Years Of Undergraduate Medical Education Research Articles

Performance and preference of problem-based learning (PBL) and lecture-based classes among medical students of Nepal.

Background: PBL (problem based learning) is new active learning educational strategy that has been extensively tested and used in recent years. Patan Academy of Health Sciences (PAHS) is one of medical schools from Nepal, a Low Income Country (LIC) implementing PBL for undergraduate medical education. This study aims to compare PAHS students' understanding and knowledge retention when taught through PBL and lecture-based classes and compare students' perceptions of PBL and lectures in medical education. Methods: This is a cross-sectional study of medical students of a PBL based medical school in Nepal, a non-Western low-income country. Ethical approval was given by the institutional research committee of the Patan Academy of Health Sciences. Understanding and knowledge retention was assessed with 50 vignette-based multiple-choice questions, half of which were taught through PBL sessions, and the remaining half were taught in didactic lectures during basic science years of medical school. A separate pre-validated perception questionnaire was used to assess students' preferences regarding PBL and lectures. Results: Out of 107 students, 99 participated in the understanding and knowledge retention questionnaires and 107 completed perception questionnaires. Understanding and knowledge retention of students was found to be the same for topics taught by PBL and lectures, with median scores of 17 and s16, respectively. PBL were mostly preferred for the physiology (59.81%), pathology (51.40%) and pharmacology (53.27%) concepts, and lectures were mostly preferred for the anatomy (78.50%), biochemistry (45.79%), and microbiology (42.99%) topics. Students wanted the same concepts to be taught through both PBL and lectures, especially for anatomy. Conclusions: Understanding and knowledge retention is the same for topics taught by either PBL or lectures during the basic science years of undergraduate medical education. Students prefer PBL for physiology, pathology, and pharmacology-related concepts, conventional didactic lecture for physiology and microbiology, and a combination of lecture and PBL sessions for anatomy.

Integrating physiology into the first two years of a new osteopathic medical school curriculum.

The integrated curriculum is a hot topic in curriculum reform in undergraduate medical education; however, there are varying definitions of the term, and resources guiding the integration of specific disciplines throughout the first 2years of undergraduate medical education in a learner-centered curriculum are limited. Our first class matriculated into our osteopathic medical school in 2017, and since then we have developed and implemented a learner-centered, integrated curriculum that begins on day one for our learners. This paper will discuss our experience with the development and implementation of the University of the Incarnate Word School of Osteopathic Medicine (UIWSOM) curriculum with specific emphasis on how we incorporate physiology into it.

Diagnostic branched tree as an assessment and feedback tool in undergraduate pharmacology education

BackgroundMultiple-choice, true-false, completion, matching, oral presentation type questions have been used as an evaluation criterion in medical education for many years. Although not as old as other question types, performance evaluation and portfolio-like assessment types, can be called alternative evaluation, have been used for a considerable time. While summative assessment maintains its importance in medical education, the value of formative assessment is gradually increasing. In this research, the use of Diagnostic Branched Tree (DBT), which is used both as a diagnostic and feedback tool, in pharmacology education was examined.MethodsThe study was conducted on 165 students (112 DBT, 53 non-DBT) on the 3rd year of undergraduate medical education. 16 DBTs prepared by the researchers were used as data collection tool. Year 3 first committee was elected for implementation. DBTs were prepared according to the pharmacology learning objectives within the committee. Descriptive statistics, correlation and comparison analyzes were used in the analysis of the data.ResultsDBTs with the most wrong exits are DBTs entitled phase studies, metabolism, types of antagonism, dose-response relationship, affinity and intrinsic activity, G-protein coupled receptors, receptor types, penicillins and cephalosporins. When each question in the DBTs is examined separately, it is seen that most of the students could not answer the questions correctly regarding phase studies, drugs that cause cytochrome enzyme inhibition, elimination kinetics, chemical antagonism definition, gradual and quantal dose response curves, intrinsic activity and inverse agonist definitions, important characteristics of endogenous ligands, changes in the cell as a result of G-protein activation, ionotropic receptor examples, mechanism of action of beta-lactamase inhibitors, excretion mechanism of penicillins, differences of cephalosporins according to generations. As a result of the correlation analysis, the correlation value calculated between the DBT total score and the pharmacology total score in the committee exam. The comparisons showed that the average score of the pharmacology questions in the committee exam of the students who participated in the DBT activity was higher than the students who did not participate.ConclusionsThe study concluded that DBTs are a candidate for an effective diagnostic and feedback tool. Although this result was supported by research at different educational levels, support could not be shown in medical education due to the lack of DBT research in medical education. Future research on DBTs in medical education may strengthen or refute our research results. In our study, receiving feedback with DBT had a positive effect on the success of the pharmacology education.

