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Albert FA, Seidu AA, Mason HM, Anderson E, Alele FO, Heggarty P, Hollins A, Gupta TS, Hays RB, McArthur L, Malau-Aduli BS. A systematic review of medical practitioners' retention and application of basic sciences to clinical practice. BMC MEDICAL EDUCATION 2024; 24:997. [PMID: 39272053 PMCID: PMC11396528 DOI: 10.1186/s12909-024-05952-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 08/23/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND Medical education offers the foundational base for future healthcare professionals, with basic sciences playing a pivotal role in providing essential knowledge and skills for clinical practice. However, the long-term retention and application of this knowledge in clinical practice remain a significant challenge. This systematic review synthesised global evidence from diverse studies on the short / long-term retention and clinical application of basic sciences among medical doctors. METHODS A comprehensive search was conducted across six databases, including Web of Science, Scopus, Medline, CINAHL, Emcare, and Informit. The review included studies that encompassed a variety of study designs, participant groups, and educational interventions. The Quality Assessment with Diverse Studies (QuADS) tool was utilised to assess the quality of the reviewed studies. RESULTS A total of 10 studies were included in the review. The findings revealed that rehearsals significantly optimise the retention of basic science knowledge among medical practitioners. Retention varied by discipline, with medical practitioners retaining more knowledge in anatomy (mean scores ranging from 45.0 to 82.9%), while microbiology had the lowest retention score (39.1%). Factors influencing retention included age, gender, and curriculum type. Educational interventions such as targeted courses, integration of basic sciences with clinical skills, generative retrieval and continuous quality improvement in the curriculum were found to enhance both knowledge retention and clinical reasoning. The concept of 'encapsulated knowledge' demonstrates that integrated basic science knowledge helps in synthesising clinical presentations, reducing the need for detailed recall as clinical experience increases. The reviewed studies primarily involved interns and surgeons, leaving a significant gap in research for specialties like internal medicine and primary care/ general practice. CONCLUSION Detailed retention of basic science knowledge may diminish over time; however, the conceptual framework remains essential for ongoing learning and clinical reasoning. This review's findings highlight the need for specialised educational interventions to improve long-term retention. Continuous professional development and targeted educational techniques are vital for maintaining clinical competence and applying basic science knowledge effectively throughout a medical career. Further research is needed to address gaps in specialty-specific knowledge application and the impact of different instructional methods.
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Affiliation(s)
- Francis A Albert
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Abdul-Aziz Seidu
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Hannah M Mason
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Emma Anderson
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Faith O Alele
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD, 4556, Australia
| | - Paula Heggarty
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Aaron Hollins
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Tarun Sen Gupta
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Richard B Hays
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Lawrie McArthur
- Adelaide Rural Clinical School, University of Adelaide, Adelaide, SA, 5606, Australia
| | - Bunmi S Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia.
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, 2308, Australia.
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Huang SS, Lin YF, Huang AY, Lin JY, Yang YY, Lin SM, Lin WY, Huang PH, Chen TY, Yang SJH, Lirng JF, Chen CH. Using machine learning to identify key subject categories predicting the pre-clerkship and clerkship performance: 8-year cohort study. J Chin Med Assoc 2024; 87:609-614. [PMID: 38648194 DOI: 10.1097/jcma.0000000000001097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Medical students need to build a solid foundation of knowledge to become physicians. Clerkship is often considered the first transition point, and clerkship performance is essential for their development. We hope to identify subjects that could predict the clerkship performance, thus helping medical students learn more efficiently to achieve high clerkship performance. METHODS This cohort study collected background and academic data from medical students who graduated between 2011 and 2019. Prediction models were developed by machine learning techniques to identify the affecting features in predicting the pre-clerkship performance and clerkship performance. Following serial processes of data collection, data preprocessing before machine learning, and techniques and performance of machine learning, different machine learning models were trained and validated using the 10-fold cross-validation method. RESULTS Thirteen subjects from the pre-med stage and 10 subjects from the basic medical science stage with an area under the ROC curve (AUC) >0.7 for either pre-clerkship performance or clerkship performance were found. In each subject category, medical humanities and sociology in social science, chemistry, and physician scientist-related training in basic science, and pharmacology, immunology-microbiology, and histology in basic medical science have predictive abilities for clerkship performance above the top tertile. Using a machine learning technique based on random forest, the prediction model predicted clerkship performance with 95% accuracy and 88% AUC. CONCLUSION Clerkship performance was predicted by selected subjects or combination of different subject categories in the pre-med and basic medical science stages. The demonstrated predictive ability of subjects or categories in the medical program may facilitate students' understanding of how these subjects or categories of the medical program relate to their performance in the clerkship to enhance their preparedness for the clerkship.
