Developing research skills in medical students: AMEE Guide No. 69

Journal response types and times: the outcomes of manuscripts finalised for submission by the University of the Free State School of Medicine medical editor, South Africa

Introduction

health professionals are involved in research as researchers themselves and as supervisors to undergraduate and postgraduate students. Authors may have unrealistic expectations regarding journal submission and review processes. The study aimed to describe journal response types and times for manuscripts finalised for submission by the University of the Free State School of Medicine medical editor.

Methods

this descriptive cohort study with an analytical component included all manuscripts finalised for submission to accredited journals by the medical editor, 2014-2017. Excel spreadsheets capturing all stages of the manuscript process were used to confidentially note information regarding submission and subsequent journal responses.

Results

ninety-five manuscripts were submitted to 72 peer-reviewed accredited journals. The total number of submissions was 163. Only 46 (48.4%) manuscripts were accepted by the first journals submitted to. Rejected submissions (n=82) had a median journal response time of 15.5 days (range 0-381 days), with a third being sent for review. Nine manuscripts were accepted with no revisions needed. Accepted submissions (n=72) had a median of one round of revision (range 0-4 rounds), and a median time of 119.5 days (range 0-674 days) from submission to final acceptance.

Conclusion

within our setting, half of first submissions were unsuccessful, but rejection usually occurred rapidly. Acceptance for publication occurred at a median time of 4 months after one round of revision. If health professionals were made aware of expected outcomes and response times, it may prevent authors from falling victim to the publication practices of predatory journals.

Assessments of Research Competencies for Clinical Investigators: A Systematic Review

Although there is extensive research literature on clinical skill competencies and the use of competency-based frameworks for clinical research, the appropriate methods to assess these competencies are not as well understood. Our goal in this systematic literature review is to identify, compare, and critique assessments of clinical research competencies. Articles were included in this review if they examined clinical investigators or clinical investigators in training, focused on research-based skills, and included some form of assessment of research-based competencies. A total of 76 articles were identified as part of the initial search; 16 met the criteria for inclusion. Two types of assessments of clinical research competence were identified: subjective self-assessments (n = 13) and objective tests (n = 6). These assessments covered a wide range of competencies, but there were no competency domains common to all. Most assessments had limited validation. Training was consistently associated with self-assessed competence but had little relationship to objective measures of competence. In contrast, experience was consistently associated with objectively assessed competence but not with self-assessed competence. These findings have important implications for those interested in assessing medical education programs. We describe a recommended standard for validity for assessments used for the purposes of summative program assessment.

Problem-based projects in medical education: extending PBL practices and broadening learning perspectives

Medical education strives to foster effective education of medical students despite an ever-changing landscape in medicine. This article explores the utility of projects in problem-based learning-project-PBL-as a way to supplement traditional case-PBL. First, project-PBL may enhance student engagement and motivation by allowing them to direct their own learning. Second, project-PBL may help students develop metacognitive competencies by forcing them to collaborate and regulate learning in settings without a facilitator. Finally, project-PBL may foster skills and competencies related to medical research. As illustrated through a brief example from Aalborg University, Denmark, students learn differently from project-PBL and case-PBL, and so one implementation cannot simply replace the other. I conclude by suggesting future directions for research on project-PBL to explore its benefits in medical education.

Project-based learning methodology in the area of microbiology applied to undergraduate medical research

In the recent years, there has been a decrease in the number of medical professionals dedicated to a research career. There is evidence that students with a research experience during their training acquire knowledge and skills that increase the probability of getting involved in research more successfully. In the Degree of Medicine (University of the Basque Country) the annual core subject 'Research Project' introduces students to research. The aim of this work was to implement a project-based learning methodology, with the students working on microbiology, and to analyse its result along time. Given an initial scenario, the students had to come up with a research idea related to medical microbiology and to carry out a research project, including writing a funding proposal, developing the experimental assays and analyzing and presenting their results to a congress organized by the University. Summative assessment was performed by both students and teachers. A satisfaction survey was carried out to gather the students' opinion. The overall results regarding to the classroom dynamics, learning results and motivation after the implementation were favourable. Students referred a greater interest about research than they had before. They would choose the project based methodology versus the traditional one.

Demonstrating specificity of bioactive peptide nucleic acids (PNAs) targeting microRNAs for practical laboratory classes of applied biochemistry and pharmacology

