Traditional Medical School Research Articles

The Opportunity for Educational Innovations and Requirements in Academic System Reform of Medical Schools

The amendment to the Higher Education Act enforced on February 20, 2024, abolishing the traditional 2-year pre-med and 4-year medical school programs, marks a significant shift in medical education in Korea. The academic system reform is expected to be a driving force for large-scale curriculum revision, presenting an opportunity to introduce new educational innovations not only in curriculum but also in student assessment and support systems. Addressing these challenges requires collaborative efforts among educators, students, and communities to navigate the evolving landscape of medical education effectively. In this regard, I will illustrate the recruitment and development of educators to implement the reform and the collaboration between communities and medical schools to innovate medical education.

Assessing First-Year (M1) Medical Students’ Understanding of Blood Glucose Control Using a “Backward Design” Asynchronous Physiology Lecture

Introduction: Backward design, an instructional model outlined by Wiggins and McTighe, emphasizes identifying key learning outcomes (LOs) that students must be able to perform after learning about a topic. It requires educators to first develop authentic assessments aligned with the key LOs, which form the basis of course content and activities. The majority of medical students across the United States encounter lecture-based learning in their first two years of basic sciences curriculum with little opportunity for hands-on training to build on necessary learning skills for future application in the clinic. Compared to traditional lecturing, a backward-designed session with planned activities may better develop medical students’ critical thinking and problem-solving skills. Our goal was to redesign a traditional first-year medical school lecture using the backward design model, and compare student perceptions and understanding of key concepts. Methods: We redesigned a traditional lecture on the topic, “Blood Glucose Control” from Fall 2022, using a backward design framework, and delivered it in Fall 2023. For redesign, we re-evaluated our LOs, and ensured that they aligned with the four assessment questions that we developed, which were used to build session content. We then compared student perceptions of learning and their performance on assessments between the two years. In both years, this topic was delivered asynchronously along with four assessment questions in the foundational course offered to 125 first-year medical students (M1s). Results: LOs were edited to include specific concepts that were tested on the four assessment questions. Upon mapping, we found that certain learning objectives were not adequately covered in the lecture, so we followed an iterative process to edit lecture content and created two activities, such as a clinical case branching scenario and a drag-and-drop activity. Of the 125 M1s, the four assessment questions in the years 2022 and 2023 were completed by a total of 50 and 60 students respectively. The average score for M1 students in Fall 2022 was 68.3562 (SEM=4.241577536) while those for students in Fall 2023 was 72.76966667 (SEM=3.655350463) ( p=0.617). Conclusion: Our results demonstrate an upward movement of the average score among students from Fall 2023 when a backward-design framework was used, compared to that of Fall 2022 students who received the traditional lecture. Although not statistically significant, the backward-design framework benefitted medical student performance when compared to traditional lecturing. Additionally, our research introduces innovative ways of incorporating interactive student activities in an asynchronous lecture that medical educators can implement into their own courses. Our future directions include comparing student perceptions between the two lecturing styles and correlating it with their performance. No funding sources to disclose. 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.

Academic performance of students in an accelerated medical pathway

ABSTRACT Accelerated medical school curricula, such as three-year programs, have gained attention in recent years but studies evaluating their impact are still scarce. This study examines the Fully Integrated Readiness for Service Training (FIRST) program, a three-year accelerated pathway, to assess its impact on students’ academic performance preparedness for residency. In this observational study, we compared the academic outcomes of FIRST program students to traditional four-year curriculum students from 2018 to 2023. We analyzed multiple metrics, including exam performance (United States Medical Licensing Examination Step scores, shelf exam scores, and pre-clinical course scores) and clinical performance scores during the application and individualization phases. Analysis of Variance was used to examine the effect of accelerated pathway program experience relative to traditional 4-year medical school curriculum on the learning outcomes. FIRST program students were on average 1.5 years younger upon graduation than their traditional peers. While FIRST program students scored slightly lower on Step 2 Clinical Knowledge (CK), they exhibited no significant differences in other exam scores or clinical performance relative to the traditional students. Notably, FIRST students achieved equivalent clinical performance ratings during critical clerkships and rotations. Our findings suggest that a three-year medical school curriculum can effectively prepare students for residency and produce graduates with comparable medical knowledge and clinical skills, offering potential benefits in terms of financial relief and personal well-being for medical students.