Incorporating ultrasound training into undergraduate medical education in a faculty-limited setting

BackgroundPoint of care ultrasound (POCUS) is becoming a major extension of patient care. From diagnostic efficacy to its widespread accessibility, POCUS has expanded beyond emergency departments to be a tool utilized by many specialties. With the expansion of its use, medical education has begun to implement ultrasound education earlier in curricula. However, at institutions without a formal ultrasound fellowship or curriculum, these students lack the fundamental knowledge of ultrasound. At our institution, we set out to incorporate an ultrasound curriculum, into undergraduate medical education utilizing a single faculty member and minimal curricular time.MethodsOur stepwise implementation began with the development of a 3-hour fourth-year (M4) Emergency Medicine clerkship ultrasound teaching session, which included pre- and post-tests as well as a survey. The success with this session progressed to the development of a designated fourth-year ultrasound elective, which was evaluated with narrative feedback. Finally, we developed six 1-hour ultrasound sessions that correlated with first-year (M1) gross anatomy and physiology. A single faculty member was responsible for this curriculum and other instructors included residents, M4 students, and second-year (M2) near-peer tutors. These sessions also included pre- and post-tests and a survey. Due to curricular time limitations, all but the M4 Emergency Medicine clerkship session were optional.Results87 students participated in the emergency medicine clerkship ultrasound session and 166 M1 students participated in the voluntary anatomy and physiology ultrasound sessions. All participants agreed or strongly agreed that they would like more ultrasound training, that ultrasound training should be integrated into all four years of undergraduate medical education. Students were in strong agreement that the ultrasound sessions helped increase understanding of anatomy and anatomical identification with ultrasound.ConclusionWe describe the stepwise addition of ultrasound into the undergraduate medical education curriculum of an institution with limited faculty and curricular time.

Biases towards different patients groups. How do they differ during medical education?

ObjectiveThis cross-sectional study was a first to attempt to assess how biases towards age, gender and sexual orientation differ during the years of undergraduate medical education. Methods600 medical students from the first, third and sixth year of study participated in the study. Three questionnaires were used: The Ambivalent Sexism Inventory scale (ASI), the Fraboni Scale of Ageism (FSA) and the Homophobia scale (HSc). ResultsResults showed statistical significant differences between the three groups in the total scores of ageism and homophobia. Students in the last year of studies reported more ageist and more homophobic biases than students in the first year of their studies. ConclusionsOur results demonstrate a need for education to reduce/address/mitigate bias in medical students. Τhe finding that biases increase in students who are farther along in their education needs further investigation. This warrants particular attention to determine if this is a change due to the medical education process itself. Practice implicationsMedical education should teach students about diversity and acceptability with updated curriculums and designed interventions.

The gaps in undergraduate medical education due to the ongoing pandemic: An experience from a private medical college in Kerala.