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Affiliation(s)
- Shiau-Shian Huang
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yu-Fan Lin
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Anna YuQing Huang
- Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Ji-Yang Lin
- Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Ying-Ying Yang
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Sheng-Min Lin
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Wen-Yu Lin
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Pin-Hsiang Huang
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Tzu-Yao Chen
- Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Stephen J H Yang
- Department of Computer Science and Information Engineering, National Central University, Taoyuan, Taiwan, ROC
| | - Jiing-Feng Lirng
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chen-Huan Chen
- Department of Medical Education, Clinical Innovation Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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Obernikhina NV, Yanitska LV, Vygovska OV. The unified state qualification exam STEP-1 as a marker of the success of the education of pediatric doctors in Ukraine and Bogomolets National Medical University. BMC MEDICAL EDUCATION 2024; 24:263. [PMID: 38459533 PMCID: PMC10924366 DOI: 10.1186/s12909-024-05261-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/04/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Ukraine's higher medical education goes deeper and deeper every year in the European integration processes in the field of «Health Care» knowledge. Since 2005, the integrated license integrated exam STEP "General medical training" has been introduced in the country to diagnose the quality of training of specialists in all medical specialties. Since 2019, Ukraine, unlike other countries in Europe and the world, has been training specialists in the specialty "Pediatrics" at the stage of undergraduate training. The quality control of the training of specialists is carried out in the form of passing the Unified State Qualification Exam STEP (USQE STEP) separately for each medical specialty (Medicine and Pediatrics). Therefore, the purpose of our research is to conduct a comparative analysis of the results of the success of the first stage of the USQE STEP-1 by students of higher medical education in the specialty "Pediatrics" with the specialty "Medicine" in Ukraine and in the Bogomolets National Medical University (Bogomolets NMU). METHODS Analytical references to the results of the first stage of the USQE STEP-1 for the students who have completed theoretical medical disciplines specialty "Pediatrics" and the specialty "Medicine" in Ukraine and Bogomolets NMU, which are provided by the Testing Center at the Ministry of Health of Ukraine. Тhe statistical significance of comparative indicators was proved using Fisher's test, with a statistical error that corresponded to the specified value for ≤ 0.05. RESULTS It is shown that in 2022, applicants of higher medical education of Ukraine with the specialty "Pediatrics" improved the overall success rate by 8.4%, and the success rate of subtests by an average of 10.5%, despite the state of war in Ukraine. The exception was the results of the licensing exam for the subtest component "Biochemistry": compared to 2021, the pass rate decreased by 3.6% in the specialty "Medicine" and by 6.4% in the specialty "Pediatrics". At Bogomolets NMU, the leaders of 2022 were the students of the "Pediatrics" specialty, their success rate is 2% higher than that of the "Medicine" specialty. CONCLUSIONS The analysis of the results of USQE STEP-1 by applicants of higher medical education of the specialties "Pediatrics" and "Medicine" in Ukraine showed the effectiveness of the selection of the specialty "Pediatrics" into a separate section of the training of specialists at the undergraduate level in the field of "Health Care". Using the methods of mathematical statistics, the effectiveness of organizational methodological techniques in the organization of the educational process in the conditions of the martial law of Ukraine and Bogomolets NMU as a leader in the training of specialists in Pediatric doctors has been proved.
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Affiliation(s)
- Nataliya V Obernikhina
- Department of Medical Biochemistry and Molecular Biology, Bogomolets National Medical University, 13 T. Shevchenko boul., 01601, Kyiv, Ukraine.