Practical laboratory classes teaching molecular pharmacology approaches employed in the development of therapeutic strategies are of great interest for students of courses in Biotechnology, Applied Biology, Pharmaceutic and Technology Chemistry, Translational Oncology. Unfortunately, in most cases the technology to be transferred to learning students is complex and requires multi-step approaches. In this respect, simple and straightforward experimental protocols might be of great interest. This study was aimed at presenting a laboratory exercise focusing (a) on a very challenging therapeutic strategy, i.e. microRNA therapeutics, and (b) on the employment of biomolecules of great interest in applied biology and pharmacology, i.e. peptide nucleic acids (PNAs). The aims of the practical laboratory were to determine: (a) the possible PNA-mediated arrest in RT-qPCR, to be eventually used to demonstrate PNA targeting of selected miRNAs; (b) the possible lack of activity on mutated PNA sequences; (c) the effects (if any) on the amplification of other unrelated miRNA sequences. The results which can be obtained support the following conclusions: PNA-mediated arrest in RT-qPCR can be analyzed in a easy way; mutated PNA sequences are completely inactive; the effects of the employed PNAs are specific and no inhibitory effect occurs on other unrelated miRNA sequences. This activity is simple (cell culture, RNA extraction, RT-qPCR are all well-established technologies), fast (starting from isolated and characterized RNA, few hours are just necessary), highly reproducible (therefore easily employed by even untrained students). On the other hand, these laboratory lessons require some facilities, the most critical being the availability of instruments for PCR. While this might be a problem in the case these instruments are not available, we would like to underline that determination of the presence or of a lack of amplified product can be also obtained using standard analytical approaches based on agarose gel electrophoresis.

An explorative vs. traditional practical course: how to inspire scientific thinking in medical students

Recently, medical students' scientific thinking skills have been identified as an important issue in medical education. Scientific thinking cannot be imparted in conventional lectures, but rather requires actively involving students. We modified a practical course in physiology. A study was designed to test whether the new course fosters scientific thinking without impairing the transfer of physiological knowledge. The study group consisted of 226 first-year medical students at the Medical Faculty Mannheim of Heidelberg University. Written consent to participate in the study was obtained from all participants. The group was then randomly divided into two groups (traditional vs. modified course). The subject of both courses was a laboratory experiment in skeletal muscle physiology. In the traditional course, the students addressed topics already presented in lectures. In the modified course, students dealt with the same topics as in the traditional course, but the experiment was expanded to include one issue not taught before. When working on this issue, the students were instructed in scientific thinking. All participants filled out a questionnaire with 15 multiple-choice questions addressing the physiological subject matter and four open-ended questions addressing the criteria of scientific methodology. Physiological knowledge in both groups did not differ [F(1) = 2.08, P = 0.15]. Scores in scientific thinking in the modified course were higher (mean = 4.20, SD = 1.89) than in the traditional course (mean = 2.04, SD = 1.91) with F(1) = 70.69, P < 0.001, η² = 0.24 (large effect). Our study demonstrates that small adjustments to courses in medical education can promote scientific thinking without impairing knowledge transfer.

Inquiry in the Medical Curriculum: A Pedagogical Conundrum and a Proposed Solution

Habits of inquiry are considered an essential component of the modern physician's profile. These habits drive physicians to recognize and address the continuous challenges inherent to the practice of medicine; consequently, they meet the aims of better patient-centered care, better health of communities, and improved functioning of the health system. Many medical schools have endeavored to integrate inquiry into their curricula as a means of supporting development of adaptive expertise, a construct that encompasses habits of inquiry. However, the diversity of conceptualizations of inquiry has resulted in correspondingly diverse instructional implementations. Much of the emphasis has been on inquiry methods (e.g., engagement in research projects, courses in research methods and statistics), but the learners' inquiry disposition and its essential attitude component have received little attention in instruction and assessment. The authors propose that both inquiry methods and attitude need to be developed explicitly and simultaneously to prepare physicians to successfully be willing and able to address the challenges of today's health care environment. Because attitudes are established predictors of behavior, a positive inquiry attitude may be the ultimate determinant of physicians' engagement in behaviors of adaptive expertise (i.e., recognizing when learned procedures do not apply, and learning or inventing effective solutions). Addressing the attitude toward inquiry as early as possible in medical school is critical because strong attitudes are difficult to modify. Thus, a curriculum that supports positive inquiry attitude formation and strengthening will carry well beyond medical school and residency training.

Embarking on a Journey of Discovery: Developing Transitional Skill Sets through a Scholarly Concentration Program

PROBLEM

Medical student participation in research enhances appreciation of the scientific literature and the conduct of investigation, and may lead to an interest in academic medicine. Independent medical student research offers frequently overlooked opportunities to develop and assess professional practice abilities, including project design and implementation, interprofessional team communication, and time management. These skills, useful to physicians, are often challenging for medical students to master as they transition into clinical careers. To address this challenge, we designed and embedded interventional modalities into a highly mentored and longitudinal scholarly concentration component of the curriculum.

INTERVENTION

The Embark scholarly concentration program incorporates traditional research training with the development of professional practice skills essential for transitioning to clinical practice. The program includes individualized and just-in-time components enabling student access to information and feedback specific to their projects and development of professional practice skills.

CONTEXT

The Embark program is a required longitudinal component of the Oakland University William Beaumont School of Medicine undergraduate medical curriculum. The Embark program consists of courses that inform and facilitate a required longitudinal independent research project.

OUTCOME

A retrospective evaluation of the Embark program's success with development of professional practice skills through the lens of both faculty and student perceptions included analysis of project records and course evaluation feedback. Evaluation of individual student development of transitional skill ability is possible through both quantitative and qualitative analysis of data collected from student project records. More than 80% of course evaluation commentary on strengths of the program addressed activities related to professional practice skills. To systematize the evaluation of these data sources, we have piloted a framework, iSAIL, designed to assess student development in these skills during the planning and conduct of a research project.

