Year Of Medical School Research Articles

Attracting medical school graduates to residency programs in remotely located hospitals: the challenge lies beyond financial incentives

BackgroundRecruitment to residency programs in hospitals located in other than major hubs (“remotely located”) is a challenge in many countries. In 2011, the Israeli Ministry of Health launched a 10-year financial incentive to encourage physicians to enroll in residency programs in such hospitals. Nearly 1 billion New Israeli Shekels (260 million US$) were invested in that program which had only limited success. As a new physician association’s collective agreement is impending, we aimed to measure the effectiveness of selected incentives in attracting medical school graduates to residencies in remotely located hospitals.MethodsThis study included Israeli medical students in their final year of medical school. We used an online questionnaire with multiple-choice demographic questions and a 5-point Likert scale to gauge the effect of various incentives on their preference for residency location.ResultsBetween July and November 2022, 522 students responded (405 studied in Israeli medical schools [out of 705 students] and 117 in foreign medical schools [out of 1936 students]). Forty-two percent had at least one clerkship in a remotely located hospital, and 24% had included at least one remotely located hospital among their top five choices for internship. Only 13% reported that they prefer a residency program in those institutions. The incentive selected by students as most persuasive was government assistance in acceptance to and financial support for a fellowship abroad, followed by a financial grant and fewer on-call hours. Only 7% of the students indicated that no incentive would influence them to choose a remotely located hospital for their residency training. Medical education in a remotely located university and the choice of at least one remotely located hospital among the top five choices for internship were significantly associated with positive incentive receptivity, whereas male sex and older age were associated with negative receptivity.ConclusionThis study on the attitudes of Israeli medical school graduates toward incentives aimed at attracting them to residencies in remotely located institutions revealed that career development opportunities and assistance in obtaining fellowships might influence their choice.

Analysis of self-reported confidence in independent prescribing among osteopathic medical graduating seniors.

Prescribing medications is one of the physicians' most important professional activities throughout their careers. Lack of confidence and competency to prescribe may lead to preventable medical errors. The prevalence of prescription errors among new graduate physicians has been widely studied. Studies have linked this to inadequate foundational pharmacology education and work environment, among other factors. Suggestions were made for different educational interventions to increase the physicians' confidence and competency in prescribing to reduce the risk of medical errors. However, many of these studies were about students or graduates of medical schools other than osteopathic medical schools. This study analyzed the self-reported confidence of graduating seniors in the United States osteopathic medical schools in their current ability to prescribe safely and independently and the possible associated factors. This study analyzed secondary data on the graduating seniors' surveys published by the American Association of Colleges of Osteopathic Medicine (AACOM) from the 2012/2013 to 2020/2021 academic years. Data were analyzed utilizing SPSS version 26.0 and MedCalc version 22.009, and statistical inferences were considered significant whenever p≤0.05. The aggregated data show that 38,712 Doctor of Osteopathic Medicine (DO) seniors responded to the AACOM survey, representing 72.1 % of expected graduates during the study period. Most of the DO graduating seniors (70.8 %) reported feeling confident in their current abilities to independently write safe and indicated orders and to prescribe therapies or interventions in various settings. Thepercentage of respondents who perceived the time devoted to clinical pharmacology instruction as appropriate increased systematically over these reported years. A positive correlation was found between the percentage ofstudents who reported the time dedicated to clinical pharmacology as excessive and the percentage of students who reported being confident in prescribing. A statistically significant positive correlation was found between the percentage of students who agreed that the first two years of medical school were well organized and the percentage ofstudents who reported being confident in prescribing. A statistically significant correlation was found between the percentage of students who agreed with statements about frequent interactions with the attendee, testing at the end ofeach rotation, and being prepared for Comprehensive Osteopathic Medical Licensing Examination Level 2-Cognitive Evaluation (COMLEX Level 2-CE) during the required clerkships and the percentage of students who reported being confident in independent prescribing. During this study period, most osteopathic medical graduating seniors (70.8 %) felt confident about their current prescribing abilities; the rest did not, whichcanincrease the risk of preventable medical errors. The prescription confidence may be boosted by more organization for the first 2 years, increasing the time devoted toclinical pharmacology education, and developing more interactive courses during the required clerkships in clinical education.

