Medical Student Education Research Articles

(074) THE REPRESENTATION OF FEMALE SEXUAL MEDICINE AND GENITAL ANATOMY IN A USMLE STEP 1 RESOURCE

Abstract Introduction Sexual health is an essential component of overall health and wellness. Sexual dysfunction is pervasive and there are barriers to adequate diagnosis and treatment, including lack of instruction for medical students. Previous work from our group assessed the curricula of all seven medical schools within the Chicago area and highlighted the need to standardize both preclinical and clinical materials to enhance student education, exposure, and preparation in female sexual medicine (FSM). The United States Medical Licensing Exam (USMLE) Step 1 significantly informs content of pre-clinical undergraduate medical education. Comprehensive USMLE Step 1 resources therefore assume an integral role in exposing medical students to key topics which may or may not be included in their individual school’s curriculum. Thus, it is important to assess if information about FSM and female genital anatomy is delivered to medical students and to what extent in board exam materials. Objective This study aims to assess the coverage of sexual medicine topics in a USMLE Step 1 resource and to compare the representation of male- versus female-specific content. Methods Digital copies of First Aid for the USMLE Step 1 2020-2023 versions were collected and evaluated for inclusion of sexual medicine subjects and topics for both males and females. The content of the chapters titled “Reproduction” and “Psychiatry” were included. To standardize our data collection, existing literature was used to identify specific components of anatomy and physiology related to genital anatomy and orgasm. Additionally, the epidemiology, pathologies, and treatments of FSM were specifically searched for in this resource. Results Across the four editions of the resource included for evaluation, all covered the physiology of the male orgasm, however, none included the physiology of the female orgasm. Moreover, the only mention of female sexual dysfunction (FSD) was in the psychiatry chapter which only briefly addressed the pathophysiology of FSD, but not the epidemiology nor the treatment of FSD. Furthermore, only one out of seven relevant anatomical terms describing parts of clitoral anatomy were included. Homologous male genitalia was consistently labeled for the glans penis, prepuce, corpora cavernosa, and corpus spongiosum as four out of six anatomical terms of interest. Additionally, all four editions from 2020-2023 included content on penile neurovasculature and a penile cross-sectional diagram; however, there was no mention of clitoral neurovasculature nor were there any cross-sectional diagrams of female anatomic components in any of the four editions evaluated. Conclusions Despite this USLME Step 1 resource’s over 840 pages, the representation of topics related to FSM is lacking compared to analogous male topics. Recent literature which has highlighted the gaps in FSM education and the importance of comprehensive sexual medicine training for physicians, however, there have been no significant changes to the content of this resource over the past four editions. USMLE Step 1 resources play a vital role in enhancing the understanding of FSM among medical students. Content expansion is needed to provide accurate information to patients, help patients make informed decisions about treatments, destigmatize reproductive and sexual health, and overall advance medical knowledge of FSM. Disclosure No.

Model for an Academic Medicine Interest Group: A student-led initiative

Academic physicians are responsible for the education of medical students, residents, and other practicing physicians through clinical rotations lectures, seminars, research, and conferences. Therefore, the increasing need to recruit academic physicians holds immense value within the healthcare system. Academic Medicine Interest Group (AMIG) is a collective made up of students who share an interest in the growth and advancement of academic medicine. We present a guide and model on establishing an AMIG. We found that AMIG fostered professional growth by providing leadership, research, and teaching opportunities. Strategic planning, effective leadership, and group organization were all necessary for the success of the group.

Integrating Large Language Models in Bioinformatics Education for Medical Students: Opportunities and Challenges.

Large language models (LLMs) offer transformative opportunities in bioinformatics education for medical students by creating interactive experiences. The integration of LLMs enhances educational outcomes through providing accessible code templates, clarifying the function of coding elements, and assisting in error troubleshooting. Here, we demonstrate the practical applications of LLMs with a case study on transcriptome sequencing data processing, a vital component of medical research. However, the reliability of the content that LLMs generate requires rigorous validation. Ensuring the accuracy and appropriateness of the LLM-generated information requires integrating innovative LLMs with traditional educational methods to prepare medical students effectively for future challenges in bioinformatics.