| | - Lesya V Yanitska
- Department of Medical Biochemistry and Molecular Biology, Bogomolets National Medical University, 13 T. Shevchenko boul., 01601, Kyiv, Ukraine
| | - Oksana V Vygovska
- Dean of the Faculty "Pediatrics" Bogomolets, National Medical University, 13 T. Shevchenko boul., 01601, Kyiv, Ukraine
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Maxwell S, Fuchs-Young R, Wells GB, Kapler G, Green S, Pepper C, Gastel B, Huston DP. Short-Term Training with Basic Science Research Literature Advances Medical Students' Skills for Adaptive Expertise. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241227328. [PMID: 38304279 PMCID: PMC10832445 DOI: 10.1177/23821205241227328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 11/28/2023] [Indexed: 02/03/2024]
Abstract
Physicians must adapt their learning and expertise to the rapid evolution of healthcare. To train for the innovation-efficient demands of adaptive expertise, medical students need to acquire the skill of adaptive self-regulated learning, which includes accessing, interpreting, and synthesizing emerging basic and translational research to support patient care. In response, we developed the course Medical Student Grand Rounds (MSGR). It engages all pre-clerkship students at our institution with self-regulated learning from translational basic research literature. In this report, we describe MSGR's methodology and important outcomes. Students found, interpreted, critically assessed, and presented basic research literature about self-selected clinically relevant topics. In less than one semester and mentored by basic science researchers, they completed eight milestones: (a) search research literature databases; (b) choose a clinical topic using searching skills; (c) outline the topic's background; (d) outline a presentation based on the topic's mechanistic research literature; (e) attend translational research-oriented grand rounds by faculty; (f) learn to prepare oral presentations; (g) write an abstract; and (h) present at Grand Rounds Day, emphasizing their topic's research literature. Graded milestones and end-of-course self-assessments indicated students became proficient in interpreting research articles, preparing and delivering presentations, understanding links among basic and translational research and clinical applications, and pursuing self-regulated learning. Qualitative analysis of self-assessment surveys found most students thought they progressed toward the learning objectives: find scientific information about a research topic (56% positive responses), interpret and critically assess scientific information (64%), and prepare and deliver a scientific presentation (50%). Milestones improve time management and provide a scaffolded method for presenting focused research topics. MSGR equips students with critical thinking skills for lifelong, adaptive, self-regulated learning-a foundation for adaptive expertise. The master adaptive learner cycle of planning, learning, assessing, and adjusting is a conceptual framework for understanding students' MSGR learning experiences.
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Affiliation(s)
- Steve Maxwell
- Department of Cell Biology and Genetics, Texas A&M University, Bryan, Texas, USA
| | - Robin Fuchs-Young
- Department of Cell Biology and Genetics, Texas A&M University, Bryan, Texas, USA
| | - Gregg B. Wells
- Department of Cell Biology and Genetics, Texas A&M University, Bryan, Texas, USA
| | - Geoffrey Kapler
- Department of Cell Biology and Genetics, Texas A&M University, Bryan, Texas, USA
| | - Sheila Green
- Medical Sciences Library, Texas A&M University, Bryan, Texas, USA
| | - Catherine Pepper
- Medical Sciences Library, Texas A&M University, Bryan, Texas, USA
| | - Barbara Gastel
- Department of Veterinary Integrative Biosciences, Texas A&M University, Bryan, Texas, USA
- Department of Humanities in Medicine, Texas A&M University, Bryan, Texas, USA
| | - David P. Huston
- Department of Microbial Pathogenesis and Immunology, Texas A&M University, Bryan, Texas, USA
- Clinical Science and Translational Research Program, Texas A&M University School of Medicine, Bryan, Texas, USA
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Fulton TB, Collins S, van der Schaaf M, O'Brien BC. Connecting Biochemistry Knowledge to Patient Care in the Clinical Workplace: Senior Medical Students' Perceptions about Facilitators and Barriers. TEACHING AND LEARNING IN MEDICINE 2023; 35:398-410. [PMID: 35796605 DOI: 10.1080/10401334.2022.2084400] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 05/18/2022] [Indexed: 06/15/2023]
Abstract
Phenomenon: Medical students have difficulties applying knowledge about biomedical mechanisms learned before clerkships to patient care activities. Many studies frame this challenge as a problem of basic science knowledge transfer predominantly influenced by students' individual cognitive processes. Social cognitive theory would support extending this framing to the interplay between the individual's cognition, the environment, and their behaviors. This study investigates senior medical students' experiences of biochemistry knowledge use during workplace learning and examines how their experiences were influenced by interactions with people and other elements of the clinical learning environment. Approach: The authors used a qualitative approach with a constructivist orientation. From September to November 2020 they conducted semi-structured interviews with 11 fourth-year medical students at one institution who had completed the pre-clerkship curriculum, core clinical clerkships, and the United States Medical Licensing Exam Step 1. The authors identified themes using thematic analysis. Findings: Participants reported that they infrequently used or connected to biochemistry knowledge in workplace patient