LESSONS LEARNED

By developing professional practice skills in the context of a scholarly concentration program, medical students can build a foundation for future engagement in research while they develop skills to overcome challenges that they are likely to encounter in their clinical careers. Modalities designed to evaluate individualized student development of professional practice skills through research participation define program successes and may lead to the identification of additional resources needed by students. By offering medical students opportunities to develop professional practice skills within the protected environment of an independent research project, this scholarly concentration program provides a valuable opportunity to influence the early development of skills necessary throughout their clinical careers.

Does reality meet expectations? An analysis of medical students' expectations and perceived learning during mandatory research projects

BACKGROUND

Although much has been written about structure and outcomes of medical students' curricular research projects, less attention has been paid to the expectations on such projects. In order to foster students' scientific understanding and improve the quality of mandatory research projects, we compared students' pre-course expectations with their post-course insights regarding learning and transferable skills.

METHODS

A prospective cross-sectional questionnaire study. All students registered on a mandatory 20-week research project course in 2011-2013 were e-mailed questionnaires in the beginning and after the course asking them to rate statements on expectations and perceived learning on a 5-point Likert scale. Of 652 students, 358 (mean age 26 years; range 21-49; 63% females) returned both questionnaires, corresponding to a response rate of 55%.

RESULTS

The ratings for expectations as well as perceived learning were highest for learning to search and critically appraise literature. The greatest pre- and post-course differences were indicated for participation in scientific discussions and oral communication. Surprisingly, both pre- and post-course ratings were low for research ethics. The highest post-course ratings regarding skills for future working life were given to items pertaining to understanding the scientific basis of medicine, ability to follow the development of knowledge and to critically integrate knowledge. Female students had higher expectations than male students. Those with a previous university degree had lower ratings of expectations and perceived learning. Students with basic science projects reported higher expectations and higher learning compared to students with other projects. Previous research experience had no significant influence on expectations nor learning. The correlations between post-course ratings of learning and skills showed that problem-solving ability had a relatively high correlation with all skills.

CONCLUSIONS

Students had high expectations and perceived the course improved crucial practical skills. However, expectations were not quite met regarding aspects of scientific communication, and hypothesis formulation, likely because these require more extensive practice and feedback. Students should be actively involved in ethical discussions and oral communication should be trained repeatedly as it is an important task of doctors to communicate scientific information to patients and non-experts.

Perceived enablers and constraints of motivation to conduct undergraduate research in a Faculty of Medicine and Health Sciences: What role does choice play?

Background

Enhancing evidence-based practice and improving locally driven research begins with fostering the research skills of undergraduate students in the medical and health sciences. Research as a core component of undergraduate curricula can be facilitated or constrained by various programmatic and institutional factors, including that of choice. Self-Determination Theory (SDT) provides a framework for understanding the influence of choice on student motivation to engage in research.

Aim

This study aimed to document the enablers and constraints of undergraduate research at a South African Faculty of Medicine and Health Sciences (FMHS) and to explore how the presence or absence of choice influenced students’ engagement with research in this context.

Methods

An exploratory descriptive design was adopted. Undergraduate students who had conducted research and undergraduate programme staff were recruited through purposive sampling. Semi-structured interviews were transcribed and thematically analysed. Findings were interpreted using SDT, focusing on how choice at various levels affects motivation and influences research experiences.

Results

Many of the programmatic and institutional enablers and constraints–such as time and supervisory availability–were consistent with those previously identified in the literature, regardless of whether research was compulsory or elective. Choice itself seemed to operate as both an enabler and a constraint, highlighting the complexity of choice as an influence on student motivation. SDT provided insight into how programmatic and institutional factors–and in particular choice–supported or suppressed students’ needs for autonomy, competence, and relatedness, thereby influencing their motivation to engage in research.

Conclusion

While programmatic and institutional factors may enable or constrain undergraduate research, individual-level factors such as the influence of choice on students’ motivation play a critical role. The implication for curriculum development is that research engagement might be enhanced if levels of choice are structured into the curriculum such that students’ needs for autonomy, competence, and relatedness are met.

Exploring the timing of medical student research internships: before or after clerkships?

BACKGROUND

The objective of this study was to determine the optimal positioning of the research internship, either before clinical clerkships, at the beginning of the medical Master's programme, or at the end.

METHODS

A mixed methods study was carried out. We compared characteristics such as duration, location and grades for internships performed and students' motives for choosing to perform their research internship before or after clinical clerkships. We analysed students' answers to open-ended questions about the reasons for their choices, using the Self-Determination Theory of motivation.

RESULTS

Students performing their research internship before clinical clerkships (n = 338) opted more often for an extended internship (OR = 3.16, 95% CI = 2.32-4.31) and an international location (OR = 2.22, 95% CI = 1.46-3.36) compared to those performing their research internships after clinical clerkships (n = 459). Neither the internship grades nor the number of international publications differed significantly between the two groups. Most of the students' motives (102 participants) were classified as extrinsic motivation for research. Students performing research before clinical clerkships more often showed intrinsic motivation for research, students performing research after clinical clerkships were mainly motivated by their career choice.

CONCLUSION

To accommodate both groups of students, offering research internships before and after clinical clerkships, is recommended.