A Language Model-Powered Simulated Patient With Automated Feedback for History Taking: Prospective Study.

Although history taking is fundamental for diagnosing medical conditions, teaching and providing feedback on the skill can be challenging due to resource constraints. Virtual simulated patients and web-based chatbots have thus emerged as educational tools, with recent advancements in artificial intelligence (AI) such as large language models (LLMs) enhancing their realism and potential to provide feedback. In our study, we aimed to evaluate the effectiveness of a Generative Pretrained Transformer (GPT) 4 model to provide structured feedback on medical students' performance in history taking with a simulated patient. We conducted a prospective study involving medical students performing history taking with a GPT-powered chatbot. To that end, we designed a chatbot to simulate patients' responses and provide immediate feedback on the comprehensiveness of the students' history taking. Students' interactions with the chatbot were analyzed, and feedback from the chatbot was compared with feedback from a human rater. We measured interrater reliability and performed a descriptive analysis to assess the quality of feedback. Most of the study's participants were in their third year of medical school. A total of 1894 question-answer pairs from 106 conversations were included in our analysis. GPT-4's role-play and responses were medically plausible in more than 99% of cases. Interrater reliability between GPT-4 and the human rater showed "almost perfect" agreement (Cohen κ=0.832). Less agreement (κ<0.6) detected for 8 out of 45 feedback categories highlighted topics about which the model's assessments were overly specific or diverged from human judgement. The GPT model was effective in providing structured feedback on history-taking dialogs provided by medical students. Although we unraveled some limitations regarding the specificity of feedback for certain feedback categories, the overall high agreement with human raters suggests that LLMs can be a valuable tool for medical education. Our findings, thus, advocate the careful integration of AI-driven feedback mechanisms in medical training and highlight important aspects when LLMs are used in that context.

Evaluation of the Effect of Nutrition Education on Osteopathic Medical Students' Personal Nutrition Choices and Incorporation Into Future Medical Practice.

Our current research project evaluates the impact of nutrition education on the medical student's personal nutrition goals and the likelihood of incorporating nutrition needs into patient evaluation and treatment plans in future practice. The growing popularity of lifestyle medicine has further emphasized the importance of nutrition in the treatment of all patients, especially those suffering from chronic diseases. The paucity of formal medical nutrition education in medical school curricula leaves a significant gap in the knowledge base of physicians in practice. In an attempt to close the gap, we increased nutrition education in first-year osteopathic medical students by establishing a nutrition course emphasizing modern competencies and their importance in clinical practice. Methods: The course evaluation utilized a two-group quasi-experimental pre-test/post-test study design. The intervention group consisted of medical students participating in the newly established course, and the control group consisted of second-year medical students who had not taken the course as part of their curriculum. Information was collected about students' knowledge, attitudes, behaviors around nutrition, their plans to pursue a residency with a focus on culinary medicine and incorporate medical nutrition into their medical practice in the future, and their intention to incorporate culinary medicine into future treatment plans. Participation rates within a voluntary culinary medicine interest group were also tracked. Students in the intervention group were 26% more likely to report that proper nutrition for patient care had been addressed in coursework. This suggests that medical students exposed to the medical nutrition course have received more training that is critical in proper patient care than students in the control group. Students in the intervention group were 93% more likely to believe that proper nutrition can be used to prevent disease. Lastly, significantly more students in the intervention group (33% more) intend to explore residency programs with a focus on culinary medicine than those students in the control group. These results demonstrate that nutritional education promotes an awareness of the effectiveness of nutritional counseling in disease prevention and management. Furthermore, it will hopefully prompt future physicians to consider nutritional counseling during their clinical rotations, through residency, and into their independent practice. The presentation of nutrition in the first year of medical school is critical to develop increasing numbers of primary care physicians that promote the importance of nutrition and a healthy lifestyle for patients.

