Preclinical Medical Education Research Articles

Impact of COVID-19 pandemic on teaching learning process in pre clinical medical education in selective medical college in Bangladesh

Background: The corona virus disease (COVID-19) pandemic has caused major disruption in educational sector including medical education. This disease outbreak has changed the medical education curriculum from traditional platform to elearning for students including Bangladesh. Objective: To observe the impact of COVID-19 pandemic on teaching learning process in medical education in Bangladesh. Methods: This qualitative survey was done among the 68 pre-clinical students aged 19 to 23years, of a non-government medical college in Bangladesh, from march to December 2021. All study participants were first year undergraduate MBBS students from anatomy, biochemistry and physiology. Data was collected by administering pre-tested questionnaires through Google form. Results: About 75% of the participants agreed that online classes were helpful during the home stay period of COVID pandemic, but about 92.2% of them were skeptical about the success of this online system for their future medical education. About 80.9% had difficulty in keeping their concentration during online class. About 94% found difficulty to follow online practical classes. Majority of the students (82.4%) feel anxious whether they were capable of doing their job properly since this method needs technical knowledge. About 50% students had limited access to internet, there were technical issues like power cut (76.5%), and poor network of internet (69.1%) also reduced the effectiveness of online education. Online class also disrupt teacher-student relationship. Conclusion: The internet based classes served the purpose of continuation of academic activity in medical education during adverse condition of COVID . But due to uneven use of technology it had some obstacles also. Student’s ability to learning in medical education was also hampered in the absence of physical classes. This online method of education system needs much improvement to be effective in medical education. J Bangladesh Soc Physiol 2022;17(2): 64-71

Studying the History of Histopathology in Preclinical Medical Education as a Guide for the Uniform Integration of Radiology in Medical Education

Radiology and pathology, though distinct fields within medical education, share a common foundation in their essential roles for accurate diagnosis and understanding of diseases. While pathology, particularly histopathology, has long been integrated into preclinical medical education in the United States, radiology education has traditionally been less emphasized. This paper examines the historical development of histopathology training in medical education and its central role, contrasting it with the comparatively peripheral position of radiology education. We explore the historical context of medical education in the United States, tracing the integration of histopathology following the Flexner Report of 1910. In contrast, radiology, emerging later as a specialized field, has faced challenges in achieving comparable integration into medical curricula. Despite the increasing importance of medical imaging in diagnosis and treatment, radiology education remains variable and often lacking in standardization across medical schools. We highlight the need for greater emphasis on radiology education to better prepare medical students for modern clinical practice, where medical imaging plays an increasingly pivotal role. A call for a comprehensive assessment of radiology education and advocacy for its integration into preclinical curricula is made, emphasizing the importance of collaboration between the radiology profession and accrediting bodies to ensure competence in imaging across medical specialties. As medical imaging continues to advance and become more integral to healthcare, it is imperative that medical education reflects this evolution by establishing radiology as a fundamental component of preclinical training.

Change in Medical Students' Attitudes Towards Family Planning After Pregnancy Counseling Panel Intervention [ID 2683614

INTRODUCTION: Abortion is one of the most commonly performed procedures in the United States, but abortion education is lacking in medical curricula. This study evaluates changes in medical students’ attitudes after a pregnancy counseling panel intervention during preclinical medical education. METHODS: Second-year medical students participated in a “Pregnancy Options Panel” with obstetrician–gynecologists, a pediatrician, and a social worker. Using a case study format, panelists guided discussion of appropriate care for a patient diagnosed with an unintended pregnancy. Two identical 19-item surveys were disseminated before and after the panel to assess students’ comfort/beliefs about pregnancy counseling and treatment. Statistical analyses were performed to compare responses. The study was IRB exempt. RESULTS: The class was composed of 366 students: 207 (60.5%) completed the pre-survey and 181 (49.5%) completed the post-survey. Students reported increased comfort when contemplating referral to an abortion provider, prescribing medication abortion, and performing a surgical abortion after the panel compared to before the panel (P<.01). Students were more likely to withhold disclosing their personal beliefs about abortion when counseling a pregnant patient (64.6% versus 42.3%; P<.01), felt more capable of counseling patients in a neutral manner (86.4% versus 71.6%; P<.01), and had a significant increase in preparedness to pregnancy options counseling (P<.01). CONCLUSION: Medical students felt more prepared to counsel patients without bias of their own beliefs after the pregnancy options counseling panel. Expert panels comprised of health professionals with diverse perspectives on pregnancy options can improve preclinical medical curriculum on the often-neglected topic of abortion.

