Medicine Education Research Articles

(138) ARE WE THERE YET? ASSESSING OUR CURRENT STATE OF SEX MED EDUCATION

Abstract Introduction Sexual concerns are prevalent, but studies have demonstrated that patients often feel most comfortable if the clinician initiates the conversation. Many patients are hesitant to discuss sexual concerns with their providers for a variety of reasons including fear of judgment, lack of clinician knowledge, and concerns that these issues are abnormal or unusual. Clinician education plays an important role in helping to facilitate these difficult conversations. However, there has never been a broad assessment of education across medical training programs, while the most recent assessment of MD training programs occurred approximately a decade ago. Objective We set out to create and administer a survey to assess sexual medicine training across most major medical disciplines where sexual health matters may be discussed, including nurse practitioner, midwifery, physician, and physician assistant training. Methods A subcommittee of the ISSWSH Advocacy Committee was formed with members representing the medical disciplines to be surveyed. A survey was developed to gather data on sexual medicine education offered at nursing, midwifery, physician, and physician assistant training programs. The survey included a series of questions regarding content taught during these programs (checklists, open ended responses). The survey was approved by the Wake Forest IRB and distributed using RedCap to various institutions from the above disciplines throughout the United States. Results We received a total of 33 complete responses. 88.5% of respondents stated they used traditional lecture as their teaching method, whilst only 11.5% used simulation, and 7.7% used actual mechanical models. The majority of programs that responded spent 3-5 hours total dedicated to human sexuality and sexual function education. Interestingly, respondents noted that faculty involved in sexual medicine education were mostly OB/GYN in background (63%), followed by family medicine (18.5%) and urology (18.5%). While not all respondents indicated that their students were assessed on their knowledge after teaching, it was noted that the majority of programs that did respond indicated that examination was the most common mode of assessment. Only 33% of institutions noted having a regional or nationally recognized expert in the field. Conclusion It is essential that the accrediting bodies for medical programs incorporate the input of international societies such as ISSWSH (in collaboration with other sexual medicine organizations) to formulate an official statement and recommendations for a standardized curriculum for sexual medicine.

(073) WOMEN'S SEXUAL DYSFUNCTION TRAINING MODULE INCREASES SCREENING COMFORT

Abstract Introduction Sexual dysfunction in women affects approximately 40% of patients, however, many providers fail to screen for it. The continual lack of screening presents limited opportunities for healthcare trainees to observe, learn and master this skill. Approximately half of medical students feel inadequately prepared to discuss these diagnoses with patients. For this reason, experts advocated a multidisciplinary, longitudinal sexual health education approach to address the exposure of women’s sexual health in the clinical setting. In order to address this issue, our institution created a module focusing on sexual dysfunction in women to educate healthcare students on screening, assessment and baseline treatment for the most common dysfunction, hypoactive sexual desire disorder or decreased libido. This module was created by a gynecologist and reviewed by professors in the psychology department and graduate nursing school. Additionally, it was approved by the medical school for use. It simulates a clinical rotation to emphasize screening for sexual dysfunction in women and baseline evaluation of decreased libido using a biopsychosocial model. Objective The primary aim of this study is to evaluate changes in students’ comfort level who screen for women’s sexual dysfunctions after completion of the Female Sexual Dysfunction Module. Additionally, we aim to assess the over baseline level of comfort in screening and determine if knowledge about when to screen is gained through the module. Methods This study was IRB approved. US medical students and graduate nursing students were approached via email to complete demographic information, a pre-survey, module, and post-survey. In the redcap survey, participants were asked to identify scenarios appropriate to broach the subject of a patient's sexual functioning. Additionally, they were asked to rate their comfort level asking patients about sexual desire, dyspareunia, and anorgasmia as well as general knowledge-based questions about sexual dysfunction in women. Results This study surveyed 425 medical students and nursing students from over 70 institutions across the US. Compared to their pre-module response, more respondents felt it was appropriate to query patients about their sexual functioning following the module (all p < .05). Respondents were also far more comfortable asking patients about their sexual health after the module compared to pre-module responses (all p < .05). Compared to their pre-module response, more respondents correctly identified the components of the linear female sexual response cycle created by Masters and Johnson (24.8% versus 61.6%; p < .001), and more respondents identified the components of the Plisst screening model (6.3% versus 53.7%; p < .001). Conclusions This nationwide study demonstrates our module provides statistical improvement in students’ comfort level when screening for female sexual dysfunction. It agrees with previous studies in terms of healthcare trainees’ overall lower baseline aptitude with this diagnosis and shows that this module statistically increases knowledge These results support using interactive modules in healthcare training curricula in order to standardize training. It can be especially helpful for schools where clinical exposure to this diagnosis is sparse. To further elucidate the most efficacious method of teaching, this study recommends future directions to assess the various models of sexual medicine education. Disclosure No.