The Covid-19 pandemic affected undergraduate medical education worldwide. By March 2020, colleges in India had to close following a national lockdown. Most of the colleges including ours started using e-platforms. Our earlier studies highlighted concern for lack of patient examination in clinical settings and successes of the online teaching programmes were limited to didactic teaching. The year 2020 also was the year in which the National Medical Commission (NMC) introduced a competency-based system, which was new to all stakeholders. We assessed the impact of Covid-19 on the ongoing teaching pattern in our institute. Actual coverage of theory classes and practical/clinical teaching sessions were gathered from departments across all years of undergraduate medical education and the gap percentage was calculated against the NMC/ Medical Council of India requirements. The gap percentage was calculated as missing classes divided by required classes multiplied by hundred. The heads of departments were consulted, and details of theory, practical and clinical classes taken for each batch before and after lockdown were gathered using a questionnaire. These were compared against the mandated teaching by the NMC guideline for theory, practical and clinics. The results showed a gap ranging from 2% to 83% for theory classes, the least being in anatomy and the highest being in medicine. As there were no practical or clinical sessions during the lockdown, the gap was zero. Various challenges were faced due to online medical education. There was a dilemma over choosing the type of training that would produce adequate numbers with low quality or a delayed training but of assured quality. Various solutions including suspending the ongoing course and converting it to short-term skill training sessions to deal with pandemic care and strategies to improve online teaching were considered.

Using Ultrasound to Augment Exam Skills Among Clerkship Students.

Point-of-care ultrasound (POCUS) is becoming more common as a diagnostic and clinical tool. Some medical schools have incorporated POCUS training in their curriculum. A family medicine clerkship during the third year of undergraduate medical education is appropriate for incorporating musculoskeletal (MSK) education. Musculoskeletal ultrasound (MSKUS) is a potential tool for augmenting this teaching. Third-year undergraduate family medicine clerkship students were given prework related to ultrasound physics, terminology, and sonographic appearance of MSK structures. This was followed by a 2-hour session in the first week of their clerkship covering the shoulder and knee MSK exams, and incorporated hands-on scanning. Students practiced MSK exams during their 8-week clerkship and POCUS was available in clinic. They were administered a postsession survey to rate the MSKUS curriculum. Objective, structured clinical exam (OSCE) testing, including performance evaluation of the knee examination during the final clerkship week, was compared to prior-year OSCE scores. Third-year medical students felt the use of MSKUS was helpful and enhanced overall understanding of MSK exams. We did not see an improvement in OSCE scores. Students reported a desire for more POCUS training. POCUS is a powerful tool within the clinical and academic setting. We were able to develop a curriculum using MSKUS to augment teaching the shoulder and knee exams to third-year family medicine clerkship students. While we did not see an improvement in OSCE scores evaluating the performance of a knee exam, students reported greater understanding of the exams with the MSKUS instruction added. Students desire more POCUS training in the undergraduate medical curriculum.

COVID-19 related disruptions to medical education and perceived clinical capability of new resident physicians: a nationwide study of over 1200 first-year residents

ABSTRACT The COVID-19 pandemic transformed the final year of undergraduate medical education for thousands of medical students across the globe. Out of concern for spreading SARS-CoV-2 and conserving personal protective equipment, many students experienced declines in bedside clinical exposures. The perceived competency of this class within the context of the pandemic is unclear. We designed and distributed a survey to measure the degree to which recent medical school graduates from the USA felt clinically prepared on 13 core clinical skills. Of the 1283 graduates who matched at HCA Healthcare facilities, 90% (1156) completed the survey. In this national survey, most participants felt they were competent in their clinical skills. However, approximately one out of four soon-to-be residents felt they were clinically below where they should be with regard to calling consultations, performing procedures, and performing pelvic and rectal exams. One in five felt they were below where they should be with regard to safely transitioning care. These perceived deficits in important skill sets suggest the need for evaluation and revised educational approaches in these areas, especially when traditional in-person practical skills teaching and practice are disrupted.

