Problems Of Medical Education Research Articles

Burnout and predictive factors among medical students: a cross-sectional survey

BackgroundBurnout is a growing problem in medical education, and is usually characterised by three dimensions: emotional exhaustion, cynicism, and reduced professional efficacy. Currently, the majority of burnout studies have been conducted in western high-income countries, overshadowing findings from low- and middle-income countries. Our objective is to investigate burnout and its associated predictive factors in Morocco, aiming to guide intervention strategies, while also assessing differences between the preclinical and clinical years.MethodsA cross-sectional, self-administered online survey assessing burnout dimensions and its main determinants was distributed among medical students at Université Mohammed VI des Sciences et de la Santé (UM6SS, Casablanca, Morocco). Descriptive analyses involved computing mean scores, standard deviations and Pearson correlations. Further, t-tests were performed to check for significant differences in burnout dimensions across the preclinical and clinical learning phase, and stepwise linear regression analyses were conducted using a backward elimination method to estimate the effects of the selected variables on the three burnout dimensions.ResultsA t-test assessing the difference in cynicism found a significant difference between students at the preclinical phase and the clinical phase, t(90) = -2.5, p = 0.01. For emotional exhaustion and reduced professional efficacy no significant difference was observed. A linear regression analysis showed that emotional exhaustion was significantly predicted by workload, work-home conflict, social support from peers and neuroticism. Cynicism was predicted by the learning phase, workload, meaningfulness and neuroticism; and reduced professional efficacy by neuroticism only.ConclusionsOur findings suggest a potential gradual increase in cynicism during medical education in Morocco. Conducting this study in a low- and middle income country has enhanced the scientific understanding of burnout in these regions. Given the identified predictive factors for burnout, such as workload, work-home conflict, support from peers, neuroticism, and meaningfulness, it is necessary to focus on these elements when developing burnout interventions.

Unravelling epistemic injustice in medical education: The case of the underperforming learner.

Epistemic injustice refers to a wrong done to someone in their capacity as a knower. While philosophers have detailed the pervasiveness of this issue within healthcare, it is only beginning to be discussed by medical educators. The purpose of this article is to expand the field's understanding of this concept and to demonstrate how it can be used to reframe complex problems in medical education. After outlining the basic features of epistemic injustice, we clarify its intended (and unintended) meaning and detail what is required for a perceived harm to be named an epistemic injustice. Using an example from our own work on introversion in undergraduate medical education, we illustrate what epistemic injustice might look like from the perspectives of both educators and students and show how the concept can reorient our perspective on academic underperformance. Epistemic injustice results from two things: (1) social power dynamics that give some individuals control over others, and (2) identity prejudice that is associated with discriminatory stereotypes. This can lead to one, or both, forms of epistemic injustice: testimonial and hermeneutical. Our worked example demonstrates how medical educators can be unaware of when and how epistemic injustice is happening, yet the effects on students' well-being and sense of selves can be profound. Thinking about academic underperformance with epistemic injustice in mind can reveal an emphasis within current educational practices on diagnosing learning deficiencies, to the detriment of holistically representing its socially constructed and structural nature. This article builds upon recent calls to recognise epistemic injustice in medical education by clarifying its terminology and intended use and providing in-depth application and analysis to a particular case: underperformance and the introverted medical student. Equipped with a more sophisticated understanding of the term, medical educators may be able to re-conceptualise long-standing issues including, but also beyond, underperformance.

Researching lived experience in health professional education.

