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Badamdorj O, Erkhembayar R, Gombo B, Baatarpurev B, Gansukh D, Tsogbadrakh B, Sandag O, Dalkh T, Nyamjav S. Medical education in Mongolia: Challenges and opportunities. MEDICAL TEACHER 2024; 46:1160-1166. [PMID: 38588714 DOI: 10.1080/0142159x.2024.2336077] [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: 10/26/2022] [Accepted: 03/25/2024] [Indexed: 04/10/2024]
Abstract
In the early twentieth century, Mongolia saw the establishment of Western medicine and educational system, supplementing its pre-existing history of eastern medicine. As a lower-middle-income country with vast landmass and low population density, Mongolia's medical education landscape has evolved significantly. The inception of the Mongolian National University of Medical Sciences in 1942 marked a pivotal moment, initiating the modern era of medical sciences and specialized training programs in the country. Initially shaped by Soviet Union-styled medical curriculum, the system has undergone substantial reform since the constitutional shift to a market economy in the 1990s. This transformation aligned the curriculum with international standards and modern educational approach, focusing on producing skilled medical professionals. Presently, over 10 public and private institutions of higher education in Mongolia provide comprehensive undergraduate, graduate and post-graduate training for medical training. These institutions vary in student enrollment, teaching staff, learning environments, and program models, contributing to the diverse landscape of medical education in the country.
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Affiliation(s)
- Oyungoo Badamdorj
- School of Nursing, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Ryenchindorj Erkhembayar
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bayarbat Gombo
- Department of Health Policy and Administration, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Baljinnyam Baatarpurev
- Division for Faculty Development and E-Learning, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Dorjbalam Gansukh
- Department of Pediatrics, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Basbish Tsogbadrakh
- School of Nursing, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Oyuntsetseg Sandag
- Department of Communication Skills, School of Biomedicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Tserendagva Dalkh
- Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Sumberzul Nyamjav
- Department of Medical Education and Legislations, Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
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Shi Z, Wu H. The trajectory and transition pattern of intention to practice medicine among medical students in China. Heliyon 2024; 10:e27704. [PMID: 38486735 PMCID: PMC10938122 DOI: 10.1016/j.heliyon.2024.e27704] [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: 07/14/2023] [Revised: 02/27/2024] [Accepted: 03/05/2024] [Indexed: 03/17/2024] Open
Abstract
There has been a growing concern about the career intentions (whether medical students have the intention to practice medicine) due to the increasingly serious problem of medical students attrition. Career intentions have the potential to promote medical students' career commitment and encourage them to stay in the medical profession. Moreover, a series of dynamic career intentions during medical education can be served as an early guide to the medical students' future career choices (whether medical students finally choose to practice medicine). However, few studies focus on the dynamics of career intentions among medical students. In this study, we utilized data from a large-scale national survey of medical students conducted in China from 2020 to 2022 to curve the trajectory of the intention to practice medicine among medical students during their undergraduate medical education by using multilevel growth model. Furthermore, we applied latent Markov model to estimate the transition matrix of the intention across each academic year during the undergraduate medical education. Our findings revealed a trajectory curve with a peak during the second year in the intention to practice medicine. In addition, we identified three latent states of career intention including "strong intention", "wavering" and "weak intention", and further found two distinct transition patterns between individuals with strong career intentions and those without strong career intentions. The transition patterns play a crucial role in understanding the changes in the trajectory of medical students' intentions and determining the optimal timing for interventions to prevent medical student attrition. Our study offers a comprehensive understanding for the dynamics of the career intention among medical students, which has practical implications for medical educators and institutions to address the issues of medical student attrition.
