Undergraduate Medical Curriculum Research Articles

Defining a set of teaching EPAs tailored to an undergraduate medical curriculum using a modified Delphi approach

BackgroundThe concept of entrustable professional activities (EPAs) has recently been extended to operationalize professional tasks in teacher training and faculty development in health professions education. The aim of this study is to report on the process and results of defining a set of teaching EPAs (t-EPAs) tailored to the local characteristics of a particular undergraduate medical program.MethodsThe undergraduate medical program at the Charité – Universitätsmedizin Berlin is competency-based, integrates thematic modules and spans 6 years. A writing team identified teaching EPAs based on the program’s study regulations and drafted content descriptions with titles, specifications and knowledge, skills and attitudes. Content validation involved a modified Delphi procedure with a systematic, iterative interaction between a panel of content experts consisting of purposively selected educators and physicians from our faculty (n = 11) and the writing team. The threshold for a consensus was an agreement of 80% of the participants.ResultsAfter two Delphi rounds, a consensus was reached regarding the teaching activities to be included and their content descriptions. The response rate was 100% in both Delphi rounds. The Delphi results include the content descriptions of a total of 13 teaching EPAs, organized into the two overarching EPA domains of classroom-based (n = 10) and workplace-based (n = 3) activities. Tailoring the classroom EPAs to small group teaching and the workplace EPAs to supervising medical students led to several distinct EPAs. Another feature was the development of 2 teaching EPAs for interdisciplinary teaching.ConclusionsIn systematic, Delphi-based process, we defined a set of 13 distinct teaching EPAs tailored to a specific undergraduate medical program that cover the core teaching tasks for faculty in this program. Our report on the principles of the process and the results may guide other medical schools and educators in defining and tailoring teaching EPAs according to their contexts.

Dementia Knowledge Among Primary Healthcare Physicians in Riyadh, Saudi Arabia.

Dementia poses a significant healthcare challenge globally, and healthcare providers musthave adequate knowledge about its diagnosis, management, and support services. By assessing the knowledge level of primary care physicians in Riyadh, we can identify potential gaps and areas for improvement in dementia care, ultimately enhancing patient outcomes and quality of life. This study holds promise in shedding light on the current state of dementia knowledge among primary healthcare physicians in Riyadh and offering insights into strategies to enhance dementia care in this region. This cross-sectional questionnaire-based study was conducted from the first of June 2023 to the end of December 2023 in Riyadh, Saudi Arabia. A validated questionnaire was used to assess physicians' knowledge, attitude, and practice toward dementia. A total of 151 physicians completed the questionnaires. The majority were male (55%), below 30 years of age (88.1%), and family medicine residents (84.8%). Most (74.8%) recognized old age as the most significant risk factor; an overwhelming majority of participants (98.7%) could not identify the minimum course of treatment to judge a medication's effectiveness. The average score of correct responses(7.74 ∓ 4.11) was equivalent to 38.7%. Furthermore, the average correct responses were significantly different among the different job levels of the participants. The findings of this study highlight a lack of knowledge among primary care physicians regarding dementia, emphasizing the crucial importance of physician education in this area. Additionally, the results strongly indicate the need foremphasis on dementia education within the undergraduate medical curriculum, family medicine curriculum, and physician training programs. By addressing these educational gaps, we can better equip physicians to provide optimal care and support for individuals with dementia, ultimately improving patient care and quality of life.

Development of a Scoring Rubric Assessing Medical Students' Explanations of Pathology Reports.

With increasing availability of immediate patient access to pathology reports, it is imperative that all physicians be equipped to discuss pathology reports with their patients. No validated measures exist to assess how pathology report findings are communicated during patient encounters. To pilot a scoring rubric evaluating medical students' communication of pathology reports to standardized patients. The rubric was iteratively developed using the Pathology Competencies for Medical Education and Accreditation Council for Graduate Medical Education pathology residency milestones. After a brief training, third- and fourth-year medical students completed 2 standardized patient encounters, presenting simulated benign and malignant pathology reports. Encounters were video recorded and scored by 2 pathologists to calculate overall and item-specific interrater reliability. All students recognized the need for pathology report teaching, which was lacking in their medical curriculum. Interrater agreement was high for malignant report scores (intraclass correlation coefficient, 0.65) but negligible for benign reports (intraclass correlation coefficient, 0). On malignant reports, most items demonstrated good interrater agreement, except for discussing the block (cassette) summary, explaining the purpose of the pathology report, and acknowledging uncertainty. Participating students (N = 9) felt the training was valuable given their limited prior exposure to pathology reports. This pilot study demonstrates the feasibility of using a structured rubric to assess the communication of pathology reports to patients. Our findings also provide a scalable example of training on pathology report communication, which can be incorporated in the undergraduate medical curriculum to equip more physicians to facilitate patients' understanding of their pathology reports.