Leveraging existing education innovations to establish a community of practice to promote medical education scholar development

ABSTRACT Problem While some academic health centers have organizational structures to support educational scholarship, such as Medical Education Research Units (MERU), many education scholars may lack access to such institutional resources to support their research agenda and professional growth. Approach In 2014, as part of an externally funded education grant, three faculty educators established a unique education data management system Research & Evaluation Data for Educational Improvement (REDEI). Lacking an institutional MERU, they established an educational research community of practice (CoP) using REDEI as the research dataset. The senior faculty member’s effort to facilitate the group is funded by the Dean’s Office. Outcomes The CoP meets every 2 weeks to generate research ideas, discuss analytic approach and strategy, review analyses designed to address or explore a research question, and plans for manuscript development. Our CoP has grown from 3 to 18 members representing faculty educators, administrators, and staff across many departments in the School of Medicine. As of 2021, the REDEI system contains performance data on 1,246 students across all years of undergraduate medical education. To date, we have published 11 peer-reviewed educational research manuscripts. Five learners have served as coauthors (three medical students and two residents), three of whom were first authors. Eleven additional papers are in process. This community of practice supports productivity, provides mentorship, overcomes barriers, and is flexible enough for people to join when they can or when an area of interest is actively under development. Next Steps We are working on educational interdisciplinary research grant submission and creating collaborations with other institutions. Our focus remains on honing skills in grantsmanship, identification of impactful research questions, application of rigorous methods and instrumentation to address them, and refining process of budget development, timelines, and other planning strategies.

A hierarchy of needs for remote undergraduate medical education: lessons from the medical student experience

PurposeThe disruption of undergraduate medical education (UME) by the COVID-19 pandemic has sparked rapid, real-time adjustments by medical educators and students. While much is known about online teaching in general, little guidance is available to medical educators on how to adapt courses not originally designed for the online environment. To guide our faculty in this transition we conducted a needs assessment of students enrolled in virtual courses across all 4 years of UME training.MethodsUsing a mixed-methods approach, we conducted a single-institution virtual learning needs assessment in May and June of 2020. We developed and disseminated a survey to assess student experiences with virtual learning. We conducted quantitative and qualitative analysis of responses (n = 255 or 39%) to identify emergent themes.ResultsWe identified six interdependent themes that need to be met for medical students to fully reach their learning potential: access to stable internet and quiet study spaces, flexible course design with asynchronous, self-paced components, clear expectations for engagement with content and each other, a sense of connectedness with faculty and peers, synchronous classes that maximize interactivity, and assessments that foster a sense of learning over performance. Interpersonal relationships with faculty and peers affected students’ sense of learning more than any other factor.ConclusionsBased on our findings we propose a hierarchy of needs for virtual learning that provides guidance on adapting existing medical school courses to the remote setting and overcoming common challenges. We highlight opportunities for how virtual elements may enrich in-person courses going forward, including in the clinical setting. Although the solutions required to meet the threshold of need at each level may differ based on the context, attending to these same fundamental needs can be extrapolated and applied to learners across a range of environments beyond the virtual.

Objectification, Desensitization, and Personification: Medical Student Strategies for Dealing with Human Body in the Anatomy Lab

Introduction & PurposeCadaver labs play a significant role in supporting learners form a professional attitude towards human body. Most medical students have their first authoritative encounter with human body in a cadaver lab where they get a right to manipulate and cut through the body. Dealing with death and dissection of the body may simply be a unique learning experience for some but it can be an emotional roller coaster for others. A few student strategies for dealing with cadaver bodies (such as objectification of the body) are documented in the literature but a full range of such strategies is rarely investigated. This study sought to understand the range of strategies medical students use for dealing with cadaver bodies in the anatomy lab at one medical school.MethodsTwenty semi‐structured interviews and four focus groups were conducted with a total of 44 students from all four years of undergraduate medical education at Indiana University School of Medicine, in 2019. All sessions were audio‐recorded and later transcribed verbatim. A qualitative thematic analysis was performed by developing an inductive coding scheme which resulted in emergence of salient themes from the data.ResultsThe full spectrum of student strategies for dealing with cadaver bodies included: 1) complete, effortless objectification of cadaver’s body as a non‐living thing, 2) actively desensitizing oneself toward cadaver’s body as so to be able to work with it, and 3) paralyzing personification of the cadaver’s body that impedes learning from it let alone dissecting it. Falling within this spectrum were also the so‐called middle ground strategies that were chosen by students attempting to adopt a more balanced behavior between desensitization and personification but still found themselves alternating between those two positions at certain times.ConclusionStudents employ certain strategies for handling human body in the cadaver lab. These strategies are based on their personal values and/or actively chosen to help them make the most out of their experience working with cadavers in the anatomy lab.Significance/ImplicationsLearning to deal with cadaver bodies in a professional manner is an impactful part of medical students’ professional identity formation process. The way students handle those bodies is likely to impact their attitude toward their patients’ bodies in the future as a doctor. Understanding the full range of student strategies for handling bodies in cadaver lab is a critical step for anatomy lab educators to facilitate a healthy, professional, ethical, and at the same time humane relationship between students and their cadaver’s body. Future studies should dig deeper into each of the strategies identified here and explore the best ways to oversee them for an effective medical professional identity formation in medical students.

