Undergraduate Medicine Research Articles

Promoting clinical reasoning in undergraduate Family Medicine curricula through concept mapping: a qualitative approach.

Clinical reasoning is a crucial skill for physicians, enabling them to bridge theoretical knowledge with practical application. The gap between basic sciences and clinical practice persists as a challenge, with traditional teaching methods yet to effectively bridge it. Concept maps (CMs), visual tools for organizing and connecting knowledge, hold promise for enhancing clinical reasoning in the undergraduate medical curriculum. However, further research is required to ascertain if CMs facilitate clinical reasoning development in medical students transitioning from basic sciences to clinical practice. This study aims to delineate how CMs can facilitate clinical reasoning in patients with multimorbidity within undergraduate Family Medicine curricula, as perceived by students and tutors, and to understand the implementation process and resources required. This exploratory qualitative study formed a part of an action research project. While introducing an educational intervention to 5th-year medical students, we conducted a qualitative evaluation. Subsequently, semi-structured group interviews were conducted with students, and a focus group was conducted with tutors. Three main educational impacts were identified: integration of clinical information, support for patient management and care plan, and collaborative learning. Key aspects for successful CM implementation included clear instructions for map construction, using user-friendly software, allocating sufficient time for the task, encouraging group discussion of CMs, and incorporating tutor feedback. CMs are pedagogical tools that facilitate clinical information integration and support management and treatment plans, helping students better understand multimorbidity patients and promoting some components of clinical reasoning in undergraduate medical education.

Practice makes perfect: the development of a medical student-led crowdsourced question bank for self-study in undergraduate medical education.

The development of multiple-choice questions (MCQs) for undergraduate medical education study purposes is resource intensive. Commercially available question banks are typically expensive, only available in English, and may not be aligned with medical school learning objectives. Here, we introduce The Ottawa Question Bank: a student-led, bilingual study resource curated to a Canadian undergraduate medicine curriculum (www.theottawaquestionbank.ca). In total, 205 medical students wrote and edited 4438 original MCQs linked to objectives from the University of Ottawa undergraduate medical education curriculum. The project has received positive feedback from both developers and users. Our experience suggests that involving medical students in MCQ development is feasible and can result in the rapid creation of a low-cost, high-quality study resource curated to a program's learning objectives. The platform outlined here can be used as a model for other medical schools and professional degree programs to develop their own question banks, including pharmacy, dentistry, nursing, and physiotherapy. Interested programs are encouraged to contact our team for collaborative opportunities.

Palliative care education in undergraduate medical and nursing programs in Colombia: a cross-sectional analysis

BackgroundThe number of people suffering from chronic diseases requiring palliative care (PC) is increasing rapidly. Therefore, PC teaching in undergraduate health science programs is necessary to improve primary PC based on international recommendations and available scientific evidence.MethodsA descriptive cross-sectional study was conducted. Active undergraduate medical and nursing programs that were approved by the Colombian Ministry of Education and integrated PC teaching into their curricula were included in the study. The total sample consisted of 48 programs: 31 nursing and 17 medical programs.ResultsPC competencies are distributed throughout the curriculum in 41.67% of programs, in elective courses in 31.25%, and in mandatory courses in 27.08% of the programs. The average PC teaching hours is 81 for nursing and 57.6 for medicine. PC clinical rotations are not offered in 75% of the programs. For undergraduate nursing programs, the most frequent competencies taught are the definition and history of PC and identifying common symptoms associated with advanced disease. In undergraduate medicine, the most common competencies are pharmacological and non-pharmacological pain management and identification of PC needs.ConclusionsPC teaching in undergraduate health science programs mainly addresses the conceptual and theoretical aspects of PC, which are part of the competencies present throughout the programs’ curricula. Low availability of PC clinical rotations was identified. Future studies should assess whether the low availability of clinical rotations in PC limits the ability of students to develop the practical competencies necessary to provide quality PC.Trial registrationNot applicable.