Sleep education for medical students: A study exploring gaps and opportunities

PurposeTo explore final-year medical students’ perceptions of sleep education during medical school to inform the development of a sleep curriculum. MethodsYear 6 medical students on their final general practice placement in 2020 were invited to complete an online survey including questions regarding sleep education recalled during the medical programme. ResultsResponses were received from 51/71 (72 %) students. Main learning topics recalled by participants were sleep apnoea (83 %), sleep physiology (71 %), and snoring (69 %). Education in other topics was reported by <65 % of students. Priority topics for students were treating common sleep disorders, taking a sleep history, and navigating shift work. ConclusionsWhilst the majority of students recalled education on specific topics, many had little awareness of education relating to sleep assessment, insomnia, or shift work. Sleep education in the curriculum needs more emphasis and reinforcement given sleep's relevance across many domains of health and morbidity. We propose that an identifiable sleep curriculum is required to ensure medical students have the necessary core education regarding sleep and sleep disorders both for patients and themselves. Further, we believe this is possible to achieve in a short timeframe within the constraints of an existing curriculum and propose some creative solutions.

Creation of a resident-led medical student education committee.

The Resident-Student Education Committee (RSEC) is a novel approach to integrate and expand medical student education within an emergency medicine (EM) residency at a large academic center. There is a paucity of literature on such programs and there is no documentation of longitudinal initiatives with residents serving as specialty-specific advisors to students throughout medical school. The goals of creating the RSEC were to expand and improve the student educational experiences in EM, strengthen the connection between students and EM residents, and foster resident career development through sustainable leadership and teaching opportunities. The RSEC was composed of three divisions: the Preclinical Division aimed to increase student exposure to EM through didactics, skill sessions, simulation, and shadowing; the Clinical Division intended to enhance the student experience during clinical EM rotations through simulation and skill sessions and resident-student socials; and the Mentoring Division focused on advising students applying into EM through informational panels and one-on-one resident mentorship. Outcome measures include students applying into EM residency, which saw an increase from 8.9% prior to the RSEC's creation in 2020 to 12.9% in 2023, despite a national decline in EM applicants. Survey data also indicates favorable student preclinical experiences and improved confidence in clinical skills. The RSEC model, with its structured approach, resident leadership, and clear objectives, presents a sustainable and replicable framework for other residency programs seeking to enhance medical student education and promote resident engagement in teaching. Future directions include expanding shadowing opportunities and procedural skills teaching, introducing career mentorship earlier in the medical education timeline, and tracking outcomes data for continuous assessment and improvement.

Education Research: What Medical Students Value in Neurology Residents: A Qualitative Study to Inform Resident as Teacher Curricula.

Residents are responsible for much of the formal and informal teaching of neurology clerkship medical students. High-quality resident teachers can enhance clerkship satisfaction, decrease neurophobia, and increase specialty interest. To train such residents, some institutions have developed resident as teacher (RAT) curricula. Existing RAT curricula are highly variable, partly because of our limited understanding of medical student attitudes and expectations regarding the qualities and skills of effective resident teachers. We sought to identify important themes in resident teaching, based on qualitative analysis of written evaluations by students, to better inform future RAT curricula in neurology. Clerkship student evaluations of residents from 2012 to 2023 at a single institution were collected and anonymized. The narrative comments were thematically coded using conventional content analysis in an iterative process of reconciliation and recoding. Randomly selected evaluations were analyzed in batches of 50 at a time until thematic saturation was achieved. A total of 200 evaluations yielded 6 themes with 27 subthemes: (1) Work-based learning, teaching and assessment: "sets expectations," "student involvement in care," "student autonomy over care," "helps students prepare/practice," "gives feedback," "mentorship and coaching," and "challenges students"; (2) Attitudes as teacher: "likes to teach," "made time to teach," "inspirational/fun," "patience," "approachability," and "learner-centric"; (3) Learning environment: "safety" and "clear communication"; (4) Role modeling: "knowledge," "skills," "attitudes," and "leadership"; (5) Content of teaching: "clinical skills," "medical knowledge," "nonmedical topics," and "directed to further learning"; and (6) Context of teaching: "bedside/in exam room," "attending rounds," "in workflow," and "break for teaching." The most prevalent subthemes were "student involvement in care," "gives feedback," "safety," "made time to teach," and "approachability." In their written evaluations of neurology residents, medical students identified many attributes, skills, and methods that led to a positive learning experience. Many of these themes highlighted the importance of residents facilitating work-based learning, cultivating the learning environment, and serving as role models rather than formal teaching activities alone. We provide recommendations for further RAT curricular development informed by these results. Using these findings, we further illustrate how residents influence the tripartite interaction between the learner, their subject, and their environment seen in existing learning theories.