Longitudinal variation of correlations between different components of assessment within a medical school

BackgroundAn assessment program should be inclusive and ensure that the various components of medical knowledge, clinical skills, and professionalism are assessed. The level and the variation over time in the strength of the correlation between these components of assessment is still a matter of study. Based on the meaningful learning theory and the integrated learning theory, we hypothesize that these components increase their connections during the medical school course.MethodsThis is a retrospective cohort study that analyzed data collected for a 10-year period in one medical school. We included students from the 3rd to 6th year of medical school from 2011 to 2021. Three assessment components were addressed: Knowledge, Clinical Skills, and Professionalism. For data analysis, Pearson correlation coefficients (R) and R2 were calculated to study the correlation between variables and a z-test on Fisher's r-to-z was used to determine the differences between correlation coefficients.Results949 medical students were included in the study. The correlation between Clinical Skills and Professionalism showed a medium to strong association (Pearson's R ranging from 0.485 to 0.734), while the correlation between Knowledge and Professionalism was weaker but exhibited a steady evolution with Pearson's R fluctuating between 0.075 and 0.218. The Knowledge and Clinical Skills correlation became statistically significant from 2013 onwards and peaking at Pearson's R of 0.440 for the cohort spanning 2016–2019. We also revealed a strengthening of correlations between Professionalism and Clinical Skills from the beginning to the end of clinical training, but not with the knowledge component.ConclusionsThis analysis contributes to our understanding of the dynamics of correlations of different assessment components within an institution and provides a framework for how they interact and influence each other.Trial registrationThis study was not a clinical trial, but a retrospective observational study, without health care interventions. Nevertheless, we provide herein the number of the study as submitted to the Ethics committee – CEICVS 146/2021.

Use of 3D foot and ankle puzzle enhances student understanding of the skeletal anatomy in the early years of medical school

Purpose3D visualization is an important part of learning anatomy with cadavers generally used to effectuate this. However, high cost, ethical considerations, and limited accessibility can often limit the suitability of cadavers as teaching tools. Anatomical 3D printed models offer an alternative tool for teaching gross anatomy due to their low cost and accessibility. This study aims to investigate if combing gamification with 3D printed models can enhance the learning experience and be effective for teaching anatomy.Methods3D printed models of the bones of the foot and ankle were generated, and 267 first-year medical students from 2 consecutive cohorts worked in groups to put it together as a puzzle. Participants completed a questionnaire regarding perceptions of 3D models and their knowledge of foot anatomy, before and after the session and were asked to provide comments.ResultsAnalysis of the responses showed a significant increase in the confidence of the learners in their anatomy knowledge and an increased appreciation of the role that 3D models have in enhancing the learning experience. After the session, there were many comments saying how enjoyable and engaging 3D models were.ConclusionThrough the puzzle element of the session, the students were challenged mentally to work out the anatomical features of the foot and ankle. The combined elements of the puzzle and the features of the 3D model assembly made the activity fun and conducive to active learning. The possibility of having fun was not something the students had considered before the session.

Smartphone Addiction and its Relation to Social Phobia in Female University Students

Abstract Background As smartphones become more accessible and more psychologically gratifying, problematic smartphone use has emerged with negative mental health consequences, especially in young adults with poor social skills and self -confidence issues. The current study aims to assess the rate of occurrence of smartphone addiction and to highlight the relationship between smartphone addiction and social phobia and its severity in a sample of female university students. Subjects and Methods This is a cross-sectional study including 540 female students in the first medical school year divided equally among practical and theoretical faculties after excluding students with psychiatric disorders except for those with social phobia using the SCID-I scale. Subjects were assessed with the Social Phobia Inventory and the Smartphone Addiction Scale for severity of both social phobia and smartphone addiction respectively. Results Out of 540 female students, 28.7% have severe smartphone addiction with higher number in students of academic faculties, also, 71.86% of the whole sample have social phobia with 22.78%, 21.85%, 16.3%, and 10.93% reporting mild, moderate, severe, and very severe social phobia scores respectively. The number of students having very severe social phobia scores in the academic group is higher than that in the practical group. Also the study shows a statistically significant relation between smartphone addiction and social phobia. Conclusion There is a high rate of distribution of social phobia in young adult females, which is accompanied with a high rate of occurrence of smartphone addiction, so, there is a need for raising the public awareness regarding hazards of problematic smartphone use especially in students and the for highlighting the importance of screening of different psychiatric disorders, as social phobia in such population.

