.

Background and ObjectiveTo determine the population prevalence and associated health impairment of disorders of gut‐brain interaction (DGBI) across Great Britain, and the emphasis placed upon them within medical education.MethodsAn Internet‐based cross‐sectional health survey was completed by 1906 general population adults across Great Britain without self‐reported organic GI disease. The survey enquired for demographics, symptom‐based criteria for Rome IV DGBI, healthcare use, non‐GI somatic symptoms, and quality of life. As a separate analysis, we evaluated which DGBI are considered core knowledge at undergraduate medical school level and post‐graduate specialization level for Gastroenterologists and General Practitioners.ResultsThe overall prevalence of DGBI across Great Britain was 37%, being similar for England (37%), Scotland (33%), and Wales (36%); p = 0.66. There was no difference between English regions (range 33%–43%, p = 0.26). The prevalence of DGBI was highest in those aged 18–40 years (40%), then 40–64 years (37%), and least amongst those ≥65 years (29%); p < 0.001. The most common DGBI were bowel disorders (30%), followed by gastroduodenal (10.5%), anorectal (8.1%) and oesophageal disorders (6.2%). Individuals with DGBI were significantly more likely than those without DGBI to have increased GI‐related healthcare visits, medication use, surgical interventions, non‐GI somatic symptoms, and reduced quality of life. One‐in‐three people with DGBI had multiple GI organ regions involved and this correlated with increased health impairment (p < 0.001).The only DGBI mentioned across all medical training curricula is irritable bowel syndrome, while the General Practitioner and Gastroenterology Curricula also recognise the outdated term non‐ulcer dyspepsia (as opposed to functional dyspepsia). The 2010 Gastroenterology Curriculum also includes functional constipation and disordered defecation, with the incoming 2022 iteration adding in functional upper GI syndromes, functional abdominal pain, and opioid‐induced GI disturbances.ConclusionDisorders of gut‐brain interaction are common across Great Britain and incur substantial health impairment. However, they are generally under‐taught within the British medical education system. Increasing awareness and education of disorders of gut‐brain interaction might improve patient outcomes.

Virtual Pathology Education in Medical Schools Worldwide during the COVID-19 Pandemic: Advantages, Challenges Faced, and Perspectives.

The COVID-19 pandemic shifted pathology education in medical schools worldwide towards online delivery. To achieve this goal, various innovative platforms were used by pathology educators and medical students, facilitating both synchronous and asynchronous learning. The aim of this study was to review the published evidence regarding remote pathology teaching at the medical school level during this period, present our own experience, and provide some perspectives regarding the best mode of pathology teaching post-pandemic. Among its advantages, virtual pathology education was considered among students and educators as convenient, flexible, and engaging, while learning outcomes were met and students’ academic performance was in general satisfactory. However, several challenges were faced. For instance, suboptimal internet connection compromised the flow of classes and was even associated with a lower academic performance. The lack of hands-on laboratory activities, such as operating the light microscope and tissue grossing, and the reduced student interactions among themselves and their instructors, were also pointed out as significant drawbacks of remote pathology education. Whereas online education has multiple advantages, experiencing the physical university environment, in-person interactions and teamwork, exposure to the “hidden curriculum”, and hands-on activities are vital for medical school education and future student development. In conclusion, the implementation of a blended approach in pathology education—where online and face-to-face sessions are jointly used to promote students’ engagement, interaction with their instructors and peers, and learning—could be the most optimal approach to pathology teaching in medical schools post-pandemic.

Is medical education systemically racist?

After the murder of George Floyd, many professions, organizations, and institutions have begun to confront the long and persistent legacy of racism in the United States. Within that context, it is critically important for the medical education community to address the question of whether medical education is systemically racist, and if so, what should be done to address this problem. In this commentary, this author seeks to answer these questions, primarily by focusing on the role of standardized multiple-choice examinations in determining who gains admission to medical school and which medical students are then determined to be the best and the brightest. Analysis leads the author to the conclusion that medical education clearly meets the definition of systemic racism and that recent attempts to increase the racial and ethnic diversity of medical students have largely failed. The author then outlines a three-pronged approach to address this problem with interventions at the admissions, medical school, and graduate medical education levels.