Student Perspectives of Threshold Concepts in Undergraduate Medical Education for Understanding the Structure and Function of the Human Body

The purpose of a curriculum is to produce individuals with proficiency in content knowledge, ability to apply knowledge, and eventually become experts in a given field. One theory of how students transition into thinking like an expert is through the acquisition of threshold concepts. Threshold concepts are pieces of knowledge in a field that, once understood, produce a qualitative shift in a student’s thinking and increases their potential to become an expert in that field. There is sparse research in threshold concepts in medical education, and most of the current literature either focuses on aspects of clinical practice or serves as a discussion piece with no empirical evidence. There are even fewer studies that attempt to identify the threshold concepts for understanding the scientific principles that underlie medicine as a field, and these studies often rely only on expert opinions. This is a shortcoming since experts in undergraduate medical education, often Ph.D. researchers, have a very different perspective than the medical student currently grappling with the scientific concepts for the first time. This study aims to address this gap in the literature by conducting focus groups with medical students in all four years of undergraduate medical education (M1‐M4) at a large allopathic medical school to examine which concepts students identify as threshold concepts in medical education for understanding the human biology. All curricular years were included determine the student perspectives at each stage of undergraduate medical education and capture any potential shifts throughout the medical curriculum in the clinical and pre‐clinical years. Sessions were semi‐structured and asked questions that inquired about the threshold concepts for understanding the human biology for medical practice. Focus group sessions were recorded, transcribed and analyzed using thematic analysis. Three M4 students, ten M3 students, nine M2 students and four M1 students participated in focus groups. At the present time, data are still undergoing thematic analysis. Thus far, the major codes emerging pertain to cardiovascular, pulmonary, renal physiology and neurobiology as potential threshold concepts. Students also identified as pathology as a potential threshold concept since it integrates the knowledge they have previously learned and applies it to medical practice. A theme that appears to be emerging is the importance of hands‐on patient/clinical experience to push students through the threshold into understanding a particular scientific concept. As the analysis of the data is completed, the results of this study will offer insight for medical educators on how to adapt their curricula to better suit the needs of their students. This may include further integration of basic science and clinical education, providing students opportunities to work with patients earlier in their education and/or shifting the emphasis to the most clinically relevant systems.

Performance and preference of problem-based learning (PBL) and lecture-based classes among medical students of Nepal

