Medicine Course Research Articles

A competency-based Internal Medicine course in an emergency education setting

IntroductionAt the beginning of 2020, the coronavirus SARS-CoV-2 arrived, triggering the COVID-19 pandemic that affected every aspect of daily life including global education systems. This dire public health situation across the planet forced the accelerated implementation of emergency remote teaching at all education levels. Educational institutions and hospitals adopted virtual classes, webinars, tutorials, and virtual libraries to continue academic activities. Other useful tools researchers used were standardizing patients and clinical simulation. The central objective of this study was to analyze how an Internal Medicine competency-based course, with a theoretical and a practical block, responded to an emergency education environment from June to December of 2020. Material and methodsStudents and teachers completed written evaluations, the students completed the DREEM questionnaire and teachers recorded their personal insights. The authors conducted focus groups and analyzed transcripts of the virtual activities. ResultsAll 60 students (100%) participated in the study. The students’ average score of the DREEM questionnaire on education environment was 177.8/200, and the students’ average teaching evaluation was 6.38/7. All students passed the final exam. The authors also categorized the favorable and unfavorable findings from both the theoretical and the practical blocks of the course on three dimensions: organization, pedagogy, and technology. ConclusionThe results indicate that the students perceived an excellent educational environment. Several points for improvement emerged such as teacher training in computer technologies, the socialization of learning objectives, and the feedback that students receive from teachers to achieve the proposed learning objectives.

Challenges in Implementing the Mediterranean Diet Identified Through a Food as Medicine Course

Challenges in Implementing the Mediterranean Diet Identified Through a Food as Medicine Course

Caracterização do perfil dos discentes dos cursos de Medicina Veterinária e Agronomia em relação ao consumo da carne suína e mitos relacionados

In Brazil, pork consumption is lower compared to the global consumption. Perspectives of sociocultural origin perpetuate the myths that surround pork, claiming it to be a fatty protein and the transmission of human cysticercosis. The objective was to characterize the profile of pork consumption and knowledge about the taeniasis-cysticercosis complex among students of Veterinary Medicine and Agronomy courses, verifying the possible aspects that interfere with consumption. A total of 137 students were interviewed. Variables such as price, flavor, and cultural aspects were the main reasons for the low consumption of pork by students, in addition to the myth that pork is involved in cases of human cysticercosis, which justifies actions with clarification to the population.

Evaluating the Impact of a Culinary Medicine Course on Confidence and Competence in Dietary and Lifestyle Counseling, Interprofessional Communication and Wellness Advocacy and Behaviors

Evaluating the Impact of a Culinary Medicine Course on Confidence and Competence in Dietary and Lifestyle Counseling, Interprofessional Communication and Wellness Advocacy and Behaviors

Night eating syndrome among university students: are aspects of academic life associated with eating disorders?

Introduction: the critical period in the lives of college adults implies lifestyle changes such as reducing physical activity and adopting unhealthy eating habits that can result in increased body fat. Thus, college students may represent a population at increased risk for Night Eating Syndrome. Objective: to analyze aspects of university students’ academic life, work and housing that could be associated with Night Eating Syndrome. Methods: cross-sectional study carried out with 900 students from Architecture, Engineering, Medicine and Psychology courses at a higher education institution located in Cajazeiras, Paraíba, Brazil. Self-administered questionnaires were used for data collection: the Night Eating instrument Questionnaire (NEQ) to quantify Night Eating Syndrome (NES) behaviors and a form for variables on demographic, health, academic life, work and housing aspects. Results: the prevalence of NES determined by the NEQ≥25 score was 16.8%. In the Engineering course, the prevalence of NES was higher in women than in men, and in the Psychology course, it was higher in men than in women. Among students with a job and who lived at home, the prevalence of the syndrome was higher for those who worked in the afternoon and lower for those who worked at night. Conclusion: the prevalence of NES found among Brazilian university students was high (16.8%), particularly in two situations: (1) being enrolled in an undergraduate course with a predominance of students of the other sex; and (2) live with parents and work in the afternoon. These observations may be helpful in identifying subpopulations of students at increased risk for eating disorders.