Block by block: Building on our knowledge to better care for LGBTQIA+ patients.

Emergency physicians need to recognize the diversity of identities held by sexual and gender minorities, as well as the health implications and inequities experienced by these communities. Identities such as lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, aromantic, and many others fall under the LGBTQIA+ acronym. This wide spectrum is seldom discussed in emergency medicine but nonetheless impacts both patient care and patient experience in acute and critical care settings. This commentary aims to provide a brief but nonexhaustive review of LGBTQIA+ identities and supply a critical framework for applying this understanding to patient encounters in the emergency department, as well as describe the challenges and educational aims at the level of medical school, residency, and postresidency. The commonly used and widely accepted definitions of LGBTQIA+ terms are described, as well as implications for patient care and emergency physician education. The authors of this writing group represent the Society for Academic Emergency Medicine, LGBTQ Task Force of the Academy of Diversity Inclusion in Medicine. LGB terms are addressed, with LGBTQIA+ adding "intersex," "asexual," and "+," to include other gender identities and sexual orientations which are not already included. This paper also addresses the terms "transition," "nonbinary," "polyamorous." "two-spirit," "queer," and others. These acronyms and terms continually expand and evolve in the pursuit of inclusivity. Additionally, with some health issues potentially related to medications, hormones, surgery, or to internal or external genitalia, important EM physician tools include gathering an "organ inventory," asking about sexual history, and conducting a physical exam. Most persons have congruent biological sex, gender identity, and attraction to the "opposite" gender. However, humans can have every imaginable variation and configuration of chromosomes, genitalia, gender identities, sexual attractions, and sexual behaviors. Terms and definitions are constantly changing and adapting; they may also vary by local culture. Obtaining relevant medical history, conducting an "organ inventory," asking about sexual history in a nonjudgmental way, and conducting a physical exam when warranted can all be important in delivering best possible medical care. Although there has been increased focus on education at the medical school, residency, and faculty level on LGBTQIA+ patient care in the ED, much work remains to be done. Emergency physicians should feel confident in providing a model of care that affirms the sexual and gender identities of all the patient populations we serve. Optimal patient-centric care requires a deeper understanding of the patient's biology, gender identity, and sexual behavior encapsulated into the ever-growing acronym LGBTQIA+.

Addressing health disparities in hispanic communities through an innovative team-based medical spanish program at the medical school level \u2013 a single-institution study

BackgroundThere are insufficient Spanish-speaking physicians to effectively serve a large and rapidly growing Spanish-speaking patient population.MethodsA team-based hybrid medical Spanish program was designed and implemented at a single medical school in Southern California. This pilot program consisted of a weekly in-person portion where students reviewed Spanish vocabulary and grammar and practiced clinical encounters in teams through active role play. Students supplemented in-class learning with online coursework. Program success was measured through physician-evaluated clinical encounters with Spanish-speaking standardized patients, a 100-question multiple-choice exam, and pre- and post-program surveys.Results97% of students in the program (n = 32) received a passing grade at program completion. Student surveys demonstrated enthusiasm and engagement in weekly sessions (95% overall attendance, 97% reported feeling either excited or ready to learn prior to class). In a post-program survey, 100% of students felt better suited and increased desire to treat Hispanic patients. Additionally, all students indicated an interest in the continued use of Spanish in both their schooling and future practice. In a follow-up survey after three months of clinical experience in their 3rd year of medical school, 100% of students reported that medical Spanish is "very beneficial" in patient care and that students with medical Spanish proficiency have advantages over non-speaking students when it comes to patient care opportunities. 100% felt that time spent learning medical Spanish during pre-clinical years was time well spent and that the medical Spanish program enhanced their care of Spanish-speaking students.ConclusionsThe results of the pilot program show a significant increase in the ability of students to engage in clinical interaction in Spanish. The results of our study demonstrate a significant increase in the knowledge, clinical skills, and self-reported confidence of students to treat Hispanic patients. Furthermore, all students not only felt better equipped and more confident to treat Hispanic patients, but they also had an increased desire to do so moving forward in their careers. We conclude that an effective medical Spanish program can be executed simultaneously with a pre-clinical medical school curriculum.