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Affiliation(s)
- Zehua Shi
- School of Management, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Hongbin Wu
- Institute of Medical Education/National Center for Health Professions Education Development, Peking University, Beijing, 100191, China
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Igić R. Preparations of Students for Enrollment in Medical Schools. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241264698. [PMID: 39050187 PMCID: PMC11268004 DOI: 10.1177/23821205241264698] [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: 03/19/2024] [Accepted: 06/08/2024] [Indexed: 07/27/2024]
Abstract
Improving medical education is an important process that changes from time to time based on the development of medical science and practice, society's need for a certain number of quality doctors, better preparations, and better selection of candidates for admission into medical schools. In most European countries, partial preparation of students for admission is done in secondary schools, and additional preparation is achieved in the first year of medical school. Such preparations enabled more than 60% of students to complete their studies, before the German Federal Ministry of Science and Education implemented the Masterplan Medizinstudium 2020. However, after a 4-year university preparation in the United States, close to 95% of students finish their medical studies on time. We proposed a 2-year university preparation for each student before his enrollment into the medical school because this strengthens his medical study, and later on, he becomes a better doctor. Thus, the number of graduated students may increase, medical studies could be shortened to 1 year, and candidates who do not enroll in medical school may continue their previous studies.
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Affiliation(s)
- Rajko Igić
- Department of Anesthesiology and Pain Management, Stroger Hospital of Cook County, Chicago, IL, USA
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Medical Faculty, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
- Medical Center, Sombor, Serbia
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Yan H, Han Z, Nie H, Yang W, Nicholas S, Maitland E, Zhao W, Yang Y, Shi X. Continuing medical education in China: evidence from primary health workers' preferences for continuing traditional Chinese medicine education. BMC Health Serv Res 2023; 23:1200. [PMID: 37924090 PMCID: PMC10623727 DOI: 10.1186/s12913-023-10153-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/16/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Continuing Medical Education (CME) is an important part of the training process for health workers worldwide. In China, training in Traditional Chinese Medicine (TCM) not only improves the expertise of medical workers, but also supports the Chinese Government's policy of promoting TCM as an equal treatment to western medicine. CME, including learning Traditional Chinese Medicine Technologies (TCMTs), perform poorly and research into the motivation of health workers to engage in CME is urgently required. Using a discrete choice experiment, this study assessed the CME learning preferences of primary health workers, using TCMT as a case study of CME programs. METHODS We conducted a discrete choice experiment among health workers in Shandong Province, Guizhou Province, and Henan provinces from July 1, 2021 to October 1, 2022 on the TCMT learning preferences of primary health workers. The mixed logit model and latent class analysis model were used to analyze primary health workers' TCMT learning preferences. RESULTS A total of 1,063 respondents participated in this study, of which 1,001 (94.2%) passed the consistency test and formed the final sample. Our key finding was that there were three distinct classes of TCMT learners. Overall, the relative importance of the seven attributes impacting the learning of TCMTs were: learning expenses, expected TCMT efficacy, TCMT learning difficulty, TCMT mode of learning, TCMT type, time required to learn, and expected frequency of TCMT use. However, these attributes differed significantly across the three distinct classes of TCMT learners. Infrequent users (class 1) were concerned with learning expenses and learning difficulty; workaholics (class 2) focused on the mode of learning; and pragmatists (class 3) paid more attention to the expected TCMT efficacy and the expected frequency of TCMT use. We recommend targeted strategies to motivate TCMT learning suited to the requirements of each class of TCMT learners. CONCLUSION Rather than a single TCMT medical education program for primary health workers, CME programs should be targeted at different classes of TCMT learners.
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Affiliation(s)
- Hao Yan
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Zhaoran Han
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Hanlin Nie
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Wanjin Yang
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Sydney, NSW, Australia
- Guangdong Institute for International Strategies, Guangdong University of Foreign Studies, Guangzhou, China
- School of Economics and School of Management, Tianjin Normal University, Tianjin, China
- Newcastle Business School, University of Newcastle, Callaghan, NSW, Australia
| | - Elizabeth Maitland
- University of Liverpool Management School, University of Liverpool, Liverpool, UK
| | - Weihan Zhao
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Yong Yang
- Medical Device Regulatory Research and Evaluation Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Xuefeng Shi
- School of Management, Beijing University of Chinese Medicine, Beijing, China.