An approach for developing integrated undergraduate medical curriculum

Background and Objectives:

Medical schools are to develop integrated medical curricula because the term ‘integrated curriculum’ has grown up and flourished globally and it has become mandatory to align the medical education with the global concept in Pakistan. This paper aims to present a guideline to design an undergraduate integrated medical curriculum.

Methods:

Various themes are used to develop integrated curriculum which are basic medical science, simulation skills, clinical science, personality development, research, entrepreneurship and pre specialization. Each theme is subdivided, termed a module and its contents primarily focus on particular aspect.

Results:

Knowledge, skill and attitude, embodied in themes or modules, are planted in specific way that they have horizontal as well as vertical integration. There is no boundary of various traditional disciplines in template of five years curriculum. For example, diagnosis is a theme which carries contents from medicine, surgery, orthopedics etc.

Conclusion:

The blueprint introduced in this paper would help medical educators to draft integrated medical curricula for those institutions which intend to switch their medical programs from traditional to integrated one.

The importance of scientific competencies in German medical curricula - the student perspective

BACKGROUND

Scientific competencies are of great importance for physicians; not only for conducting reliable research, but also for patient care. However, there is growing concern that a lack of scientific competencies among physicians may lead to a deterioration in the quality on biomedical research. This study aims at assessing medical students' perspectives on the implementation of scientific competency training in German medical curricula.

METHODS

An online survey was conducted in order to collect German medical students' opinions on the importance of acquiring scientific competencies during their medical studies and to provide us with an assessment of their current levels of basic scientific competencies by having them conduct a self-evaluation. Moreover, we wanted to understand their perceptions of current curricular content and to receive suggestions for improving scientific competency training. Participants were reached via the mailing lists of the German Medical Students' Association, as well as of local medical student committees, and the German Medical Students' Associations social media channel on Facebook.

RESULTS

In total, 2380 medical students from across all 37 German medical faculties participated in the survey. The majority of students agreed that the ability to critically evaluate the relevant literature is an important competency for physicians, and that every student should conduct a research project during their medical studies. However, the students evaluated their scientific competencies as unsatisfactory, especially with regard to statistics and scientific writing. They were strongly in favor of receiving extended research training.

CONCLUSION

Our study provides insight into German medical students' self-perception in relation to both patient care and biomedical research, and makes recommendations for potential improvements in scientific training. The study demonstrates that scientific competencies are of great importance to medical students in Germany. Students are not lacking motivation for scientific practice and have numerous ideas for enhancing scientific teaching opportunities. Scientific training should follow a holistic approach based on three pillars: (i) a scientific core curriculum, (ii) intracurricular research projects, and (iii) special research programs for students strongly interested in medical research.

Student learning outcomes, perceptions and beliefs in the context of strengthening research integration into the first year of medical school

Research integrated into undergraduate education is important in order for medical students to understand and value research for later clinical practice. Therefore, attempts are being made to strengthen the integration of research into teaching from the first year onwards. First-year students may interpret attempts made to strengthen research integration differently than intended by teachers. This might be explained by student beliefs about learning and research as well as student perceptions of the learning environment. In general, student perceptions of the learning environment play a pivotal role in fostering student learning outcomes. This study aims to determine whether a curriculum change intended to promote research integration fosters student learning outcomes and student perceptions of research integrated into teaching. To serve this purpose, three subsequent cohorts of first-year students were compared, one before and two after a curriculum change. Learning outcomes of these students were measured using scores on a national progress test of 921 students and assessments of a sample of 100 research reports of a first-year student research project. 746 Students filled out the Student Perceptions of Research Integration Questionnaire. The findings suggest that learning outcomes of these students, that is, scores on research related test items of the progress test and the quality of research reports, were better than those of students before the curriculum change.

Nurturing professional identity through a community based education program: medical students experience

Objectives

Community-based education (CBE) has an impact on the types of medical students produced at the end of medical training. However, its impact on professional identity development (PID) has not been clearly understood. This study thus explores the effect of the CBE program on PID.

Methods

A qualitative phenomenological study was conducted on a group of Universiti Sains Malaysia medical students who had finished the Community and Family Case Study (CFCS) program. Data were gathered through focused group discussions and student reflective journals. Participants were sampled using the maximal variation technique of purposive sampling. Three steps of thematic analysis using the Atlasti software were employed to identify categories, subthemes, and themes.

Results

Personal, role, social, and research identities were generated that contribute to the PID of medical students through the CFCS program. The results indicate that the CFCS program nurtured personal identity through the development of professional skills, soft skills, and personal values. Pertaining to role identity, this is related to patient care in terms of primary care and interprofessional awareness. Pertaining to social identity, the obvious feature was community awareness related to culture, society, and politics. A positive outcome of the CFCS program was found to be its fostering of research skills, which is related to the use of epidemiology and research methods.

Conclusion

The findings indicate that the CFCS program promotes PID among medical students. The current data highlight and provide insights into the importance of integrating CBE into medical curricula to prepare future doctors for their entry into the profession.