Neuropsychiatry Teaching for Medical Students: A Narrative Review

Neuropsychiatry Teaching for Medical Students: A Narrative Review

'Needing to be seen and heard': is this why GPs are educators?

Recruitment and retention of undergraduate (UG) GP educators is vital, they are essential to educating the next generation of doctors. The expected loss of GPs as they retire and leave the profession means clinical delivery is under tension; adding to the strain on the number of GP educators. With GP educators numbers decreasing and student numbers increasing, the pressure on the system is growing. To explore the experience of the GP educator, investigate the impact participation in UG medical education has, the barriers there are, and what support educators need to continue. This qualitative study uses individual semi-structured interviews of four active GP educators with at least 4 years of experience teaching medical students in a primary care setting; these were then transcribed and thematically analysed. One of the most surprising results showed that GPs' enjoyed their work as educators as it allowed them t'o be seen and heard'. One participant stated; I want 'my blood, sweat and tears to mean something to somebody [the students]'. It also allowed the GPs' to reflect on their life's work and gave them a platform to demonstrate this. The Wass report, 2016 showed that students' exposure to GPs in UG education plays a significant role in choosing a career in general practice. This exposure needs GPs to act as positive role-models. Further research is required to examine the GP educators' need to 'be seen and heard', and if this can be used to recruit/retain GP educators.

General Knowledge or The Use of Menstrual Cycle Tracking App among Medical Students at Sriwijaya University

Introduction. As technology and science develop, the menstrual cycle can be known practically by using menstrual cycle tracking applications on gadgets. The many features in the application are an added value, so many women choose to use menstrual cycle tracking applications compared to other platforms. This research aims to identify the general level of knowledge or use of the menstrual cycle tracking app among medical students at the Faculty of Medicine Sriwijaya University. Methods. This type of research is descriptive using a survey. The sample in this study was female medical students at the Faculty of Medicine Sriwijaya University class 2018—2023 who fulfilled the inclusion and exclusion criteria. Sampling was collected by total sampling. Results. In this study, 868 respondents participated, it was found that 467 (53.8%) had the highest level of knowledge, namely with “good” category. 685 (78.9%) controlled their menstrual cycles. 450 (65%) used a menstrual cycle tracking application with the most duration of use being ≥ 1 year 311 (49.8%). The most widely used application name is Flo My Health &amp; Period Tracker 308 (66.5%). 294 (63.9%) chose the quite satisfied category for the level of satisfaction with using the application. In addition, 396 (86.1%) chose the sufficient category for the level of accuracy in using the application. Conclusion. Female medical education students at the Faculty of Medicine, Sriwijaya University have a general level of knowledge with the dominance of the category “good” and a usage rate of 467 (53.8%) in the menstrual cycle monitoring application.

The Blue Ribbon Committee II Report and Recommendations on Surgical Education and Training in the United States: 2024.

An expert panel made recommendations to optimize surgical education and training based on the effects of contemporary challenges. The inaugural Blue Ribbon Committee (BRC I) proposed sweeping recommendations for surgical education and training in 2004. In light of those findings, a second BRC (BRC II) was convened to make recommendations to optimize surgical training considering the current landscape in medical education. BRC II was a panel of 67 experts selected on the basis of experience and leadership in surgical education and training. It was organized into subcommittees which met virtually over the course of a year. They developed recommendations, along with the Steering Committee, based on areas of focus and then presented them to the entire BRC II. The Delphi method was chosen to obtain consensus, defined as ≥80% agreement among the panel. Cronbach α was computed to assess the internal consistency of 3 Delphi rounds. Of the 50 recommendations, 31 obtained consensus in the following aspects of surgical training (# of consensus recommendation/# of proposed): Workforce (1/5); Medical Student Education (3/8); Work Life Integration (4/6); Resident Education (5/7); Goals, Structure, and Financing of Training (5/8); Education Support and Faculty Development (5/6); Research Training (7/9); and Educational Technology and Assessment (1/1). The internal consistency was good in Rounds 1 and 2 and acceptable in Round 3. BRC II used the Delphi approach to identify and recommend 31 priorities for surgical education in 2024. We advise establishing a multidisciplinary surgical educational group to oversee, monitor, and facilitate implementation of these recommendations.