- National Institute of Traditional Chinese Medicine Strategy and Development, Beijing University of Chinese Medicine, Beijing, China.
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Sechelski A, Bhattacharjee R, Reynolds A, Manis M, Elshabrawy HA, Zhao Y. Analysis of Student Perceptions of a Newly Developed Integrative System Course Model. MEDICAL SCIENCE EDUCATOR 2023; 33:1061-1071. [PMID: 37886269 PMCID: PMC10597954 DOI: 10.1007/s40670-023-01834-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 10/28/2023]
Abstract
Background During Spring 2021, we piloted a course model that integrated the immune system and HEENT (head, eyes, ears, nose, and throat) by concurrently presenting them in the context of clinical cases. Immune system topics (e.g., infection, cancer) were tied to their manifestations in the HEENT system, and concepts from both systems were consolidated in weekly case-based learning and small group discussion (CBL/SGD) sessions. Methods To evaluate students' perceptions of the effectiveness of this model, we administered to the class a voluntary survey containing closed- and open-ended items; conducted a focus group of 10 students selected via convenience sampling; and employed a mixed approach to analyze the resulting data, including multiple qualitative methods. Results Thirty-nine of 74 students completed the survey (53% response rate). In response to the item related to overall effectiveness of using CBL/SGD for system integration, nearly half (48.72%) of these students rated the overall effectiveness as average. Constant comparison analysis of the qualitative data revealed three major themes-student satisfaction with integration of immunology and HEENT, content and time involved in CBL/SGD, and suggestions for improvement-and classical content analysis revealed the relative importance of these themes. Participants held positive and negative perceptions, expressed concerns regarding CBL/SGD (e.g., its helpfulness, complexity), and made suggestions for improvement of integration. Conclusions Using multiple methods allowed us to gain a deeper understanding of students' perceptions of the new course model, and we have taken actions to improve course quality in the future.
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Affiliation(s)
- Amber Sechelski
- Division of Educational Affairs, College of Osteopathic Medicine, Sam Houston State University, Conroe, TX USA
| | | | - Austin Reynolds
- College of Osteopathic Medicine, Sam Houston State University, Conroe, TX USA
| | - Mary Manis
- Department of Primary Care and Clinical Medicine, College of Osteopathic Medicine, Sam Houston State University, Conroe, TX USA
- Trillium Educational Partners, 221 Trillium Park Loop, Conroe, TX USA
| | - Hatem A. Elshabrawy
- Department of Molecular and Cellular Biology, College of Osteopathic Medicine, Sam Houston State University, Conroe, TX USA
| | - Yuan Zhao
- Department of Molecular and Cellular Biology, College of Osteopathic Medicine, Sam Houston State University, Conroe, TX USA
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Cho HB, Sung WS, Hong J, Kang Y, Kim EJ. A Survey on Perceptions of the Direction of Korean Medicine Education and National Licensing Examination. Healthcare (Basel) 2023; 11:1685. [PMID: 37372803 DOI: 10.3390/healthcare11121685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/04/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Recent changes in medical education and assessment led to a focus on occupational competency, and this study investigated the perceptions of Korean medicine doctors (KMDs) on the national licensing examination for KMDs (NLE-KMD). The survey aimed to understand KMDs' recognition of the current situation, items to improve, and items to emphasize in the future. We conducted the web-based survey from 22 February to 4 March 2022, and 1244 among 23,338 KMDs answered voluntarily. Through this study, we found the importance of competency-related clinical practice and Korean standard classification of disease (KCD), and the presence of a generation gap. KMDs considered clinical practice (clinical tasks and clinical work performance) and the item related to the KCD important. They valued (1) the focus on KCD diseases that are frequently seen in clinical practice and (2) the readjustment and introduction of the clinical skills test. They also emphasized KCD-related knowledge and skills for the assessment and diagnosis of KCD diseases, especially those frequently treated at primary healthcare institutes. We confirmed the generation gap in the subgroup analysis according to the license acquisition period, and the ≤5-year group emphasized clinical practice and the KCD, while the >5-year group stressed traditional KM theory and clinical practice guidelines. These findings could be used to develop the NLE-KMD by setting the direction of Korean medicine education and guiding further research from other perspectives.