Assessing the Need for Clinical Forensic Medicine Training in the Medical Undergraduate Curriculum

Assessing the Need for Clinical Forensic Medicine Training in the Medical Undergraduate Curriculum

Use of Social Learning Tools Improves Engagement and Performance in Undergraduate Medical Physiology Education

Objective: We sought to increase engagement, reduce cognitive load, and foster self-directed learning while potentially improving exam performance by incorporating a social annotation tool (SAT) into a flipped classroom setting in an undergraduate medical education curriculum. Hypothesis: We hypothesized that using the SAT (Perusall) as preparatory material for a flipped classroom would increase engagement and academic performance compared to using a pre-recorded lecture video when teaching cardiovascular physiology. Methods: Within a first-year undergraduate medical physiology course, students (n=125) used the SAT to annotate assigned cardiovascular physiology readings before a flipped classroom session. This strategy was compared to the common practice of providing students with a pre-recorded lecture. Students took an assessment before and after to assess knowledge acquisition and engagement with both formats. Results: The SAT intervention identified an average time spent engaged with the material of 142.1 minutes ( n=125), with a pre- and post-assessment score improvement of approximately 20.25% (61.5% vs 82%; n=81). The pre-recorded one-hour lecture found that students engaged with the material, on average, for 51.45 minutes, corresponding to an average of 91% video completion. Findings from this lecture intervention showed the pre- and post-assessment scores improved by an average of 5% (71% vs. 76%; n=80). A paired sample t-test identified a significant difference between the percent improvement between quizzes for SAT (M=19.71, SD=26.374) and percent improvement for recorded lecture (M=6.57, SD=26.369); [t(69)=3.450, p=0.001]. The use of SAT enhanced academic performance in midterm and final exams. The average performance in questions that mapped back to the flipped classroom utilizing SAT text was 91% (n=6) , as compared to an average performance of 73% to those questions that mapped back to the online pre-recorded lecture (n=11 ). Conclusions: Incorporating SATs into a flipped classroom model increased engagement and academic performance versus passive lectures when teaching medical physiology. Our study provides support to the use of social learning tools to enhance active learning in undergraduate medical education. none. 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.

Student Performance and Stress in Histology and Cell Biology in a Redesigned Preclinical Undergraduate Medical Curriculum

In the legacy curriculum at TTUHSC School of Medicine, histology and cell biology were taught in dedicated units in Block 2: Biology of Cells & Tissues (BCT). In Fall 2021 (Class of 2025), a new compressed organ-based integrated curriculum with restructured delivery of histology and cell biology and permanent change to pass/fail grading was implemented. Therein, basic histology was integrated into Unit 1 of Block 1: Anatomy, Histology & Embryology (AHE). Cell biology was divided into AHE and the second unit of Block 2: General Principles (GPX). Our objective was to evaluate performance in histology and cell biology and influential factors, such as student stress and academic and personal concerns in the new organ-based integrated curriculum. For AHE and GPX students completed pre- and post-block surveys regarding stress and academic and personal concerns. Deidentified scores for performance on the 10 most diffcult histology questions on the fall 2021 AHE Exam 1 were compared to the same exam questions in BCT in fall 2020. Scores for the 10 most diffcult cell biology questions on the fall 2021 GPX Exam 2 were compared to those for same exam questions in BCT in fall 2020. Biochemistry performance also was evaluated, as its instruction remained similar to that in the legacy curriculum. Fall 2021 histology scores were markedly lower than scores in fall 2020 (p = 0.002); however, end of block NBME exam scores for histology were comparable to scores in fall 2020 (p = 0.445). Cell biology scores in fall 2021 were moderately lower than in fall 2020 (p = 0.0035). Surprisingly, scores for the 13 most diffcult biochemistry topics in fall 2021 were lower than in fall 2020 (p = 0.0051). AHE pre- and post-block surveys indicated students anticipated dedicating 12% of their time studying histology, but actually allocated 10% of their time. At the start of AHE, the top concern was the amount of material in the block; by the end, it was learning histology. GPX post-surveys indicated student stress was comparable or even less than anticipated. Top concerns were curriculum design, biochemistry, and amount of material. Over 50% of students felt overwhelmed by the amount of material in GPX. In the new curriculum, student performance in histology on the unit exam was attenuated, but NBME exam scores were on par with the legacy curriculum. Student acclimation to the rigors of school and honing of time management skills may explain improved performance at the end of AHE. Lower performance in cell biology and biochemistry might be due in part to inclusion of medical genetics and pharmacology that were not taught in the analogous legacy block. Whether such trends in student performance in these foundational blocks persist in subsequent iterations of the curriculum and potential influence of student perception on performance are being evaluated. Funded through TTUHSC-SOM. 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.