RISE-EM: Resident Instruction in Social Emergency Medicine, a Cohort Study of a Novel Curriculum.

There is recognition in the field of emergency medicine (EM) that social determinants of health (SDoH) are key drivers of patient care outcomes. Leaders in EM are calling for curricula integrating SDoH assessment and intervention, public health, and multidisciplinary approaches to EM care throughout medical school and residency. This intersection of SDoH and the emergency care system is known as social emergency medicine (SEM). Currently, there are few resources available for EM training programs to integrate this content; as a result, few EM trainees receive adequate education in SEM. To address this gap, we developed a four-part training in SEM tailored to EM residency programs and medical schools. This curriculum, known as RISE-EM (Resident Instruction in Social Emergency Medicine), uses video lectures, case examples, and group discussions to engage trainees and develop competency in providing sound care that is grounded in evidence-based principles of SEM. In the current study, we tested RISE-EM by delivering the video lectures to residents and medical students in two training programs. We administered pre- and post-course knowledge tests and a post-course participant attitudes survey to assess the acceptability and potential efficacy of the program for improving SEM knowledge and attitudes among EM learners. We found it to be both feasible and acceptable to introduce SEM content in residency conferences, with preliminary data showing statistically significant improvement in knowledge of the content and self-efficacy to apply it to their clinical practice. In summary, RISE-EM has been highly valued by EM learners and viewed as a strong supplement to their existing training, and it has been shown to successfully improve SEM knowledge and attitudes.

Preclinical obesity curriculum: audit, implementation, and evaluation

BackgroundThis study aimed to (1) evaluate the current status of obesity education at Case Western Reserve University School of Medicine (CWRU) (2), introduce a comprehensive first-year curriculum on obesity, and (3) assess the impact of the curriculum on self-reported attitudes and knowledge regarding obesity among first-year medical students.MethodsThe preclinical curriculum at CWRU was reviewed to determine the degree of coverage of Obesity Medicine Education Collaborative (OMEC) competencies for healthcare professionals, and recommendations were provided for revising the curriculum to better adhere to these evidence-based competencies. A survey on obesity attitudes and knowledge was given before and after the implementation of the new curriculum to measure intervention-related changes. Changes in obesity attitudes and knowledge were compared (1) before and after the intervention for the class of 2025 and (2) after the intervention for the class of 2025 to a historical cohort that did not receive the intervention.ResultsAmong the 27 competencies examined in the audit, 55% were unmet and 41% were partially met. Of 186 first-year medical students (M1s), 29 (16%) completed the baseline survey and 26 (14%) completed the post-intervention survey. Following the intervention, there was a notable improvement in attitudes and knowledge regarding obesity. Specifically, there was a significant decrease in the belief that obesity is caused by poor personal choices, and knowledge of obesity in fourteen out of fifteen areas showed significant improvement from pre- to post-intervention. Additionally, obesity attitudes and knowledge were significantly better post-intervention when compared to the historical cohort.ConclusionsThe improvements made to the preclinical curriculum through this project improved obesity attitudes and knowledge among first-year medical students. This method provides a practical approach for evaluating and enhancing obesity education in medical school curricula.

Climate Change Curricula in Family Medicine Residency Programs: Program Directors' Perspectives From a CERA Survey.