156 A Survey of the Estimated Cost of Consumables Amongst UK Medical Students

Abstract Aim With increasing financial difficulties for the NHS, clinician’s awareness of the cost of consumable items utilised is vital. Unfortunately, clinician’s cost-awareness and exposure to health economics amongst students is limited. We hence undertook this survey to assess cost-awareness amongst medical students. Method An online questionnaire was distributed to London medical students. Participants were asked their demographic data and to estimate the cost of 10 consumable items. Each item’s actual cost was compared with the average, median and interquartile range of the estimated price. An estimate was deemed ‘correct’ if it was within 20% of the actual price. Results Across all items 9.63% of estimates were ‘correct’. There was no correlation between medical school or academic year and accuracy of cost-estimation. The most accurately estimated item cost was the ‘10ml syringe’ (19.55%), the least was the ‘1 litre bag of intravenous normal saline’ (0.50%). The most overestimated item cost was the ‘vial of 1.2g intravenous co-amoxiclav’ (median estimate/actual cost = 9.43), the ‘pair of standard sterile surgical gloves’ was the only underestimated item cost (median estimate/actual cost = 0.97). Conclusions We found a poor understanding of the cost of consumables amongst medical students. Whilst a lack of year 6 students and the London geographic limited this study, we believe this is the first large-scale survey assessing the cost of consumables amongst UK students. By providing a benchmark of current knowledge, this survey could serve as a catalyst for the inclusion of health economics in medical school, improving cost-awareness amongst students and doctors.

Where Will I Go? Relative Location of Physical Medicine & Rehabilitation Residencies Compared to Medical Schools Among Recent Residents.

Physical Medicine and Rehabilitation (PM&R) has rapidly been garnering interest as healthcare increases the emphasis on rehabilitation and management for acute and chronic diseases. This study analyzes recent geographical trends of PM&R residents via PM&R residents from 2019 to 2023 which were identified from publicly available data. The relative distribution from medical school to residency, medical school to preliminary program, and preliminary program to residency were analyzed. These locations were categorized as within 100 miles, same state, same region, or different region. Odds ratio (OR) were calculated for the aforementioned relative locations with respect to the presence of a home residency program. A total of 1836 residents were included. The majority of residents (51%) stayed within the same region as their medical school. Residents from medical schools with a home program were more likely to stay within 100 miles (OR: 3.64), the same state (OR: 3.19), and same region (OR: 2.56). Overall, PM&R residents are likely to stay within the same region as their medical school and preliminary year. Additionally, the presence of a home program significantly increases the odds of matching within 100 miles, same state, and same region.

Māori Medical Student and Physician Exposure to Racism, Discrimination, Harassment, and Bullying