Benchmarking for research-related competencies - a curricular mapping approach at medical faculties in Germany

OBJECTIVES

Internationally, scientific and research-related competencies need to be sufficiently targeted as core outcomes in many undergraduate medical curricula. Since 2015, standards have been recommended for Germany in the National Competency-based Learning Objective Catalogue in Medicine (NKLM). The aim of this study is to develop a multi-center mapping approach for curricular benchmarking against national standards and against other medical faculties.

METHOD

A total of 277 faculty members from four German medical faculties have mapped the local curriculum against the scientific and research-related NKLM objectives, using consented procedures, metrics, and tools. The amount of mapping citations of each objective is used as indicator for its weighting in the local curriculum. Achieved competency levels after five-year education are compared.

RESULTS

All four programs fulfill the NKLM standards, with each emphasizing different sub-competencies explicitly in writing (Scholar: 17-41% of all courses; Medical Scientific Skills: 14-37% of all courses). Faculties show major or full agreement in objective weighting: Scholar 44%, scientific skills 79%. The given NKLM competency level is met or even outperformed in 78-100% of the courses.

CONCLUSIONS

The multi-center mapping approach provides an informative dataset allowing curricular diagnosis by external benchmarking and guidance for optimization of local curricula.

Student experiences and perceptions of compulsory research projects: a veterinary perspective

Background

Although research underpins clinical work, many students training to be clinicians are not inherently interested in developing research skills.

Aim

To characterise and understand veterinary student experiences and perceptions of compulsory research projects.

Methods

This was an explanatory sequential mixed-methods study, with a questionnaire survey of an entire cohort informing purposive selection for focus group discussions. Student views were triangulated with staff questionnaire data.

Results

About a third of the cohort felt that the project had not been worthwhile or had not fostered useful skills. Focus group data analysis identified fragility of motivation and lack of clear schemata for the research process as key themes. Students were easily demotivated by typical research challenges and lack of schemata contributed to a poor understanding of the rationale for the project, encouraging highly extrinsic forms of motivation. Triangulation with staff questionnaire data indicated that staff understood students’ challenges, but were more likely than students to consider it to be a valuable learning experience.

Conclusions

Findings support ongoing curriculum development and emphasise that, to optimise motivation, engagement and learning, students training to be clinicians need a clear rationale for research, based on development of critical inquiry skills as a core clinical competency.

Medical students' perceptions of their learning environment during a mandatory research project

OBJECTIVES

To explore medical students´ perceptions of their learning environment during a mandatory 20-week scientific research project.

METHODS

This cross-sectional study was conducted between 2011 and 2013. A total of 651 medical students were asked to fill in the Clinical Learning Environment, Supervision, and Nurse Teacher (CLES+T) questionnaire, and 439 (mean age 26 years, range 21-40, 60% females) returned the questionnaire, which corresponds to a response rate of 67%. The Mann-Whitney U test or the Kruskal-Wallis test were used to compare the research environments.

RESULTS

The item My workplace can be regarded as a good learning environment correlated strongly with the item There were sufficient meaningful learning situations (r= 0.71, p<0.001). Overall satisfaction with supervision correlated strongly with the items interaction (r=0.78, p < 0.001), feedback (r=0.76, p<0.001), and a sense of trust (r=0.71, p < 0.001).  Supervisors´ failures to bridge the gap between theory and practice or to explain intended learning outcomes were important negative factors.  Students with basic science or epidemiological projects rated their learning environments higher than did students with clinical projects (χ²_{(3, N=437)}=20.29, p<0.001).

CONCLUSIONS

A good research environment for medical students comprises multiple meaningful learning activities, individual supervision with continuous feedback, and a trustful atmosphere including interactions with the whole staff.  Students should be advised that clinical projects might require a higher degree of student independence than basic science projects, which are usually performed in research groups where members work in close collaboration.

Essential competencies in global health research for medical trainees: A narrative review

INTRODUCTION

Participation in short-term educational experiences in global health (STEGHs) among medical trainees is increasingly accompanied by interest in conducting research while abroad. Because formal training in both global health and research methods is currently under-represented in most medical curricula, trainees are often unfamiliar with the knowledge, attitudes, and skills necessary to design and conduct research successfully. This narrative review identifies essential global health research competencies for medical trainees engaged in STEGHs.

METHODS

The authors searched the literature using the terms global health, competency, research, research methods/process/training, scholarly project, medical student, and medical education/education. Because articles directly addressing global health research competencies for medical trainees were limited, the authors additionally drew on the broader literature addressing general research competencies and global health competencies.

FINDINGS

Articles yielded by the literature search, combined with established guidelines in research ethics and global health ethics, were used to identify six core domains and twenty discrete competencies fundamental to global health research at a level appropriate for medical trainees enrolled in STEGHs. Consideration was given to diverse research modalities, varying levels of training, and the availability of mentoring and on-site support.

DISCUSSION

Research may provide important benefits to medical trainees and host partners. These competencies provide a starting point; however, circumstances at any host site may necessitate additional competencies specific to that setting. These competencies are also limited by the methodology employed in their development and the need for additional perspectives from host partners.

CONCLUSIONS

The competencies identified outline basic knowledge, attitudes, and skills necessary for medical trainees to conduct limited global health research while participating in STEGHS. They may also be used as a basis for curriculum development, assessment, and research capacity development.