Assessing the Use of Virtual Reality as a Tool for Teaching Body Responses to Hypoxia in Pre-clinical Medical Education: A Mixed-Methods Study Focusing on Student Experience and Learning

Virtual reality (VR) has revolutionized medical education, yet its specific effcacy in teaching medical physiology remains underexplored. Conveying the complexities of physiological responses to hypoxia through traditional teaching methods poses logistical challenges, potentially hindering students’ deep understanding. This study investigates the impact of incorporating VR into pre-clinical medical physiology teaching, focusing on students’ self-reported 1) knowledge acquisition and understanding of body responses to hypoxia, 2) VR technology acceptance and satisfaction, and 3) overall learning experience. Methods: In 2022, an ANU Medical School teaching enhancement grant funded data collection to develop a comprehensive storyboard for a VR hypoxia simulation program. With support from the school’s Technology-enhanced Learning and Teaching team and the university’s Centre for Learning and Teaching, we created an in-house limited prototype focusing on key aspects of the scripted VR simulation program to test its feasibility and perceived usefulness within our MCHD program. The tool was integrated into a year 1 practical session, followed by a two-part series of data collection, comprising a questionnaire and video interviews. The questionnaire used a mixed-methods approach, including 5-point Likert scale closed-ended questions rating VR perceived usefulness and ease of use, and open-ended questions allowing participants to provide qualitative responses. Interviews delved deeper into users’ experience, interactivity, collaboration, realism, practicality, knowledge acquisition, improvement suggestions, and overall technology and learning satisfaction. Results: Although the implemented intervention did not represent the full range of features envisioned for the final program, preliminary findings from the first round of data collection via questionnaires (n=45/96) reported positive user experiences. Sixty percent of responses showed agreement (agree (n=22) and strongly agree (n=5)) that learning outcomes were clear and aided by VR. Qualitative findings revealed higher motivation to use VR for learning and an intuitive interface. Thematic analysis identified improvement opportunities, including enhancing hypoxia symptom discernibility and refining visual resolution. These insights will inform the next study phase, refining features to improve the overall learning experience and address technical challenges. Conclusion: Grounded in constructivist learning theory and technology acceptance frameworks, our findings leverage realistic VR simulations to enhance knowledge acquisition and understanding of complex physiological responses. We express gratitude to the hypoxia simulation development project team (Dr Katie Freund, Yili Peng, Dr Siddarth Iyer, Dr Benjamin Mead, Prof Kevin Saliba and Dr Suzanne Estaphan) for their exceptional contributions. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Launching an Interactive, Interdisciplinary, Hands-on Clinical Neurosciences Workshop During Preclinical Medical Education to Enhance Student Learning (P1-7.005)

Launching an Interactive, Interdisciplinary, Hands-on Clinical Neurosciences Workshop During Preclinical Medical Education to Enhance Student Learning (P1-7.005)

Core Procedural Skills to be Taught for III-Year Undergraduate Medical Students: A Modified Delphi Study.