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Affiliation(s)
- Han-Byul Cho
- Department of Neuropsychiatry, Graduate School, College of Korean Medicine, Dongguk University, Seoul 04620, Republic of Korea
| | - Won-Suk Sung
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam-si 13601, Republic of Korea
| | - Jiseong Hong
- Teaching & Learning, 7 Days Inc., Seoul 06247, Republic of Korea
| | - Yeonseok Kang
- Department of Medical History, College of Korean Medicine, Wonkwang University, Iksan-si 54538, Republic of Korea
| | - Eun-Jung Kim
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam-si 13601, Republic of Korea
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Eley DS, Cortes C, Arja S, Villafuerte FRB, Khan YH, Grannum J, Jia Z. Perspectives on Medical Education in an Increasingly Globalized Society: Recognizing and Embracing Our Diversity. MEDICAL SCIENCE EDUCATOR 2023; 33:247-254. [PMID: 37008439 PMCID: PMC10060606 DOI: 10.1007/s40670-022-01705-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 06/19/2023]
Abstract
Medical curricula around the globe are diverse, accommodating the social, political, cultural, and health needs in each country. Every medical school has the responsibility to educate graduates capable of providing quality medical care to their communities. Yet true globalization of medical education is a challenge. Little is known about the intrinsic variations which impact curricula in countries around the world. There are unique, often historical reasons that explain the challenges in attaining a genuine globalization of the medical curricula. This perspective provides a glance and general comparison of traditions, economic, and socio-political influences on medical education across seven countries.
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Affiliation(s)
- Diann S. Eley
- Academy for Medical Education, Medical School, The University of Queensland, Brisbane, QLD Australia
| | - Claudio Cortes
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI USA
| | - Sateesh Arja
- Sateesh Arja, Clinical Skills and Medical Education, Avalon University School of Medicine, Curacao Caribbean, Netherlands
| | | | - Yawar Hayat Khan
- Faculty of Dentistry, Riphah International University, Islamabad, Pakistan
| | - Joseph Grannum
- Centre for Educational Technology, University of Tartu, Tartu, Estonia
| | - Zhimin Jia
- Shenzhen Hospital of Southern Medical University, Shenzhen, China
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Chen H, Teng T, Chen H, Liu X, Liu Z, Li X, Jie W, Wu X, Cao L, Hongyan W, Zhu D, Zhou X. Motivation, self-efficacy, perception, curiosity, and barriers toward medical research among undergraduates in China. BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION : A BIMONTHLY PUBLICATION OF THE INTERNATIONAL UNION OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 2023; 51:18-28. [PMID: 36285877 DOI: 10.1002/bmb.21684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 09/25/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
Medical research is important to scientific progress and medical education. Institutions worldwide have sought to increase student involvement in research such as clinician-scientists training programs, while little is known about how medical undergraduates perceive research. A cross-sectional study was conducted in Chongqing Medical University, Chongqing, China, with first-fourth year undergraduates. An online, anonymous, and self-rating 5-point Likert questionnaire was conducted to investigate medical undergraduates' demographic characteristics and assess motivation, self-efficacy, perception, curiosity, and barriers regarding medical research. Content validity was checked with experts and face validity was checked for clarity and understanding of the questionnaire. The Cronbach's alpha coefficient of the questions ranged from 0.813 to 0.879. A total of 3273 medical undergraduates were surveyed, and 86.62% (2835) participants (male 962, female 1873) were identified as effective. Males scored higher than females on self-efficacy (p < 0.001), perception (p = 0.017), and curiosity (p < 0.001), and lower on barriers (p < 0.001). The second year students are at the peak of their perception (p = 0.006) and lowest barrier scores (p = 0.003). Students with scientific research experience scored higher in motivation (p = 0.002), self-efficacy (p < 0.001), perception (p < 0.001), and curiosity (p < 0.001). Lack of proper mentoring opportunity (86.2%) and knowledge (84.5%) were the main barriers in conducting research. Even though they have a positive perspective, only a few undergraduates enrolled in research. Medical universities should encourage faculties to supervise and guide undergraduates' projects, and provide feasible solutions for students to learn scientific knowledge and skills. It is vital to build a research-oriented environment and academic atmosphere.