The inventory as a core element in the further development of the science curriculum in the Mannheim Reformed Curriculum of Medicine

Introduction: The German Council of Science and Humanities as well as a number of medical professional associations support the strengthening of scientific competences by developing longitudinal curricula for teaching scientific competences in the undergraduate medical education. The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) has also defined medical scientific skills as learning objectives in addition to the role of the scholar. The development of the Mannheim science curriculum started with a systematic inventory of the teaching of scientific competences in the Mannheim Reformed Curriculum of Medicine (MaReCuM). Methods: The inventory is based on the analysis of module profiles, teaching materials, surveys among experts, and verbatims from memory. Furthermore, science learning objectives were defined and prioritized, thus enabling the contents of the various courses to be assigned to the top three learning objectives. Results: The learning objectives systematic collection of information regarding the current state of research, critical assessment of scientific information and data sources, as well as presentation and discussion of the results of scientific studies are facilitated by various teaching courses from the first to the fifth year of undergraduate training. The review reveals a longitudinal science curriculum that has emerged implicitly. Future efforts must aim at eliminating redundancies and closing gaps; in addition, courses must be more closely aligned with each other, regarding both their contents and their timing, by means of a central coordination unit. Conclusion: The teaching of scientific thinking and working is a central component in the MaReCuM. The inventory and prioritization of science learning objectives form the basis for a structured ongoing development of the curriculum. An essential aspect here is the establishment of a central project team responsible for the planning, coordination, and review of these measures.

Medical students' research productivity and career preferences; a 2-year prospective follow-up study

BACKGROUND

Linking undergraduate medical education to scientific research is necessary for the quality of future health care, and students´ individual research projects are one way to do so. Assessment of the impact of such projects is of interest for both educational and research-oriented segments of medical schools. Here, we examined the scholarly products and medical students' career preferences 2 years after a mandatory research project course.

METHODS

A prospective cross-sectional questionnaire study. All 581 students registered on a 20-week research project course between September 2010 through September 2012 were e-mailed a questionnaire 2 years after completing the course.

RESULTS

In total, 392 students (mean age 27 years; 60% females) responded (67% response rate). 59 students (15%) were co-authors on a scientific paper published in an international journal, 6 students had published in a national journal, and 57 students had co-authored a paper submitted for publication. Totally, 122 scientific papers had been submitted. Moreover, 67 (17%) students had given 107 oral or poster presentations nationally or internationally during the follow-up. Career-wise, 36 students (9%) had been registered as PhD students and an additional 127 students (34%) were planning to register. Those who did not plan doctoral studies were significantly older (p = 0.013) than those who did. However, 35% reported that they would in the coming 5 years prefer to work as clinicians only, and this group was significantly younger than those who envisaged participation in research. There were no significant gender differences.

CONCLUSIONS

Approximately a third of the students had authored papers and/or public presentations, and a similar fraction had career plans involving a PhD degree. The results indicate that the project course had a positive impact on continued supervisor-student collaboration on a professional level, but also that strategies to encourage young doctors to perform clinical research may be needed.

Clinical Pharmacology Research Internships at the Interface between Academia and Industry: Students' Perceptions and Scientific Output

The Centre for Human Drug Research (CHDR) is a non-profit clinical research institute at the interface between academia and the pharmaceutical industry. CHDR hosts a research internship programme for undergraduate (bio)medical students. The aim of this study was (i) to investigate the student perceptions of the undergraduate research internship and (ii) to quantify the scientific output related to these internships. We surveyed former interns at the CHDR from the year 2007 to 2014 and quantified their scientific output with a PubMed search. There was a response rate to the survey of 61%, with a good overall rating of the internships. Many students considered their internship at CHDR to be (much) more broad (55%) and with a (much) stricter planning (48%), compared to previous internships at academic research groups. In turn, there were many aspects reported to be similar to academic research internships such as focus on research methodology and 'outcome-drivenness'. Twenty-four per cent of the internships resulted in a co-authorship on papers published in peer-reviewed journals with an average impact factor of 3.3. In conclusion, with appropriate management and supervision, effective research electives are possible in the more commercial environment of a clinical research organization.

An Assessment Study of Quality Model for Medical Schools in Mexico

Excellence in healthcare delivery is only possible by addressing the quality issues in medical education. The authors in this paper assess the development of medical schools in Mexico considering a proposed Quality Model for Medical Schools (QMMS) having five levels of the Incremental Quality Model (IQM). An exploratory descriptive approach was applied in this study wherein 46 authorities from medical schools self-assessed their processes (strategic, core, support and evaluation) included on the QMMS to determine their development in the five levels of the IQM i.e. Start, Development, Standardization, Innovation and Sustainability. The results of the study show the average were: 3.09 strategic processes, 2.96 core processes, 3.19 support processes and 3.00 in evaluation process. The overall mean obtained was 3.07 which correspond to Standardization level. The authors consider that the proposed quality model may serve as a guide to improve their performance to advance to innovation and sustainability.