While medical students are expected to learn procedural skills during their training, there is no consensus on their level of learning. Further, the most essential procedural skills across medical curricula which need to be taught during their III-year clinical posting are often not considered. The purpose of this study was to identify the core procedural skills needed to be taught during the III-year undergraduate medical students clinical posting. A three-round, online Modified Delphi method was used to identify consensus on selecting the most essential procedural skills prescribed in National Medical Commission (NMC) curriculum 2019. In Round 1, a list of 54 procedural skills from the National Medical Commission's (NMC) Graduate Medical Education Regulations (GMER) 2019 curriculum was distributed to 22 experts in pre-clinical medical education and multidisciplinary clinicians.They rated the skills in terms of importance. In Round 2, the skills that received consensus in Round 1 were presented, resulting in 13 skills for evaluation. Round 3 further narrowed down the skills to a final consensus of 6. An interclass correlation coefficient of 0.767 among experts indicates a substantial level of reliability. Consensus was achieved for six procedural skills, each demonstrating over 80% agreement among the experts. These skills include basic life support, intravenous cannulation, urinary catheterization for both male and female patients, nasogastric tube insertion, oxygen administration, and basic suturing. Notably, all these skills received the highest level of agreement, surpassing 90% consensus. The results of the modified Delphi study offer crucial insights into the procedural skills that should be included in the curriculum for third-year undergraduate medical students during their clinical rotations in a tertiary care teaching hospital. Faculty members at these institutions differ in their opinions regarding the importance of teaching specific procedural skills, influenced by their teaching background and the student cohorts they instruct. From a comprehensive list, six skills have been pinpointed as the most vital through the modified Delphi technique. Moreover, the Delphi technique is acknowledged as a valuable method for achieving a consensus on prioritizing the training of certifiable skills.

Reimagining human dissection in preclinical medical education using studio-based learning: A retrospective pilot study.

Human dissections in the current medical curriculum are conducted using a checklist approach to prioritize the exposure of anatomical structures. In this setting, anatomy educators are labored to enhance their engagement during the dissection. To address this issue, we considered the current medical education pedagogies and identified a novel approach of studio-based learning (SBL) for application in a Human Dissection Workshop. This study aimed to (1) evaluate students' perceptions of SBL, (2) appraise the impact of SBL on anatomical knowledge learning, and (3) interpret the results of a validated questionnaire. Workshop participants were recruited from Year 2 medical students at the Chinese University of Hong Kong from the 2020 and 2021 cohorts. Fifty-one students participated in the workshop (N = 24 [2020], N = 27 [2021]), and 50 of them completed the postworkshop questionnaire rated on a 5-point Likert scale. Nineteen items were validated using a factor analysis. The interpretation of the questionnaire results demonstrated the different learning outcomes of the workshop, which included (1) enhancing students' knowledge and spatial understanding of anatomical structures, (2) strengthening students' appreciation of gross pathologies and clinical relevance, and (3) promoting higher-order thinking skills. To our knowledge, this is the first study to introduce SBL in medical education. The successful implementation of the workshop reflects the promising potential of SBL for enhancing human dissection and supplementing the medical curriculum.

Impact of the Covid-19 pandemic and ensuing online teaching on pre-clinical medical education