A trial of structured debate as a self-learning method for students and young healthcare providers to discuss social issues in general and family medicine: A case report in Japan.

The structured debate as a means of medical education for medical students and young healthcare providers was performed, with diverse topics related to general and family medicine.

The impact of COVID-19 on medical education and training.

The COVID-19 pandemic social isolation policies have accelerated the shift to online teaching for medical students and doctors in training worldwide. Online learning is cost-effective, available, and flexible. However, it can be challenging due to the technical system errors, which results in the disruption of the learning process and social isolation yielding to less satisfaction among students and teachers. The above can have negative consequences on the mental health of medical students and trainees, which is an under-researched area. United Kingdom based medical students and doctors in speciality training encountered disruptions to medical education and training due to the pandemic. Medical school and deaneries had to endorse adjustments to teaching and training delivery methods, examination, and assessments to ensure the continued progression of learning and training. A successful e-learning model depends on motivated and well-prepared medical students and teachers and structured educational materials in supported learning environment and institutions. A blended model is likely to be utilised by medical institutions for medical training in the future, which will need to be researched.

Proximie in the operating theatre: evaluation of a virtual operating platform for medical student education.

Medical students often hesitate to enter the operating theatre because of poor visibility of the surgical field and anxiety about the theatre environment. In addition, ear, nose and throat (ENT) surgery is underrepresented in many medical curricula. Virtual systems like Proximie offer flexible viewing of surgeries with surgeon commentary, potentially addressing these issues. This descriptive survey study aimed to evaluate the use of Proximie as a surgical education tool for delivering ENT teaching to medical students. Live ENT procedures were recorded at the ENT Department of the John Radcliffe Hospital and shared with interested clinical medical students through Proximie accounts. Students were added to a private group chat to ask questions and provided feedback through structured forms, assessing procedural effectiveness and the platform's technology. Live-streaming and recording of procedures were facilitated by ENT surgeons providing commentary. Conducted over four virtual theatre days, the study gathered 52 responses: 96% of students rated Proximie's educational value as 4 of 5 or higher; 57% preferred the virtual experience over physical attendance because of its convenience and the improved view of the surgical field. Students valued the live commentary and showed interest in using Proximie for a broader range of surgeries. Suggested improvements included fixing technical issues, better communication of theatre lists, and expanding surgical specialty coverage. Proximie has been highly rated by medical students for its effective and engaging approach in the instruction of surgical skills, underscoring its value as an educational tool. Future research is needed to formally assess knowledge acquisition and retention across multiple surgical subspecialties. This work is the first step towards evaluating the utility of virtual operating theatre platforms for medical student education.

Community Partners' Perceptions of the Benefits and Burdens of Participating in a Community Engagement Course with Medical Students.

Service-learning courses improve medical students' ability and willingness to participate in community engagement as future physicians. However, few studies examine the community partners' (CP) perceptions of the utility of these courses in accomplishing the goals of their organizations. This qualitative study sought to understand the CPs' perspective of the benefits and burdens they face while participating in a university-affiliated medical school's Community Learning and Social Medicine (CLSM) course. This was a qualitative focus group study conducted with CPs participating in the CLSM course. A trained facilitator virtually conducted focus groups. The study team recorded and professionally transcribed these conversations. The team subsequently developed a code book, and two independent coders analyzed all materials. The team used reflective thematic analysis to identify prominent themes. Fifteen out of 28 CPs participated in the study. The study team organized themes from the analysis into three categories: benefits to participation, challenges to participation, and minor themes. CP-perceived benefits to participating in the CLSM course included help with organizational activities, dissemination of clinically relevant skills to medical students, and effective engagement with community members. Barriers to participation included course constraints and a lack of clarity on course content and student expectations. CPs also described their role in medical student education as an extension of faculty members. Finally, CPs offered solutions for improving course communication among site leads, students, and course instructors. CPs acknowledged that this service-learning course provides collective benefit to students, community organizations, and community members. However, challenges such as navigating student schedules and understanding course expectations lead to additional work for CPs. Acting on suggestions for improvement will help secure this course's longevity and collective benefit to the community.