Advancing diversity: the role of international medical graduates

A physician workforce that reflects the population it serves has been highlighted as one solution for persistent race-based health disparities.1 Efforts to diversify the gastroenterology and hepatology workforce in the USA have, historically, focused on improving diversity among fellows and faculty and increasing the number of potential trainees at the medical school and residency levels.1 Non-US international medical graduates (IMGs) help to diversify the US gastroenterology and hepatology workforce, but several issues need to be addressed so that the effect of IMGs on diversity is sustained.

The AMA Graduate Profile: Tracking Medical School Graduates Into Practice.

Purpose: Medical schools aim to train competent physicians that meet the health care needs of society. Yet beyond the results of the residency match, medical schools often do not know what kind of workforce they are creating or how their graduates perform in practice. 1 Here, we describe the creation of a personalized Graduate Profile for 32 medical schools in the American Medical Association (AMA) Accelerating Change in Medical Education grant consortium. The Graduate Profile addressed 3 core questions: (1) Workforce: Where do graduates practice and to which communities do they contribute?, (2) Clinical Exposure: What prescriptions are graduates ordering for various patient types?, and (3) Quality of Care: What are graduates’ standardized quality measures? Approach: The Graduate Profile links the AMA Physician Masterfile—a nationwide database of physicians in training and practice—to multiple public data sources spanning undergraduate medical education, graduate medical education (GME), and post-GME practice using individuals’ unique national provider identification numbers. Medical students graduating from 32 institutions between 1981 and 2012 were included (n = 120,426 graduates). Graduates’ demographics, self-designated practice specialty, practice location, and practice setting in the year 2019 were tabulated. Specialties were coded as primary care or not primary care. Practice locations were geocoded to identify practice in underserved or rural areas. Additionally, Centers for Medicare and Medicaid Services (CMS) utilization data and Merit-based Incentive Payment System (MIPS) standardized quality scores from the year 2017—representing over 140 million Medicare beneficiary interactions—were tabulated. Outcomes: Graduate Profiles were delivered to 32 medical schools in November 2020. A webinar and 2 office hours were held to support rollout of the profiles. The profiles compared each institution’s graduates from 1981 to 2012 with an average across all medical schools in a series of tables and figures. Trends in graduate gender distribution, in-state retention, practice specialty, primary care practice, office-based practice, and underserved practice were visualized and benchmarked against all 32 medical schools. For example, practice in primary care specialties peaked in the late 1990s and has since declined. Practice in medically underserved communities remained largely constant across 3 decades of graduate cohorts, suggesting that programmatic and policy efforts have not dramatically increased underserved practice. Average MIPS scores were delineated by specialty and over time. Overall, more recent graduates were associated with higher MIPS scores. Finally, graduates’ most prescribed medications to Medicare beneficiaries were tabulated. Across these 32 medical schools, the most prescribed medications were hydrocodone–acetaminophen, lisinopril, atorvastatin, omeprazole, and levothyroxine; as expected, substantial prescribing differences were observed by specialty. Each institution’s personalized profile differed, with substantial interinstitutional differences in most assessed areas. Discussion: Harnessing the AMA Physician Masterfile and multiple open data sources, this project provided medical schools with detailed profiles of their graduates—some of whom had been in practice for nearly 40 years. The project relied on data science and informatics approaches, using a centralized process that had “economy of scale.” Early feedback from medical schools indicates that the profiles are hypothesis generating and may highlight alignment (or misalignment) with their stated educational mission. We envision a future state where the constituent institutions generate questions to be answered via the Graduate Profile, which then drives medical education innovation at the medical school level. 2 Significance: The AMA Graduate Profile uses informatics approaches to link multiple data sources for 3 decades of graduates, providing medical schools a tool to understand if their graduates’ practice patterns align with their stated mission and workforce needs. The Graduate Profile is unique as it incorporates actual practice specialties, practice locations, prescribing behaviors, and standardized quality scores of over 120,000 graduates—a proof of concept for future work exploring additional domains of graduates in practice.