Discrimination, bullying, and harassment in medicine have been reported internationally, but exposures for Indigenous medical students and physicians, and for racism specifically, remain less examined. To examine the prevalence of racism, discrimination, bullying, and harassment for Māori medical students and physicians in New Zealand and associations with demographic and clinical characteristics. This cross-sectional study used data from an anonymous national survey of Māori medical students and physicians in New Zealand in late 2021 and early 2022. Data were analyzed from March 2022 to April 2024. Age, gender, marginalized status (ie, in addition to being Māori, belonging to other groups traditionally marginalized or underrepresented in medicine), year of medical school, year of graduation, and main work role. Direct and witnessed racism, discrimination, bullying, and harassment were measured as any experience in the last year and ever. Any exposure to negative comments about social groups and witnessing discriminatory treatment toward Māori patients or whānau (extended family). Considering leaving medicine, including because of mistreatment, was measured. Overall, 205 Māori medical students (median [IQR] age, 23.1 [21.6-24.3] years; 137 [67.2%] women) and 200 physicians (median [IQR] age, 36.6 [30.1-45.3] years; 123 [62.8%] women) responded. Direct and witnessed exposure to racism (184 students [91.5%]; 176 physicians [90.7%]) and discrimination (176 students [85.9%]; 179 physicians [89.5%]) ever in medical education, training, or work environments was common. Ever exposure to witnessed and direct bullying (123 students [66.5%]; 150 physicians [89.3%]) and harassment (73 students [39.5%]; 112 physicians [66.7%]) was also common. Most respondents reported witnessing Māori patients or their whānau being treated badly in clinical settings, in direct interactions (67 students [57.8%]; 112 physicians [58.9%]) or behind their backs (87 students [75.0%]; 138 physicians [72.6%]). One-quarter of Māori medical students (45 students), and 37.0% of physicians (61 physicians) had considered leaving or taken a break from medicine because of these experiences. Additional marginalized statuses were significantly associated with any direct experience of mistreatment in the last year for students and physicians. Exposure to some forms of mistreatment were also significantly associated with higher likelihood of thinking about leaving or taking a break from medicine for physicians. In this study, Māori medical students and physicians reported high exposure to multiple forms of racism, discrimination, bullying, and harassment in medical education, training, and work environments, requiring an urgent response from medical institutions.

Performance of ChatGPT in Solving Questions From the Progress Test (Brazilian National Medical Exam): A Potential Artificial Intelligence Tool in Medical Practice.

Background The use of artificial intelligence (AI) is not a recent phenomenon, but the latest advancements in this technology are making a significant impact across various fields of human knowledge. In medicine, this trend is no different, although it has developed at a slower pace. ChatGPT is an example of an AI-based algorithm capable of answering questions, interpreting phrases, and synthesizing complex information, potentially aiding and even replacing humans in various areas of social interest. Some studies have compared its performance in solving medical knowledge exams with medical students and professionals to verify AI accuracy. This study aimed to measure the performance of ChatGPT in answering questions from the Progress Test from 2021 to 2023. Methodology An observational study was conducted in which questions from the 2021 Progress Test and the regional tests (Southern Institutional Pedagogical Support Center II) of 2022 and 2023 were presented to ChatGPT 3.5. The results obtained were compared with the scores of first- to sixth-year medical students from over 120 Brazilian universities. All questions were presented sequentially, without any modification to their structure. After each question was presented, the platform's history was cleared, and the site was restarted. Results The platform achieved an average accuracy rate in 2021, 2022, and 2023 of 69.7%, 68.3%, and 67.2%, respectively, surpassing students from all medical years in the three tests evaluated, reinforcing findings in the current literature. The subject with the best score for the AI was Public Health, with a mean grade of 77.8%. Conclusions ChatGPT demonstrated the ability to answer medical questions with higher accuracy than humans, including students from the last year of medical school.

Prevalence of Internet Addiction and Its Association with Psychological Disorders Among Medical Students in Saudi Arabia.