Knowledge Retention From Emergency Medicine Simulation-Based Learning Curriculum for Pre-clinical Medical Students.

Introduction Traditional medical school curricula rely on textbook-based learning during the first two years, often limiting students' clinical exposure. Simulation-based learning (SBL) provides an opportunity for students to gain clinical exposure and competency with common procedures as well as to gain knowledge related to common clinical topics. Retention of factual knowledge is a current topic of discussion as medical learners often have difficulty with long-term retention. The aim of this study was to assess if students would learn, retain, and enjoy emergency medicine (EM)-focused SBL. Materials and methods We developed an EM-focused SBL curriculum consisting of four main educational events: suturing, medical stabilization, mass casualty triage, and point-of-care ultrasound (POCUS). Participants were first- and second-year healthcare students enrolled in a traditional, preclinical curriculum, who completed pre- and post-event quizzes consisting of multiple-choice questions on topics covered during the SBL scenario. We compared pre- and post-event quiz scores using a one-way paired t-test. Quizzes were readministered up to 100 days after each SBL event to test knowledge retention, and scores were compared across time by repeated-measures analysis of variance (RMANOVA). Results For suture (n=22), mass casualty (n=20), and ultrasound simulations (n=17), post-event mean quiz scores increased significantly in comparison to mean quiz scores from before the event (p≤0.05). Medical stabilization simulation post-event scores were increased but did not reach statistical significance. Data collected at 45, 74, and 94 days following the suture lab as well as 29 and 49 days after the medical evacuation event, and 20 days after the mass casualty event showed no statistical decrease in quiz means suggesting retention of knowledge amonglearners. Subjective assessments of participant satisfaction demonstrated an enjoyment of the events. Discussion EM-focused SBL events offered enjoyable learning opportunities for students to effectively obtain and possibly retain clinical knowledge. Conclusion SBL has the potential to improve student retention of clinical knowledge during the preclinical years and, therefore, should be further explored and implemented as a core pillar of medical education as opposed to its current state as a learning adjunct.

Training visual pattern recognition in ophthalmology using a perceptual and adaptive learning module

ObjectifÉvaluer l'efficacité d'un module d'apprentissage perceptif et adaptif (MAPA) en vue de l'enseignement de 5 affections du nerf optique. MéthodesOn a réparti des étudiants de la deuxième à la quatrième année de médecine en 2 groupes : MAPA ou cours magistral vidéo. Le MAPA présentait de courtes tâches de classification d'images du nerf optique. La séquence des tâches successives dépendait de l'exactitude des réponses de l’étudiant et de son délai de réponse jusqu’à ce qu'il maîtrise le sujet. Le cours magistral consistait en un enregistrement vidéo qui simulait une portion d'un cours magistral classique d'une faculté de médecine. L'exactitude et l'aisance des étudiants ont été mesurées dans le cadre d'un prétest et d'un post-test, puis 1 mois après la formation. On a comparé les résultats des étudiants à l'intérieur d'un même groupe de même que d'un groupe à l'autre. RésultatsAinsi, 83 étudiants ont pris part à notre étude. Leur exactitude et leur aisance se sont améliorées significativement (p < 0,001) entre le prétest et le post-test dans les 2 groupes (MAPA – exactitude : d de Cohen = 2,94; aisance : d = 3,39; cours magistral – exactitude : d = 2,32; aisance, d = 1,06). Pour ce qui est du test réalisé 1 mois plus tard, le MAPA a donné des résultats significativement supérieurs (p < 0,001) à ceux du prétest, tant au chapitre de l'exactitude (d = 0,89) que de l'aisance (d = 1,16). En revanche, les résultats du cours magistral sont demeurés supérieurs en matière d'exactitude seulement (d = 0,44; p = 0,02). ConclusionsLe MAPA a facilité la reconnaissance des formes visuelles des affections du nerf optique chez des novices après une seule séance d'autoformation de courte durée. L'apprentissage perceptif et adaptif peut donc être utilisé conjointement aux cours magistraux classiques pour accélérer la reconnaissance des formes visuelles en ophtalmologie.