Feedback practices in undergraduate clinical teaching in Sri Lanka - a qualitative study.

Feedback is integral to medical education, enabling students to improve their knowledge, skills, and attitudes. Feedback practices may vary according to prevalent cultural and contextual factors. This study aimed to explore how feedback is conceptualized and practised in the clinical education of medical students in Sri Lanka. The study was conducted in three medical schools and affiliated hospitals that represent the cultural diversity of Sri Lanka. Purposive sampling was utilized to recruit clinical teachers and students who would provide rich information for the study. The study had three components: an observation study, interviews with clinical teachers and focus group discussions with clinical students. During the observation study, video recording was used as a data collection tool to observe feedback in real-life clinical teaching/learning settings. A constructivist grounded theory approach was adapted for analysis to explore current practices and perceptions inductively. Feedback was conceptualised as spontaneous unidirectional provision of information for the improvement of students. It was often provided in public settings and in student groups. Error correction was the primary focus of feedback, but both teachers and students desired a balanced approach with reinforcement and reflection. Although the direct approach to corrective feedback was found beneficial for student learning, participants agreed that harsh feedback was to be avoided. The hierarchical culture and lack of programmed feedback in the curricula influenced feedback practices, suggesting the need for modification. This study highlighted feedback practices in the local context, emphasizing the need to address the hierarchical gapin clinical settings, balance reinforcement and correction, and promote dialogue and reflection in the feedback processes. The findings will help clinical teachers from both the global south as well as the global north to recognize cultural and contextual differences in providing feedback.

Using Neurology Trainees as Standardized Patients in a Neurological Emergency Simulation Curriculum for Medical Students.

Simulation manikins have limited ability to mimic neurological exam findings, which has historically constrained their use in neurology education. We developed a cased-based simulation curriculum in which neurology trainees acted as standardized patients (SPs) and portrayed the neurologic exam for medical students. We ran monthly simulations of two cases (acute stroke and seizure) with resident/fellow SPs. Pre-/post-session surveys assessed students' self-rated confidence in neurological clinical skills (gathering a history, performing an exam, presenting a case) and knowledge domains. Questions about students' attitudes about neurology were adapted from a validated assessment tool. Paired t-tests were performed for quantitative items. Qualitative thematic analysis identified key themes. Sixty-one students participated. Post-session, students reported significantly higher self-confidence in all neurological clinical skills and knowledge domains (p < 0.002). Greater than ninety-five percent agreed the session met the learning objectives; 95% recommended it to others. Resident/fellow SPs were cited as the most effective educational component. Students appreciated evaluating acute emergencies and reported an increased interest in neurology careers. A case-based simulation curriculum with neurology trainees portraying the SP increased students' self-reported knowledge, skills, and confidence in managing neurological emergencies. Our intervention may improve medical student neurology education and increase interest in the field. Future research should evaluate clinical skills objectively. The online version contains supplementary material available at 10.1007/s40670-024-02016-w.

Personalized medicine in the evaluation of Müllerian anomalies: the role of three-dimensional printing technology

To present the comprehensive methodology for generating personalized three-dimensional (3D) printed uterine models from 3D ultrasound (US) volumes in individuals diagnosed with Müllerian anomalies and discuss potential applications in the field of reproductive endocrinology and infertility. Pilot study. Single large university-affiliated teaching hospital. Patients with the presence of a Müllerian anomaly between the ages of 18 and 45 years attending the maternal-fetal medicine as well as reproductive endocrinology and infertility outpatient offices from 2018 to 2023 were included in the study. Subjects underwent 3D US transvaginal scanning for the collection of data. The 3D US volumes were acquired, edited, and exported from a US cart Voluson E10 system (GE Healthcare, Chicago, IL). High-definition virtual models were created and modified, making them suitable for printing using Materialise 3-Matic Medical (Materialise NV, Leuven, Belgium). The models were printed on a J5 MediJet 3D printer (Stratasys, Rehovot, Israel). Colors were set to mimic a realistic appearance, and shore values were set before printing. Successful creation and utilization of personalized 3D-printed uterine models for individuals with Müllerian anomalies. Three-dimensional models were created for a uterus without anomalies, 2 variations of a partial septum, a unicornuate, and a didelphys uterus. Models were used as a tactile and customized tool for patient education, counseling, and medical student and resident teaching. This technique illustrates that the creation of personalized 3D-printed uterine models for utilization in the fields of reproductive endocrinology and infertility is feasible. We propose a novel use of individualized 3D-printed uterine models in the evaluation of individuals with Müllerian anomalies. These models may play a complementary role to standard imaging options in the assessment of these anomalies, with a special potential for application in highly complex or yet-to-be-determined types of anomalies.