Qualitative approaches have flourished in medical education research. Many research articles use the term 'lived experience' to describe the purpose of their study, yet we have noticed contradictory uses and misrepresentations of this term. In this conceptual paper, we consider three sources of these contradictions and misrepresentations: (1) the conflation of perspectives with experiences; (2) the conflation of experience with lived experience; and (3) the conflation of researching lived experience with phenomenology. We offer suggestions to facilitate more precise use of terminology. Our starting point is to free researchers from unnecessary shackles: Not every problem in medical education should be studied through experience, nor should every study of experience be phenomenological. Data based on participants' perceptions, beliefs, opinions and thoughts, while based on reflections of experiences, are not in and of themselves accounts of experience. Lived experiences are situated, primal and pre-reflective; perspectives are more abstract. Lived experience-as opposed to experiences as such-deeply attune to bodies, relationality, space and time. There is also a difference between experiences as lived, how a person makes sense of these and what the researcher interprets and represents. Phenomenology is a meaningful approach to the study of lived experience, but other approaches, such as narrative inquiry and self-study, can also offer useful avenues for undertaking this type of research. We aim to broaden researchers' scope with this paper and equip researchers with the information they need to be clear about the meaning and use of the terms experience and lived experience. We also hope to open new methodological possibilities for researching experiences as lived and, through highlighting tensions, to prompt researchers of lived experience to strive for ontological closeness and resonance.

Problems of medical education in the context of a healthy lifestyle and rehabilitation of elderly patients

This article analyzes pre- and postgraduate education by surveying 765 family doctors, local internists and hospital doctors from various regions of the Kyrgyz Republic (KR) with a total medical experience of 2 to 34 years on healthy lifestyles and rehabilitation of elderly patients. An analysis of the current State educational standard for higher professional education in the specialty “General Medicine” of medical universities of the Kyrgyz Republic is also presented in the context of teaching issues of healthy lifestyle and rehabilitation in gerontology and geriatrics. The importance of studying the principles of a healthy lifestyle and rehabilitation in geriatrics for the training of medical specialists and postgraduate education of doctors is considered, taking into account demographic trends and the needs of the aging population. The purpose of this analysis is to stimulate debate and develop strategies to improve the training of health workers in the field of geriatric rehabilitation in Kyrgyzstan.

Implementing Workplace-Based Assessments at Scale: The SIMPL Approach.

Over the past decade, medical education has shifted from a time-based approach to a competency-based approach for surgical training. This transition presents many new systemic challenges. The Society for Improving Medical Professional Learning (SIMPL) was created to respond to these challenges through coordinated collaboration across an international network of medical educators. The primary goal of the SIMPL network was to implement a workplace-based assessment and feedback platform. To date, SIMPL has developed, implemented, and sustained a platform that represents the earliest and largest effort to support workplace-based assessment at scale. The SIMPL model for collaborative improvement demonstrates a potential approach to addressing other complex systemic problems in medical education.

Social Studies of Scienceand Technology: New ways to illuminate challenges in training for health information technologies utilisation.

Electronic health records (EHRs) have transformed clinical practice. They are not simply replacements for paper records but integrated systems with the potential to improve patient safety and quality of care. Training physicians in the use of EHR is a highly complex intervention that occurs in a dynamic socio-technical health system. Training in this complex space is considered a wicked problem and would benefit from different analytic approaches to the traditional linear causal relationship analysis. Social Sciences theories see technological change in relation to complex social and institutional processes and provide a useful starting point. Our aim, therefore, is to introduce the medical education scholar to a selection of theoretical approaches from the Social Studies of Science and Technology (SSST) literatures, to inform educational efforts in training for EHR use. We suggest a body of theories and frameworks that can expand the epistemological repertoire of medical education scholarship to respond to this wicked problem. Drawing from our work on EHR implementation, we discuss current limitations in framing training for EHRs use as a research problem in medical education. We then present a selection of alternative theories. Unified Theory of Acceptance and Use of Technology (UTAUT) explains the individual adoption of new technologies in the workplace and has four key constructs: performance/effort expectancy, social influence and facilitating conditions. Social Practice Theory (SPT), rather than focusing on individuals or institutions, starts with the activity or practice. The socio-technical model (STM) is a comprehensive theory that offers a multidimensional framework for studying the innovation and application of EHRs. Practical examples are provided. We argue that education for effective utilisation of EHRs requires moving beyond the epistemological monism often present in the field. New theoretical lenses can illuminate the complexity of research to identify the best practices for educating and training physicians.