Restoring Trust in Science and Medicine: Empowering and Educating Future Physicians in Science Communication With the Public.

While the traditional medical school curriculum specializes in teaching doctor-patient communication at the individual patient level, the need to train physicians to communicate science and medicine effectively to the public at large is, for the most part, ignored. With the unchecked proliferation of misinformation and disinformation during the COVID-19 pandemic, it is critical that current and future medical professionals learn to engage in the public arena using multiple methods (written, oral, social media) across multimedia platforms to dispel misinformation and accurately educate the public. This article describes the authors' interdisciplinary approach at the University of Chicago Pritzker School of Medicine to teaching science communication to medical students, early experiences, and future directions in this vein. The authors' experiences show that medical students are viewed as trusted sources of health-related information, and thus, need the skills and training to tackle misinformation and that students across these learning experiences appreciated the opportunity to choose a topic of their interest according to what matters to them and their communities most. The feasibility of successfully teaching scientific communication in an undergraduate and medical education curriculum is confirmed. These early experiences support the feasibility and impact of training medical students to improve communication about science with the general public.

Medical School Students’ Knowledge of Pain and Palliative Care: An Observational Study

Background: Pain and palliative care are a reality in daily routines of medical treatment. However, the theoretical-practical curricula of traditional medical school course still unsatisfactorily contemplate pain management, as well as the palliative care approach. Objective: To assess the knowledge of medical students about pain and palliative care, as well as to identify their perception of teaching these topics during hospitalization. Methods: A cross-sectional observational study, with a descriptive and exploratory approach, data collection for which was carried out between August and November 2020. The target population was medical students, who responded to an online survey of a quantitative, anonymous and follow-up nature. The survey study variables concerned knowledge about pain management and palliative care. Results: An expressive majority of academics showed difficulty in understanding the pathophysiology of pain related to prescribing drugs for pain management purposes, and all of them believe that it is necessary to acquire more knowledge about pain treatment. In parallel, only 9.3% report having received sufficient information regarding palliative care during medical school. Conclusion: The results suggest a certain lack of knowledge and insecurity among medical school students with respect to pain management and care for patients receiving palliative care. The didactical approach to this theme is still deficient in the medical curriculum and requires immediate improvement and new proposals that address the training of these professionals in a more specific and effective way.

MONGOLIAN MEDICAL EDUCATION: THE PAST, PRESENT AND FUTURE

The ancient traditional system of medicine and medical education has a long history of several hundred years, whereas it has been merely 80 years since modern medical education developed in Mongolia. Beginning in the 17 th century when Mongolia was under the rule of Manchu Qing dynasty and had suffered for over 220 years, a Mongolian traditional medical school named Mamba Datsan was founded and has been developing ever since. In 1911 the National liberation movement abolished Manchu ruling and the nation stepped onto the path towards independence. As Manchu Qing dynasty laws and rules were abandoned, Manchu Tibetan script fell out of use and monasteries were closed down, the country’s shift into a new system caused the old system of medical education to be demolished and altered. In 1921 People’s revolution won in Mongolia, feudalism was abolished and Soviet style culture started flourishing. Overcoming obstacles is a difficult and a time consuming challenge while transitioning from an old system to a new one. Through the relations built with the USSR, the first steps were built for Europian Medicine and the Europian Medical Education [EME] system started to pervade. In specific, preparation of junior physicians and nurses commenced in Mongolia. In 1942 the government of the Mongolian People’s Republic made the historically pivotal decision to found National University of Mongolia (NUM) with three faculties including Faculty of Medicine . Initially the Faculty of Medicine had a shortage of teaching staffs, textbooks, laboratories and other resources, but thanks to the contributions made by Russian teachers the Medical Institute of Mongolia (MIM of) became an integral part of the curriculum. This is how the contemporary medical education system developed in Mongolia scince 1942 until 2022. By starting to select and train the first graduates as the teaching human resource base by 1942-1961, the faculty of medicine stood on its feet as an independent Medical Institute of Mongolia . At that time Russian style curriculum for preparing physicians was still being used. In 1990, the Medical Institute of Mongolia expanded and became the Medical University of Mongolia (MUM). From the founding of NUM and until mid 1990s, MUM single handedly fulfilled the role of preparing generations of medical doctors in the healthcare system in Mongolia.