A Study to Determine the Knowledge, Attitude and Usage of Traditional (AYUSH) Systems of Medicine among the Students Seeking Admission to the Bachelor in Homoeopathic Medicine and Surgery (BHMS) Course - Telangana, India

AYUSH system of medicines consists of seven systems - Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa- Rigpa, and Homeopathy.1 Apart from these many other systems like, acupuncture, Chinese medicines, Chiropractic and osteopathic medicine, etc. are included under Complementary and Alternative medicines (CAM). In India, only the above-mentioned. AYUSH systems and educational courses related to these systems are considered under medical stream. AYUSH medicines though are popular among people, the knowledge regarding these systems in medical science and medical course is not evident. Hence this study is aimed to estimate the knowledge, attitude towards, and usage of AYUSH systems of medicine among the students seeking admission to the BHMS course. Materials and Methods: For this observational, cross-section study, a total of 132 students of both sexes, seeking admission to the BHMS course between October 2022 to May 2023, were selected by random sampling. A closed-ended, self-structured online questionnaire was used after validation and approval, to assess the knowledge, attitude towards and usage of the AYUSH system of medicines. Descriptive statistical analysis was done using MS EXCEL. Result: The study revealed that students had good knowledge and positive attitudes towards AYUSH systems. 74% of students had used AYUSH medicines at least once. 84% of students willingly joined the course. The most popular system was Homoeopathy, while no student was aware of Sowa-Rigpa as the system of medicine. Conclusion: This study concludes that the knowledge and attitude among the students seeking admission to the BHMS course, regarding Homoeopathy is good compared to other AYUSH systems. Keywords: Alternative; Complementary; AYUSH; Traditional; Attitude; Knowledge; Usage; BHMS

Active methodologies in human physiology teaching: experience report in the medicine course

The medical curriculum traditionally has divisions such as the basic cycle and the clinical cycle, in which the first includes subjects and areas of knowledge that serve to guide and subsidize the clinical reasoning built in the second. Among the subjects of the basic cycle, Human Physiology is included, responsible for studying the physiological processes that determine the state of balance in the organism. However, not infrequently, it is noted that some obstacles hinder the study of physiology: high workload, complexity of subjects, and interest of students. In this sense, this study aims to present an experience report on the importance of monitoring in the discipline of physiology as an opportunity for active methodologies. During the monitoring, the organic systems studied were worked on in the form of clinical cases, which required reasoning, study, and participation from the students. At the end of the semester, an online questionnaire was constructed to obtain students' opinions about the impact of monitoring on their learning. As a result, based on the assessment made by the students, monitoring exerted a positive influence on the process of studying physiology, since students were able to practice what was learned in class, bringing the subject closer to medical practice.

'Hold the course(s)!' - a qualitative interview study of the impact of pandemic-triggered contact restrictions on online instruction in community-based family medicine teaching.

The COVID-19 pandemic has been identified as a catalyst for the digitalization of medical education. Less is known about the specific impact of the pandemic on decentralized, community-based education, such as in General Practitioner practices. The aim of this study is to understand the impact of the digital transformation process, triggered by the COVID-19 pandemic. As, family medicine courses involve both university-based and community-based teaching, this study focuses the mode and quality of instruction and instructors in family medicine teaching. A qualitative interview study was conducted. The participants (N = 12) of a multi-perspective Quality Circle in family medicine teaching were interviewed twice: first, in 2019, about digitalization in family medicine teaching in Tübingen, Germany, not yet aware of the global changes and local transformation that would take place shortly thereafter. Second, in a follow-up interview in 2020 about the transition process and digitalization following the impact of contact restrictions during the pandemic. Grounded Theory was used as a qualitative research approach to analyze the complex processes surrounding this transformation. By analyzing the interviews with various stakeholders of community and university-based teaching, a model for the digital transformation process of family medicine teaching at the University of Tübingen in response to an external stimulus (the pandemic) was developed. It involves six chronological steps: "The calm before the storm," "The storm hits," "All hands on deck," "Adrift," "Reset course," and "The silver lining." This model seeks to understand the process of digital transformation and its impact on the teaching institution (medical faculty of the University of Tübingen, Institute for General Practice and Interprofessional Health Care) and instructors from an integrated perspective and thereby critically revisits prior concepts and opinions on the digitalization of medical teaching. Insights gained are presented as key messages.