Integrating MDT Tumor Board Shadowing into the Undergraduate Medical Curriculum: Perspective of Medical Students.

Site-specific multidisciplinary team (MDT) tumor boards are valuable resources for medical students, enabling them to familiarize themselves with the latest evidence-based cancer management strategies and observe effective teamwork in action. In this study, we looked at the awareness and perceptions of medical students about incorporating MDT tumor boards in the medical curriculum. A cross-sectional study was conducted among medical students from year 1 to year 5 at the Aga Khan University after exemption from ethical review committee. A 20-item self-administered questionnaire was used to evaluate the awareness and perceptions of medical students regarding MDT tumor boards. A total of 285 medical students participated in this study, with their mean age (± standard deviation) being 21.91 ± 1.67years. A majority of 183 (64.2%) had no prior knowledge of the existence of a site-specific MDT tumor board for cancer management. Of the 285 students, 252 (88.4%) demonstrated sufficient awareness of the effectiveness of MDT tumor boards; similarly, 232 (81.4%) responded positively to the idea of mandatory tumor board rotations being incorporated into the undergraduate curriculum. No significant association was found between the student's year of study (χ2 = 6.03, p = 0.20) or gender (χ2 = 35, p = 0.84) and their perceptions of the effectiveness of MDT tumor boards. However, it was found that students who had prior knowledge of their existence had a stronger association with sufficient awareness (χ2 = 4.2, p = 0.04). The results indicate that while the majority of the medical students have no prior attendance or knowledge regarding MDT tumor boards, there is an overwhelming willingness among students to incorporate them into the medical curriculum.

Design, implementation and evaluation of a spiral module combining data science, digital health and evidence-based medicine in the undergraduate medical curriculum: A mixed methods study

BackgroundDigital health, data science and health informatics are increasingly important in health and healthcare, but largely ignored in undergraduate medical training. MethodsIn a large UK medical school, with staff and students, we co-designed a new, ‘spiral’ module (with iterative revisiting of content), covering data science, digital health and evidence-based medicine, implementing in September 2019 in all year groups with continuous evaluation and improvement until 2022. ResultsIn 2018/19, a new module, ‘Doctor as Data Scientist’, was co-designed by academic staff (n = 14), students (n = 23), and doctors (n = 7). The module involves 22 staff, 120 h (43 sessions: 22 lectures, 15 group and six other) over a 5-year curriculum. Since September 2019, 5,200 students have been taught with good attendance. Module student satisfaction ratings were 92%, 84%, 84% and 81% in 2019, 2020, 2021 and 2022 respectively, compared to the overall course (81%). ConclusionsWe designed, implemented and evaluated a new undergraduate medical curriculum that combined data science and digital health with high student satisfaction ratings.

Critical Thinking and Clinical Reasoning in Undergraduate Medical Course: A Mixed-Methods Study in a Medical College in Kolkata, West Bengal, India.