'Involve Me and I Learn': Development of an Assessment Program for Research and Critical Analysis

Evidence-based medical practice is best achieved by developing research understanding in medical practitioners. To this end, medical councils worldwide increasingly recognise the importance of medical schools graduating students with well-developed research skills and research capacity. To meet this need, the principles of programmatic assessment were implemented in designing a research and critical analysis curriculum and assessment program that aimed to enhance the research and critical analysis skills of medical students. The program was developed by mapping assessment tasks to a research capabilities framework that was in turn scaffolded to different levels of Miler's pyramid. The curriculum and assessments were integrated with the science, clinical, and professional aspects of the medical course. The progressive longitudinal development of research skills, with feedback and academic mentoring, culminated in the students' capacity to undertake an independent research project. Designing an assessment program for learning encouraged students to develop their research capacity by involving them in their learning.

Performance of a core of transversal skills: self-perceptions of undergraduate medical students

BACKGROUND

There is an increasingly growing trend towards integrating scientific research training into undergraduate medical education. Communication, research and organisational/learning skills are core competences acquired by scientific research activity. The aim of this study was to assess the perceived performance of a core of transversal skills, related with scientific research, by Portuguese medical students.

METHODS

A cross-sectional study was conducted in 611 Portuguese students attending the first, fourth and sixth years of the medical course, during the same academic year. A validated questionnaire was applied for this purpose.

RESULTS

Medical students felt confident regarding the majority of the analyzed transversal skills, particularly regarding team work capacity (72.7% perceived their own capacity as good). On the other hand, the perceived ability to manage information technology, time and to search literature was classified only as sufficient by many of them. The progression over the medical course and participation in research activities were associated with an increasing odds of a good perceived performance of skills such as writing skills (research activity: OR = 2.00; 95% CI: 1.34-2.97) and English proficiency (research activity: OR = 1.59; 95% CI: 1.06-2.38/final year medical students: OR = 3.63; 95% CI: 2.42-5.45).

CONCLUSIONS

In this line, the early exposure to research activities along undergraduate medical education is an added value for students and the implementation of an integrated research program on medical curriculum should be considered.

How do students' perceptions of research and approaches to learning change in undergraduate research?

OBJECTIVE

This study aimed to examine how students' perceptions of research and learning change through participation in undergraduate research and to identify the factors that affect the process of their engagement in research projects.

METHODS

This qualitative study has drawn on phenomenography as research methodology to explore third-year medical students' experiences of undergraduate research from participants' perspectives (n=14). Data included semi-structured individual interviews conducted as pre and post reflections. Thematic analysis of pre-course interviews combined with researcher-participant observations informed design of end-of-course interview questions.

RESULTS

Phenomenographic data analysis demonstrated qualitative changes in students' perceptions of research. At the beginning of the course, the majority of students ex-pressed a relatively narrow definition of research, focusing on the content and outcomes of scientific research. End-of-course reflections indicated increased attention to research processes including researcher autonomy, collaboration and knowledge construction processes. Furthermore, acknowledgement of the linkage between research and learning processes indicated an epistemological change leading them to take a deep approach to learning in undergraduate research. Themes included: an inquiring mind, synthesis of knowledge, active participation, collaborative and reflective learning. However, they also encountered some difficulties in undertaking group research projects. These were attributed to their prior learning experiences, differences in valuing towards interpersonal communication, understanding of the research process, and social relationships with others.

CONCLUSIONS

This study provided insights into the potential for undergraduate research in medical education. Medical students' awareness of the linkage between research and learning may be one of the most important outcomes in the undergraduate research process.

Scholarly contributions of required senior research projects in a doctor of pharmacy curriculum

OBJECTIVE

To determine dissemination outcomes and faculty perceptions of senior research projects conducted from 2008 to 2011 by PharmD students in a curricular pathway focused on direct patient care.

METHODS

Preceptors' reported dissemination outcomes of research projects were surveyed and their perceptions of the precepting experience were rated using a web-based survey. Results were compared to those from an earlier pharmaceutical care cohort (2002-2007) and a combined cohort of 2, more research-intensive curricular pathways at the school.

RESULTS

The overall response rate was 90.2%. Project dissemination included 61.3% at an institutional forum, 42.3% as a submitted publication, 37.8% as a poster, and 4.5% as an oral presentation. Projects completed from 2008-2011 were significantly more likely than those from 2002-2007 to be submitted for publication (42.3% vs 10.7%, p<0.001) and published (28.8% vs 5.3%, p<0.001). Most preceptors found their research projects valuable to them professionally (88.3%) and to their own or another institution (83.5% and 78.5%, respectively). Ninety-five percent of preceptors would precept again.

CONCLUSION

Dissemination rates for pharmaceutical care projects increased over time. Despite modest dissemination levels, the majority of preceptors agreed that required student research projects provide a valuable learning experience for students.