Analysing the Applicability of ChatGPT, Bard, and Bing to Generate Reasoning-Based Multiple-Choice Questions in Medical Physiology.

Background Artificial intelligence (AI) is evolving in the medical education system. ChatGPT, Google Bard, and Microsoft Bing are AI-based models that can solve problems in medical education. However, the applicability of AI to create reasoning-based multiple-choice questions (MCQs) in the field of medical physiology is yet to be explored. Objective We aimed to assess and compare the applicability of ChatGPT, Bard, and Bing in generating reasoning-based MCQs for MBBS (Bachelor of Medicine, Bachelor of Surgery) undergraduate students on the subject of physiology. Methods The National Medical Commission of India has developed an 11-module physiology curriculum with various competencies. Two physiologists independently chose a competency from each module. The third physiologist prompted all three AIs to generate five MCQs for each chosen competency. The two physiologists who provided the competencies rated the MCQs generated by the AIs on a scale of 0-3 for validity, difficulty, and reasoning ability required to answer them. We analyzed the average of the two scores using the Kruskal-Wallis test to compare the distribution across the total and module-wise responses, followed by a post-hoc test for pairwise comparisons. We used Cohen's Kappa (Κ) to assess the agreement in scores between the two raters. We expressed the data as a median with an interquartile range. We determined their statistical significance by a p-value <0.05. Results ChatGPT and Bard generated 110 MCQs for the chosen competencies. However, Bing provided only 100 MCQs as it failed to generate them for two competencies. The validity of the MCQs was rated as 3 (3-3) for ChatGPT, 3 (1.5-3) for Bard, and 3 (1.5-3) for Bing, showing a significant difference (p<0.001) among the models. The difficulty of the MCQs was rated as 1 (0-1) for ChatGPT, 1 (1-2) for Bard, and 1 (1-2) for Bing, with a significant difference (p=0.006). The required reasoning ability to answer the MCQs was rated as 1 (1-2) for ChatGPT, 1 (1-2) for Bard, and 1 (1-2) for Bing, with no significant difference (p=0.235). K was ≥ 0.8 for all three parameters across all three AI models. Conclusion AI still needs to evolve to generate reasoning-based MCQs in medical physiology. ChatGPT, Bard, and Bing showed certain limitations. Bing generated significantly least valid MCQs, while ChatGPT generated significantly least difficult MCQs.

Общие современные тенденции и проблемы в медицинском образовании

Medical education is an essential component of healthcare, providing the training and education needed by healthcare professionals to provide high-quality care. Despite the development of this field, medical education still faces a number of problems and trends that threaten to undermine its quality and effectiveness.The purpose of this review was to study current trends and problems in medical education. The review included published publications on current trends and highlighted problems in medical education, published in English in international peer-reviewed journals.According to the results of the review, the difficulties in the field of medical education include a lack of opportunities for clinical training, lack of integration between basic science and clinical education, rising costs and changing conditions for providing medical education. In this regard, by solving the above problems and adapting to changing needs, medical education can continue to provide the training and education necessary for medical professionals to provide high-quality care and advancement in the field of medicine.Keywords. medical education, barriers, difficulties, problems, current trends

Understanding the Estranged Attitude of Medical Students while Attending Lectures at a Medical College in Eastern India: A Cross-sectional Study

