Social Determinants, Risk Factors, and Needs: A New Paradigm for Medical Education

The effect of spaced learning method on the evaluation score and education quality in nursing students

INTRODUCTION

Spaced learning is a teaching method aiming to stabilize long-term memory. The present study aims to evaluate the effect of the spaced learning method on the evaluation scores and education quality in the practical course of principles and techniques of nursing.

MATERIALS AND METHODS

In this quasi-experimental study, 51 nursing students in four semesters were selected by convenience sampling and randomly divided into experimental and control groups. We used the demographic characteristics form, student scores, and students' evaluations of the educational quality questionnaire (SEEQ) for data gathering. In the next step, the classes of the experimental groups were held with the spaced learning method, and the traditional methods were used for the control groups. After the end of each semester, the SEEQ questionnaire was given to the students of both groups, and their evaluation scores were extracted. The collected data were analyzed using SPSS version 26 using descriptive and inferential statistics.

RESULTS

After ensuring the independence of the data, the results showed that the difference in the mean evaluation score of the students in the two groups is not statistically significant (p > 0.05). However, the mean score of total SSEQ in the experimental group was significantly higher than the control group. Furthermore, except for the dimension of examination assignments and group interaction, the mean score of other SSEQ dimensions in the experimental group was statistically higher than the control group (p < 0.05).

CONCLUSION

Spaced learning is an easy, low-cost, and fun learning method that affects the teaching method compared to evaluation results and effortlessly has the potential to become an appropriate alternative to traditional teaching methods.

Re-conceptualizing medical education in the post-COVID era

PURPOSE

The COVID-19 pandemic has forced changes in the delivery of medical education. We aimed to explore these changes and determine whether they will impact the future of medical education in any way.

METHODS

We invited leaders in medical education from all accessible US-based medical schools to participate in an online individual semi-structured interview.

RESULTS

Representatives of 16 medical schools participated. They commented on the adequacy of online education for knowledge transfer, and the logistical advantages it offered, but decried its negative influence on social learning, interpersonal relationships and professional development of students, and its ineffectiveness for clinical education. Most participants indicated that they would maintain online learning for didactic purposes in the context of flipped classrooms but that a return to in-person education was essential for most other educational goals. Novel content will be introduced, especially in telemedicine and social medicine, and the students' roles and responsibilities in patient care and in curricular development may evolve in the future.

CONCLUSIONS

This study is the first to document the practical steps that will be adopted by US medical schools in delivering medical education, which were prompted and reinforced by their experience during the COVID-19 pandemic.

Graduating Medical Students' Perceptions of the COVID-19 Pandemic's Impact on Their Medical School Experiences and Preparation for Careers as Physicians: A National Study

PURPOSE

The COVID-19 pandemic resulted in unprecedented changes to the medical education learning environment. The graduating class of 2021 was particularly affected. To better understand how students were affected, the authors explored positive and negative experiences described by graduating U.S. medical students.

METHOD

Using the conceptual framework of affordances, the authors examined narrative responses to 2 new open-ended questions on the Association of American Medical Colleges 2021 Graduation Questionnaire in which graduating students described the pandemic's positive and negative effects on their medical school experiences and career preparation. Conventional content analysis was used to identify affordances and themes in responses.

RESULTS

Of 16,611 Graduation Questionnaire respondents, 8,926 (54%) provided narrative responses. Of these 8,926 respondents, responses from 2,408 students (27%) were analyzed. Students described positive and negative perceptions of affordances, centering around virtual learning, social connection, and transition to residency. Fewer in-person and increased virtual clinical rotations offered students flexible scheduling, allowing them greater opportunity to explore academic and professional interests. Additionally, students' sense of isolation from their medical school was alleviated when schools exercised intentional open communication and student involvement in decision making. Although many described a diminished sense of preparedness for residency due to limited access to in-person clinical experiences and to assessing residencies largely through virtual away rotations and interviews, the sense of community, adaptability, and resiliency gained through varied activities reinforced students' professional identity and commitment to medicine during a time of much uncertainty.

CONCLUSIONS

This national exploration of students' pandemic experiences highlights what students value as fundamental elements of medical education and student support and describes how innovation can improve long-standing practices. These findings, guided by students' insights, can help inform the work of educational leaders as they consider which innovations should remain to continue enhancing student learning, engagement, and well-being.

Occupying liminal spaces: The figured worlds of student affairs senior leaders in the United States

INTRODUCTION

Student Affairs Senior Leaders (SASLs) in the United States lead offices responsible for academic advising, administrative documentation, scheduling, student health, financial aid, and transition to residency, yet they infrequently draw attention in the field's literature. We explore the role of SASLs and how they describe the social space of medical education.

METHODS

Using a constructivist approach informed by Figured Worlds theory, we conducted a sequential narrative and thematic analysis of the stories SASLs tell about their roles and experiences in the world of medical education.

RESULTS

SASLs inhabit complex roles centred on advocating for medical students' academic, personal and social well-being. Their unique position within the medical school allows them to see the harm to vulnerable students made possible by misalignments inherent within medical education. Yet even with the challenges inherent in the environment, SASLs find reasons for hope.

CONCLUSION

SASLs' identities are full of potential contradictions, but they have a unique view into the often-chaotic world of medical education.

Addressing diversity in the physician workforce through social determinants of medical education

Social determinants of medical education are the most impactful aspects of recruiting, retaining, and producing the next generation of a diverse physician workforce. We can use the same framework well known to describe social determinants of health to identify social determinants that impact medical education learners and their ability to enter the workforce and succeed to completion. Efforts aimed at recruitment and retention should not exist in isolation and must be matched with those that continuously assess and evaluate the learning environment. The development of a climate where all can bring their full selves to learn, study, work, and care for patients is critically important in the creation of a learning environment where every participant can grow and thrive. If we are to address the need to diversify the workforce, we must be intentional with strategic plans, which includes addressing the social determinants that are prohibitive for some of our learners.

Racial Bias on the Emergency Medicine Standardized Letter of Evaluation

BACKGROUND

Studies on components of residency applications have shown evidence of racial bias. The Standardized Letter of Evaluation (SLOE) is an assessment measure for emergency medicine (EM) residency applications and, as more specialties opt to use SLOEs in place of narrative letters of recommendation, understanding bias on standardized assessments is essential.

OBJECTIVE

To determine whether there is a difference in rankings on the EM SLOE between underrepresented in medicine (UIM) and non-UIM applicants, White and non-White applicants, and to examine whether differences persist after controlling for other characteristics.

METHODS

The sample was drawn from medical students who applied to EM residency at the study institution in 2019. We compared rankings between UIM and non-UIM students and between students of each individual race/ethnicity and White students, after controlling for United States Medical Licensing Examination Step scores, Alpha Omega Alpha status, type of school (US MD, US DO, internation medical graduate), Medical Student Performance Evaluation class percentile, affiliated program vs visiting clerkship SLOE, gender and the interaction of race/ethnicity and gender, and adjusted for students submitting multiple SLOEs, using ordinal regression.

RESULTS

There were 1555 applicants to the study institution in 2019; 1418 (91.2%) had a SLOE and self-identified race/ethnicity. After controlling for applicant characteristics, non-UIM students were significantly more likely to be ranked higher than UIM students on "Rank Against Peers," (OR 1.46, 95% CI 1.03-2.07) and Grade (OR 1.46, 95% CI 1.05-2.04).

CONCLUSIONS

Analysis of EM SLOEs submitted to our institution demonstrates racial bias on this standardized assessment tool, which persists after controlling for other performance predictors.