Operational aeromedical training during COVID-19 pandemic

The Institute of Aerospace Medicine Indian Air Force regularly conducts Operational Training in Aerospace Medicine (OPTRAM) courses for the fighter, transport, and helicopter pilots, and navigators. The OPTRAM is directly linked with the pilots flying training and operational readiness as well. The COVID-19 pandemic halted training activities globally. Online training was not an option as it is a simulator-based training module. There was an urgent need to continue the course without compromising the safety of our pilots. A standard operating procedure (SOP) was prepared to conduct the course in a safe and timely manner within the available resources of the Institute. This paper intends to bring out the various rationale and considerations that go into formulating an SOP like this which has a huge implication on the operational preparedness of the organization and the operational readiness of our pilots.

ВОЗМОЖНОСТИ САНАТОРНО-КУРОРТНЫХ МЕТОДИК В РЕАБИЛИТАЦИИ ПАЦИЕНТОК С РАННИМИ ГЕСТАЦИОННЫМИ ПОТЕРЯМИ

Introduction. Early pregnancy loss is still an unresolved problem in obstetric and gynecology. The pathogenesis is based on the comorbidity of pathological factors such as subclinical hormonal, immune, psychoneurotic disorders and endometrial pathology. It requires complex rehabilitation pregnancy planning programs for such patients. Aim. Aim of research is to optimize treatment and rehabilitation measures in patients with the history of early pregnancy lost using the Belokurikha’s spa and resort clusters. Material and methods. 79 patients with early reproductive lost history underwent a course of medical and rehabilitation treatment in the «Altai Castle» spa and resort (Belokurikha, Altai Region). Complex spa treatment included climatotherapy and combination of various methods: balneo-, peloid-, physiotherapy and a prolonged course of herbal medicine. Results and discussion. Women with a history of early pregnancy loss had significant improvement in physical and mental health, ultrasound chronic endometritis markers were decreased. The first year onset pregnancy occurred in 70.9% after rehabilitation and most of them (92.8%) delivered at term. Proposed rehabilitation program is highly efficient due to the multidirectional potentiating action of natural factors that have powerful immunomodulatory, anti-inflammatory and regenerating effects. Conclusion. A complex rehabilitation program for patients with a history of early pregnancy lost in Belokurikha’s spa and resort with a prolonged course of herbal medicine helps to make rapid psychosomatic and reproductive health recovery.

Holistic Approach Toward Senile Dementia with <i>Ayurveda</i> – A Case Report

Neurological problems are a burning issue in today’s Era. The brain is that vital organ which makes humans unique from other living beings. It is the site of all the intellectual powers humans have. Memory is an important aspect of this intellectual property. It gives us protection from harmful things. Here is a case of mild cognitive impairment. The patient, 68 years old came with his son to OPD with loss of memory for 2 years. He used to forget his meals, and juices from taking on time. He used to forget the flame of burners. He used to repeat the same phrases after a fraction of the time. The patient had taken many medicines, but the condition got worse. He felt sleepy and drowsy all day. The patient was well-oriented to time and place. The Mini-mental scale examination score of this patient was 22. This patient was treated with a holistic approach. Holistic means to treat all aspects of the patient. The patient was advised to take internal medicine (Shatavari Ghanavati), meditation, counselling, and diet. The internal medication was given for three months. Counselling was done every fortnight. The patient was advised to do meditation on a daily basis. Some food regimes were advised to the patient. Then after the complete course of medicine. The Mini-mental scale examination was performed, and the score was 25 which was satisfactory for that patient. The herbal medicine along with other aspects of surviving healthy life helped this patient to live normally.