BackgroundMajor disruptions and changes in education have occurred worldwide as a result of the coronavirus disease (COVID-19) pandemic and the ensuing shift from in-person to online education. However, the effect of such changes on medical education, its magnitude, and the learning domains impacted by such rapid changes have not been adequately addressed, particularly with regard to objective assessment approaches.MethodsSecond-year medical students enrolled in our Medical English Course between 2019 and 2021 were recruited from Hokkaido University, Japan (N = 321) to participate in this study. We evaluated the potential impact of teaching styles on the academic performance of students before (2019; face-to-face) and during (2020; online; 2021; in-person and online) the pandemic. We examined the potential effect of three teaching styles––in-person (2019), online (2020), and a combination of these (2021) on the academic performance of medical students using: (i) subjective assessment of self-reported general English skills, including reading, writing, listening, and speaking; and (ii) objective assessment of medical terminology scores, evidence-based medicine (EBM) skills, and final written exam scores.ResultsIn-person education significantly improved listening and speaking skills in 2019 (p < 0.001). This trend was observed for writing skills in an online course in 2020 (p = 0.001). With the combined teaching method, students reported significant improvements in all four English skills. In our objective assessments, medical terminology improved significantly post-test versus pre-test for all three teaching styles, and we found that the online course did not adversely affect the gain in medical terminology knowledge during the course. Additionally, we did not find any significant differences across the three applied teaching styles regarding EBM skill levels. It is noteworthy that the students taking online courses had a significantly higher final exam score (mean ± SD; 82.8 ± 8.2) than in in-person (78.6 ± 8.8) and combined (79.7 ± 12.1) teaching styles.ConclusionsIn our study, the online/combined courses showed better academic outcomes compared to the face-to-face course in the preclinical clerkship. Although the current results need to be replicated on a larger scale, online/combined courses can continue and evolve in the post-pandemic education of medical students. Medical schools and institutions should consider incorporating such courses, especially combined courses, into their curricula in the future to improve the effectiveness, accessibility, and flexibility of medical education.

Celiac Disease in Medical Curriculum

Introduction: Celiac disease is a common autoimmune illness precipitated by the ingestion of gluten, a protein contained in grains (e.g., wheat, barley, and rye). Celiac disease can present with a wide variety of manifestations across nearly any body system, but most individuals with celiac disease present with subclinical symptoms. Despite relatively inexpensive testing and an effective treatment (i.e., a gluten free diet), most individuals with celiac disease remain undiagnosed, leading to significant disease burden. Research suggests that physicians have poor knowledge of celiac disease, likely contributing to the high rates of missed diagnoses. This study sought to assess the information encountered by students in pre-clinical medical education regarding celiac disease.&#x0D; Methods: Information was drawn from recent literature to create a rubric to evaluate the presentation of celiac disease in curricular and educational resources for pre-clinical medical students. Categories evaluated included prevalence, morbidity/mortality, manifestations, comorbidities, and testing recommendations. This rubric was used to assess the curriculum from a large US medical school and First Aid for the USMLE Step 1, a popular commercial resource used by medical students.&#x0D; Results: The medical school curriculum scored higher overall than First Aid (31/48 and 12/48, respectively). The curriculum also scored higher in all categories except morbidity/mortality. The curriculum showed deficits predominantly in morbidity/mortality and testing recommendations. First Aid showed deficits in all categories.&#x0D; Discussion: Results showed that the medical school curriculum provided more complete information about several aspects of celiac disease. First Aid did not thoroughly address any of the categories evaluated with the rubric. While First Aid may be an effective consolidation of Step 1 material, it seems likely that it is focused on “teaching to the test” rather than providing thorough medical education for future physicians. The medical curriculum is a more complete resource for students to learn about celiac disease.

Learning Assistants in Flipped-Classrooms: A New Pedagogical Strategy for Pre-Clinical Medical Education.

The online version contains supplementary material available at 10.1007/s40670-023-01958-x.

Preparing Preclinical Medical Students for Routine Code Status Discussions: A Mixed-Methods Study

ContextMedical students are expected to gain competency in inquiring about patients’ goals of care, per the Association of American Medical Colleges’ Entrustable Professional Activities. While students may be part of teams that conduct routine code status discussions (CSDs), formal training in this skill prior to clinical clerkships is lacking. ObjectivesWe aimed to address this training gap by designing a curriculum to teach preclinical medical students about routine CSDs. MethodsWe designed and conducted an interactive workshop for preclinical medical students to learn about routine CSDs and practice this skill, using Kern's Six Steps to Curriculum Design. A qualitative and quantitative pre- and postsurvey was administered. A convergent, parallel, mixed methods analysis was performed. ResultsStudents (n = 135) named more options for code status following the workshop (presurvey 1.3 vs. postsurvey 4.3, P < 0.01). There was an increase in the proportion of students reporting that they felt “somewhat comfortable” or “extremely comfortable” conducting a CSD (presurvey 19% vs. postsurvey 64%, P < 0.01), and a decrease in those reporting that they felt “extremely uncomfortable” or “somewhat uncomfortable” (presurvey 53% vs. postsurvey 18%, P < 0.01). Thematic analysis revealed that students were concerned about knowledge gaps, communication tools, personal discomfort, and upsetting patients or family. ConclusionA workshop to train medical students to conduct routine CSDs can be included as part of a preclinical medical education curriculum. Students reported that the workshop increased their confidence in conducting CSDs and demonstrated an increase in corresponding knowledge, preparing them to deliver person-centered care on their clerkships.