Role of Rawalpindi Medical University Students in Perspective of Public Health

Role of Rawalpindi Medical University Students in Perspective of Public Health

Implementation of disaster medicine education in German medical schools - a nationwide survey.

Objectives: Floods, earthquakes and terror attacks in recent years emphasize the importance of disaster preparedness for the medical community. To best prepare doctors for providing optimal care in disaster situations, specific education and training should start at the medical school level. This study containes an online survey among German medical schools to evaluate the status quo of teaching disaster medicine and to reveal potential obstacles.Methods: The dean’s offices of 36 German medical schools were contacted from April 2016 to May 2017. Via an e-mail link, recipients could anonymously and voluntarily access an online questionnaire (74 items, 42 with a four-point “Likert-like” scale, 12 yes/no questions and 20 with listed items to choose from). The answers were analyzed by descriptive statistics. Results: A total of 25 medical schools participated in the survey. Twenty respondents were in favor of expanding disaster medicine teaching at their institutions. Incorporating single topics ranging from triage (n=21) to accidents involving radioactive materials (n=4) into the curriculum varied widely. Only two schools had established a teaching coordinator for disaster medicine and only one e-learning course had been established. Twenty-one respondents regarded funding issues and 18 regarded organizational matters to be major hurdles in the future. Conclusion: Though most faculty representatives indicated that they favor expanding and implementing disaster medicine education, German medical schools still have a lot of room for enhancement in this field. The incorporation of e-learning tools could facilitate the expansion of disaster medicine teaching while simultaneously addressing the expressed concerns of the survey’s participants and guarantee nationwide standardization.

The prevalence of lesbian, gay, bisexual, and transgender health education and training in emergency medicine residency programs: Where are we now?

Despite identified inequities and disparities in lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) health, past studies have shown little or no education at the medical school or residency level for emergency physicians. With increased focus on health inequities and disparities, we sought to reexamine the status of sexual and gender minority health education in U.S. emergency medicine (EM) residencies. Our primary objective was to determine how many EM residencies offer education on LGBTQ+ health. Secondary objectives included the number of actual versus preferred hours of LGBTQ+ training, identification of barriers to providing education, and correlation of education with program demographics. Finally, we compared our current data with past results of our 2013 study. The initial survey that sought to examine LGBTQ+ training in 2013 was used and sent in 2020 via email to EM programs accredited by the American Council for Graduate Medical Education who had at least one full class of residents in 2019. Reminder emails and a reminder post on the Council of Residency Directors in Emergency Medicine listserv were used to increase participation. A total of 229 programs were eligible, with a 49.3% response rate (113/229). The majority (75%) offered education content on LGBTQ+ health, for a median (IQR) of 2 (1-3) hours and a range of 0 to 22 hours. Respondents preferred more hours of education than offered (median desired hours = 4, IQR= 2-5 hours; p<0.001). The largest barrier identified was lack of time in curriculum (63%). The majority of programs had known LGBTQ+ faculty and residents. Inclusion and amount of education hours positively correlated with presence of LGBTQ+ faculty or residents; university- and county-based programs were more likely to deliver education content than private groups (p=0.03). Awareness of known LGBTQ+ residents but not faculty differed by region, but there was no significant difference in actual or preferred content by region. The majority of respondents offer education in sexual and gender minority health, although there remains a gap between actual and preferred hours. This is a notable increase from 26% of responding programs providing education in 2013. Several barriers still exist, and the content, impact, and completeness of education remain areas for further study.