Background: PBL (problem based learning) is new active learning educational strategy that has been extensively tested and used in recent years. This study aims to compare students' understanding and knowledge retention when taught through PBL and lecture-based classes and compare PAHS students' perceptions of PBL and lectures in medical education. Methods: This is a cross-sectional study of medical students of a PBL based medical school in Nepal, a non-Western low-income country. Ethical approval was given by the institutional research committee of the Patan Academy of Health Sciences. Understanding and knowledge retention was assessed with 50 vignette-based multiple-choice questions, half of which were taught through PBL sessions, and the remaining half were taught in didactic lectures during basic science years of medical school. A separate pre-validated perception questionnaire was used to assess students' preferences regarding PBL and lectures. Results: Out of 107 students, 99 participated in the understanding and knowledge retention questionnaires and 107 completed perception questionnaires. Understanding and knowledge retention of students was found to be the same for topics taught by PBL and lectures, with median scores of 17 and s16, respectively. PBL were mostly preferred for the physiology (59.81%), pathology (51.40%) and pharmacology (53.27%) concepts, and lectures were mostly preferred for the anatomy (78.50%), biochemistry (45.79%), and microbiology (42.99%) topics. Students wanted the same concepts to be taught through both PBL and lectures, especially for anatomy. Conclusions: Understanding and knowledge retention is the same for topics taught by either PBL or lectures during the basic science years of undergraduate medical education. Students prefer PBL for physiology, pathology, and pharmacology-related concepts, conventional didactic lecture for physiology and microbiology, and a combination of lecture and PBL sessions for anatomy.

Performance and preference of problem-based learning (PBL) and lecture-based classes among medical students of Nepal

Background: PBL (problem based learning) is new active learning educational strategy that has been extensively tested and used in recent years. This study aims to compare students' understanding and knowledge retention when taught through PBL and lecture-based classes and compare PAHS students' perceptions of PBL and lectures in medical education. Methods: This is a cross-sectional study of medical students of a PBL based medical school in Nepal, a non-Western low-income country. Ethical approval was given by the institutional research committee of the Patan Academy of Health Sciences. Understanding and knowledge retention was assessed with 50 vignette-based multiple-choice questions, half of which were taught through PBL sessions, and the remaining half were taught in didactic lectures during basic science years of medical school. A separate pre-validated perception questionnaire was used to assess students' preferences regarding PBL and lectures. Results: Out of 107 students, 99 participated in the understanding and knowledge retention questionnaires and 107 completed perception questionnaires. Understanding and knowledge retention of students was found to be the same for topics taught by PBL and lectures, with median scores of 17 and s16, respectively. PBL were mostly preferred for the physiology (59.81%), pathology (51.40%) and pharmacology (53.27%) concepts, and lectures were mostly preferred for the anatomy (78.50%), biochemistry (45.79%), and microbiology (42.99%) topics. Students wanted the same concepts to be taught through both PBL and lectures, especially for anatomy. Conclusions: Understanding and knowledge retention is the same for topics taught by either PBL or lectures during the basic science years of undergraduate medical education. Students prefer PBL for physiology, pathology, and pharmacology-related concepts, conventional didactic lecture for physiology and microbiology, and a combination of lecture and PBL sessions for anatomy.

Evaluation of an elective ultrasound course for medical students.

To evaluate the educational benefits of teaching ultrasound in an elective radiological course for medical students. We conducted a single-center retrospective analysis of a one-week elective ultrasound course in which 39 medical students (25 female; median age 25.8 ± 2.8 years, range 21-35, 4th and 5th years of undergraduate medical education) participated as part of their radiological training. The students completed a pre- and post-course questionnaire using a five-point Likert scale for self-assessment of technical knowledge, confidence in the procedure regarding different organs, motivation for performing ultrasound, and the importance of ultrasound in medical education. The students also assessed the value of ultrasound teaching in the context of their general medical degree. Pre-test and post-test scores showed significantly improved radiology knowledge (p ≤ 0.001) concerning all abdominal organs (liver, spleen, gallbladder, kidney, urinary bladder, aorta and retroperitoneum). A significant improvement was registered in performing ultrasound of peripheral arteries and venous structures (each p=0.001), and also of the thyroid gland (p=0.006). General surveys at the end of the elective were overwhelmingly positive, with constructive criticism and complimentary comments. Systematic training in ultrasound markedly improved the students' skills. This was especially pronounced for solid organ structures, while students requested more education regarding the retroperitoneum and vascular structures. Teaching ultrasound in an elective hands-on training course improves anatomical understanding and practical skills associated with increased motivation. The results affirm the necessity and clinical relevance of the course during the radiological training of medical students.