Climate change is a major threat to the health of people worldwide. The health care system deals with the immediate health-related effects of climate change and, at the same time, is a major emitter of greenhouse gas. This study aimed to investigate (a) the awareness and perception of climate change among family medicine residency program directors, and (b) the state of climate change education in family medicine residency programs. The Council of Academic Family Medicine Educational Research Alliance (CERA) conducted a cross-sectional survey of family medicine program directors in the United States in April 2023. We analyzed anonymous data using descriptive and bivariate statistics. We analyzed responses from 284 family medicine residency program directors (response rate 41.1%). Of these, 56.8% indicated not having any lectures/seminars dedicated to climate change and no plans to introduce such curricula, with considerably higher rates in East South Central United States (92.8%). A majority considered principles of climate change, carbon emissions emitted by the health care system, and discussion of climate change with patients of lesser importance for residency program education. While climate change is an emerging topic affecting health and the provision of health care worldwide, our study suggests that many family medicine residency programs do not teach about it. Family medicine trainees may not always receive sufficient education about the risks posed to their patients by climate change, which could lead to them having limited knowledge and skills when discussing this topic with their patients in the future.

Holistic Review in Family Medicine Residency Programs: A CERA Study.

Interest in using holistic review for residency recruitment as a strategy to improve the diversity of the physician workforce has increased. However, no data are published on the prevalence of holistic review in the selection process for family medicine residency programs. We designed this study to assess programs' knowledge, skills, and attitudes; prevalence; barriers to implementation; and program characteristics associated with the use of holistic review. Data for this study were elicited as part of a 2023 survey conducted by the Council of Academic Family Medicine Educational Research Alliance. The nationwide, web-based survey was sent to 739 family medicine residency program directors. A total of 309 program directors completed the holistic review portion of the survey. Programs that understood and agreed with holistic review used it more in their selection process. Holistic review was more common in programs with higher rates of residents, faculty, and patients that are underrepresented in medicine. Barriers to holistic review utilization were increased number of applicants, increased resources associated with holistic review, and lack of consensus on the holistic review approach. The holistic review process is an area of growing interest to diversify the physician workforce, especially among residencies caring for underresourced communities. Further discussions on the specific scoring rubrics of family medicine residency programs that use holistic review are needed and could help programs that are facing barriers. Widespread use of holistic review to diversify the physician workforce has the potential to improve patient care access and health.

Did the students’ satisfaction rates at Avalon University School of Medicine correlate with the occurrence of accreditation site visits?

Introduction Accreditation of medical education programs can be observed from different perspectives. Regulatory/accreditation agencies consider it vital to assure a certain level of quality. Other stakeholders may perceive the accreditation process as a negative experience, draining resources, and efforts. Although accreditation may improve the program’s governance and administration, its direct or indirect impact on students must be further investigated. This study explores the relationship between the occurrence of accreditation site visits and student satisfaction rates at Avalon University School of Medicine. Methods A comparison study was conducted with retrospective satisfaction data from two accreditation cycles at AUSOM. We used the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP) student surveys for data collection, and data from 2017, 2019, and 2022 were used. The response rate was 70% (n = 71), 72% (n = 47), and 60% (n = 56) for basic science students and 80% (n = 111), 82% (n = 115), and 70% (n = 76) for clinical students in 2017, 2019, and 2022, respectively. The survey for basic sciences students included 37 questions/items, and the survey for clinical students included 39 questions/items. The responses for the questionnaire were on the five-point Likert scale. The retrospective data were evaluated using the unpaired Wilcoxon-rank sum test. Results The ratings for the basic science students’ survey increased from 2017 to 2019 (first accreditation cycle) only for 11 items/questions and they were increased from 2019 to 2022 for all items/questions. The ratings for clinical science students’ surveys increased from 2017 to 2019 (the first accreditation cycle) for all items/questions with a statistically significant p-value. They increased for 28 questions/items from 2019 to 2022, and two items (availability and adequacy of career counseling) showed statistically significant p-values. Conclusions The pre-accreditation preparation and the self-evaluation process while correcting the program’s deficiencies are essential triggers for the quality improvement process associated with accreditation.

Establishing consensus on nutrition competencies for medicine: a Delphi study

BackgroundSignificant research, regulatory bodies and even governmental resolutions have identified meaningful nutrition education for medical and other healthcare professionals as a priority. Doctors are well placed to provide nutrition care,...