Using latent class growth analysis to detect group developmental trajectories in preclinical medical education.

Medical educators and programs are deeply interested in understanding and projecting the longitudinal developmental trajectories of medical students after these students are matriculated into medical schools so appropriate resources and interventions can be provided to support students' learning and progression during the process. As students have different characteristics and they do not learn and progress at the same pace, it is important to identify student subgroups and address their academic needs to create more equitable learning opportunities. Using latent class growth analysis, this study explored students' developmental trajectories and detected group differences based on their coursework performance in Anatomy within the two years of preclinical education in one medical school. Four subgroups were identified with various intercepts and slopes. There were significant group differences between these subgroups and their standardized scores in MCAT and UCMLE Step 1. The study provides evidence about the heterogeneity of the student population and points out future research directions.

Barriers and Solutions to Successful Problem-Based Learning Delivery in Developing Countries - A Literature Review.

Problem-based learning (PBL) was introduced in the 1960s as an alternative to traditional teacher-centered and discipline-based preclinical medical education. A literature review was conducted to explore the barriers and solutions to successful PBL uptake and delivery in developing countries. The review involved the search of articles and scientific studies on PubMed, The Lancet, and Scielo. The review focused on the medical education literature, using as a primary search criterion "problem-based learning" in combination with "developing countries" and "education". The search was limited to articles in Spanish and English published between 2011 and November 2021, except for three articles due to their relevance to the subject. Faculty development programs are the cornerstone when implementing a new methodology in developing countries. Early career development, PBL methodology, and the available assessment options should be the primary learning objectives of these programs. Stakeholders will need to plan using available resources following the experience of other countries and institutions encouraging collaborative development. Evaluation and assessment will be crucial to understand the impact of PBL, and considerations should be taken to implement an integrated curriculum. Medical Education Research should be encouraged, appraised, and disseminated to improve evidence-based decision-making, creating a constant development cycle. PBL is innovative and represents many unanswered questions that will develop in the following decade as more schools implement new methodologies and Research on PBL.

It’s “not black and white”: Students’ perceptions of “altruism” content in preclinical medical education

Objective This study investigated how students as stakeholders viewed behavioral and social science (BSS) content in a preclinical longitudinal course entitled “Medicine, Body, and Society” (MBS) at UT Health San Antonio Long School of Medicine (LSOM). We present students’ perceptions of successes and challenges tied to “altruism” and other non-biomedical objectives outlined by this institution. Methods We conducted a qualitative thematic analysis of MBS course evaluation data. Two researchers independently performed initial coding followed by interrater reliability checks to revise codes and a final MAXQDA lexical search to refine three themes. Results Three major themes emerged: (1) Students shared pedagogical preferences strongly favoring stories. (2) Students detected deficits in the module content tied to identities. (3) Students labelled BSS content as “soft,” “subjective,” and “siloed” which confounded its role in the course. Conclusions Advancing altruism aligned with BSS content in preclinical medical education remains a challenge. A closer review of student evaluations framed as learner-centeredness is key to a greater understanding and resolution of competency issues in preclinical curriculum and its impact on mastery in subsequent clinical education and practice.

Physiology Education and Teaching in Chinese Mainland Medical Schools: The status quo and the changes over the past two decades.