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Affiliation(s)
- Huiyu Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Academy of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Teng Teng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongyu Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- The First Clinical Medical School, Chongqing Medical University, Chongqing, China
| | - Xiaoying Liu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- The First Clinical Medical School, Chongqing Medical University, Chongqing, China
| | - Zhaohong Liu
- Department of Student Affairs, The First Clinical Medical School, Chongqing Medical University, Chongqing, China
| | - Xuemei Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wang Jie
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiang Wu
- Department of Student Affairs, The First Clinical Medical School, Chongqing Medical University, Chongqing, China
| | - Lu Cao
- Department of Student Affairs, The First Clinical Medical School, Chongqing Medical University, Chongqing, China
| | - Wu Hongyan
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dan Zhu
- Dean's Office, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Chaou CH, Yu SR, Ma SD, Tseng HM, Ou LS, Huang CD, Fang JT. Effect of national curriculum reform on medical students' preparedness for practice: a prospective cohort study from undergraduate to postgraduate periods. BMC MEDICAL EDUCATION 2022; 22:826. [PMID: 36451197 PMCID: PMC9709741 DOI: 10.1186/s12909-022-03909-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND In recent years, a national curriculum reform was implemented in undergraduate medical education in Taiwan to reduce clinical rotation training from 3 years to 2 years. The last generation of the old curriculum and the first generation of the new curriculum both graduated in 2019. This study aimed to compare the learning outcomes of the medical students in these two curriculum groups in terms of preparedness for practice during the transition from undergraduate to postgraduate study. METHODS This was a 3-year prospective, longitudinal, comparative cohort study between 2017 and 2020. Medical students from both the 7-year and 6-year curriculum groups received biannual questionnaire surveys starting 18 months before graduation and running until 11 months after graduation. The measurement tools were the Preparedness for Hospital Practice Questionnaire (PHPQ) and Copenhagen Burnout Inventory (CBI). Personal demographic information was also collected. Linear mixed models were used to determine the effect of curriculum change on learners' preparedness and burnout levels. RESULTS A total of 130 medical students from the two cohorts provided 563 measurements during the study period. Compared to their counterparts following the old curriculum, the participants following the new curriculum showed a lower level of preparedness when first entering clinical rotation (p = 0.027) and just after graduating (p = 0.049), especially in the domains of clinical confidence (p = 0.021) and patient management p = 0.015). The multivariate linear mixed model revealed gradual increases in preparedness and burnout in serial measurements in both curriculum groups. Students following the new curriculum, which involved a shortened clinical rotation, showed a slightly lower overall preparedness (p = 0.035) and the same level of burnout (p = 0.692) after adjustment. The factor of year of change did not show a significant effect on either preparedness (p = 0.258) or burnout (p = 0.457). CONCLUSION Shortened clinical rotation training for medical undergraduates is associated with a decrease in preparedness for practice during the transition from undergraduate to postgraduate study. Clinical confidence and patient management are the main domains affected.
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Affiliation(s)
- Chung-Hsien Chaou
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shiuan-Ruey Yu
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shou-De Ma
- Tungs' Taichung Memorial Hospital, Taichung, Taiwan
| | - Hsu-Min Tseng
- Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
| | - Liang-Shiou Ou
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chien-Da Huang
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ji-Tseng Fang
- Chang Gung University College of Medicine, Taoyuan, Taiwan.
- Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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Kenny EJG, Makwana HN, Thankachan M, Clunie L, Dueñas AN. The Use of Ultrasound in Undergraduate Medical Anatomy Education: a Systematic Review with Narrative Synthesis. MEDICAL SCIENCE EDUCATOR 2022; 32:1195-1208. [PMID: 36276779 PMCID: PMC9583998 DOI: 10.1007/s40670-022-01593-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 06/16/2023]
Abstract
This systematic review aimed to synthesize the literature on how ultrasound is currently used in anatomy education within medical schools. A systematic search of Ovid MEDLINE, Scopus, and Educational Resources Information Centre was conducted. Thirty-four relevant unique articles were included from the 1,272 identified from the databases and analyzed via narrative synthesis. Thematic analysis generated two domain summaries: "Successful Aspects of Ultrasound Teaching" and "Barriers to Implementation," each with additional subthemes, aimed to help educators inform best teaching practices from the current evidence base in this field.
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Affiliation(s)
- Edward J. G. Kenny
- Centre for Anatomical and Human Sciences, Hull York Medical School, University of Hull, Kingston Upon Hull, UK
| | - Haran N. Makwana
- Centre for Anatomical and Human Sciences, Hull York Medical School, University of Hull, Kingston Upon Hull, UK
| | - Maria Thankachan
- Centre for Anatomical and Human Sciences, Hull York Medical School, University of Hull, Kingston Upon Hull, UK
| | - Lauren Clunie
- Centre for Anatomical and Human Sciences, Hull York Medical School, University of Hull, Kingston Upon Hull, UK
| | - Angelique N. Dueñas
- Health Professions Education Unit, Hull York Medical School, University of York, York, UK
- Department of Medical Education, Northwestern University, Feinberg School of Medicine, Chicago, IL USA
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11
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Hart A, Romney D, Sarin R, Mechanic O, Hertelendy AJ, Larson D, Rhone K, Sidel K, Voskanyan A, Ciottone GR. Developing Telemedicine Curriculum Competencies for Graduate Medical Education: Outcomes of a Modified Delphi Process. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:577-585. [PMID: 34670239 DOI: 10.1097/acm.0000000000004463] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Telemedical applications have only recently begun to coalesce into the field of telemedicine due to varying definitions of telemedicine and issues around reimbursement. This process has been accelerated by the COVID-19 pandemic and the ensuing expansion of telemedicine delivery. This article demonstrates the development of a set of proposed competencies for a telemedicine curriculum in graduate medical education. METHOD A modified Delphi process was used to create a panel of competencies. This included a systematic review of the telemedicine literature through November 2019 to create an initial set of competencies, which were analyzed and edited by a focus group of experts in January 2020. Initial competencies were distributed in a series of 3 rounds of surveys to a group of 23 experts for comments and rating from April to August 2020. Competencies that obtained a score of 4.0 or greater on a 5-point Likert scale in at least 2 rounds were recommended. RESULTS Fifty-five competencies were developed based on the systematic review. A further 32 were added by the expert group for a total of 87. After 3 rounds of surveys, 34 competencies reached the recommendation threshold. These were 10 systems-based practice competencies, 7 professionalism, 6 patient care, 4 practice-based learning and improvement, 4 interpersonal and communication skills, and 3 medical knowledge competencies. CONCLUSIONS Half (17/34) of the competencies approved by the focus group and surveyed expert panel pertained to either systems-based practice or professionalism. Both categories exhibit more variation between telemedicine and in-person practice than other categories. The authors offer a set of proposed educational competencies that can be used in the development of curricula for a wide range of providers and are based on the best evidence and expert opinion available.