Implementation of a Trauma-Informed Care Elective in Medical Education

Background: Education about the harm trauma does to one’s health is lacking in traditional medical school curricula. The goal of our elective extracurricular course on trauma-informed care (TIC) was to provide students with experience, knowledge, and resources to care for future patients who may have lived through traumatic experiences. Methods: We created a semester-long elective TIC course for first year medical students at a large, public medical school. We developed one - and one retrospective /post-course survey for studentsusing a mix of sliding scale and free text responses to capture student evaluations of the course. ANOVA was used for statistical analysis. Results: Of the 11 students who completed the retrospective - and post- surveys, there was a significant increase in student’s rating of their knowledge regarding impact of trauma on health by the end of the course (retro : 45.55+24.73, post: 81.64+11.79). Importantly, the group felt significantly more comfortable screening for intimate partner violence (retro : 34.09+31.05, post: 77.00+23.81), performing a physical exam for patient’s experiencing intimate partner violence (retro : 17.55+22.17, post: 67.27+18.35), accessing resources for patients experiencing addiction and recovery (retro : 35.00+32.25, post: 76.82+17.79), and caring for patients who have had adverse childhood experiences (retro : 28.27+32.18, post: 66.36+21.46). Discussion: This study is limited in a small sample size and the biases that accompany survey-based qualitative studies. It can only be interpreted in the context of a large public medical school in the southern United States. Conclusion: An elective course on TIC can be a way to make medical students feel more comfortable providing trauma-informed care. Additional research is needed to evaluate the long-term influence of a TIC course on medical students’ patient interactions.

A harder road travelled.

Based on traditional medical school application metrics, it’s easy to underestimate socioeconomically disadvantaged applicants, but the author cautions against undervaluing their talents, motivations and potential.

The Importance of Gender Inclusive Terminology in Anatomy Education

Current medical and health care programs lack formal and longitudinal integration of gender inclusive curricula, including consistent and up to date use of gender inclusive language. This roundtable presentation will focus on how moving towards more gender inclusive language when teaching pelvic anatomy will benefit the professor‐student relationship between anatomy educators and their students. Gender neutral language also creates a framework for future medical practitioners to obtain gender inclusive histories with their patients. Patients who are gender minorities are often subject to gender dysphoria during pelvic examinations due to a lack of gender inclusive language and clinical training among medical students in the traditional medical school curriculum. The current use of pelvic anatomy language can subject transgender and gender expansive students to feeling ostracized or like an invisible demographic in the classroom setting. We must teach students culturally sensitive language before students begin clinical practice to promote effective patient‐provider relationships, thereby optimizing outcomes for transgender and gender expansive patients (i.e “person who is pregnant” or “person with a prostate”). This session will address several questions relevant to developing a gender inclusive classroom environment. A lecture‐style presentation will be given followed by small group discussion to address the following questions:How do you create a learning environment that is inclusive to all students?How do you incorporate pre‐established curricula into your courses to gender inclusive cultural sensitivity and language?

Modern and synchronized clinical anatomy teaching based on the BDIE method (board-digital dissection-imaging-evaluation).

Anatomy has historically been taught via traditional medical school lectures and dissection. In many countries, practical or legal issues limit access to cadaveric dissection. New technologies are favored by students and could improve learning, complementing traditional teaching. All students in second-year medicine at a single medical school were submitted to a novel anatomical course with digital tool exposure. We explored a new combined teaching method: a physical blackboard lesson synchronized with digital dissection, imaging and direct evaluation (BDIE). Synchronized dissection is broadcast live in the classroom and in partner medical schools. Following the course, students completed a short survey about their perception of this new anatomic clinical course. The survey included 183 students whom 178 completed the questionnaire, i.e., a 97% response rate. Ninety-nine percent of students thought this synchronized method useful to improve their understanding of anatomy and 90% stated it helped them retain this learning. This BDIE method, in conjunction with teaching guidelines and dissection, is highly appreciated by students who consider it helps them to acquire lasting knowledge.