Embracing Diversity in Mental Health Education: A Primary Study on Cultivating Cultural Humility in Undergraduate Medicine

Embracing Diversity in Mental Health Education: A Primary Study on Cultivating Cultural Humility in Undergraduate Medicine

MEDICAL HUMANISM. FICTION OR PARADIGM? THE ROLE OF HUMANISM IN THE TRAINING OF PHYSICIANS

There is still considerable resistance to accepting that the medical humanities could play an important role as core and integrated provision in an undergraduate medicine curriculum. Sceptics towards this curriculum innovation are usually strong proponents of “evidence-based medicine”, where what count as evidence is constrained by scientific paradigm. Arts practi­tioners and humanities scholars are not used to working within such a paradigm that appears constrictive and theoretical rationales for including the medical humanities in medical edu­cation are generally flimsy. The voiced skepticism of many basic science teachers towards the humanities may contribute to the “empathy decline” from the population to medical physicians around the world, the so called “inhumanity” of the medical doctors. Considering the value of humanities as important for the training of the new generation of professionals requires thinking medicine with the incorporation of arts and other areas of humanities. Supporters of the medical humanities point out that it is in the arena of patient-centered narrative based medicine, rather than population-centered evidence, that the medical humanities play a sig­nificant role. Rifts and tensions exist in the worlds of biomedical science and clinical practice as these apply to medical education. However,the question of impact of medical humanities interventions in medical education should be addressed and critically evaluated.

Electronic distance based clinical skills training development in family medicine in Namibia.

Workplace-based evaluation is one of the most important, but challenging aspects of medical education. The aim was to improve the assessment of the rural community-based clinical training for undergraduate 3rd and 4th year family medicine students at the University of Namibia (UNAM) and implement a paperless process. An online module was developed on the Moodle platform to include a study guide, an electronic portfolio, and electronic resources (e-books and apps) to replace the current paper version of the logbook. We explored local resources by engaging with students and clinical trainers on how to best conduct the initial implementation. Engagement also entailed motivating students to actively participate in the implementation process. All 3rd and 4th year community-based education end service (COBES) students are now submitting proof of clinical learning electronically with the use of their phones in their online portfolio and using online resources. In addition, students in the practical family medicine module that has been introduced in the 6th year since 2023 are now also using an electronic portfolio and these assessment tools.Contribution:Overall feedback from students and supervisors indicates a positive atmosphere of learning and constructive feedback on performance from all team members, hopefully improving work-based assessments and ultimately patient care. More members of the primary health care team were involved and the carbon footprint has also been decreased.

Income contingent financing as a guarantee of the right to access higher education for medicine undergraduate programs in Colombia

Income contingent financing as a guarantee of the right to access higher education for medicine undergraduate programs in Colombia

New horizons in undergraduate geriatric medicine education.

Current projections show that between 2000 and 2050, increasing proportions of older individuals will be cared for by a smaller number of healthcare workers, which will exacerbate the existing challenges faced by those who support this patient demographic. This review of a collection of Age and Ageing papers on the topic in the past 10years explores (1) what best practice geriatrics education is and (2) how careers in geriatrics could be made more appealing to improve recruitment and retention. Based on these deeper understandings, we consider, as clinician educators, how to close the gap both pragmatically and theoretically. We point out paradigm shifting solutions that include innovations at the Undergraduate level, use of simulation, incorporation of learner and patient perspectives, upskilling professionals outside of Geriatrics and integration of practice across disciplines through Interprofessional Learning. We also identify an education research methodological gap. Specifically, there is an abundance of simple descriptive or justification studies but few clarification education studies; the latter are essential to develop fresh insights into how Undergraduate students can learn more effectively to meet the needs of the global ageing challenge. A case of improving understanding in delirium education is presented as an illustrative example of a new approach to exploring at greater depth education and outlines suggested directions for the future.

Enhancing General Surgery Clerkships: The Application and Value of Standardized Patient-Based Situational Simulation Teaching.