Introduction: Absenteeism among medical undergraduate students during lecture classes is a worldwide problem in medical education. Their disengaged attitude towards attending lectures is associated with poor grades in examinations and contributes to poor professional socialisation. Aim: To identify the different factors responsible for absenteeism among medical undergraduate students during lecture classes and gather feedback that may help improve the content and delivery of these classes. Materials and Methods: This cross-sectional survey was conducted at the Department of Biochemistry, Bankura Sammilani Medical College, West Bengal, India. The study duration was six months, from October 2022 to March 2023. A total of 199 undergraduate medical students from phase-I voluntarily participated in the study out of a total of 200 students. A prevalidated questionnaire using the Likert scale was used as the study tool to determine the students’ perspectives on poor attendance. Additionally, a focused group discussion was held to obtain the students’ opinions on improving the presentation of lectures. The responses were recorded, and the Tastle and Wierman tests were conducted to derive a consensus opinion. Results: Among the participants, 169 (84.9%) strongly agreed and 125 (62.8%) agreed that access to multiple websites and a preference for self-study were factors leading to skipping lectures, respectively. There was a strong agreement, with a consensus score of 0.52, that factors such as the inability of the mental capacity to match the chosen course, poor content, and monotonous presentation were important contributors to absenteeism. A significant correlation was observed between internal assessment scores and lecture attendance (p-value &lt;0.01, r-value=0.4). Approximately 44% of participants believed that a chalk and talk approach followed by small group discussions was the best teaching method. Conclusion: This cross-sectional survey identified multiple factors, such as access to various e-learning platforms, a preference for self/group study, and technical difficulties, as reasons for poor attendance in lecture classes. However, improvements in content, mode of presentation, and clinical relevance of topics may enhance students’ attitudes towards attending regular lectures and improve their performance.

A Critical Review of Simulation-Based Medical Education: An Advanced Opportunity for Next Generation of Medical Education

Mistakes made by medical personnel may cause numerous medical errors and accidents, resulting in the death of patients. Therefore, it is imperative to increase overall medical knowledge and to improve the medical skills of caregivers during their education and training. Simulation-Based Medical Education (SBME) is a compelling method for medical training; it not only improves medical education quality and trainee confidence but also reduces medical error risk and keeps patients safe, increasing patients’ satisfaction. SBME provides valuable tools to address realistic, challenging problems in medical education. Multiple factors are carefully evaluated and incorporated into the simulator design to most accurately mimic the real clinical situation and to measure the teamwork competency and learning objectives. Those practices include performance designs, a virtual platform for invasive medical procedures and noninvasive medical operations, psychology simulation, the combination of simulation and live/replayed surgery observation, and platform real force feedback. Simulation is the key element for SBME. The use of simulation in education ensures compliance with the established norms for clinical diagnosis, treatment, and some specific emergency cases. Trainees can repeatedly practice and learn from SBME without the risk of medical accidents. Improving the design of simulators with sufficient fidelity to the clinical events, in reality, will improve the quality of SBME.

Addressing Challenges of Undergraduate Medical Education in India Through Massive Open Online Courses (MOOCs)

Context: Massive open online courses (MOOCs) have much potential in higher education, including medical education. This paper explores the challenges and potential solutions through planning, developing, and integrating MOOCs into the medical curriculum. Evidence Acquisition: A non-systematic review study was conducted in March and April 2021. A comprehensive literature search was done on Pubmed, Scopus, Web of Science, Google Scholar, and websites to retrieve articles on MOOCs and medical education using relevant search terms. Results: With their wide availability, open access, and affordability, MOOCs have attracted the attention of several educationalists and learners. Indian medical undergraduates face several problems, such as introducing the new competency-based curriculum, information overload, the COVID-19 pandemic, and increased health care demand. The advantages of MOOCs can be leveraged to solve some of the problems in medical education. They can be effectively used to educate and empower the general public and provide patient education and continuous professional development. Conclusions: With embedded advanced interactive tools, MOOCs have the potential to reshape medical education. Sustained commitment, promotion competition, and collaboration can help overcome the common barriers to MOOC development and integration into the undergraduate medical curriculum.