Physiology is a critical subject which bridges basic and clinical medicine. The reform of physiology education is crucial to improving the quality of teaching and support student learning, while there is a lack of comprehensive data documenting the current state of physiology education in medical programs in China. This study conducted an online survey among experienced teachers from the top 100 medical schools in Chinese mainland in 2022. A total of 89 valid questionnaires were included in this study. In 57.3% of the surveyed medical schools, 70% of the physiology teachers have a PhD degree, while the number of faculty members with a medical background has tended to decrease in 53.9% of the surveyed medical schools. Of the 89 medical schools, 62 have implemented physiology course integration, with 69.4% of the respondents believing that curriculum integration could enhance students' knowledge acquisition and application. The lecture hours per term are 50-70 and 71-90 in 49.4% and 42.7% of the 89 medical schools, respectively. The ratio of course duration of lecture to laboratory was 2:1 in 47.2% of the surveyed medical schools, while the ratio was between 1:1 and 2:1 in 47.2% of the surveyed medical schools, and only 5.6% of medical schools opted for a 1:1 course arrangement. For teaching methods, about 60% of medical schools used PBL/CBL/TBL for clinical medicine students only, and 25.4% of medical schools applied PBL/CBL/TBL to all students. This study is conducive to promoting dialogue and communication among physiology teachers, administrators, and researchers.

Evaluation of US Medical Student Bias Toward Mental Health Before and After First-Year Pre-clinical Psychiatry Education.

Much of mental health care is provided by non-psychiatric providers, and unfortunately, bias toward patients with mental health conditions leads to worsened outcomes. The authors endeavored to determine if pre-clinical medical student psychiatry education had an impact on these perceptions. All 366 first-year medical students at Indiana University were invited to participate in a survey that consisted of the Mental Illness: Clinician's Attitudes version 2 (MICA-2) and six supplemental questions, pre- and post-course. One hundred seventeen students completed both surveys. The pre- and post-course means were 36.6 and 33.6, a change of - 2.9 (paired t-test p-value < 0.001), indicating a reduction in bias. These results suggest that pre-clinical education can lead to a measurable decrease in bias in medical students early in training. Unfortunately, individual question results and free responses continue to highlight significant bias in US medical students against mental illness and the field of psychiatry. Health care educators should be aware of these biases and their potential impact on patient outcomes so that these harmful perceptions can be targeted.

Strategies to Create a More Gender Identity Inclusive Learning Environment in Preclinical and Clinical Medical Education.

Recognition of the spectrum of gender identities has been a recent phenomenon in the medical profession. Over the past 20 years, medical literature related to gender identity diversity has increased several-fold, yet it more commonly addresses clinical care rather than aspects related to medical education. Medical educators continue to struggle with appropriate language and inclusive approaches when discussing gender-based aspects of medical education. Reproductive health education, including obstetrics and gynecology clerkships, is particularly vulnerable to missteps and anachronisms regarding gender identity.This article aims to provide preclinical and clinical medical educators with strategies to identify and predict situations where missteps related to gender identity inclusivity may occur in their curriculum or learning environment, and to develop approaches to improve gender identity inclusivity within medical education. The authors explore 3 areas that commonly pose challenges for medical educators: inclusive language and terminology, anatomy education, and reproductive genetics and genetic counseling. They hope the tools and strategies provided here will be useful to reproductive health medical educators across specialties to enable the realization of a more inclusive learning environment in reproductive health.