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Affiliation(s)
- Alexander Hart
- A. Hart is director of research, Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, and emergency physician, Hartford Hospital, Hartford, Connecticut; ORCID: https://orcid.org/0000-0002-0910-2316
| | - Douglas Romney
- D. Romney is director of education, Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, and instructor of emergency medicine, Harvard Medical School, Boston, Massachusetts
| | - Ritu Sarin
- R. Sarin is affiliated faculty, Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Oren Mechanic
- O. Mechanic is director of telehealth, Harvard Medical Faculty Physicians, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Attila J Hertelendy
- A.J. Hertelendy is assistant professor, Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, Florida, and director of innovation and technology, Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; ORCID: https://orcid.org/0000-0001-6174-0289
| | - Deanna Larson
- D. Larson is senior vice president, Avera Health, and chief executive officer, Avera eCare, Sioux Falls, South Dakota
| | - Kelly Rhone
- K. Rhone is medical director of outreach and innovation, Avera eCare, Sioux Falls, South Dakota, and assistant professor, University of South Dakota Sanford School of Medicine, Vermillion, South Dakota
| | - Kristi Sidel
- K. Sidel is director of telemedicine education, American Board of Telehealth, Sioux Falls, South Dakota
| | - Amalia Voskanyan
- A. Voskanyan is co-director, Disaster Medicine Fellowship, Department of Emergency Medicine, Harvard Medical Faculty Physicians, Boston, Massachusetts
| | - Gregory R Ciottone
- G.R. Ciottone is director, Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, and associate professor of emergency medicine, Harvard Medical School, Boston, Massachusetts
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Meng J, Love R, Rude S, Martzen MR. Enhancing Student Learning by Integrating Anatomy in Pathology Teaching. MEDICAL SCIENCE EDUCATOR 2021; 31:1283-1286. [PMID: 34457970 PMCID: PMC8368952 DOI: 10.1007/s40670-021-01330-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Vertically integrating anatomy into pathology curricula is beneficial for student-centered learning. This study investigates the effectiveness of this approach on student learning outcomes. ACTIVITY Learners received a vertically integrated pathology curriculum; their pre- and post-course test data were collected. RESULTS AND DISCUSSION Two-hundred thirty-two learners participated in the activity. Upon completing the activity, their average post-course performance was significantly better than that of a control group (P < 0.05), with significantly higher scores on solving pathology case problems (P < 0.05), as well as on retaining anatomy concepts (P < 0.05). Vertically integrating anatomy in pathology instruction is an effective educational approach.
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Affiliation(s)
- Jing Meng
- Department of Basic Sciences, Bastyr University, 14500 Juanita Drive NE, Kenmore, WA 98028 USA
| | - Rebecca Love
- Department of Basic Sciences, Bastyr University, 14500 Juanita Drive NE, Kenmore, WA 98028 USA
| | - Steven Rude
- Department of Basic Sciences, Bastyr University, 14500 Juanita Drive NE, Kenmore, WA 98028 USA
| | - Mark R. Martzen
- Department of Basic Sciences, Bastyr University, 14500 Juanita Drive NE, Kenmore, WA 98028 USA
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Chaou CH, Yu SR, Chang YC, Ma SD, Tseng HM, Hsieh MJ, Fang JT. The evolution of medical students' preparedness for clinical practice during the transition of graduation: a longitudinal study from the undergraduate to postgraduate periods. BMC MEDICAL EDUCATION 2021; 21:260. [PMID: 33957907 PMCID: PMC8101179 DOI: 10.1186/s12909-021-02679-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/20/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Graduating from medical school and beginning independent practice appears to be a major transition for medical students across the world. It is often reported that medical graduates are underprepared for independent practice. Most previous studies on undergraduates' preparedness are cross-sectional. This study aimed to characterize the development and trend of medical students' preparedness and its association with other objective and subjective indicators from the undergraduate to postgraduate periods. METHODS This was a prospective cohort study. The participants were recruited and followed from two years before graduation to the postgraduate period. The preparedness for independent practice, professional identity, and teamwork experience were biannually measured using previously validated questionnaires. The participants' basic demographic information, clinical learning marks from the last two years, and national board exam scores were also collected. RESULTS A total of 85 participants completed 403 measurements in the 5 sequential surveys. The mean age at recruitment was 23.6, and 58 % of participants were male. The overall total preparedness score gradually increased from 157.3 (SD=21.2) at the first measurement to 175.5 (SD=25.6) at the fifth measurement. The serial individual preparedness scores revealed both temporal differences within the same learner and individual differences across learners. Despite the variations, a clear, steady increase in the overall average score was observed. Participants were least prepared in the domain of patient management at first, but the score increased in the subsequent measurements. The participants with better final preparedness had better professional identity (p<0.01), better teamwork experience (p < 0.01), and higher average clinical rotation marks (p<0.05). CONCLUSIONS The preparedness for practice of medical students from the undergraduate to postgraduate periods is associated with their professional identity, teamwork experience, and objective clinical rotation endpoint. Although preparedness generally increases over time, educators must understand that there are temporal fluctuations and individual differences in learners' preparedness.