Acquiring evidence-based medicine and research skills in the undergraduate medical curriculum: three different didactical formats compared

Medical schools have recently witnessed a call for authentic research activities that equip students with the skills required for evidence-based medicine (EBM) and research. Because it is not always possible to make such activities available as a part of the curriculum, evaluating the effectiveness of the various choices of traditional and authentic EBM and research skills courses is essential. This study's purpose was to evaluate students' perceived EBM and research skill acquisition in three different courses in a Dutch medical school. Self-reported surveys were conducted among 163 Dutch medical undergraduates who participated in an undergraduate research project, a basic EBM skills elective, or a traditional lecture-based skills course. MANCOVA was employed to test for group differences in perceived skill acquisition. Students who finished their research project perceived themselves as more experienced in writing and information retrieval skills than students who participated in the lecture-based course or basic skills elective. Students in the lecture-based course identified themselves as being the most experienced in critical judgment. No group differences were found for overall gains. Authentic research activities may have benefits over traditional lecture-based courses in the undergraduate medical curriculum, especially in terms of equipping students with writing and information retrieval skills.

Enhanced research assessment performance in graduate vs. undergraduate-entry medical students: implications for recruitment into academic medicine

BACKGROUND

Studies investigating variance between the academic performance of direct-entry (DEM) versus graduate-entry (GEM) medical students have yielded conflicting results, but their performance in undergraduate research-based assessments has not been compared to-date.

AIM

We aimed to compare the results of DEM and GEM students with respect to their senior research dissertation module.

METHODS

This retrospective study examined the final year results between 2011-2012 in DEM, (n = 219) and GEM (n = 84) students. Between-group comparisons of dissertation module marks were conducted using independent t-tests. Correlations between marks in dissertation module and in other disciplines assessed during the final year were attained using Pearson's correlation. Multiple regression analysis was employed to adjust for potential confounding factors such as student age and gender.

RESULTS

No apparent difference was apparent between the DEM and GEM students with respect to results achieved across the clinical disciplines examined. However, GEM students performed significantly better than DEMs in their senior research dissertation assessment (Mean = 66.81% vs. 65.00%, fully adjusted p = 0.048). The variable which remained influential in regression analysis was nationality, where North American and Asian students were demonstrated to score lower than their Irish counterparts in the dissertation module (B coefficient = -1.90, SE = 0.94, P = 0.045 and B coefficient = -4.88, SE = 1.00, P < 0.001 respectively).

CONCLUSIONS

Performance in the research-based module was significantly better in GEM relative to their DEM colleagues. This finding may have implications for future recruitment into academic medicine, as aptitude and interest in research at undergraduate level has been shown to be associated with increased likelihood of an academic career in medicine.

An integrated model for developing research skills in an undergraduate medical curriculum: appraisal of an approach using student selected components

Student selected components (SSCs), at that time termed special study modules, were arguably the most innovative element in Tomorrow's Doctors (1993), the document from the General Medical Council that initiated the modernization of medical curricula in the UK. SSCs were proposed to make up one-third of the medical curriculum and provide students with choice, whilst allowing individual schools autonomy in how SSCs were utilized. In response, at the University of Edinburgh the undergraduate medical curriculum provides an integrated and sequential development and assessment of research skill learning outcomes, for all students in the SSC programme. The curriculum contains SSCs which provide choice to students in all 5 years. There are four substantial timetabled SSCs where students develop research skills in a topic and speciality of their choice. These SSCs are fully integrated and mapped with core learning outcomes and assessment, particularly with the 'Evidence-Based Medicine and Research' programme theme. These research skills are developed incrementally and applied fully in a research project in the fourth year. One-third of students also perform an optional intercalated one-year honours programme between years 2 and 3, usually across a wide range of honours schools at the biomedical science interface. Student feedback is insightful and demonstrates perceived attainment of research competencies. The establishment of these competencies is discussed in the context of enabling junior graduate doctors to be effective and confident at utilizing their research skills to effectively practice evidence-based medicine. This includes examining their own practice through clinical audit, developing an insight into the complexity of the evidence base and uncertainty, and also gaining a view into a career as a clinical academic.

Tuning research competences for Bologna three cycles in medicine: report of a MEDINE2 European consensus survey

Medical curricula, like healthcare systems and medical practice, have a strong cultural component and vary considerably between countries. Increasing mobility of medical graduates, and increasing pressure to ensure they are all fit for practice, have highlighted an urgent need to establish common ground in learning outcomes at all stages of training. A research-based approach, developed by the Tuning project, was used previously by the MEDINE Thematic Network to gain consensus on core learning outcomes/competences for primary medical degrees ( www.tuning-medicine.com ), but no consensus was reached for learning outcomes relating to research. As part of MEDINE2, a focussed Tuning project was undertaken to explore opinions on more detailed core learning outcomes in research for all three Bologna cycles (Bachelor, Master, and Doctor). Responses from 417 stakeholders, representing 29 European and 13 non-European countries, revealed a relatively high degree of consensus. The findings strongly suggest that these stakeholders think that learning outcomes related both to 'using research' and 'doing research' should be core components of medical curricula in Europe. The challenge now, however, is to promote further local and international discussion on these issues, and to find ways of achieving these competences within the context of already crowded medical curricula.

Medical education in Poland

Both undergraduate and postgraduate medical education in Poland are currently undergoing a significant reform, based on new national educational standards, arising from European Union recommendations. This article describes the previous system and the new approach to medical curriculum, draws a picture of the current situation and discusses the impact of this educational change on the quality of future graduates.