Emotional Intelligence and perceived stress against the backdrop of the Covid-19 Pandemic among students of a medical college in Pakistan: A cross-sectional correlational study

Introduction:There is scant knowledge about emotional intelligence and pandemic perceived stress scores of medical students in Pakistan. The Covid-19 Pandemic has underscored the reality of a myriad of problems in medical education, academic stress amongst them. This study aims to find the corelation between emotional intelligence and pandemic perceived stress scores of students in a medical college in Pakistan. Socio-demographic factors are used tofind possible correlations and divergences between pandemic perceived stress scores and emotional intelligence in undergraduate medical students.&#x0D; Objective:The primary objectives are an exploration of the demographic attributes of participants, an assessment of students’ levels of perceived stress during the COVID-19 pandemic and emotional intelligence, and an exploration of a correlation between pandemic perceived stress scores and emotional intelligence&#x0D; Methods:The present study utilizes a descriptive, cross-sectional, correlational design. A convenience sample of 86 medical students in the first and second years of MBBS were recruited for the study. The participants completed a self-report questionnaire, covering three sections: demographic factors, pandemic perceived stress (the Perceived Stress Scale) and, emotional intelligence (the MindTools test).&#x0D; Results:The results demonstrated that majority of the participants (86%) had an average level of emotional intelligence. Only 14% had high levels of emotional intelligence. A negative non-significant correlation was noted between Pandemic perceived stress scores and emotional intelligence. While a significant difference (P&lt; 0.01) was noted between the Pandemic perceived stress scores of males and females, with females exhibiting more stress than males. A slightly less significant difference (P&lt;0.05) for Pandemic perceived stress was also found between students of first and second years medical students. Second year students were observed to exhibit greater stress.&#x0D; Conclusion:The study findings demonstrate that emotional intelligence does not significantly differ by educational year or gender while greater levels of Pandemic perceived stress was noted to differ across genders and educational years. However, lower levels of Pandemic perceived stress were associated with higher (although non-significant) levels of emotional intelligence. It is thus, important to impart pertinent information about emotional intelligence to medical students. It is also essential to teach them to identify and therefore, overcome stressors. Information and guidance about stress and emotional intelligence should be incorporated into the curricula of health-related fields.&#x0D; &#x0D; KEYWORDS:&#x0D; Emotional intelligence, Pandemic, perceived stress, correlational study, medical students&#x0D;

The science of education: using learning theory to solve teaching problems in medical education

ABSTRACT Although theories do not play a major role in clinical medicine, the application of established theories of education can improve medical teaching. By understanding and harnessing learning theories, clinician educators can solve common teaching problems, thoughtfully craft their teaching sessions, determine whether learners or residents have achieved the intended learning objectives, and even earn higher course ratings. Key theories to be aware of include cognitive load theory, social learning theory, experiential learning, constructivism, humanism, behaviourism and connectivism. Various teaching problems are presented, along with explanations rooted in educational theory and possible solutions for use in the clinical educational setting.

Imposter Syndrome Relation to Gender Across Osteopathic Medical Schools.

This study explores the rate of Imposter Syndrome (IS) in osteopathic medical students specifically in regard to gender. Additionally, we compare IS with previous performance on the Medical College Admission Test (MCAT) and undergraduate science GPA. IS has been described as a psychological term that refers to a pattern of behavior wherein people doubt their abilities and have a persistent fear of being exposed as a fraud regardless of adequate external evidence of success. Females in professional fields have been shown to experience IS at a significantly higher rate than their male counterparts, the cause of which is unknown. We performed an anonymous survey distributed to osteopathic medical students in the USA from the classes of 2020-2023. The final data included information from 23 classes across 9 osteopathic medical schools. Students were asked eight questions from the Young Imposter Scale questionnaire to determine if a student had IS. Students were also asked to provide MCAT scores and undergraduate science GPA information. This study confirms that female osteopathic medical students experience IS at a higher rate than their male counterparts. This phenomenon is not dependent on gender ratios in medical school classes, nor is it dependent on previous student success on the MCAT or undergraduate science GPA. This indicates that medical schools need to be aware of IS throughout the student population, not just high-achieving individuals. IS is a significant problem in medical education, which can lead to physician burnout and deteriorating well-being.