Assessment Methods Used during Clinical Years of Undergraduate Medical Education at Moi University School of Medicine, Kenya

Background: Assessment is the systematic collection, review, and use of information about educational programs undertaken to improve teaching and learning. It ensures quality in training programmes, motivates, and directs students’ learning. Assessment is also used for verification of achievement of objectives of training, feedback to students, licencing, certification, and screening of students for advanced training. It is guided by several principles, including the aims of the assessment (why assess), who to assess, timing (when to assess), what to assess, methods (how to assess), and the criteria for determining the usefulness of the assessment. Objective: To describe the assessment methods used during clinical years of the undergraduate programme at Moi University School of Medicine (MUSOM) and determine the student’s perspectives concerning the comprehensiveness, relevance, objectivity of various assessment methods and challenges faced. Methodology: The study was carried out at MUSOM and a cross-sectional study design was employed. Ten study participants were studied using convenience sampling. Data were collected using an interview guide and was analyzed using content analysis. An informed consent was obtained from the study participants. Results: The methods used during clinical years at MUSOM for assessing knowledge and its applications include multiple-choice questions (MCQ), short answer questions (SAQ), modified essay questions (MEQ), long essay questions (LEQ), and oral exam. Whereas the methods for assessing clinical competence include long case, short cases, objective structured clinical examinations (OSCE), and logbook. Students felt that MCQs were comprehensive, objective, and relevant to the curriculum content. They reported that feedback was not provided after assessments. Conclusion: The assessment methods used at MUSOM during clinical years include MCQ, SAQ, MEQ, LEQ, Short cases, long cases, and OSCE. Students reported varied perceptions of the different assessment methods but favored MCQ and OSCE over other formats for assessing knowledge and clinical skills respectively.

Exploring the Validity Based on Internal Structure of the Oldenburg Burnout Inventory – Medical Student (OLBI-MS)

Construct The study gathers validity evidence for the use of the Oldenburg Burnout Inventory – Medical Student (OLBI-MS), a 16-item scale used to measure medical student burnout. The 16 items on the OLBI-MS are split to form two subscales, disengagement and exhaustion. Background Medical student burnout has been empirically linked to several detrimental professional and personal consequences. In recognition of the high prevalence of medical student burnout, one recommendation has been to regularly measure burnout using standardized measures that have strong validity evidence for their intended use. The OLBI-MS, a frequently used measure of medical student burnout, was adapted from the Oldenburg Burnout Inventory (OLBI). The OLBI has been studied in many occupational settings and been found to have a two-factor solution in majority of these populations, but there is limited validity evidence available that supports the use of the OLBI-MS subscales in a medical student population. Approach Two years of Association of American Medical College Year 2 Questionnaire data (n = 24,008) were used in the study for a series of exploratory and confirmatory factor analyses. The data from the first year (n = 11,586) was randomly split into a confirmatory and exploratory sample, with the data from the second year (n = 12,422) used as a secondary confirmatory sample. Because the questionnaire is administered to medical students during their second year of undergraduate medical education, we consider this a study as providing validity evidence specifically for the measure’s use with that population. Findings The two-factor structure of the OLBI-MS was not empirically supported in the second year medical-student population. Several of the items had low inter-item correlations and/or moderate correlations with unexpected items. Three modified versions of the OLBI-MS were tested using subsets of the original items. Two of the modified versions were adequate statistical explanations of the relationships in the data. However, it is unclear if these revised scales appropriately measure all aspects of the construct of burnout and additional validity evidence is needed prior to their use. Conclusions The use of the OLBI-MS is not recommended for measuring second-year medical student burnout. It is unclear if the OLBI-MS is appropriate for medical students at all, or if different measures are necessary at different stages in a medical student’s professional development. Additional research is needed to either improve the OLBI-MS or use it as a foundation for a new measure. Supplemental data for this article is available online at at www.tandfonline.com/htlm .