Current Efforts in Diversity for Pediatric Subspecialty Fellows: Playing a Zero-sum Game

* Abbreviation: URiM — : underrepresented in medicine Medicine in the United States has been hampered by a lack of diversity for centuries. Over the past few decades, greater attention and efforts have been focused on tackling this problem. A diverse workforce is important for many reasons, including a commitment toward a representative workforce in the name of social justice, improved patient care in the form of increased access and patient satisfaction,1 and service to communities for whom we provide care.2 Programs aimed at increasing diversity exist at every level of medical training, from premedical programs to the subspecialty match. Programs throughout are important because structural and individual racism impede minority success at every level, but the earliest interventions are the most likely to succeed. Efforts aimed at increasing diversity will not succeed by simply targeting subspecialty trainees alone. In essence, at the subspecialty level, this is a zero-sum game. The gains made by any one program are exactly balanced by the losses borne by others. A significant impact on increasing the pool of underrepresented in medicine (URiM) candidates for fellowship positions requires that efforts begin early and continue throughout the entire educational journey. The Association of American Medical Colleges defines URiM as “racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.” This … Address correspondence to Angela C. Weyand, MD, Division of Pediatric Hematology and Oncology, Department of Pediatrics, Medical School, University of Michigan, 1150 W Medical Center Dr, Medical Sciences Research Building III, Room 8220E, Ann Arbor, MI 48109. E-mail: acweyand{at}med.umich.edu

Changing the channel on medical ethics education: systematic review and qualitative analysis of didactic-icebreakers in medical ethics and professionalism teaching.

As medical ethics and professionalism education continues to equip medical students and residents with long-lasting tools, educators should continue to supplement proven teaching strategies with engaging, relatable, and generationally appropriate didacticsupplements. However, popular teaching aids have recently been criticized in the literature and summative information on alternatives is absent. The purpose of this review is to evaluate and assess the functional use and application of short form audiovisual didactic supplements or "icebreakers" in medical ethics and professionalism teaching. A systematic review of both the medical and humanities literature (i.e., PubMed/MEDLINE, Cochrane Library, and JSTOR) was conducted from inception to August 1, 2019. Final articles were subjected to a qualitative appraisal and thematic analysis. Thirteen articles were included forfinal analysis. Sixty-nine percent (n = 9) of the studies were published after 2000. Two studies were qualitative, one study was quantitative,and the remaining articleswere commentaries. Short form audiovisual media was most popular outside of the United States (n = 10). Sixty-nine percent (n = 9) of articles advocated for self-contained media in the form of trigger films or short films/videos, while the remaining articles (n = 4) discussedthe use of TV/film clips. Producibility of media was exclusive to short/trigger films. Nine themes were identified in the content analysis: adaptability, conversation catalyst, effective, engaging, nuance, practice, producibility, real, and subject diversity. The three most common themes in descending order of frequency were: conversation catalyst, realness, and adaptability. Trigger films represent an effective and unique pedagogical strategy in supplementing current medical ethics and professionalism teaching at the medical school level.

Investigating interest in orthopedic surgery within an entire medical faculty: A cross-sectional study

BackgroundDiscrepancies exist between the magnitude of musculoskeletal problems and the competency of physicians practicing musculoskeletal medicine, which likely stems from medical school-level educational deficiencies. Therefore, inadequate orthopedic surgery education during medical school may affect the number of students aspiring to practice orthopedic surgery. However, the motivating factors underlying medical students' selection of a career specialty are largely unknown. This study aims to use a survey to examine the motivations of medical students who consider orthopedic surgery as a potential career specialty. MethodsA questionnaire survey was administered to medical students in our medical faculty. The results were stratified on the basis of gender, year, and experience as a patient; results were then compared between students who wished to practice orthopedic surgery and those who did not consider it a potential specialty. ResultsOf the 499 students who responded to the questionnaire, 47% considered orthopedic surgery as their career specialty. Being male and having experienced orthopedic surgery as a patient were significant factors influencing the aspiration to practice orthopedic surgery (p < 0.001). In addition, the motivation for choosing orthopedic surgery was academic interest for 55% of students. In the first and fifth years, more than half of the students preferred an orthopedic surgery specialty. The percentage of fifth-year students who were candidates for orthopedic surgery as their career specialty significantly exceeded that of students in other years (p = 0.03). However, the percentage of students considering orthopedic surgery decreased in the sixth year. ConclusionOur findings suggest that orthopedic surgeons should provide a clearer, more informative job description to attract female medical students' attention and change their negative perception of orthopedic surgery. Furthermore, including education that incorporates experiences closer to clinical practice at the medical-school level is important for increasing the number of candidates for orthopedics.