Where Do We Go From Here? An Inventory of Publicly Available Data About Educator Academies, Medical Education Departments, and Offices of Medical Education.

With the recent widespread growth and interest among medical educators, analysis of how departments of medical education are structured and their intersection with existing structures within the same institution, such as an office of medical education and/or academy of educators, is warranted. Based on a review of the literature, the authors determined there was a need for an inventory of what medical schools have to offer their faculty, whether it be an office, an academy, or a department. This project sought to inventory the current structures of medical education departments, offices, and academies at U.S. medical schools to explore reporting structure, functions, and characteristics of these entities. Data were extracted from A Snapshot of Medical Student Education in the United States and Canada: Reports From 145 Schools, published in 2020 in the journal Academic Medicine , for each reporting institution. This led to exploration of medical school websites to catalogue institutional structures. Data collected in this inventory demonstrate the range of structures used by medical schools to offer faculty support for their work as teachers and educational researchers. The hypothesis was that departments of medical education would be the least prevalent structures identified in U.S. medical schools, which was indeed a finding. Although the search yielded considerable data for the inventory, there is a dearth of published literature describing current models and characteristics of these different entities. Significant difficulties were encountered locating information clearly delineating roles and responsibilities of each entity on many medical schools' public-facing web pages. Findings are significant because they underscore the challenges medical education leaders have in obtaining information to research, compare, select, and design the administrative model(s) best suited to support faculty educators at their institution. Future work should include creating a detailed catalogue with descriptive information supplied by schools.

Patients as educators in medical student education in forensic psychiatry: a scoping review of the barriers and facilitators

ABSTRACT Patient educator programmes have become a fundamental part of medical student education, delivering rich and transformative learning. However, little is known about the barriers and facilitators to implementing patient educator programmes for medical students in psychiatry and specifically forensic psychiatry. A systematic search of three databases with no date parameters was undertaken in November 2022, using keywords related to medical education, coproduction, patient involvement, and psychiatry. Five papers on patient educator programmes in psychiatry were located. No literature related to patient educator programmes in forensic psychiatry was identified. Facilitators include a robust policy infrastructure and transparent arrangements for safe educational practices alongside a commitment to coproduction and relational working. Barriers include epistemic injustice, the skills of professional facilitators, and a lack of supporting educational theory. There appears to be scope to deliver high-quality medical student education in forensic psychiatry through patient educator programmes with reciprocal benefits for educators such as rehabilitation, skills development, and possibly therapeutic benefits. The educational and therapeutic value of patient as educator programmes in forensic psychiatry are under-researched. Patient as educator programmes in forensic psychiatry require careful consideration regarding risk, while patients’ prior involvement with the criminal justice system may increase stigma and discrimination. The complexity and risks have seldom been considered. It appears a priority to address the knowledge gap identified by this review.

Five Evidence-Based Strategies to Foster a Culture of Well-Being in Physician Assistant Education.

The objective of this study was to discuss evidence-based strategies to promote a culture of well-being with physician assistant (PA) education. Published literature on medical student, resident, and PA student well-being was reviewed with findings subsequently categorized according to well-being strategy. Five themes were found from existing well-being research within medical student and PA student education: faculty role modeling and support, dedicated curricular time, pass/fail grading schema and de-emphasizing grades, peer support and learning communities, and evaluation importance. Physician assistant educators may be able to foster a culture of well-being for their students by making even small adjustments to the existing educational curriculum.