The PASS Course: Practical Anatomy and Surgical Skills Course as a Pragmatic Primer for Senior Medical Students Pursuing Surgical Residency.

The senior year of undergraduate medical education has been scrutinized for lacking emphasis from educators and value for students. Surgical residency program directors and medical students have reported different sets of perceived weaknesses as surgical trainees enter residency. With this in mind, we developed a novel rotation for senior medical students pursuing surgical residency. The rotation incorporates practical didactics, robust skill and simulation training, and an enriching anatomy experience that entails dissections and operations on embalmed and fresh tissue cadavers. To our knowledge, this is the first reported formal training experience for medical students that involves working with fresh tissue cadavers, which have been described as effective models for live human tissue in the operating room. We describe our multifaceted curriculum in detail, discuss its organization, and elaborate on its potential value. We also provide detailed explanations of the curriculum components so that other surgical educators may consider adopting them.

Brain networks and medical education

<p><strong>Background:</strong> There has been significant progress in understanding the human brain with the development of modalities like functional magnetic resonance imaging (fMRI), positron emission tomography (PET) etc. Education is an important source of intellectual, emotional and cultural stimulus to the brain. In this resting fMRI study, we aim to map out specific regions in the brain in which changes occur relating to memory, language, motor, behavioural and cognitive functions after five years of undergraduate medical education and how this knowledge can bring us closer to understanding the brain and its functions and applications in clinical practice.</p><p><strong>Methods:</strong> A total number of 48 normal, healthy medical students from our medical college were included in the study, and were divided into two groups, the first group completed five years of under-graduate medical training and the second group consisted of individuals who had only 4 months of exposure to medical training. Resting state fMRI study was performed and seed-to-voxel based functional connectivity analysis method was used to derive between group differences</p><p><strong>Results: </strong>Out of the 48, 13 played one or more sport professionally, 8 were musically oriented with skills to play one or more musical instrument professionally and 9 had other talents (2-Good academic, 2-theatre, 3-dancing, 2-art like pottery and painting). <strong></strong></p><p><strong>Conclusions:</strong> There were significant differences in the right inferior temporal gyrus which is the seat of many cognitive functions like language, emotion and memory and the left cerebellar hemisphere, which is known to play a role in fine motor functions, language and visual learning.</p>

Palliative care in undergraduate medical education - consolidation of the learning contents of palliative care in the final academic year.

Background: Demographic change and the medical imperative to accompany patients at all times and also in the case of illness leading to death require good basic knowledge of palliative care in large parts of the medical profession. Palliative care has been introduced into undergraduate medical education as a compulsory subject: “interdisciplinary subject 13 palliative care” (Q13). While course concepts for Q13 have already been positively evaluated, assessment of the consolidation and practical relevance of the knowledge taught is lacking.Methods: Assessment of the consolidation of the learning content from Q13 after the practical year (the “practical year” is the sixth and final year of undergraduate medical education in Germany) by means of a survey with a proven questionnaire and integrated qualitative free-text analysis of a cohort of medical students (n=176) who had already participated in an evaluation before and after Q13.Results: The response rate was 96% after Q13 and 45% after the practical year (PY). Teaching was predominantly perceived as more helpful than the PY (p<0.001). Compared to the status after Q13, students rated themselves as less competent after the PY in all areas surveyed, including drug-based pain therapy (p=0.0386). The certainty in informing patients about the incurability of the disease also decreased significantly after the PY (p=0.0117), although the preparation in Q13 was positively highlighted.Conclusion: The knowledge acquired in Q13 could not be anchored in the PY. On the contrary, after initial practical experiences, the students found it challenging to conduct conversations in cases of serious illness and to deal with their own uncertainty in the care of seriously ill patients. Structural factors regarding palliative care in the PY, as well as intrinsic motives of students, such as prior knowledge or motivation to learn, should be analyzed to identify ways to close the gap between theoretical and practical training in general palliative care. To generate samples that are sufficiently representative, future studies on teaching should be easily accessible to students and consider attractive forms of evaluation including electronic methods and social media.