Critical thinking is considered as the essential set of skills for medical practice, particularly during emergencies. However, there is lack of conceptual clarity around it and it was not explicitly included in the undergraduate medical curriculum in India. The present study has been planned to assess the critical thinking disposition and clinical reasoning skills among medical undergraduate students in a medical college in West Bengal, India. The perceived definition and attributes of critical thinking in medical education will be explored and the contexts where application of critical thinking skills may be crucial for medical practice will be identified. The content validity index, test-retest agreement; internal consistency and construct validity of the Critical Thinking Disposition Assessment Questionnaire (CTDAQ) will be assessed through step-by-step procedure. CTDAQ and the case-based objective-type questions for the clinical reasoning skills will be applied to around 200 medical undergraduate students. Their perception and experience on critical thinking in medical education will be assessed with structured open-ended questions. In-depth interviews with medical teachers of the second and third phases of undergraduate medical curriculum will be conducted to assess their perception and experiences on critical thinking. The quantitative analysis will be conducted with MS excel and R software using the relevant packages. The qualitative data will be transcribed and translated in English, close to the participants' verbatim. The thematic analysis will be conducted with inductive coding and memoing. The study will be conducted maintaining ethical standards for epidemiological studies. The present study, one of the first a few studies in India, will help to meet the conceptual gap in understanding the attributes of critical thinking, its association with clinical reasoning and the contexts of preferred application in medical practice.

Bioethics curriculum for undergraduate medical students: an evaluation study utilizing mixed methods approach

BackgroundThe undergraduate bioethics curriculum introduced in a private medical college in Pakistan in 1988 and revised in 2009 has evolved over time to incorporate globally relevant innovations, including integration of bioethics spirally within an existing problem-based learning curricular framework. The present evaluation study shares the results of this integrated bioethics curriculum delivered for 10 years across the five-year undergraduate medical curriculum. The study assessed the effectiveness of the curriculum in terms of student achievement, appropriateness of course contents and efficiency of instructional methods.MethodsThe study utilized a mixed method sequential explanatory design. The quantitative method was used in the first phase to gather data by utilizing a structured online questionnaire. This was followed by the second phase of qualitative methods to explain the findings of the first phase and enrich the data gathered. This phase was based on focus group discussions and document review.ResultsStudent and faculty responses showed the curriculum contents to be relevant, informative, and appropriate as per learning objectives and student achievement. Multi-modal instructional methods used were stated to be effective and engaging; small group teaching and shorter sessions suggested to be preferable for fostering discussion and maintaining student engagement and attention. Large class formats were stated to be less effective. Students affirmed the contribution of bioethics education to their personal and professional development and ethical positioning. The majority of students agreed that the curriculum contributed to their knowledge acquisition (60.3—71.2%), skill development (59.41—60.30%) and demonstration of ethical/professional behavior (62.54—67.65%). The ranges indicate agreement with related sets of questions.Participants suggested that the curriculum could be further strengthened by better integration in clinical years, role modelling and providing opportunities for application in clinical health care settings. Moreover, topics like ethical issues related to the use of social media, public health ethics and ethics and law were suggested as additions to the existing curriculum. These findings have regional and global relevance for the development and assessment of effective bioethics curricula.ConclusionAn effective bioethics curriculum for undergraduate medical education should run longitudinally across the 5 year curriculum and be integrated in the modules and clerkships. Basic acquisition of knowledge and skills takes place in Years 1 & 2 with reinforcement and application in Years 3–5. Learning embedded in an integrated curriculum can help students recognize, critically analyze and address ethical dilemmas. Involvement and commitment of the clinical faculty is essential for reinforcing the ethical principles and concepts learnt in the earlier years.

Exploration of the integration of microbiology and immunology emerging topics into undergraduate medical education

ABSTRACT Purpose Medical school educators face challenges determining which new and emerging topics to incorporate into medical school curricula, and how to do so. A study was conducted to gain a better understanding of the integration of emerging topics related to microbiology and immunology in the undergraduate medical curriculum (UME). Methods An anonymous survey with 17 questions was emailed to medical school faculty who teach immunology and/or microbiology through the DR-Ed listserv, the American Society for Microbiology (ASM) Connect listserv, and attendees of the Association of Medical School Microbiology and Immunology Chairs (AMSMIC) Educational Strategies Workshop. Participants were asked about experiences, perceptions, and the decision-making process regarding integrating emerging topics into UME. Results The top emerging topics that were added to the curriculum or considered for addition in the last 10 years included COVID-19, Zika virus, mRNA vaccines, and Mpox (formerly known as monkeypox). Most respondents reported lectures and active learning as the major methods for topic delivery, with most faculty indicating that formative assessment was the best way to assess emerging topics. Content experts and course directors were the most cited individuals making these decisions. Top reasons for incorporating emerging topics into curricula included preparing students for clinical treatment of cases, followed by demonstrating the importance of basic science, and opportunities to integrate basic science into other disciplines. Challenges for incorporating these topics included making room in an already crowded curriculum, followed by content overload for students. Conclusions This study describes the rationale for integrating emerging topics related to microbiology and immunology into UME, and identifies the current new and emerging topics, as well as the main methods of integration and assessment. These results may be used by medical educators to inform curricular decisions at their institutions. Future studies will include developing innovative learning modules that overcome barriers to integration.