care activities, yet all had examples of such connections that they found valuable to learning. Most participants felt the responsibility for making connections between biochemistry knowledge and activities in the clinical workplace should be shared between themselves and supervisors, but connections were often recognized and acted on only by the student. Connections that participants described prompted their effort to retrieve knowledge or fill a perceived learning gap. Participants identified multiple barriers and facilitators to connecting, including supervisors' behaviors and perceived knowledge, and "patients seen" in clerkships. Participants also reported learning biochemistry during USMLE Step 1 study that did not connect to patient care activities, underscoring a perception of disconnect. Insights: This study identifies specific personal, social, and physical environmental elements that influence students' perceived use of biochemistry during patient care activities. Though these findings may be most significant for biochemistry, they likely extend to other basic science disciplines. Students' self-directed efforts to connect to their biochemistry knowledge could be augmented by increased social support from clinical supervisors, which in turn likely requires faculty development. Opportunities for connection could be enhanced by embedding into the environment instructional strategies or technologies that build on known authentic connections between biochemistry and "patients seen" in clerkships. These efforts could strengthen student learning, improve clinical supervisors' self-efficacy, and better inform curriculum design.
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Affiliation(s)
- Tracy B Fulton
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
| | - Sally Collins
- Center for Faculty Educators, University of California, San Francisco, California, USA
| | - Marieke van der Schaaf
- Faculty of Medicine, Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bridget C O'Brien
- Department of Medicine, University of California, San Francisco, California, USA
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Rogers M, Lyden C, Steinke M, Windle A, Lehwaldt D. An international comparison of student nurse practitioner diagnostic reasoning skills. J Am Assoc Nurse Pract 2023; 35:477-486. [PMID: 37471527 DOI: 10.1097/jxx.0000000000000902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 05/05/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Nurse practitioners (NPs) play a pivotal role in health care provision. Diagnostic reasoning is an important core skill of advanced practice. PURPOSE The purpose of this study was to compare diagnostic reasoning skills of NP students. It also identified the variability in clinical teaching components of a sample of international NP curricula. METHODS An international group of NP students completed an online survey using a validated diagnostic reasoning scale during the first year of their NP program. Program faculty surveyed provided data on core curricula. RESULTS The NP students' ( n = 152) mean diagnostic thinking inventory (DTI) score was 142, flexibility in thinking subscale score mean of 73 with a knowledge structure in memory of 69. The programs surveyed required bioscience courses. Most programs provided opportunities for students to practice diagnostic thinking using individual precepted clinical hours (range 500-950) and objective structured clinical examinations. CONCLUSION The lower scores of this group of NP students were similar to other NP students and first-year medical residents. Higher mean scores in the DTI reflect expertise and are developed over time. Courses providing a foundation of biomedical knowledge were identified in each program, with opportunities for the NP students to practice diagnostic thinking using objective structured clinical examinations and clinical practice hours. IMPLICATIONS The use of the diagnostic reasoning inventory is a useful tool for evaluating student NP's diagnostic reasoning during their NP program. Nurse practitioner programs should consider the provision of dedicated clinical hours, including supervised clinical practice experiences and objective structured clinical examinations to improve diagnostic reasoning.
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Affiliation(s)
- Melanie Rogers
- Department of Nursing, University of Huddersfield, Huddersfield, United Kingdom
| | - Catherine Lyden
- School of Nursing, University of Southern Maine, Portland, Maine
| | | | - Angela Windle
- Department of Nursing, University of Huddersfield, Huddersfield, United Kingdom
| | - Daniela Lehwaldt
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
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Donovan CM. Augmented Reality Integration in Manikin-Based Simulations: Bringing Basic Science to the Critical Care Bedside with Limited Augmented Reality Resources. MEDICAL SCIENCE EDUCATOR 2023; 33:829-833. [PMID: 37546210 PMCID: PMC10403467 DOI: 10.1007/s40670-023-01821-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 08/08/2023]
Abstract
Immersive simulation and augmented reality (AR) are powerful educational tools in high-risk medical professions. Basic science AR, such as anatomic holograms, are gaining popularity. Many educators want to adopt AR and integrate basic science review in high-risk clinical decision-making but cannot afford it. In this project, we designed three AR integrated manikin-based simulations (ARI-MBS) by combining critical care scenarios with commercially available AR programs. Using a single headset and limited equipment, we technically integrated AR into MBS in a way that both students and faculty found rewarding. We present our design, so that others may replicate it. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01821-z.