We explored the value of a standardized patient-based situational simulation teaching method in general surgery internships. A prospective, single-blind, randomized controlled trial was conducted with clinical medicine undergraduates from the 2020 cohort of our university as subjects. These students were randomly divided into a traditional teaching (TT) group and a combined teaching (CT) group based on their internship schedules. The TT group followed the conventional teaching model, while the CT group engaged in the standardized patient-based situational simulation teaching method. The study compared differences in pre-internship theoretical scores, post-internship theoretical scores, medical record writing quality, and student satisfaction between the two groups. The CT group (n=108) significantly outperformed the TT group (n=104) in post-internship theoretical scores and medical record writing quality (allP<0.05) and showed marked improvement in stimulating students' interest in learning (P=0.015), enhancing clinical diagnostic and treatment abilities (P<0.001), improving doctor‒patient communication skills (P<0.001), strengthening medical mission sense (P<0.001), reinforcing physicians' sense of responsibility (P<0.001), and facilitating the application of learned knowledge (P<0.001). These differences were statistically significant. The standardized patient-based situational simulation teaching method (CT) in general surgery internships has been highly recognized by students and can enhance their clinical competency, offering considerable value for broader.

Teaching Research and Effect Observation on the Integration of Clinical Medicine Integrated Course and Ideological and Political Elements from the Perspective of “Sanquan Education”

Purpose: To analyze the application path of the integration of clinical medicine integrated courses with the elements of ideology and politics under the theory of “Sanquan Education,” and to provide references for the promotion of educational reform in medical schools. Methods: 60 clinical medicine undergraduates at Jiamusi University in 2018 and 2019 were randomly selected as research subjects. On the basis of the analysis of students’ characteristics and pre-study content, the students were divided into the integration group and the traditional group, each with 30 students. Students in the integration group carried out clinical medicine integrated class with the integration of ideological and political elements. Students in the traditional group carried out the traditional clinical medicine integrated class. Classroom evaluation scales, anonymous questionnaires, and interviews were used to conduct research, collect data, and compare and observe the application effects. Results: After carrying out different modes of clinical medicine integrated courses, the undergraduates of the Excellent Physician Class in the integration group were higher than those in the traditional group in terms of teaching satisfaction, comprehensive quality, basic knowledge test, and case analysis scores through questionnaire analysis (P &lt; 0.05). In the evaluation of the effect of ideological education, the undergraduates of the Excellent Physician Class of the integration group were higher than the traditional group in terms of the acceptance of doctor-patient communication, the correct rate of mastering the history of the discipline, and the correct rate of mastering the frontiers and policies (P &lt; 0.05). Conclusion: Through the integration of clinical medicine integrated course and ideological and political elements, we can help students establish correct values while teaching them professional knowledge, improve the implementation of moral education in medical schools, cultivate excellent medical workers with high morality and firm beliefs for the society, and realize the fundamental educational task of establishing morality and educating people in medical schools in the context of “Sanquan Education.”

Current status of undergraduate teaching in forensic & legal medicine in Europe

The European Council of Legal Medicine (ECLM) is the body established in 1992 to represent practitioners forensic & legal medicine and is composed of delegates of the countries of the European Union (EU) and from other countries which form part of Europe to a current total of 34 member countries. The aims of this study were to determine the current status of undergraduate forensic & legal medicine teaching in the curriculum of medical studies in ECLM countries and to use the results of this study to determine whether it would be appropriate to develop new guidelines and standards for harmonising the content of undergraduate forensic medicine training across ECLM member countries. A detailed questionnaire was sent to all individuals or organisations listed on the ECLM contact database. Responses were received from 21 of 33 countries on the database. These responses showed considerable emphasis on undergraduate teaching of forensic medicine in all countries with the exception of Belgium and the United Kingdom. There was great general consistency in the subjects taught. The data from this survey provide a baseline which should assist in developing a strategy to harmonise forensic & legal medicine undergraduate training in member countries of the ECLM. The ECLM is now in a good position to establish a pan-European working group to coordinate a consensus document identifying an appropriate and modern core undergraduate forensic medicine curriculum that can be presented to the medical education authorities in each country, and which can be adapted for local requirements, based on available personnel, the forensic medicine structure in the country, and most importantly, the needs of the local population.