IJCM_32A: Attitude of Medical Students Regarding Empathy towards Patients in a Medical College in Mangalore

Background: The incorporation of medical humanities, an interdisciplinary field of medicine, in medical education may offer significant benefits to the medical community. This study was done to assess the attitude of medical students regarding empathy towards patients and to find out the perception of students about the inclusion of humanity studies to their undergraduate medical curriculum. Methodology: It was a Cross-sectional study done among Final Year MBBS Part One and Part Two, Post Graduate Students of Clinical Specialities and Interns of Kasturba Medical College, Mangalore and its associated teaching hospitals. Data was collected using semi-structured questionnaire which consisted of three sections including Participant information, Jefferson Scale of Physician Empathy – Student’s Version (JSPE-S) which will be used to measure empathy towards patients among medical students and questions on assessing the perception of students regarding the introduction of humanity studies in the medical curriculum. The collected data were entered and analyzed using SPSS version 11.5. Likert scale was analysed using median (±2SD). For qualitative data statistical test Chi-square was used Results: The mean age of the 410 students who were surveyed was 22.11 with a standard deviation of ± 2.136. 41% of the respondents were male and 59% were female. The Jefferson Scale of Physician Empathy is measured on a scale of 20-140. Among the participants, 167 (40.7%) students scored between 46-90, categorized according to the Jefferson Scale as moderately empathetic. 243 students scored between 91-140 - categorized as high empathetic. None of the students scored between 20-45 (least empathetic category) Conclusion: Our study found that all the respondents were either moderately or highly empathetic according to the Jefferson Scale of Physician Empathy. A majority of respondents felt that it is important to understand the feelings and body language of the patient and that the emotions of the patient and family are important in the physician-patient relationship.

IJCM_400A: Perception towards family adoption programme among MBBS students of a medical college - A cross sectional study

Background: National Medical Commission (NMC) in their recent notification included the Family Adoption Program (FAP) in the undergraduate medical curriculum to provide a learning opportunity towards community- based health care to Indian Medical Graduates. Notification documented that around 65.5 % of population resides in rural settings (as per 2020 statistics) whereas availability of health care facilities and services are skewed towards urban set ups. The student is expected to establish a rapport, understand their health and related factors, and help improve the healthcare of the family, by extensions, the community. FAP brings its challenges and opportunities. It is a very challenging task to implement programme by allotting families to each student and sustaining the follow up throughout the undergraduate period. Objective: 1. To assess the perception of students towards FAP. 2. To assess attitude of students towards FAP Methodology: Medical students who have completed their first year MBBS in RIMS, After obtaining informed oral consent, predesigned semi-structured questionnaire will be distributed to students who have completed their first year of MBBS Raichur will be included in the study. Students who are willing to participate in the study will be included in the study. Results: Will be presented in the conference. Conclusion: As this study aims to find the Perception of FAP for medical students, results of the study can be utilized to analyse the factors and take appropriate actions in the coming days.

Periodically Modified Regulatory Reforms for Implementation of Competency-driven Undergraduate Medical Curriculum in India: A Comparative Analysis

Periodically Modified Regulatory Reforms for Implementation of Competency-driven Undergraduate Medical Curriculum in India: A Comparative Analysis

The Utility of Anatomy Assessment in Preclinical Undergraduate Medical Curriculum: A Scoping Review Protocol