90 years of the Ural State Medical University: development of scientific activity

Since the foundation of the Ural State Medical University (USMU), the importance of scientific activity in the training of specialists with higher medical education has been determined. A contribution to the history of medical science in the Urals since the 30s of the twentieth century was made by those who began work at the Sverdlovsk State Medical Institute, whose discoveries made it possible to find new methods of diagnosis and treatment, to identify the causes of any disease. For 90years, the results of the activities of representatives of the established scientific directions and schools of Ural State Medical University have been used in the educational process and healthcare. The article describes the promotion of scientific activity of Ural State Medical University and its productivity over the previous decade. We analyzed reports on research activities for 20102020, materials based on the results of monitoring the effectiveness of Ural State Medical University, scientometric databases Russian Science Citation Index (RSCI), Web of Science, Scopus. Along with the development of traditional medical research areas and schools, the university researches in the areas of scientific medical platforms, cooperates with leading scientific, educational and medical organizations. The development of personalized medicine, digital medicine, reconstructive medicine, as well as the use of cellular technologies, and the fight against infectious diseases are highlighted among the topical areas. Over the current decade, the number of publications indexed in international abstract databases has increased 4times in Scopus, 2times in Web of Science, and 2.6times in RSCI. The total number of citations of articles over five years (20162020) in Scopus was 990, Web of Science 766. The number of articles included in the list of the Higher Attestation Commission under the Ministry of education and science of the Russian Federation, for a number of years on average 456. There is the dynamic development of the scientific activity of Ural State Medical University with a focus on cooperation with leading research teams of other organizations, the implementation of research on a state assignment, accompanied by a significant increase in publication activity.

234 Remote Surgical Teaching During COVID-19: Early Feedback from Students and Teachers

BackgroundOn the 23rd March 2020 the government issued a nationwide lockdown in response to COVID-19. Using Microsoft Teams software, Brighton and Sussex Medical School transitioned to remote surgical teaching. We discuss the early feedback from students and tutors.MethodAll students (N = 40) and tutors (N = 7) were invited to complete an online feedback survey.ResultsTwenty students responded. Nine preferred remote teaching. The teaching was described as either good (10/20) or excellent (10/20). Small group teaching, lectures and student lead seminar sessions all received positive feedback. Students preferred sessions that were interactive. One hour was optimal (17/20). There was no consensus over class size. 15/20 (75%) would like remote teaching to continue after the pandemic.All tutors responded. There was a preference towards shorter sessions: 45 minutes (2/7) one hour (5/7). Tutors found virtual sessions less interactive (6/7). All tutors would like remote teaching to continue after the pandemic. Three suggested extending teaching to remote surgical ward rounds.Concern was raised by both students and tutors regarding the absence of practical skills.ConclusionsThe value of remote teaching has been highlighted by COVID-19. Our feedback recommends a transition towards blended learning; using the convenience of remote teaching to help augment traditional medical school teaching.

Access to a dermatoscope during dermatology courses motivates students’ towards thorough skin examination

Introduction. Dermatoscope is a tool for a skin examination, used especially in early detection of malignant skin lesions. Non-dermatologists are being trained for opportunistic melanoma detection with the usage of dermatoscopy, however, still non-satisfactory. This study was aimed to determine whether practical dermoscopy adjunct to traditional, lecture and seminar-based medical school curriculum would improve the perceived relevance of regular skin examination and basic skin lesions differentiation. Material and method. Fourth-year medical students participating in a 3-week-long dermatology course were randomly assigned to two groups: the first one called A with limited access to a dermatoscope and the second one called B, with unlimited access to dermatoscopes throughout the course. All participants answered surveys concerning their attitude towards skin examination, with a rating scale from 1 to 5, before and after the course. Also, all participants completed an image-based dermoscopy test for distinguishing benign from malignant skin lesions. Results. Students assigned to group B significantly improved their perceived importance of routine skin examination (mean scores before 4.38; after 4.57, P = 0.03). No such tendency was observed in group A — before 4.40, after 4.49 (P = 0.29). Students in the group with higher dermatoscope availability considered buying a dermatoscope more often (61%) than those without (44%) (P = 0.037). No significant score difference was observed when testing skin lesions identification, mean for extended access 7.84 vs. normal 7.64 points (P = 0.69). Conclusions. Higher availability of dermatoscopy during dermatology rotations may encourage students to use this tool in future clinical practice and improve early detection of malignant skin lesions.