Implementation of telemedicine as a medical practice in the undergraduate curriculum

Our study aimed to develop a project to implement telemedicine, using the ProntLife platform, in the clinical and internship cycles of the undergraduate Medicine course at two institutions in the Inspirali group, UNIBH and FASEH, with UNIBH located in Belo Horizonte ( BH), and FASEH in Vespasiano, metropolitan region of BH, Minas Gerais, Brazil. Methodologically, the study is descriptive, qualitative and quantitative. The data taken from ProntLife were treated through content analysis, thematic modality. Furthermore, a literature review was carried out using the PUBMED, LILACS and SCIELO databases. We demonstrate the importance of using telemedicine in simulated practical activities and in the outpatient clinics of Medicine courses, where the positive effects on the training of undergraduates can be assessed, both in skills and competencies, as well as providing vulnerable groups with greater access to health care. It is worth noting that all the positive points reported impact the health services that partner with medical teaching institutions.

Comparison of the effects of using feedback devices for training or simulated cardiopulmonary arrest

BackgroundHigh-quality chest compression is essential for successful cardiac arrest resuscitation. High-quality cardiopulmonary resuscitation (CPR) can effectively improve the survival rate of patients with cardiopulmonary arrest. However, bystanders untrained in cardiopulmonary resuscitation may provide inadequate chest compressions. Previous studies have shown that the use of feedback devices in training alone or in simulated cardiopulmonary arrest alone can improve cardiopulmonary resuscitation. This study aims to determine whether using an audiovisual feedback (AVF) device during CPR training or a simulated cardiopulmonary arrest (CA) scenario would be more effective in improving the quality of chest compressions (CC).MethodsWe use a prospective, randomized, 2 × 2 factorial design trial. A total of 160 participants from Wuhan University and senior clinical medicine undergraduates who had not participated in any CPR training before and had no actual CPR experience are recruited. Each participant is randomized to 1 of 4 permutations, including AVF device vs. no AVF device during CPR training and AVF device vs. no AVF device during simulated CA. Main outcomes and measures are the depth, the percentage of CCs with correct depth (5–6 cm), the rate of CCs, and the percentage of CCs with the correct rate (100–120 cpm).ResultsThe use of the AVF device during simulated CA resulted in improved CC quality. In CA without AVF device, the average compression depth and the percentage of adequate depth with AVF device are 5.1 cm, 5.0 cm and 55.5%, 56.3%, respectively, which are higher than those without AVF device (4.5 cm, 4.7 cm and 32.8%, 33.6%). (p = 0.011, p = 0.000, both < 0.05).Compared with CA without AVF device, the average compression rate and the percentage of adequate rate with AVF device are 112.3 cpm, 111.2 cpm and 79.4%, 83.1%, respectively. The average compression rate and the percentage of adequate rate without using the AVF device are 112.4 cpm, 110.3 cpm and 71.5%, 68.5%, respectively. (p = 0.567 > 0.05, p = 0.017 < 0.05)Although the average compression rate in group D is slightly lower than that in group C, the percentage of suitable frequency with the feedback device is still higher than that without AVF device.ConclusionUsing a feedback device during simulated cardiopulmonary arrest is more effective in improving cardiopulmonary resuscitation than during training.

Development, implementation, and evaluation of an undergraduate family medicine program in the United Arab Emirates

BackgroundHealthcare systems rely on well-trained family medicine physicians who can offer continuous quality services to their communities and beyond. The American Academy of Family Physicians and the World Organization of Family Doctors recommend that medical curricula should have adequately supervised education and training of the learners in family medicine during their preclinical and clinical placements. However, some medical schools don’t have a comprehensive family medicine program to prepare graduates who can meet the community needs. This work aims to report the essential steps for the development, implementation, and evaluation of the family medicine program at the College of Medicine at the University of Sharjah in United Arab Emirates.MethodsWe used the Kern’s 6-step model to describe the development, implementation, and evaluation of the family medicine program. This includes problem identification, needs assessment, goals setting, educational strategies, implementation, and evaluation. During 2014–2022, we longitudinally collected essential information about the family medicine program from different stakeholders including the feedback of clinical coordinators, adjunct clinical faculty, and medical students at the end-of-clerkship. All responses were analysed to determine the effective implementation and evaluation of the family medicine program.ResultsOver the course of 8 academic years, 804 medical students, 49 adjunct clinical faculty and three College of Medicine faculty participated in the evaluation of the family medicine program. The majority of respondents were satisfied with various aspects of the family medicine program, including the skills gained, the organisation of program, and the variety of clinical encounters. The medical students and adjunct clinical faculty suggested the inclusion of e-clinics, faculty development program, and the expansion of more clinical sites for the effectiveness of the family medicine program.ConclusionsWe report a successful development, implementation, and evaluation of the family medicine program in United Arab Emirates with a positive and impactful learning experience. More attention should be paid towards a suitable representation of family medicine program in the medical curriculum with focused and targeted educational plans for medical students.