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Affiliation(s)
- Colleen M. Donovan
- Department of Emergency Medicine, Rutgers-RWJMS, New Brunswick, NJ USA
- Department of Pharmacy Practice & Administration, Rutgers-EMSOP, Piscataway, USA
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Kiessling C, Perron NJ, van Nuland M, Bujnowska-Fedak MM, Essers G, Joakimsen RM, Pype P, Tsimtsiou Z. Does it make sense to use written instruments to assess communication skills? Systematic review on the concurrent and predictive value of written assessment for performance. PATIENT EDUCATION AND COUNSELING 2023; 108:107612. [PMID: 36603470 DOI: 10.1016/j.pec.2022.107612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES To evaluate possible associations between learners' results in written and performance-based assessments of communication skills (CS), either in concurrent or predictive study designs. METHODS Search included four databases for peer-reviewed studies containing both written and performance-based CS assessment. Eleven studies met the inclusion criteria. RESULTS Included studies predominantly assessed undergraduate medical students. Studies reported mainly low to medium correlations between written and performance-based assessment results (Objective Structured Clinical Examinations or encounters with simulated patients), and gave correlation coefficients ranging from 0.13 to 0.53 (p < 0.05). Higher correlations were reported when specific CS, like motivational interviewing were assessed. Only a few studies gave sufficient reliability indicators of both assessment formats. CONCLUSIONS Written assessment scores seem to predict performance-based assessments to a limited extent but cannot replace them entirely. Reporting of assessment instruments' psychometric properties is essential to improve the interpretation of future findings and could possibly affect their predictive validity for performance. PRACTICE IMPLICATIONS Within longitudinal CS assessment programs, triangulation of assessment including written assessment is recommended, taking into consideration possible limitations. Written assessments with feedback can help students and trainers to elaborate on procedural knowledge as a strong support for the acquisition and transfer of CS to different contexts.
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Affiliation(s)
- Claudia Kiessling
- Chair for the Education of Personal and Interpersonal Competencies in Health Care, Witten/Herdecke University, Witten, Germany.
| | - Noelle Junod Perron
- Unit of Development and Research in Medical Education and Department of community health and medicine, Geneva Faculty of Medicine and Medical Directorate, Geneva University Hospitals, Geneva, Switzerland
| | - Marc van Nuland
- Academic Center for General Practice, Leuven University, Leuven, Belgium
| | | | - Geurt Essers
- Network of GP Training Programs in the Netherlands, the Netherlands
| | - Ragnar M Joakimsen
- Department of Clinical Medicine, Faculty of Health Sciences, UIT The Arctic University of Norway and Department of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Peter Pype
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Zoi Tsimtsiou
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Porter-Stransky KA, Gibson K, VanDerKolk K, Edwards RA, Graves LE, Smith E, Dickinson BL. How Medical Students Apply Their Biomedical Science Knowledge to Patient Care in the Family Medicine Clerkship. MEDICAL SCIENCE EDUCATOR 2023; 33:63-72. [PMID: 36467744 PMCID: PMC9702919 DOI: 10.1007/s40670-022-01697-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED Medical students enter clerkships with the requisite biomedical science knowledge to engage in supervised patient care. While poised to apply this knowledge, students face the cognitive challenge of transfer: applying knowledge learned in one context (i.e., preclinical classroom) to solve problems in a different context (i.e., patients in the clinic). To help students navigate this challenge, a structured reflection exercise was developed using Kolb's experiential learning cycle as an organizing framework. Students selected a patient encounter (concrete experience), wrote and addressed biomedical science learning objectives related to the care of the patient (reflective observation), reflected on how addressing the learning objectives influenced patient care (abstract conceptualization), and described their attending engaging in a similar process (active experimentation). A directed content analysis of students' written reflections revealed that most students wrote clinical science learning objectives in addition to biomedical science learning objectives. When viewed through the lenses of knowledge encapsulation theory and illness script theory, some students recognized knowledge encapsulation as a process beginning to occur in their own approach and their attendings' approach to clinical reasoning. Students readily applied their biomedical science knowledge to explain the pathophysiologic basis of disease (fault illness script domain) and signs and symptoms (consequence illness script domain), with fewer addressing predisposing conditions (enabling conditions illness script domain). Instances in which students observed their attending applying biomedical science knowledge were rare. Implications for using structured reflective writing as a tool to facilitate student application of their biomedical science knowledge in clerkships are discussed. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-022-01697-5.