Virtual Reality and Augmented Reality Training in Disaster Medicine Courses for Students in Nursing: A Scoping Review of Adoptable Tools.

Nurses and paramedics play a pivotal role when mass casualty incidents (MCI) occur, yet they often feel unprepared for such events. Implementation strategies for training activities, including virtual reality (VR) and augmented reality (AR) simulations, offer realistic and immersive learning experiences, enhancing skills and competencies for nursing students. The aim of this work was to investigate the adopted tools in studies on VR and AR simulations for training nursing and paramedic students in managing MCI. A scoping review was performed following the PRISMA-ScR statement, and the search strategy was conducted through five electronic databases from December 2022 to March 2023. Of 162 records identified, 27 full texts were screened and, six studies were included in this review. These studies involved students who were assigned to different training methods, including immersive VR simulation, written instruction, and traditional lecture. VR and AR and immersive simulation generally show promising evidence in enhancing practical skills and knowledge in MCI management. VR and AR showed to be promising in disaster education and preparedness training, offering different levels of immersiveness and engagement, encouraging active and experiential learning. Further research is needed to determine their long-term effectiveness. The choice of training method should consider program goals, target population, and available resources.

Awareness, Adjustment, Assistance, Alignment, and Advocacy: Operationalizing Social Determinants of Health Topics in Undergraduate Medical Education Curricula.

Social and economic factors, such as those related to food, housing, and transportation, are major drivers of health and health inequities. Multiple national professional organizations have articulated roles for physicians in identifying and addressing social determinants of health (SDOH) and the need to include SDOH in all stages of physician education. Despite encouragement from these professional organizations, medical schools still do not routinely offer SDOH education alongside basic and clinical sciences curricula. A recent national expert consensus process identified priority SDOH knowledge domains and professional skills for medical students but lacked an organizing schema and specific pedagogical examples to help translate prioritized skills into routine pedagogical practice. One such schema is the 5As framework developed by the National Academies of Sciences, Engineering, and Medicine, which elaborates on 5 strategies to strengthen social care: awareness, adjustment, assistance, alignment, and advocacy. In this article, the authors highlight and provide examples of how mapping SDOH skills to the 5As framework can help educators meaningfully operationalize SDOH topics into specific curricular activities during the preclinical and clinical stages of undergraduate medical education. As a foundational first step in this direction, medical schools should conduct an internal curricular review of social care content (ideally mapped to the 5As framework) and identify opportunities to integrate these topics into existing courses when relevant (e.g., in social medicine, population health, and health systems science courses). Given that health and social care integration is highly context dependent, each medical school will likely need to tailor curricular changes based on their own institutional needs, mission, patient populations, and ties to the community. To increase interinstitutional alignment, medical schools might consider using or adapting peer-reviewed materials and assessments curated and centralized by the National Collaborative for Education to Address the Social Determinants of Health.

ChatGPT in Nuclear Medicine Education.

Academic integrity has been challenged by artificial intelligence algorithms in teaching institutions, including those providing nuclear medicine training. The GPT 3.5-powered ChatGPT chatbot released in late November 2022 has emerged as an immediate threat to academic and scientific writing. Methods: Both examinations and written assignments for nuclear medicine courses were tested using ChatGPT. Included was a mix of core theory subjects offered in the second and third years of the nuclear medicine science course. Long-answer-style questions (8 subjects) and calculation-style questions (2 subjects) were included for examinations. ChatGPT was also used to produce responses to authentic writing tasks (6 subjects). ChatGPT responses were evaluated by Turnitin plagiarism-detection software for similarity and artificial intelligence scores, scored against standardized rubrics, and compared with the mean performance of student cohorts. Results: ChatGPT powered by GPT 3.5 performed poorly in the 2 calculation examinations (overall, 31.7% compared with 67.3% for students), with particularly poor performance in complex-style questions. ChatGPT failed each of 6 written tasks (overall, 38.9% compared with 67.2% for students), with worsening performance corresponding to increasing writing and research expectations in the third year. In the 8 examinations, ChatGPT performed better than students for general or early subjects but poorly for advanced and specific subjects (overall, 51% compared with 57.4% for students). Conclusion: Although ChatGPT poses a risk to academic integrity, its usefulness as a cheating tool can be constrained by higher-order taxonomies. Unfortunately, the constraints to higher-order learning and skill development also undermine potential applications of ChatGPT for enhancing learning. There are several potential applications of ChatGPT for teaching nuclear medicine students.