Appreciating the global impact of cleft lip and palate at the medical school level

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Pilot study of a longitudinal integrated disaster and military medicine education program for undergraduate medical students.

Disaster medicine education in medical curricula is scarce and frequently nonexistent. It is reasonable to initiate educational approaches for physicians in this field at the medical school level. An understanding of disaster medicine and the health care system during massive casualty incidents has been recommended as an integral part of the medical curriculum in the United States and Germany.The goal of the reformed curriculum was to develop a longitudinal integrated disaster and military medicine education program extending from the first year to the sixth year based on previously separated clinical and military medicine topics. Emergency medicine physicians, military emergency medical technicians, and Tactical Combat Casualty Care instructors formed an interprofessional faculty group and designed a learning curriculum.A total of 230 medical students participated in the revised disaster preparedness curriculum. Satisfaction survey response rates were high (201/230, 87.4%). Most of the free-text comments on the program were highly appreciative. The students considered the number of teaching hours for the whole program to be adequate. The students showed significant improvements in knowledge and judgment regarding disaster medicine after the program.We found that medical students were highly interested, were appreciative of, and actively participated in this longitudinal integrated disaster and military medicine education program, but gaps existed between the students' scores and the educators' expectations. The educators believed that the students needed more disaster preparedness knowledge and skills.

Evaluation of a Novel Pediatric &amp; Adolescent Gynecology Sub-Internship for Medical Students [12G

INTRODUCTION: Although Pediatric and Adolescent Gynecology (PAG) is an important and growing field, training opportunities are limited, especially at the medical school level. To address this gap, we developed a PAG sub-internship and elective course for medical students. Our course represents the fourth PAG sub-internship available in North American medical schools; by contrast, other available sub-internships include 113 in Maternal Fetal Medicine and 82 in Gynecologic Oncology. METHODS: Our four-week PAG sub-internship and two-week elective include a multi-pronged evaluation system with three components: a written test taken on the first and last day of the sub-internship, direct observation and evaluation of clinical skills using the Entrustable Professional Activities (EPAs) framework, and a 360-degree feedback system allowing students to provide anonymous feedback regarding the sub-internship. RESULTS: In the first year of our sub-internship, seven students applied and five students enrolled; in the second year, eight students have applied. Mean overall EPA entrustability scores were 2.3 and 3.7 on the first and final day of the sub-internship, respectively. Preliminary evaluation data showed a mean score of 5.0 (strongly agree) for the evaluation question “Were you satisfied with the clinical teaching in this elective/sub-internship?” Excerpts from the written feedback provided via anonymous evaluations included “This elective provided an excellent cross-section between pediatrics and gynecology.” CONCLUSION: We have developed, implemented, and evaluated a PAG sub-internship for medical students. We share our evaluation data to demonstrate the value of such training opportunities and help other institutions who wish to create a PAG sub-internship.

Improving Patient Experience by Teaching Empathic Touch and Eye Gaze: A Randomized Controlled Trial of Medical Students

Background:Empathy is critical for optimal patient experience with health-care providers. Verbal empathy is routinely taught to medical students, but nonverbal empathy, including touch, less so. Our objective was to determine whether instruction encouraging empathic touch and eye gaze at exit can impact behaviors and change patient-perceived empathy.Materials:A randomized, controlled, double-blinded trial of 34 first-year medical students was conducted during standardized patient (SP) interviews. A video either encouraging empathic touch and eye gaze at exit or demonstrating proper hand hygiene (control) was shown. Encounter videos were analyzed for touch and eye gaze at exit. The Jefferson Scale of Patient Perceptions of Physician Empathy was used to measure correlations. Intervention students were surveyed regarding patient touch.Results:Of this, 23.5% of intervention students touched the SP versus zero controls; 88.2% of intervention students demonstrated eye gaze at exit. Eye gaze at exit positively impacted patient-perceived empathy (correlation = 0.48, P > .001). Survey responses revealed specific barriers to touch.Conclusion:Medical students may increase perceived empathy using eye gaze at exit. Instruction on empathic touch and sustained eye gaze at exit at the medical school level may be useful in promoting empathic nonverbal communication. Medical educators should consider providing specific instructions on how to appropriately touch patients during history-taking. This is one of the few studies to explore touch with patients and the first ever to report the positive correlation of a health provider’s sustained eye gaze at exit with the patient’s perceived empathy. Further studies are needed to explore barriers to empathic touch.