Integrating Social and Behavioral Sciences Into the Pakistani Medical Curriculum is Essential

The majority of respondents who took part in a survey were of the opinion that there should be a greater focus placed on behavioural and social sciences within the curriculum of medical schools. This is done to ensure that graduates of medical schools will be able to practise medicine in a manner that is both safe and effective. Despite the fact that behavioural and social sciences make significant contributions to the effectiveness of health care delivery, traditional medical school curricula have not traditionally placed a significant amount of focus on the study of these subjects. This article's objective is to provide the reader with a more in-depth comprehension of the value of social and behavioural sciences in medical education as well as the breadth of their application in a variety of different settings. Additionally, it discusses the areas of social and behavioural sciences that are significant to medicine, as well as the efficacy of incorporating them into the curricula of medical schools in order to educate and train future medical professionals to practise medicine in a manner that is fully informed. Place of Study: Foundation University Islamabad Study Duration: February 2022 to July 2022 Study Design: Empirical research Conclusion: This study examines the importance of teaching future doctors about medicine's social and behavioural aspects. It gives medical school educators the latest information on how to best teach medical students to succeed in the medical industry. Medical educators, administrators, policymakers, and other stakeholders must work together to integrate social and behavioural sciences into medical curricula. Keywords: Medical curriculum's courses, the social and behavioral sciences, and the foundations of medical education.

Traversing the American Dream in Medical School – The FGLI Experience

First-generation, low-income (FGLI) medical students are the first in their family to obtain a four-year college degree and to pursue medical education. Unfortunately, these students lack the social capital, financial resources and knowledge of the hidden curriculum of medical school possessed by their non-FGLI peers. Additionally, the intersectionality of SES, race, and gender, with FGLI status contributes to poorer wellbeing, lower self-care, and lower perceptions of support. FGLI students often come from more interdependent, working-class cultural backgrounds than their independent minded peers, which creates a cultural mismatch with the traditional medical school structure. In 2017, the AAMC began to assess first-in-family status within the medical school admissions application, an important consideration for a holistic, diversity-oriented approach to shape the medical student body. It is crucial that each medical school continue to build infrastructure which helps FGLI students flourish during the medical school journey. Underrepresented students also face differences in the type and quality of mentorship they receive, which translates to differences in student preparedness to pursue competitive specialties. The inequalities that FGLI students face have been exacerbated by fewer face-to-face interactions and clinical opportunities in the setting of a more virtual learning environment. Student-led efforts at the University of Michigan Medical School are dedicated to providing FGLI students with community and multiple mentorship opportunities early in medical school. In addition to facilitating near-peer mentorship opportunities with other FGLI students and residents, we have connected students with specialty-oriented mentorship programs, such as Anastomosis (general surgery), Uroversity (urology), and Michigan Ophthalmology Pipeline. These intentional efforts promote FGLI student mentorship from multiple entities, which allows them to find fit in the mentorship relationship, meet mentors in different stages of their careers, and leverage the benefits of the multi-mentor model. We recommend dedicated support and recognition of the FGLI community from medical school leadership. We further suggest building infrastructure for clear pathways to mentorship opportunities as a more equitable approach to medical education that will build greater diversity across all medical specialties.

A Comparative Study Between Nineveh and Tikrit Medical School Teachers Perceptions regarding the Effectiveness of OSCE in Clinical Examination

Assessment students competence is of much importance especially when evaluation the expected learningout come of medical education and because of increasing students number enrolled in medical colleges , thislead to enhance the chance of malpractice that compromise patient conditions , therefore it is challenging todevelop and implement such an objective assessment method in clinical examination. Objective of the study:The study aim is to compare the traditional and innovative medical school teachers perceptions regardingthe effectiveness of OSCE in clinical examination . A descriptive cross sectional study has been conductedin both (Nineveh and Tikrit medical college from the period of 15th February till 20 th April / 2014.The study was included 95 medical teachers from both traditional and innovative schools .( 55 teachersfrom the traditional school and 40 from innovative school). A special questionnaire form was prepared bythe researcher through direct interviewing with the study sample. The results show that 63.1% of medicalteachers are male , 49.5% aged between 40-49 years ,65.3 % from basic specialty sciences , 51.6% havinga period more than 10 years in teaching, 70.9% of traditional school teachers agree that OSCE evaluate thepractical objectives in comparison to 67.5% of innovative school teachers agree with that OSCE evaluateknowledge, understanding , practical , and intellectual objectives. The study concluded that more than halfof traditional medical teachers agree with the affectivity of OSCE in assessing large number of studentswithout bias while medical teachers from innovative school agree with the objectivity of OSCE in clinicalevaluation.