ACADEMIC MONITORING IN THE MEDICINE COURSE AS A LEARNING STRATEGY IN THE WEST OF THE BAHIA

Introduction: The current scenario imposes changes and adaptations in medical course teaching, including the relationships between professors and students with the use of the new era of technology. In this sense, academic monitoring becomes an important activity where, in a mutual way, it enables the expansion of the didactic repertoire, development of the educator profile by the monitor, communication, body expression, professional planning, responsibility, leadership, and trust, among others. Experience report: The objective of this work is to report the experience of academic monitoring as an auxiliary learning strategy at a private university in Bahia, together with a curricular component that includes theory in the context of the discipline Biophysics for students of the 1st semester in the course of Medicine. This is a qualitative, descriptive study, of the experience report type on the activities carried out with academic monitoring. Weekly meetings were held with the subject's guiding teacher, time was available for questions with the students, a clinical case was prepared and presented on the curricular component and objective activities of study review. Discussion: Monitoring becomes essential for the academic experience since it is the link between the scope of professors and students, transposing the roles of students in the position of professors, expanding the professional, interpersonal, creative perspective together with responsibility. The execution of this activity allowed the monitor to experience the responsibility of supervision, study guidance, clinical reasoning and reflection on the importance of communication in the education process. Final considerations: Therefore, given its complexity, teaching associated with monitoring proves to be effective for all involved. Also noteworthy is the need to publish more studies reporting experience in academic monitoring within the scope of the medical course.

Evidence-Based Medicine and Pharmacotherapy Content Alignment

ObjectiveWhen effectively executed, content alignment can aid student performance in associated courses. Limited research exists for content alignment of evidence-based medicine (EBM) and pharmacotherapy courses. This study assesses the impact of EBM and pharmacotherapy course alignment on student performance. MethodsContent alignment included assignment of 6 landmark trials in EBM coursework. The articles were identified by pharmacotherapy instructors as “landmark” to management of associated diseases in the aligned pharmacotherapy semester. Articles were the basis for quizzes over skills taught in the EBM course and were referenced during pharmacotherapy lectures. ResultsDuring the alignment semester, students were more likely to cite specific guidelines and/or primary literature to rationalize pharmacotherapeutic plans on examinations compared with the prealignment period (54% vs 34%). Overall, pharmacotherapy case performance and plan rationale scores were significantly higher in the alignment semester compared with prealignment. Student performance on the Assessing Competency in Evidence-Based Medicine tool improved from the start of the semester (8.64, SD 1.66) to the end (9.5, SD 1.49; mean score +0.86). Comfort in applying EBM analysis to primary literature increased significantly between the first and final assignments, with 6.7% and 71.7% of students self-reporting a high degree of confidence, respectively. Students (73%) reported an enhanced understanding of pharmacotherapy due to alignment compared with a previous semester of pharmacotherapy without alignment. ConclusionThe use of landmark trial assignments to align EBM and pharmacotherapy coursework demonstrated a positive impact on student rationale for clinical decision-making and student confidence in evaluating primary literature.