Preparing tomorrow's doctors for the genomics era: A nationwide survey of UK medical students

IntroductionLow confidence in genomics knowledge among clinicians is a major barrier to the integration of genomics into mainstream medicine. Here, we assessed the genomics confidence of UK medical students approaching graduation. MethodsWe conducted a web-based nationwide survey of UK medical students in the final 2 years of study where participants rated their confidence in genomics concepts. ResultsIn total, 145 medical students across 19 medical schools participated. The amount of genomics teaching students reported receiving was positively associated with genomics confidence, with the amount of basic science teaching having the strongest influence. While confidence was high in core genomics principles, such as the difference between DNA, genes and chromosomes (95%), confidence dropped in clinical applications of genomics – only 50% reported a good understanding of the genetic contribution to disease and 28% reported good knowledge of clinically used genomic tests. Overall, 59% reported a poor understanding of variant interpretation; however, over half who reported receiving ‘lots’ of genomic medicine teaching reported a good understanding of this topic. ConclusionGaps in genomics knowledge and drivers in confidence have been identified herein, highlighting the need for improvements in undergraduate genomics education to prepare future doctors to confidently practise in the genomics era.

Case series of 3 Pressure Ulcers Cured with Education through Telemedicine

Objectives: The case series with pressure ulcers who was cured by education through telemedicine will be presented as a model for how a Korean medicine doctor can participate in the telemedicine of pressure ulcers. We also aim to report on the perspectives of medical staff and patients regarding the improved telemedicine services in Korean medicine.Methods: The study included three cases of pressure ulcers in home care, and education on pressure ulcer management was provided to patients, caregivers, and collaborators via telemedicine. Basic training was provided to teach the sealed wet dressing therapy method. After the basic training, feedback on the treatment was provided by taking photos or videos of the patient's treatment process, and the feedback process was repeated until the dressing method was perfected.Results: A combination of telemedicine, home visits, and home care successfully treated pressure ulcers in home care patients using a multidisciplinary approach. The education through telemedicine alone improved the National Pressure Ulcer Advisory Panel (NPUAP) stages and the total score of the Pressure Ulcer Scale for Healing (PUSH) Tool, and all three cases were finally cured with an average treatment duration of 26.7 days. The patient's and clinician's perspectives also showed that telemedicine can effectively engage patients, caregivers, and collaborators, and motivate them to manage pressure ulcers.Conclusions: For patients having trouble visiting the hospital or desiring treatment at home, consideration can be given to telemedicine for traditional Korean medicine education in pressure ulcer management.

Trends in the Study of Korean Medicine Education : Based on domestic and international research

Objectives: The purpose of this study is to review trends in Korean medical education research.Method: We searched Korean Medicine Education research in 4 domestic and 4 international datebases. The studies were analyzed with journal, year, keyword and detailed topic, word frequency in research context, divided into four categories: basic Korean medicine, clinical Korean medicine, medical humanities, education.Result: 128 Korean studies and 30 International studies, total 158 studies, published from 1993 to 2024 have been selected. Research on Korean medicine education has been consistently published every year since 2003, by 61 journals. The period when the most papers were published was 2020, with 16 papers. Journal of Physiology & Pathology in Korean Medicine published a relatively large number of studies, with 19. Among the keywords divided into 4 categories according to Institute of Korean Medicine Education & Evaluation, studies related to 'basic medicine' were the most with 45 cases. When classified into detailed topics, there were 40 papers related to 'subject', and 21 papers related to ‘awareness’.Discussion and Conclusion: The study suggests that Korean medicine education method and curriculum should be developed. As educational research and method progresses, the corresponding curriculum has to be improved and applied to the field. This study would contribute to the foundation of Korean medicine education.

Korean radiographers’ awareness, experiences, and education needs in forensic medicine and forensic radiology

This study assesses the need for education in forensic medicine and forensic radiology among radiographers by investigating the perceptions and experiences of Korean radiographers working in medical institutions. A structured questionnaire was administered to participants, collected, and analyzed. The results showed that despite receiving frequent forensic cases, Korean radiographers face difficulties in taking appropriate measures about forensic radiology due to a lack of awareness and knowledge of its forensic aspects. The participants indicated that university education in forensic medicine and forensic radiology is necessary. Therefore, it is imperative to develop and implement policies for forensic education programs to enhance radiographers’ forensic knowledge and capabilities. Universities should conduct courses on forensic radiology and provide continuing education for radiographers working in this field.