Corona Crisis in Medical Education: How to strengthen educational resilience in professors and students

Introduction: As a result of the Corona 2019-2020 pandemic, crisis happened in the globe. This educational crisis impact on all aspects of students and professors’ life. It need to pay attention to educational resilience as an important and debatable field. In this article,we provide suggestions to improve resilience in professors and students and to improve their resilience. Results: Corona's crisis has created many problems in medical education among which the following can be mentioned: Staying away from face-to-face training, promoting information literacy, technology-based thinking as a way to things, changing traditionalist and teacher-centered attitudes, need to upgrade basic knowledge and up-to-date content production and changes in educational expectations. Conclusion: The Corona crisis has created the challenges and opportunities in medical education , it seems necessary to upgrade and empower professors and students by strengthening educational resilience and most importantly, all should be the motivation to teach and learn at the present time. It can improve resilience in students and support them to have the best performance along the way.

Problems of Medical Education in Pakistan

Background and Aim: As the new millennium dawned, there were numerous difficulties to overcome, particularly in the field of health education. As the first line of defence against many diseases, oral health was given prime consideration. The study's primary goal is to identify the challenges faced by Pakistan's medical education system. Study Design: Descriptive cross sectional study Place and Duration: Department of Medical Education CMH Institute of Medical Sciences, Bahawalpur during from September 2020 to Jan 2021. Methodology: The data was collected from 200 participants of different age groups from FSc to Ist year of medical colleges. We wish to examine the difficulties that students and their families faced at the beginning and during their medical education in Pakistan. Results: A total of 200 people were surveyed. Interviews were performed with each and every one of the individuals who had been shortlisted. We then come across the following issues that students and their families faced while pursuing medical degrees in Pakistan. The mainstay of education at the undergraduate and graduate levels is the standardisation of instruction. Lectures are considered to be the most efficient method of delivering information to students, as they need minimal engagement from the students. Conclusion: Medical educationists, teachers, administrators, and policymakers in poor nations should endeavour to transform the adversary of difficulties into a chance to construct excellent learning programmes. Perhaps it will lead to new pathways of lear. Keywords: Medical Education, Teaching Methodology, Problems

When I say… empathic dissonance.

A new term defined as 'the mental discomfort created by making expressions of empathy that are not sincerely felt', the authors explore how "empathic dissonance" presents a common problem in medical education.

An Invisible Virus Has Made Visible Many Underestimated Problems in Medical Education and Research

An Invisible Virus Has Made Visible Many Underestimated Problems in Medical Education and Research

An Invisible Virus Has Made Visible Many Underestimated Problems in Medical Education and Research

In days of Global and national stress-tragedies, when what we considered to be a stable value is shaken, our eyes turn to a critical rethinking of the past. Today’s reality needs more than ever not only urgent practical procedures, restrictions, etc., but a very deep and unified concept and strategy based on sound philosophy and analyses. Evidence-based practical action is the philosophy of our behavior today. But do we have enough evidence and what are they? This is the question that still has no definite answers. Medicine is rightly proud of many of its achievements. But today, her pride is overshadowed by her inability to defeat a microscopic invisible enemy of human health. We must be honest: it turned out that medicine is strong in new modern technologies, but it is powerless to manage an invisible enemy, massively threatening the health of the Planet. It turned out that medicine is poorly prepared for surprises – not only to meet them, but also to anticipate them. Medicine is an art of probability and it must permanently prove the most probable predictions and the most effective actions. Now, by accident, the means used are mainly from the middle of the twentieth Century, from this classic epidemiology that we had forgotten. But now we are not the twentieth Century, and the media constantly suggests to us as fateful paths “social distance” and “social isolation”.

An Invisible Virus Has Made Visible Many Underestimated Problems in Medical Education and Research

An Invisible Virus Has Made Visible Many Underestimated Problems in Medical Education and Research