Enhancement of Human Anatomy and Nervous System Learning using Mobile Augmented Reality Application

Advancements of recent technology allows the delivery of educational materials to be highly interactive. Augmented reality (AR) is one of the most promising technology that augments reality with computer generated imagery, objects, information etc. and allows user interaction. By providing visualization and interactive 3D models, it allows students to understand any abstract concept on any time, at any place easily. In this work we have developed an AR based mobile application that can create an interactive 3D view of human skeleton and nervous system by using a target image captured by a mobile phone camera. The main motive of this application is to help the medical students and school level science students to learn human anatomy and nervous system in an interactive way so that they can enhance their learning procedure. This research narrates the concept, application development and results of the pilot test. This test is conducted by the medical students of different medical colleges of Bangladesh. We have done this pilot test to get the users’ experiences from technical viewpoint. According to this test we can concluded that students were satisfied with this application in terms of the features, usability, feasibility and understandability.

Knowledge, attitude, and perceived barriers regarding colorectal cancer screening practices and risk factors among medical students in Saudi Arabia

BackgroundColorectal cancer (CRC) is a major health problem. It is the third most diagnosed common tumour and the fourth leading cause of cancer-related deaths worldwide. Early screening has been shown to decrease the incidence of CRC cancer and decrease mortality. In Saudi Arabia (SA), there is no national policy for CRC screening despite the growing incidence of the disease. This study investigated the knowledge of risk factors for CRC, recommendations for screening, and attitudes and barriers towards screening among medical students.MethodsData was collected using a self-administered valid and reliable questionnaire consisting of demographic characteristics, knowledge, attitude, and barriers measurements completed by 581 medical students from two Saudi schools. Frequencies and mean scores of knowledge and attitude were determined. The likelihood of students having adequate knowledge of CRC risk factors and screening modalities was estimated using multivariate logistic regression analysis.ResultsKnowledge of the risk factors for CRC and screening modalities, and attitude towards screening were poor in 52.47 and 57.83% of the surveyed medical students; respectively. Higher level of medical education (OR = 3.23; 95% CI: 2.01–5.18) and a positive attitude towards CRC screening (OR = 2.74; 95% CI: 1.86–4.03) were independent predictors of higher knowledge levels. Lack of awareness about CRC and screening modalities among patients, and shortage of specialized healthcare providers were barriers independently associated with low knowledge levels.ConclusionsSaudi medical students have limited knowledge of CRC risk factors of and a poor attitude towards CRC screening. These results contribute to our understanding of missed teaching opportunities in Saudi medical schools and suggest intervening at the medical school, clinical practice, and population levels to increase CRC screening practices.

The Sooner the Better: High-Value Care Education in Medical School.

Over the last decade in the United States, a national emphasis on controlling health care costs has prompted the medical community to embrace the ideal of high-value care (HVC), with value defined as health outcomes achieved per dollar spent. Despite increasing recognition of its importance as a skill for the modern physician, the practice of HVC remains a relatively new concept. Integrating HVC into medical education has been heterogeneous at best, with the majority of current HVC education thus far implemented at the postgraduate level. The authors present the unique benefits of the earlier introduction of HVC training at the medical school level, including ease of standardization across programs, a synergy in learning the value of an intervention alongside its other innate qualities, and the establishment of a foundational HVC education to allow for specialty-specific value training during residency. In this Invited Commentary, the authors offer practical recommendations for the incorporation of HVC training into medical schools' curricula, with special attention to correlating specific education strategies with the preclerkship, clerkship, and elective years of medical school.