Crime Scene Simulation: A Novel Approach to Forensic Medicine Education

Crime Scene Simulation: A Novel Approach to Forensic Medicine Education

Team based learning: an effective teaching-learning method in undergraduate teaching in community medicine

Team based learning: an effective teaching-learning method in undergraduate teaching in community medicine

Experiences of community pharmacists in the United Kingdom on the provision of travel health services and associated educational requirements.

Travel health services play a critical role in public health. Previously, travel services were provided solely through GPs or private specialist clinics. In recent years, they have been available from community pharmacists in the UK. This study sought to understand the types of travel health services provided by community pharmacists and to establish the educational needs. Qualitative interviews and focus groups explored current practices and educational needs in travel medicine. Thematic analysis of transcribed interviews and focus groups was conducted to understand how travel services are provided and the training undertaken by community pharmacists in delivering these services. Nine individual interviews and one focus group of seven additional pharmacists was conducted. Pharmacists considered that they provided a comprehensive service and undertook the necessary training for safe delivery. Pharmacists described a 'vaccine centric' approach to travel services, with aspects, such as management of chronic conditions, fitness/preparedness for travel, prevention and self-management of travel-related conditions considered to be of lower priority. This was reflected in the travel medicine education that they had received and their perception of future requirements. Whilst vaccination is a critical aspect of travel health medicine, taking a 'vaccine centric' approach represents a missed opportunity in public health. Future educational opportunities for pharmacists could include training that encourages a broader approach to travel health consultations, to include a co-created, structured, and holistic risk assessment for travellers and recommendations for appropriate prevention and management strategies for travellers prior to, during and after travel.

Design and practice of blended teaching of internal medicine nursing based on O-AMAS effective teaching model

BackgroundSelf-directed learning (SDL) ability is the basis for cultivating nursing students’ ability to find and solve problems, lifelong learning, and providing high-quality nursing talents for healthcare. The O-AMAS (Objective, Activation, Multi-learning, Assessment, Summary) model adheres to the teaching philosophy of student-centered, result-oriented, combines the advantages of online and offline teaching, enriching teaching resources and learning channels, diversifying teaching and evaluation methods, and emphasizing integrating and applying knowledge conducive to improving students’ SDL ability and achieving teaching objectives. This study explored the course design, practical, and application effects under the O-AMAS effective teaching model in internal medicine nursing to provide a basis and reference for combining effective teaching models with blended teaching in future nursing courses.MethodsThis study is a self-controlled before-after trial. The participants were 76 nursing undergraduates from Hunan Normal University. This study utilizes the O-AMAS effective teaching model to design internal medicine nursing courses and implement blended online and offline teaching. Main links: The overall course design and application are student-centered, after clarifying macro and micro multi-dimensional learning objectives, with online and offline blended teaching environments activated students’ learning behavior and diversified teachers’ teaching activities, then based on instant and dynamic provide effective feedback; finally, students take the initiate to make a brief and potent summary under the teacher guidance. After the course, a unified assessment of the learning effect of nursing students was conducted, including the evaluation of the SDL ability of nursing students, a final comprehensive evaluation grade, and a teaching satisfaction survey.ResultsThe nursing students’ SDL ability scores are higher than before teaching, and the results were statistically significant (P < 0.05). The final average comprehensive evaluation grade of nursing students was 78.38 ± 7.12. More than 96% of the students are satisfied with this course.ConclusionApplying for internal medicine nursing blended teaching integrated with the O-AMAS effective teaching model is conducive to improving nursing students’ SDL ability, academic grades, and teaching satisfaction.

Exploration and Practice of Teaching Methods of Comprehensive Knowledge and Skills of Traditional Chinese Medicine with Traditional Chinese Medicine Traditional Skills Inheritance as the Core

Traditional Chinese Medicine (TCM) is a core component of Chinese traditional medicine, and its unique therapeutic concepts and techniques have received high attention worldwide. In the current medical education system, there are still many challenges in teaching Chinese medicine, especially the insufficient transfer of practical skills. This study aims to explore an integrated teaching model that combines theoretical teaching and practical operation with traditional skills of Chinese medicine as the core. Through literature review and case studies, this paper analyzes the deficiencies of Traditional Chinese Medicine teaching and then designs a new teaching model that highlights the integration of theory and practice, the enhancement of teacher-student interaction, and the application of diverse teaching methods. The implementation results show that this teaching model effectively improves students' practical skills in Chinese medicine, enhances their understanding and application of Chinese medicine knowledge, and significantly stimulates their interest in learning Chinese medicine. The successful practice of this teaching model not only provides valuable experience for the innovation of TCM education but also provides strong educational support to promote the continuous development of TCM. The results of this study emphasize the importance and practical value of teaching integrated skills centered on traditional skills in TCM education.