Internet addiction is increasing worldwide. Internet addiction (IA) refers to excessive Internet usage in an uncontrolled and time-consuming manner, causing loss of time and disruption of daily life. However, the prevalence of IA may vary according to age, sex, and ethnicity, and is more prevalent among college students. There is a strong link between problematic Internet usage and an increased risk of developing Post Traumatic Stress Disorder PTSD and depression symptoms. Medical students were chosen for this study due to their unique stressors, including rigorous academic demands, extensive study hours, and clinical practice requirements. It is critical to address behavioral addictions and their psychological effects in this group, as they are linked to the future quality of healthcare provision compared with their non-medical peers. To estimate the prevalence of Problematic Internet Use (PIU) in medical students and explore their correlation with the medical students' PTSD and Patient Health Questionnaire -9 (PHQ9) scores. A cross-sectional online survey was conducted including 506 medical students in the second year of medical school up to internship year at Imam Abdulrahman bin Faisal University (IAU) between June 2021 and January 2022. The questionnaire consisted of consent forms, sociodemographic data, and screening tools for PTSD, the GPIU, and PHQ-9. The prevalence of problematic internet usage (PIU) was 30.6% in the sample group. Students with moderate-to-moderately severe PTSD were 1.7 times more likely to have PIU OR (95% CI): 1.7 (1.091, 2.879). Students with moderate to severe depression were 2.2 times more likely to have PIU OR (95% CI); 2.2 (1.333, 3.950).Having a Saudi nationality, lower income, and being single was significantly associated with PIU. Single Saudi medical students with lower income are at risk of developing more problematic internet use. Especially those who score moderate to high on PTSD and PHQ-9 scales.

Dispelling the myth: comparable duration and impact of research training for MD-PhD and PhD graduates.

The average time to degree for completing a life sciences PhD in the United States is longer for single-degree than dual-degree trainees, supporting a perception that the PhD training of MD-PhDs is less rigorous or fulsome. To determine whether degree format influences the duration and impact of graduate training, we analyzed data for the 2011-2016 graduates of 3 Harvard Medical School PhD programs. Linear mixed effects models were used to determine the association between degree type (MD-PhD vs. PhD) and research outcomes, including time to degree, time to thesis defense, and publications submitted during the PhD. Although pursuing an MD-PhD was associated with a 1.5-year shorter time to PhD degree, basing this calculation on the official PhD period does not account for completion of early PhD requirements, including research rotations and qualifying coursework, during the first 2 years of medical school. There was no association between degree format and total number of first-author or overall publications, though pursuing a dual degree was associated with increased impact metrics of published papers. The results highlight that despite the seemingly shorter PhD durations of MD-PhD graduates based on graduate program enrollment period, research training is on par with their single-degree peers, rendering MD-PhD graduates well equipped to become successful scientific investigators.

Mindful Eating, Nutrition Knowledge, and Weight Status among Medical Students: Implications for Health and Counseling Practices.

Academic stress and transitioning to young adulthood can lead medical students to develop inadequate eating habits, affecting both their physical and mental well-being and potentially compromising their ability to offer effective preventive counseling to future patients. The primary objective of this study is to analyze the levels of mindful eating and nutrition knowledge in Romanian medical students and their associations with various sociodemographic variables. Additionally, we explore the relationship between mindful eating and nutrition knowledge while accounting for sociodemographic factors and examine the impact of these factors on excess weight. Significant predictors of excess weight include high weight gain in the past year (OR = 15.8), the mindful eating questionnaire (MEQ) score (OR = 0.131), male gender (OR = 2.5), and being in the clinical years of medical school (OR = 2.2). While nutrition knowledge levels do not directly impact weight status, they share a 4% common variance with mindfulness in multivariate analysis. Notably, high weight gain is independent of the levels of mindful eating, but univariate testing links it to disinhibition and emotional response, components of mindfulness. Mindful eating stands out as independently associated with both nutrition knowledge and excess weight among medical students. Thus, interventions to address obesity should consider incorporating mindfulness training to enhance food intake awareness and improve weight management outcomes in Romanian medical students.

Improving medical students recognizing surgery of glioblastoma removal/decompressive craniectomy via physical lifelike brain simulator training