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Affiliation(s)
| | - Kristine Gibson
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI USA
| | - Kristi VanDerKolk
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI USA
| | - Roger A. Edwards
- Massachusetts General Hospital Institute of Health Professions, Boston, MA USA
| | - Lisa E. Graves
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI USA
| | - Edwina Smith
- Mercer University School of Medicine, Macon, GA USA
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Masava B, Nyoni CN, Botma Y. Scaffolding in Health Sciences Education Programmes: An Integrative Review. MEDICAL SCIENCE EDUCATOR 2023; 33:255-273. [PMID: 37008420 PMCID: PMC10060462 DOI: 10.1007/s40670-022-01691-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 06/19/2023]
Abstract
The complexity of health sciences programmes justifies scaffolding to support students in becoming competent health professionals. This article reports on an integrative review that aimed to describe the application of scaffolding in health sciences programmes. Twenty-nine sources, inclusive of theoretical and empirical studies, were reviewed. The sequencing of educational activities, the application of scaffolding tools or resources, frameworks for applying scaffolding, modelling, and fading represented the application of scaffolding in health sciences programmes. Awareness of the application of scaffolding in health sciences programmes could contribute to enhancing competence development among students when applied across all learning platforms.
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Affiliation(s)
- Beloved Masava
- School of Nursing, University of the Free State, Bloemfontein, South Africa
| | - Champion N. Nyoni
- School of Nursing, University of the Free State, Bloemfontein, South Africa
| | - Yvonne Botma
- School of Nursing, University of the Free State, Bloemfontein, South Africa
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Assing Hvidt E, Ulsø A, Thorngreen CV, Søndergaard J, Andersen CM. Weak inclusion of the medical humanities in medical education: a qualitative study among Danish medical students. BMC MEDICAL EDUCATION 2022; 22:660. [PMID: 36064397 PMCID: PMC9442995 DOI: 10.1186/s12909-022-03723-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The modern medical education is predominantly grounded in the biomedical sciences. In recent years, medical humanities have been included into the medical curricula in many countries around the world one of the objectives being to promote patient-centred, empathic care by future physicians. Studies have been made of the impact of inclusion of medical humanities components within the medical curriculum. Although some results suggest increased empathy, others remain inconclusive. To gain insight into the depth, context, and impact of inclusion of the medical humanities for future physicians, this study aimed to explore Danish medical students' understanding of and reflections on how the medical humanities relate to the medical education, including the clinic. METHODS We conducted a qualitative research study, involving semi-structured interviews with twenty-three Danish medical students across years of curriculum and medical schools. Interviews were recorded, transcribed verbatim and analyzed using Braun and Clarke's thematic analysis. RESULTS The findings demonstrate the subordinate role of the medical humanities in the medical educational system. Students prioritize biomedical knowledge building in the preclinical curriculum, partly as a reaction to an unbalanced institutional inclusion of the medical humanities. Observing how structural empathy incentives are lacking in the clinical curriculum, the values inherent in the medical humanities are undermined. CONCLUSION Danish medical students become part of an educational environment with lacking institutional conditions and structures to promote the strong inclusion of the medical humanities. A focus is therefore needed on the values, norms and structures of the medical educational systems that undermine a strong inclusion of the medical humanities into medical education.
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Affiliation(s)
- Elisabeth Assing Hvidt
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark.
| | - Anne Ulsø
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | | | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark
| | - Christina Maar Andersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
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International guidelines to inform policy development to address client violence in South Africa: an ATA-document analysis. BMC Health Serv Res 2022; 22:1025. [PMID: 35962449 PMCID: PMC9373364 DOI: 10.1186/s12913-022-08196-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research shows that the most typical response to client violence has been to implement policies that safeguard social workers at their workplaces. This article examined, through a document analysis, the international norms for the protection of social workers. The goal of the document analysis was to inform policy development in South Africa against client violence. METHODS The researchers found, selected, analysed, and synthesised 17 international policies, frameworks, protocols, guidelines, and legislative frameworks using the applied thematic analysis (ATA) approach. The data was analysed at three levels, and open coding yielded 18 codes. RESULTS The codes were refined into three main themes and subthemes related to protecting social workers from client violence: (1) employers inspired a culture of safety and security within the work-environment, (2) social workers prioritised their safety by using their clinical skills, and (3) actively implementing initiatives to ensure the safety of social workers. CONCLUSIONS The research highlighted social work safety while providing services at an office, visiting sites, or traveling. Examining these practicalities provided valuable data that can inform policy development processes in different countries.