Virtual versus paper-based PBL in a pulmonology course for medical undergraduates

BackgroundProblem-based learning (PBL) remains a valid and effective tool for small-group medical education. Using Virtual patients (VP) case simulation in PBL is a recognizable educational method that has successfully prepared students to focus learning on core information that uses realistic patient-based cases relating to everyday clinical scenarios. Using other modalities as the virtual patient in PBL instead of the paper-based methods remains debatable.This study aimed to evaluate the effectiveness of using VP case simulation mannequin in PBL versus the PBL in paper-based cases in improving the cognitive skills by comparing the grades of a multiple-choice question test and assess its ability to reach students' satisfaction using questionnaire with Likert survey instrument.MethodsThe study was conducted on 459 fourth-year medical students studying in the pulmonology module of the internal medicine course, Faculty of Medicine, October 6 University. All students were divided into 16 PBL classes and randomly divided into groups A and B by simple manual randomization. The groups were parallel with a controlled cross-over study between paper-based and virtual patient PBL.ResultsThe pre-test showed no significant difference between both, while post-test scores were significantly higher in both VP PBL cases 1 discussing COPD (6.25 ± 0.875) and case 2 discussing pneumonia (6.56 ± 1.396) compared to paper-based PBL (5.29 ± 1.166, 5.57 ± SD1.388, respectively) at p < 0.1 When students in Group A experienced PBL using VP in case 2 after paper-based PBL in case 1, their post-test score improved significantly. (from 5.26 to 6.56, p < .01). Meanwhile, there was a significant regression in the post-test score of the students in Group B when they experienced the paper-based PBL session in case 2 after using PBL using VP in case 1, (from 6.26 to 5.57, p < .01). Most of the students recommended using VP in PBL as they found VP was more engaging and inducing concentration in gathering the information needed to characterize the patient’s problem than in a classroom- paper-based cases session. They also enjoyed the teaching of the instructor and found it a suitable learning style for them.ConclusionImplementing virtual patients in PBL increased knowledge acquisition and understanding in medical students and was more motivating for students than paper based PBL to gather the needed information.

An educational game for teaching osmolarity and tonicity: opinions of dental and medical students.

In health courses, the students must be familiar with the effects of intravenous solutions on cell volume and function, a topic where there can be learning difficulties and misunderstandings. Since educational games can assist in understanding complex concepts, we created a game relating solution osmolarity and tonicity to red blood cell volume that was used in undergraduate Dentistry and Medicine courses. The students, working in groups, completed the game board by indicating the effect of the solutions on the red blood cell volume, classifying the solutions in terms of tonicity and osmolarity. The student indicated that use of the educational game contributed to their understanding of osmolarity and tonicity.

EFFECTIVENESS OF BLENDED TEACHING METHOD IN TOOTH CARVING APPLIED IN PRECLINICAL COURSE OF DENTAL EDUCATION DURING THE COVID-19 PANDEMIC

Background: The knowledge of dental morphology is essential in every aspects of dental medicine. Tooth carving is useful for development of the manual skills and has positive influence on students performance in clinical practice. In the extraordinary situation caused by the COVID-19 pandemic we needed to use innovative blended models in teaching of dental morphology. Te Aim of the research was to perform comparative analysis of the teeth carved by students in preclinical courses in prosthetic dental medicine, tutored in two methods – conventional and blended, applied in the circumstances of the COVID-19 pandemic. Methodology: Detailed evaluation of 381 carved teeth was done according to strictly defined criteria. Results: The analysis of work of students tutored through blended method demonstrates good level of the skills for reproduction of dental morphology. The approximal and masticatory surfaces of the tooth crown and the teeth roots of premolars and molars were reproduced in better quality by the students in the course with blended tuition. The differences in realization of the criteria are in range of 5%. Statistical significance was established only in re-creation of the masticatory surfaces of molars (p&lt; 0.05). Conclusion:The blended model of tuition can be considered as effective educational model for tooth carving in courses of pre-clinics of prosthetic dental medicine. It would be purposeful for this practice to be combined with traditional educational methods in order to improve the tuition quality.

Beyond the Basics: A Novel Approach to Integrating a Social Determinants of Health Curriculum into an Emergency Medicine Course

Beyond the Basics: A Novel Approach to Integrating a Social Determinants of Health Curriculum into an Emergency Medicine Course