Virtual Care and Virtual Medical Education: A Canadian Medical Student Perspective

&#x0D; Background: The COVID-19 pandemic had accelerated the adoption of virtual care as an extension of routine clinical practice. In addition, pre-clinical undergraduate medical education was affected by the transition to both synchronous and asynchronous online learning. The objective of this study was to assess the current experience and knowledge of medical students with regards to virtual care. A secondary objective was to identify opportunities for improvement in the undergraduate medical curriculum.&#x0D; Methods: An electronic survey was distributed to undergraduate medical students in Canadian medical schools. Main sections of the survey addressed experience with virtual care encounters and perceived impact of virtual learning on medical education.&#x0D; Result: Out of our 53 respondents, the majority (80%) of medical students perceived high educational importance of virtual care encounters. 91% of the students recognized the developing role of virtual care in current and future medical practices. 55% of the surveyed showed readiness to conduct virtual care in the current curriculum. 94% of the responses stated the preferred feedback method for clinical learning was immediate faculty assessment following the encounter.&#x0D; Discussion: The results from this study provided insight on the medical learner’s experience while navigating virtual care and identified areas of improvements at an institutional level. Effective medical training that integrates the advantages of virtual care is crucial.

Otolaryngology-Head and Neck Surgery Boot Camp in Preclinical Undergraduate Medical Education: A Pilot Study.

Objectives: There are limited opportunities in the medical school curriculum to learn about the field of Otolaryngology-Head and Neck Surgery (ORL) and to acquire relevant clinical skills, especially during preclinical years. The purpose of this pilot study was to investigate the impact of implementing an ORL boot camp in preclinical undergraduate medical education to help first- and second-year medical students learn about common ORL problems and become more comfortable performing basic ORL clinical skills so that they are better prepared to provide care for patients during clerkships and beyond. Methods: First- and second-year medical students were recruited to a single 3-hour boot camp session consisting of didactics/demonstrations and clinical experiences. The boot camp provided an introduction into the field of ORL, description of common ORL pathologies, associated management and procedures, and demonstrations of basic ORL procedures typically performed in clinic. Under supervision, subjects practiced complete head and neck physical examinations (H&NPE) on their peers including otoscopy, tuning fork tests, examination with a nasal speculum, and oral, basic cranial nerve, and neck examination. Pre- and post-tests assessing subjective (0-5 point Likert scale) and objective (content exam) measures of ORL knowledge, comfort level performing ORL skills, and interest in ORL were used to evaluate the intervention. Results: A total of 17 students participated in the boot camp as part of an extracurricular session. Seventeen students completed pre-tests and 16 completed post-tests. Ratings of self-reported knowledge of ORL (2.06 vs 3.00; P = .019) and comfort level in performing H&NPE (1.76 vs 3.44; P < .001) increased significantly after the boot camp. Mean performance on an ORL content exam also increased significantly from 42.17% to 71.35% (P < .001). Conclusions: An ORL boot camp may be an effective method of teaching for preclinical medical students. Further studies with a larger cohort are warranted.

Visual Learning Equity: A Course Auditing System of Skin Color in Preclinical Medical Education.

Visual learning equity is a health justice effort in response to the lack of representation of brown and black skin images in medical education. This paucity creates a knowledge gap and decreases providers' competence in managing skin disease in minoritized populations. Herein, we aimed to create a standardized course auditing system to assess the use of brown and black skin images in medical education. We performed a cross-sectional analysis of the 2020-2021 preclinical curriculum at one US medical school. All human images in the learning material were analyzed. Skin color was categorized as light/white, medium/brown, and dark/black using the Massey-Martin New Immigrant Survey Skin Color Scale. We included 1,660 unique images in our analysis; 71.3%, (n=1,183) were light/white, 16.1% (n=267) were medium/brown and 12.7% (n=210) were dark/black. Dermatologic images of skin, hair, nails, or mucosal disease made up 62.1% (n=1,031) of the images and 68.1% (n=702) were light/white. The pulmonary course presented the highest proportion of light/white skin (88.0%, n=44/50) and the dermatology course presented the lowest proportion of light/white skin (59.0%, n=301/510). Images of infectious diseases were more frequently presented in darker skin colors (χ2 [2]=15.46, P&lt;.001). Light/white skin was the standard used for visual learning images in the medical school curriculum at this institution. The authors outline steps to perform a curriculum audit and diversify medical curricula to ensure the next generation of physicians are educated to care for all patients.