Medical History Taking Using Electronic Medical Records: A Systematic Review

Background: The relationship between digital tools and medical history taking (classically referred to as anamnesis) in clinical settings is problematic. We explored the medical history taking context, how data is managed by physicians and patients and which tools are used, particularly electronic health record, to gather, organize and record patient’s medical history and related health data. Materials and methods: Systematic review of the literature following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines, using published studies in English-language available from PubMed and Cochrane databases, using a combination of Medical Subject Headings and keywords. Our search yielded 162 citations of which 18 corresponded to our criteria and were included, regardless of study design, sample size or measurement type as a variety of perspectives and methodologies was deemed useful for an exploratory review and under a socio-technical research epistemology. The small number of publications related to the topic conditioned our analysis. Discussion: This review shows the paucity of relevant studies in the area of interest. Even thought it was possible to evaluate context changes in history taking that relate to EHR implementation and usage. Also, multiple challenges, benefits, risks and workflow adaptations have impacts on medical history taking. A potentially useful workflow adaptation is the access to the EHR previously or during the patient encounter with him or her. Conclusion:With the ever-increasing adoption of EHRs and its varying influence in clinical practice, physician’s adaptability was strained. Multiple workflow challenges and necessary changes regarding EHR use have been identified. Improving anamnesis practice is possible through better documentation, EHR templates and tools. Yet a new aspect of anamnesis – Digital anamnesis – benefits from better conceptualization and integration with classic anamnesis still taught in traditional medical schools. This study points to implications for medical schools and medical education in general. Highlights: Electronic Health Records implementation transformed clinical practice and redesigned workflows, improving patient safety and care within a multidisciplinary care setting. Some concerns surfaced concerning information privacy, quality of documentation and doctor-patient relationship, however many studies developed implemented and evaluated tools, templates and mnemonics to mitigate such distresses. “Digital anamnesis” is a proposed concept and refers to the process of medical history and information gathering using digital tools. This will be evermore important in the future, since technological development increasingly adds relevant features and functions to Electronic Health Record.

Turmeric and Curcumin: From Traditional to Modern Medicine.

The rhizome of turmeric (Curcuma longa L.) has been used as an herbal medicine, coloring agent, spice, and food additive for thousands of years in different parts of the world particularly in Asian countries. It has been used for a range of diseases in many traditional medical schools, including Islamic traditional medicine, Chinese traditional medicine, and Ayurveda. It has been used mainly for digestive problems, as a cardio-, hepato-, and neuroprotective agent as well as in many inflammatory conditions such as arthritis and for enhancing immune system. Curcumin, a diarylheptanoid derivative found in turmeric, has anti-inflammatory, antioxidant, and anticancer properties; controls obesity and metabolic problems; and improves memory and mood disorders. Therapeutically, curcumin exhibits promising potential in preclinical and clinical studies and is currently in human trials for a variety of conditions, including metabolic syndrome, nonalcoholic fatty liver disease, rheumatoid arthritis, migraine, premenstrual syndrome, ulcerative colitis, knee osteoarthritis, polycystic ovarian syndrome, atherosclerosis, liver cirrhosis, amyotrophic lateral sclerosis, depression, psoriasis, and Alzheimer's disease. Among all beneficial activities reported for curcumin, the research toward the obesity and metabolic-preventing/suppressing aspects of curcumin is growing. These findings emphasize that most of the traditional applications of turmeric is due to the presence of its key constituent, curcumin. According to the traditional background of turmeric useand clinical values of curcumin, further preclinical studies for unstudied properties and clinical studies with larger sample sizes for confirmed activities are expected.