Wings of Knowledge: Navigating Learner Confidence and Cognitive Load in Avian Radiography with a Low Fidelity Model.

In veterinary first opinion practice, radiography is an important diagnostic tool for avian patients. Teaching of such diagnostic skills to learners is usually conducted using teaching models in clinical skills laboratories. The aim of this work is to evaluate the impact of using a teaching model for avian radiography positioning by measuring learner's cognitive load, confidence, satisfaction, and assessing learning by OSCE assessment. An avian radiography positioning model was created and evaluated with pre- and post-Likert questions on confidence, a pre and post 9-point cognitive load scale, an OSCE assessment (max score = 20), and post Likert questions on satisfaction. Thirty-two undergraduate veterinary medicine and veterinary nursing students participated in the study. The results showed the cognitive load of participants was high and did not change with the use of a physical model (p = .882). Participants exhibited increased confidence in avian radiography positioning (pre; M = 2, post; M = 4, p < .001) and expressed high overall satisfaction with the model (x̄ = 4.6, no negative or neutral Likert responses). The OSCE results demonstrated a higher pass rate mean (82%) for the positioning tasks compared to the collimation and centering tasks (53%). Overall, the model was well received by learners with increased confidence and a satisfactory learning experience in a clinical skill for exotics species. These findings suggest the avian radiography positioning model is an effective model to train students to position avian patients for radiography.

Trabajo colaborativo como método de enseñanza innovador: beneficios y desafíos

IntroductionThe use of innovative teaching methodologies, such as collaborative work, constitutes a significant change for both teachers and students. This method requires greater autonomy from students, and significantly more effort from both students and teachers due to the importance of careful planning and the monitoring of learning. Thus, this teaching model promotes the development of various skills which include critical thinking and self-management. MethodWe carried out a cross-sectional observational study of a collaborative activity used in several classes in the subject Diagnostic Imaging and Physical Medicine in the third year of an undergraduate medicine degree. The students were divided into 13 groups of 8 people, separated using the order of the class list to avoid grouping friends. Each group was given a different clinical case with a radiological image of a bone tumour, and the students were asked to describe it individually at home applying the theory they had been taught in previous Semiology of bone tumours classes. Subsequently and autonomously, they then had to describe it to a classmate from the same group. Later, they described it in groups of 2 and 4 during class time before the group of 8 students finally had to describe it in front of the whole class and try to provide a diagnosis. During the preparatory classes, the teacher went around the groups answering questions. After the final description, the teacher provided feedback. The activity was evaluated through a questionnaire filled out by the students. ResultsThe results of the survey reveal the opinions of the students. Overall, they found the methodology to be appropriate, and 60% of those surveyed said that it facilitated the acquisition of knowledge, is an innovative form of self-learning, increased their level of involvement and improved their relationships with their colleagues. Likewise, more than 50% of the participants believe that collaborative work is an appropriate method for their training, providing them with a greater sense of participation. ConclusionCollaborative work is found to be an appropriate methodology to improve the acquisition of knowledge. However, it requires greater effort and involvement from both teachers and students, which means that students are not keen on applying it to other subjects. Students consider as a drawback the potential for imbalances of participation.

Distribution of cases encountered in Oral Medicine Undergraduate Clinic: A retrospective analysis