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Li X, Jiang MYC, Jong MSY, Zhang X, Chai CS. Understanding Medical Students' Perceptions of and Behavioral Intentions toward Learning Artificial Intelligence: A Survey Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8733. [PMID: 35886587 PMCID: PMC9315694 DOI: 10.3390/ijerph19148733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 01/27/2023]
Abstract
Medical students learning to use artificial intelligence for medical practices is likely to enhance medical services. However, studies in this area have been lacking. The present study investigated medical students' perceptions of and behavioral intentions toward learning artificial intelligence (AI) in clinical practice based on the theory of planned behavior (TPB). A sum of 274 Year-5 undergraduates and master's and doctoral postgraduates participated in the online survey. Six constructs were measured, including (1) personal relevance (PR) of medical AI, (2) subjective norm (SN) related to learning medical AI, (3) perceived self-efficacy (PSE) of learning medical AI, (4) basic knowledge (BKn) of medical AI, (5) behavioral intention (BI) toward learning medical AI and (6) actual learning (AL) of medical AI. Confirmatory factor analysis and structural equation modelling were employed to analyze the data. The results showed that the proposed model had a good model fit and the theoretical hypotheses in relation to the TPB were mostly confirmed. Specifically, (a) BI had a significantly strong and positive impact on AL; (b) BI was significantly predicted by PR, SN and PSE, whilst BKn did not have a direct effect on BI; (c) PR was significantly and positively predicted by SN and PSE, but BKn failed to predict PR; (d) both SN and BKn had significant and positive impact on PSE, and BKn had a significantly positive effect on SN. Discussion was conducted regarding the proposed model, and new insights were provided for researchers and practitioners in medical education.
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Affiliation(s)
- Xin Li
- Department of Infectious Disease, The First Affiliated Hospital of China Medial University, Shenyang 110000, China;
| | - Michael Yi-chao Jiang
- Department of Curriculum and Instruction, Faculty of Education, The Chinese University of Hong Kong, Hong Kong SAR, China; (M.Y.-c.J.); (M.S.-y.J.); (C.-s.C.)
- Centre for Learning Sciences and Technologies, Hong Kong Institute of Educational Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Morris Siu-yung Jong
- Department of Curriculum and Instruction, Faculty of Education, The Chinese University of Hong Kong, Hong Kong SAR, China; (M.Y.-c.J.); (M.S.-y.J.); (C.-s.C.)
- Centre for Learning Sciences and Technologies, Hong Kong Institute of Educational Research, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xinping Zhang
- Hunnan Tumour Centre, The First Affiliated Hospital of China Medical University, Shenyang 110000, China
| | - Ching-sing Chai
- Department of Curriculum and Instruction, Faculty of Education, The Chinese University of Hong Kong, Hong Kong SAR, China; (M.Y.-c.J.); (M.S.-y.J.); (C.-s.C.)
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Darici D, Missler M, Schober A, Masthoff M, Schnittler H, Schmitz M. "Fun slipping into the doctor's role"-The relationship between sonoanatomy teaching and professional identity formation before and during the Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2022; 15:447-463. [PMID: 35274467 DOI: 10.1002/ase.2178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Abstract
The various psychological dimensions of professional identity formation (PIF) are an important aspect of the study course for undergraduate medical students. Anatomical learning environments have been repeatedly shown to play a critical role in forming such an identity; however, relevance of PIF during sonoanatomical training remains underexplored. At the end of their basic anatomy studies, third-semester medical students took part in a four-day block course on anatomy and imaging. Anatomical content was revised in small groups using peer teaching and imaging methods, including one hour of hands-on sonoanatomy sessions each day. On-site sonoanatomy was identified as an excellent format to support students' transition from the pre-clinical to clinical phase as medical experts-to-be. Students enjoyed practical exercises and the clinical input, which increased their interest in the medical profession and their academic studies. This study further examined the effects of the transition into an online-only format, necessitated by the current Covid-19 pandemic. A comparison was made between the quantitative and qualitative evaluation data, and the written results of examinations of several on-site (n = 1096, mean age = 22.4 years ± 2.18), and online-only cohorts (n = 230, mean age = 22.6 years ± 2.21). The online-only transition led to a reduction of all PIF-related variables measured, losing identity-related variables, increasing students' stress levels, and reducing their long-term academic performance. Together, this study demonstrates presence of PIF in undergraduate sonoanatomy teaching, and cautions against the uncritical online-only substitution of hands-on learning environments.