BackgroundThis study aims to investigate the benefits of employing a Physical Lifelike Brain (PLB) simulator for training medical students in performing craniotomy for glioblastoma removal and decompressive craniectomy.MethodsThis prospective study included 30 medical clerks (fifth and sixth years in medical school) at a medical university. Before participating in the innovative lesson, all students had completed a standard gross anatomy course as part of their curriculum. The innovative lesson involved PLB Simulator training, after which participants completed the Learning Satisfaction/Confidence Perception Questionnaire and some received qualitative interviews.ResultsThe average score of students’ overall satisfaction with the innovative lesson was 4.71 out of a maximum of 5 (SD = 0.34). After the lesson, students’ confidence perception level improved significantly (t = 9.38, p < 0.001, effect size = 1.48), and the average score improved from 2,15 (SD = 1.02) to 3.59 (SD = 0.93). 60% of the students thought that the innovative lesson extremely helped them understand the knowledge of surgical neuroanatomy more, 70% believed it extremely helped them improve their skills in burr hole, and 63% thought it was extremely helpful in improving the patient complications of craniotomy with the removal of glioblastoma and decompressive craniectomy after completing the gross anatomy course.ConclusionThis innovative lesson with the PLB simulator successfully improved students’ craniotomy knowledge and skills.

Pain: A fractured sense of self.

This poem was inspired by a patient I followed during my third year of medical school. It invites the reader to ponder the dangers of implicit and explicit bias toward patients who suffer from chronic pain, and who often simply want to be understood in the context of their lived experience and identity separate from their illness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Surveying Undergraduate Medical Students' Motivational Orientations and Learning Strategies in the First and Last Year of Medical School.

Motivation to learn has been linked to learning outcomes, academic performance, learner well-being, and choice of medical specialty. Previous studies showed successful educational interventions to optimize students' levels of motivation and learning strategies. The purposes of this study are (1) to describe undergraduate medical students' motivational orientations and learning strategies in the first and last year at a Canadian university and (2) to analyze possible differences between undergraduate medical students' motivational orientations and learning strategies in those two academic years. An online cross-sectional survey was conducted using the Motivated Strategies for Learning Questionnaire (MSLQ). The survey was sent to a total of 207 first-year and 203 third-year students. We received a total of 58 surveys, 32 of them were complete and analyzed. The overall response rate was 14.1%. The internal consistency for all the scales varied from 0.61 to 0.904. The overall score for the survey was 4.97 on a 7-point scale for all students. Highest scales' scores were obtained for elaboration (mean 5.68) and learning beliefs (mean 5.64), with the lowest scores obtained for rehearsal (3.82) and test anxiety (3.94). The total scores did not differ by students' academic year (p = 0.764), except for the effort regulation scale in which first-year students scored higher (p = 0.01). The largest differences between first- and last-year students were found in effort regulation, where first-years scored higher (difference of 0.99), followed by peer learning (difference of - 0.51), and then test anxiety (- 0.36). Our results showed a sample of students that are highly motivated, mostly driven by intrinsic goals, and are confident that they will master the tasks given to them. They rely more on elaboration strategies building connections between new and prior information, and less in rehearsal strategies used for simple tasks and memorization. The MSLQ showed to be a reliable instrument in our sample, and it could be use as an instrument to identify students' adaptive changes to enhance students' motivation to learn. A portrayal of medical students' attitudes in learning could guide educators to develop instructional programs that would help students to optimize their own learning.

Climate Change, Environment, and Health: The implementation and initial evaluation of a longitudinal, integrated curricular theme and novel competency framework at Harvard Medical School

Climate change, air pollution, and ecological degradation impact health through numerous, complex mechanisms. To train future physicians to understand these impacts, medical schools can deliver longitudinal climate curricula in undergraduate medical education, but the field remains nascent. This report describes the development, implementation, and evaluation of the longitudinal, integrated Climate Change, Environment, and Health curricular theme and novel competency framework at Harvard Medical School (HMS). A group of HMS students collaborated with faculty to integrate climate content into the pre-clerkship curriculum. The team subsequently pursued institutional recognition as a formal HMS curricular theme and created a new competency framework that guided curriculum integration mapping and evaluation tool development. The competencies cover the impact of climate change, air pollution, and ecological degradation on health in the context of historical and structural inequities and explore the role of healthcare in contributing to both climate change and solutions. A retrospective, eight-item survey using a seven-point Likert scale and two open-ended questions was administered at the end of the pre-clerkship curriculum. HMS approved a required, four-year Climate Change, Environment, and Health curricular theme in January 2023. Survey data from 100/134 (74.6%) study participants showed that most students agreed (somewhat agree/agree/strongly agree) the curricular theme was valuable (76.0%) and improved their understanding of the health impacts of climate change (80.0%). Most students agreed that their abilities in the five competencies improved because of exposure to the curricular theme. Qualitative comments indicated that students found the curriculum valuable, and also provided constructive feedback. Efforts to expand the curriculum to all four years of medical school and conduct further evaluation continue. Further scholarship is needed to present different curricular approaches and competency frameworks, which can ultimately support effective training of future physicians to understand and respond to the impacts of climate change on health and health equity.