Oral medicine (OM) is a dental specialty concerning the diagnosis and non-surgical management of oral conditions closely related to medical disorders. This study aims to evaluate the distribution of OM cases at the International Islamic University Malaysia (IIUM) undergraduate dental polyclinic and to determine its relationship with sociodemographic background via disease category. Students’ OM logbooks across four academic years were used for convenient sampling. Disease categories were based on previously published studies. Total cases were classified into 22 diagnosis codes and analysed using SPSS version 23. A total of 1917 cases were recorded at the undergraduate dental polyclinic across four academic batches, from year 2010 until 2018. OM case with highest frequency was oral ulcer (31%), followed by temporomandibular disorder (23%), and pericoronitis (10%). In contrast, the least common cases were lichen planus (0.4%), oral potentially malignant disease (0.3%), and tumour (0.2%). With regards to age group, second decade age group was reported the most across the observation period. OM cases were higher in females across most disease categories and Malays were the highest ethnicity reported. The current study identified the most common OM cases encountered in IIUM undergraduate dental polyclinic. The findings may portray the disease burden in the Kuantan population in general. Knowledge of common cases is crucial to prepare clinicians with safe and competent management required in clinical practice.

Efficacy of an Antimicrobial Reality Simulator (AMRSim) as an Educational Tool for Teaching Antimicrobial Stewardship to Veterinary Medicine Undergraduates.

Simulation-based medical education has changed the teaching of clinical practice skills, with scenario-based simulations being particularly effective in supporting learning in veterinary medicine. In this study, we explore the efficacy of simulation education to teach infection prevention and control (IPC) as part of Antimicrobial Stewardship (AMS) teaching for early years clinical veterinary medicine undergraduates. The intervention was designed as a 30-minute workshop with a simulation and script delivered online for 130 students as a part of hybrid teaching within the undergraduate curriculum. Learning outcome measures were compared between an intervention group and waitlist-control group using one-way between-groups analysis of covariance tests. Significant differences between groups were found for outcomes measures related to short-term knowledge gain and confidence in IPC and AMS in small animal clinical practice. However, lateral knowledge transfer to large animal species clinical practice showed no significant differences. Student feedback indicated that the intervention was an enjoyable and engaging way to learn AMS. The intervention provided short-term knowledge gain in IPC protocols and enhanced procedural skills via active learning and motivation to learn in large groups of students. Future improvements would be to include large animal clinical scenario discussions and evaluate longer-term knowledge gain.

Oral mucosal disease: dilemmas and challenges in general dental practice

Oral medicine (OM) is a recognised component of all UK undergraduate dental programmes and practising dentists are expected to safely investigate and manage patients presenting with oral mucosal disease. Delivering OM care for patients in a general dental practice setting does however come with a number of challenges and dilemmas for practitioners.General dental practitioners may be limited in their ability to arrange diagnostic tests such as biopsies or blood tests, important in reaching a definitive OM diagnosis. Lack of operator skill or lack of access to appropriate laboratory facilities to process diagnostic samples will likely contribute to this. In addition, general dental practitioners may feel underconfident to reliably interpret test results. Management of OM patients can also be time-consuming and may not generate a significant remunerative reward under current NHS payment systems.OM is a subject that overlaps with several medical specialities, and up until 2010, required dual qualification in both undergraduate dentistry and medicine. Practitioners who have not undertaken OM training beyond undergraduate dentistry may lack confidence with the subject, and fear of misjudging a lesion of concern will certainly prompt referrals from primary care into hospital-based OM clinics.

Problem-Based Learning in Medical Education: A Global Research Landscape of the Last Ten Years (2013-2022).

Problem-based learning (PBL) constructs a curriculum that merges theory and practice by employing clinical scenarios or real-world problems. Originally designed for the pre-clinical phase of undergraduate medicine, PBL has since been integrated into diverse aspects of medical education. Therefore, this study aims to map the global scientific landscape related to PBL in medical education in the last ten years. We combined bibliometrics and network analysis to analyze the metadata of related research articles published between 2013 and 2022 and indexed in the Web of Science Core Collection. Our results show an annual publication rate of 9.42%. The two main journals disseminating research on this subject are BMC Medical Education and Medical Teacher. Education & Educational Research and Health Care Sciences & Services are the two most frequent research areas, and also the two most central nodes of the related network. The USA and China are the most publishing countries, while the Netherlands and Canada are the most collaborative. The Maastricht University holds the position of most publishing and collaborative research organization. The University of California ranks second in publications, while the University of Toronto is the second most central research organization. Our study provides an overview of the last ten years of publications related to PBL and medical education, and we hope it can be of interest to educators, researchers, and students involved with this subject. The online version contains supplementary material available at 10.1007/s40670-024-02003-1.