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Affiliation(s)
- Dogus Darici
- Institute of Anatomy and Molecular Neurobiology, Westfälische Wilhelms-University, Münster, Germany
| | - Markus Missler
- Institute of Anatomy and Molecular Neurobiology, Westfälische Wilhelms-University, Münster, Germany
| | - Anna Schober
- Institute of Anatomy and Molecular Neurobiology, Westfälische Wilhelms-University, Münster, Germany
| | - Max Masthoff
- Institute of Clinical Radiology, University Hospital Münster, Münster, Germany
| | - Hans Schnittler
- Institute of Anatomy and Vascular Biology, Westfälische Wilhelms-University, Münster, Germany
| | - Martina Schmitz
- Institute of Anatomy and Vascular Biology, Westfälische Wilhelms-University, Münster, Germany
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15
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Porter-Stransky KA, Gallimore RM. Medical Student Attitudes and Perceptions on the Relevance of Neuroscience to Psychiatry: a Mixed Methods Study. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:128-132. [PMID: 34499342 DOI: 10.1007/s40596-021-01525-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 08/10/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Many psychiatry residency programs are actively incorporating neuroscience training into their curricula; however, relatively little scholarship exploring neuroscience and psychiatry integration in undergraduate medical education has been conducted. This study investigated second-year, pre-clerkship medical students' perceptions on the relationship between neuroscience and psychiatry following foundational neuroscience and behavior instruction to identify their views before they enter clerkships. METHODS A mixed methods design combined qualitative analysis of medical students' essays in response to the prompt: "What is the relationship between neuroscience and psychiatry?" with quantitative analysis of survey responses on a 7-point scale. RESULTS Ninety-three percent of the class participated in the study (n = 77). Learners rated neuroscience as important for understanding and treating psychiatric disorders, albeit less important for psychiatric compared to neurological disorders. Using applied thematic analysis, the authors identified qualitative themes. Specifically, participants recognized neuroscience as a foundational science for psychiatry, but some emphasized that factors other than neuroscience are needed to explain psychiatric disorders. Some students perceived neuroscience and psychiatry as complementary approaches to understanding the brain and behavior. Others identified a role for neuroscience in reducing the stigma of psychiatric disorders and thereby improving access to psychiatric care. CONCLUSIONS The quantitative and qualitative findings reinforced each other and provided novel insight to pre-clerkship medical students' views on the relevance of neuroscience for psychiatry. Educating all medical students, not just psychiatry residents, on the neuroscience of psychiatric disorders may better equip the next generation of physicians, regardless of specialty, to care for their patients with psychiatric conditions.
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Affiliation(s)
| | - Rachel M Gallimore
- Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
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Dickinson BL, Gibson K, VanDerKolk K, Greene J, Rosu CA, Navedo DD, Porter-Stransky KA, Graves LE. Correction to: "It is this very knowledge that makes us doctors": an applied thematic analysis of how medical students perceive the relevance of biomedical science knowledge to clinical medicine. BMC MEDICAL EDUCATION 2020; 20:428. [PMID: 33187510 PMCID: PMC7666490 DOI: 10.1186/s12909-020-02371-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
An amendment to this paper has been published and can be accessed via the original article.
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Affiliation(s)
- Bonny L Dickinson
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA, USA.
| | - Kristine Gibson
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Kristi VanDerKolk
- Department of Family and Community Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Jeffrey Greene
- Department of Medical Education, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Claudia A Rosu
- Center for Interprofessional Studies and Innovation at Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
| | - Deborah D Navedo
- Massachusetts General Hospital, Learning Laboratory, Massachusetts General Hospital, Boston, MA, USA
| | - Kirsten A Porter-Stransky
- Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
| | - Lisa E Graves
- Department of Family and Community Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
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