Exploring the usage of learning resources by medical students in the basic science stage and their effect on academic performance

BackgroundThe United States Medical Licensing Examination (USMLE) step 1 is one of the two examinations written after completion of the first two years (basic science stage) of medical school to be eligible to apply for residency training in the USA. A huge number and types of study materials are available to prepare for the exam which might confuse students choosing a resource.We investigated learning resources being used by the third and fifth-semester medical students and their association with academic performance. We also compared learning resources and exam scores of high-performing and low-performing students.MethodsData collection was done using structured (quantitative study) and semi-structured (qualitative study) questionnaires during a face-to-face interview. This article is about the quantitative part which was designed as a correlational study. Single factor one-way analysis of variance (ANOVA), Pearson correlation coefficient test, T-test, and Fisher’s exact test were used to analyze the data.ResultsAbout half of all students used three or more commercial resources dealing with the same content. A weak negative correlation was observed between the number of commercial resources and the exam scores, especially when the number of these resources was three or more (r = -0.26). The mean exam score of textbook users was statistically significantly higher than the mean score of textbook non-users (p = 0.01). The usage of textbooks was statistically significantly higher in the cohort of top performers in comparison to the rest of the students (p = 0.006). In addition to less usage of textbooks, the mean number of review books was higher in the group of weakest students (2.84 versus 3.7; p = 0.75).ConclusionsMost students did not use professional textbooks and about half used too many commercial review resources. While the former fact was significantly associated with poor academic performance, the later fact had weak negative correlation with exam score.Pedagogical interventions are urgently needed to make the right type of learning resources available by making professional textbooks more USMLE-oriented and helping the students choose the best and right number of resources for optimum academic performance. By fulfilling the observed needs of the students in this way, they might feel empowered because of self-determination which will motivate studies.

Pilot Study: Developing Curriculum to Prepare Fourth-Year Medical Students Applying for OBGYN Residency Within the Defense Health Agency.

Obstetrics and gynecology (OBGYN) is becoming increasingly competitive among medical specialties. As a result, many medical schools have frameworks to help their students increase their competitiveness to maximize chances of a successful match. However, "boot camps" have traditionally been geared toward the transition to intern year and not to sub-internships during the fourth year of medical school. We aimed to develop a boot camp for rising fourth-year medical students planning to apply into OBGYN before the initiation of their sub-internships and interview season. Sixteen students enrolled in this course led by faculty OBGYNs at our institution. We utilized a combination of mentorship, coaching, and education to achieve applicant success. The curriculum included formal lectures, surgical skills training, and focused feedback from our applicant development committee. Our response rate was 100% and 94% for the pre-intervention and post-intervention survey, respectively. Before the intervention, the majority of participants felt either neutral (47.4%) or unprepared (21.1%) regarding their knowledge before their sub-internships. However, after the intervention, all reported feeling more prepared for their rotations. All respondents either agreed (60%) or strongly agreed (40%) that the course increased their confidence in performing well on audition rotations. Our match rate increased from 62% for the class of 2022 (before this intervention) to 75% for the class of 2023. In light of the increasing residency match competitiveness, it is crucial to investigate programs that can assist students in developing stronger applications. This reproducible intervention utilizes few resources and can be implemented at most medical schools to better support their OBGYN applicants.