Anatomy has been taught predominantly in the preclinical years. However, little guidance exists for medical educators in designing appropriate assessments of anatomy knowledge. In general, medical schools implement and determine their own curricula and methods of assessment. The purpose of this scoping review is to examine the breadth of literature regarding the utility of anatomy assessments, which will be reported whether they have been investigated in terms of validity, reliability, practicality, feasibility, cost-effectiveness, and educational impact in the included resources. This scoping review will be conducted using the Joanna Briggs Institute (JBI) scoping review guideline, and its protocol is outlined to systematically map the utility of anatomy assessments in preclinical undergraduate medical curricula over the past 20 years. Primary data will be searched from relevant studies, review articles, and grey literature sources between 2002 and 2023. The resource searching will be performed using the three-step search strategy, namely review search, study selection, and evidence charting, which will involve four electronic databases and two independent reviewers. As secondary research, this review does not require ethical approval. The review will not only permit better comparisons of anatomy assessment and foster meaningful evaluation of both medical students and teaching establishments to take place in the anticipation of ensuring the constructive alignment in anatomy education but also produce important information on the quality of anatomy assessment in the context of the undergraduate medical curriculum. The findings will be disseminated through journals and conferences targeting anatomy educators worldwide.

An Overview of Information Instruction in Hospital Libraries in Spain

Introduction: Information instruction is essential to providing support for clinical care, teaching and research in hospitals. In the international literature, little has been published about this function of hospital libraries in Spain. This study examines the education activities of Spanish hospitals.
 Methods: A questionnaire about staff, education activities and institutional recognition was distributed via email to Spanish hospital libraries. The data was analysed in February 2023.
 Results: 84% of libraries provide education activities. The average number education staff is 1.3. Common instruction topics are database searching, citations, researcher identity and scientific journals (quality, impact and publication standards). 83% of libraries are part of the undergraduate medical curriculum, 67% are involved in graduate medical education, and 30% are part of the institutional research plan.

Developing a national undergraduate medical education pain management and substance use disorder curriculum to address the opioid crisis: a program evaluation pilot study

BackgroundPain and addiction are one of the most common reasons for adults to seek health care, yet educational programs focused on pain are often underrepresented in medical school curricula. In January 2021, the Association of Faculties of Medicine of Canada (AFMC) launched an online national, bilingual, competency-based curriculum for undergraduate medical (UGME) students in pain management and substance use in response to the opioid crisis and to bridge the content gaps in programs across Canada. The purpose of this study is to evaluate the pilot of this national curriculum.MethodsUGME students, from across Canada, participated in the program evaluation by completing online pre- and post-program surveys that assessed the influence of the curriculum on participants’ knowledge as well as the value, usability, and feasibility of this curriculum.ResultsParticipants’ perceived confidence in their new knowledge and in utilizing resources required to maintain their knowledge significantly increased (75% and 51% respectively). Their perceived knowledge that addressed the 72 learning objectives within the curriculum significantly increased from pre- to post-program. Over 90% of participants reported that the curriculum was valuable, feasible, and usable. The most frequently discussed program strengths were the clear and comprehensive content, interactive and well-organized design, and relevance of curriculum content for future clinical practice. The overall weakness of the curriculum included the length, repetition of content, the lack of clarity and relevance of the assessment questions, end-user technology issues, and French translation discrepancies. Participant’s recommendations for improving the curriculum included streamlining content, addressing technology issues, and enhancing the clarity and relevance of assessment questions embedded within each of the modules.ConclusionParticipants agreed that an online pain management and substance use curriculum is a valuable, usable, and feasible learning opportunity. Given the severity of the opioid crisis in Canada, these online modules provide a curriculum that can be integrated into existing UGME programs or can provide self-directed learning.

Integrating Shared Decision-Making into Undergraduate Oncology Education: A Pedagogical Framework.

The integration of shared decision-making (SDM) into undergraduate oncology education represents a critical evolution in medical pedagogy, reflecting the growing complexity and patient-centric focus of contemporary healthcare. This paper introduces a comprehensive pedagogical framework designed to embed SDM within the undergraduate medical curriculum, particularly in oncology, where the multiplicity of treatment options and their profound impact on patient life underscore the necessity of this approach. Grounded in a systematic literature review and aligned with established educational theories, this framework proposes twelve strategic approaches to cultivate future physicians proficient in both clinical acumen and patient-collaborative decision-making. The framework emphasizes real-world clinical experience, role-playing, case studies, and decision aids to deepen students' understanding of SDM. It advocates for the development of communication skills, ethical deliberation, and cultural competence, recognizing the multifaceted nature of patient care. The inclusion of patient narratives and evidence-based decision-making further enriches the curriculum, offering a holistic view of patient care. Additionally, the integration of digital tools within the SDM process acknowledges the evolving technological landscape in healthcare. The paper also addresses challenges in implementing this framework, such as curricular constraints and the need for educator training. It underscores the importance of continual evaluation and adaptation of these strategies to the dynamic field of medical education and practice. Overall, this comprehensive approach aims not only to enhance the quality of oncological care but also to prepare medical students for the complexities of modern medicine, where patient involvement in decision-making is both a necessity and an expectation.