Emerging Trends in the Prevalence of Military Medicine Interest Groups and Specialty Tracks at U.S. Medical Schools.

A challenge confronting health care is the national physician shortage, notably impacting the DoD's recruitment of military physicians. To address this, the Health Professions Scholarship Program is annually awarded to medical students to facilitate their transition into the U.S. Armed Forces. There is a glaring absence of military medical education in civilian schools to accommodate the unique interests of these students. While medical schools have adapted with interest groups and specialty tracks, the current presence of military medicine interest groups (MMIGs) and military medicine specialty tracks (MMSTs) remains under-explored. This study aimed to (1) update the prevalence of MMIGs in U.S. medical institutions, (2) identify the presence of MMSTs, and (3) compare military medicine involvement between allopathic and osteopathic programs. The study was approved for exempt status from the Kansas City University Institutional Review Board (study number 20,211,568-1). In a cross-sectional analysis, surveys were sent to 208 U.S. medical schools, with responses from student services or available public data from 200 institutions included in the final analysis. A secondary survey was sent to respondents who provided MMIG or MMST contacts. Results indicated that 62% (n = 124/200) of schools currently have an established MMIG, a modest growth from 56% (n = 70/125) in 2015 (p = .14). MMST prevalence, however, is minimal at 2.5% (5/200). Osteopathic institutions demonstrated a significantly greater engagement in military medicine education (88.7%) compared to allopathic schools (52.4%) (p < .001). This research underscores the need for comprehensive military medical training in medical schools to meet the interests and career aspirations of their students. Future studies should also evaluate the efficacy of MMIGs and MMSTs in preparing students for military medical roles.

Update of the competence-based catalog of learning objectives in nuclear medicine for the study of human medicine in Germany.

To update the subject-specific, competence-based catalog of learning objectives for medical studies in Germany published by the German Society of Nuclear Medicine (DGN) in 2018, prioritizing relevant learning objectives. Based on the previous catalog, the writing group compiled nuclear medicine topics and formulated competence-based learning objectives, including medical developments, device innovations and new radiopharmaceutical approvals. These were presented for prioritization to the 180 habilitated DGN members as an expert group in a Delphi process. The first round of voting assessed firstly the topics in terms of necessity or dispensability, and secondly the detailed learning objectives of the topics were assessed for their relevance to academic teaching in nuclear medicine. The results of the first survey were used to draft a catalog of learning objectives with final approval by the expert group in a second survey. The time available for teaching nuclear medicine was also recorded. The writing group developed 240 competence-based learning objectives from 41 topics. After a first Delphi round, 73 detailed competence-based learning objectives from 15 topics were compiled. The mean teaching time was 8.4 h for lectures, 3.7 h for seminars and 3.6 h for practical courses. In a second Delphi round, the agreement of the expert group was at least 95% for the selected topics and at least 90% for the detailed learning objectives. The catalog of subject-specific learning objectives, updated by expert consensus, provides basic knowledge, skills and competences related to the most relevant diagnostic and therapeutic procedures in nuclear medicine, taking into account both long-established topics and recently introduced innovations.

Pharmacogenomics in Lebanon: current status, challenges and opportunities.

Pharmacogenomics (PGx) research and applications are of utmost relevance in Lebanon considering its population genetic diversity. Moreover, as a country with regional leadership in medicine and higher education, Lebanon holds a strong potential in contributing to PGx research and clinical implementation. In this manuscript, we first review and evaluate the available PGx research conducted in Lebanon, then describe the current status of PGx practice in Lebanon while reflecting on the local and regional challenges, and highlighting areas for action, and opportunities to move forward. We specifically expand on the status of PGx at the American University of Beirut Faculty of Medicine and Medical Center as a case study and guide for the further development of local and regional comprehensive PGx research, teaching, and clinical implementation programs. We also delve into the status of PGx knowledge and education, and prospects for further advancement such as with online courses and certificates.