Anatomical knowledge enhancement through echocardiography and videos, with a spotlight on cognitive load, self-efficacy, and motivation.

In recent years, there has been a growing recognition of the importance of integrating ultrasound into undergraduate medical curricula. However, empirical evidence is lacking as to its effect on anatomy learning and related student cognition. Therefore, the present study compared the impact of echocardiography-based instruction with narrated videos on students' understanding of anatomical relationships, as well as the interaction with students' autonomous motivation, self-efficacy beliefs, mental load, and attitudes. Second-year medical students were given the opportunity to enroll in a supplementary booster course about cardiac anatomy. On the base of a randomized controlled trial with a cross-over design, we studied the effect of taking this course on spatial anatomical knowledge. After completing a pre-test (T0), students were allocated randomly to either the echocardiography-based teaching condition (cohort A) or the narrated anatomy video condition (cohort B). Next, participants were crossed over to the alternative intervention. Immediately after each phase in the intervention, students were asked to rate their mental load. Additionally, a spatial anatomical knowledge test, an autonomous motivation scale, and a self-efficacy scale were administered before (T0) and after the first intervention (T1) and at the end of the study (T2). Finally, each student completed a perception-based survey. The study design allowed a comparative evaluation of both interventions at T1, while the cross-over design facilitated the assessment of the most optimal sequencing in the interventions at T2. A total of 206 students participated (cohort A: n = 99, cohort B: n = 107). At T1, no significant differences in the knowledge test and the autonomous motivation scale were observed between cohorts A and B. However, cohort A showed higher self-efficacy beliefs compared to cohort B (p = 0.043). Moreover, cohort A reported higher levels of perceived mental load (p < 0.001). At T2, the results showed that neither sequence of interventions resulted in significant differences in anatomy scores, autonomous motivation, or self-efficacy. However, a significant difference in mental load was found again, with students in cohort B reporting a higher level of mental load (p < 0.001). Finally, based on the perception-based survey, students reported favorably on the echocardiography experience. In conclusion, the hands-on echocardiography sessions were highly appreciated by the medical students. After participating in the ultrasound sessions, they reported higher levels of self-efficacy beliefs compared to the video-based condition. However, despite embodied cognition principles, students in the echocardiography condition did not outperform students in the narrated anatomy video condition. The reported levels of mental load in the ultrasound condition could explain these findings.

Professionalism-training in undergraduate medical education in a multi-cultural, multi-ethnic setting in the Gulf Region: an exploration of reflective essays

BackgroundDespite the established need to prioritize professionalism-training in developing future physicians, very few medical programs in the Gulf Region embed in their curricula discrete contextualized courses aimed at developing the corresponding competencies, while fostering self-directed learning. This study aims at exploring the perception of undergraduate medical students in a multi-cultural, multi-ethnic setting regarding their understanding of, and personal experience with professionalism through their engagement with the content of an innovative curriculum-based professionalism course, offered at a Medical School in Dubai, United Arab Emirates.MethodsThe study used a qualitative phenomenological research design. Out of 33 students, 29 students had submitted reflective essays. The content of these essays was inductively analyzed following a six-step framework for conducting thematic analysis. The framework’s steps include familiarizing oneself with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report.FindingsThe inductive qualitative analysis generated the Professionalism Learning Journey model. This conceptual model includes four interconnected themes: Awareness, Acknowledgement, Realization, and Application. The generated model depicts the trajectory that the learners appear to experience while they are engaging with the content of the course.ConclusionIntegrating a professionalism-training course into an undergraduate medical curriculum is likely to be positively appraised by the learners. It raises their awareness, enables them to value the subject matter and the sophistication of its application, and empowers them to put into practice the taught principles, on an individual basis and collectively. This is especially true when the course is entrenched in constructivism experiential learning theory and designed to foster self-directed learning. The introduced conceptual model, in conjunction with the innovative professionalism-training course curriculum, can serve as a template for other competencies and other schools.