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Affiliation(s)
- Chung-Hsien Chaou
- Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
- Chang Gung University College of Medicine, Taoyuan, Taiwan.
| | - Shiuan-Ruey Yu
- Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Yu-Che Chang
- Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Shou-De Ma
- Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hsu-Min Tseng
- Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
- Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Ju Hsieh
- Chang-Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Taoyuan City, Taiwan
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Thoracic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ji-Tseng Fang
- Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
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Zalts R, Green N, Tackett S, Lubin R. The association between medical students' motivation with learning environment, perceived academic rank, and burnout. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2021; 12:25-30. [PMID: 33513127 PMCID: PMC7883805 DOI: 10.5116/ijme.5ff9.bf5c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 01/09/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To assess the correlations between extrinsic and intrinsic motivation, personal growth and quality of life with learning environment perceptions, perceived academic rank and burnout among medical students. METHODS Cross-sectional questionnaires were administered to medical students at three medical schools in Israel, Malaysia, and China, at the end of one academic year. Surveys included demographic data, students' perceived academic rank, two learning environment perceptions scales, and scales for personal growth, goal orientation, burnout and quality of life. Comparative analyses were made to determine the significance of relationships between the outcome measures and control variables, using a series of t-tests. Pearson correlation coefficients were used to test the hypothesis. RESULTS Sixty-four percent (400/622) of the students responded. Significant correlations were found between: intrinsic motivation (r(398) =.37, p<.001); personal growth (r(398)=.62, p<.001); and quality of life (r(398)= .48, p <.001) with higher learning environment perceptions, intrinsic motivation (r(398)= .21, p<.001); personal growth (r(398) =.21, p< .001); and quality of life (r(398)=.18, p<.001) with perceived academic rank, and negative correlation between personal growth (r(398) =-.38, p<.001); and quality of life (r(398) =-.42, p<.001) with burnout. CONCLUSIONS Intrinsic motivation, personal growth and quality of life are correlated with higher learning environment perceptions and perceived academic rank. Burnout is influenced by personal growth and quality of life. We suggest focusing on motivation profiles before acceptance to medical school and during studies.
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Affiliation(s)
| | - Nathaniel Green
- Technion American Medical Students Program, Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Sean Tackett
- Johns Hopkins Bayview Medical Center, Baltimore, Maryland USA
| | - Robert Lubin
- Technion American Medical Students Program, Bruce Rappaport Faculty of Medicine, Haifa, Israel
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Matsuyama Y, Nakaya M, Leppink J, van der Vleuten C, Asada Y, Lebowitz AJ, Sasahara T, Yamamoto Y, Matsumura M, Gomi A, Ishikawa S, Okazaki H. Limited effects from professional identity formation-oriented intervention on self-regulated learning in a preclinical setting: a randomized-controlled study in Japan. BMC MEDICAL EDUCATION 2021; 21:30. [PMID: 33413338 PMCID: PMC7791888 DOI: 10.1186/s12909-020-02460-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 12/16/2020] [Indexed: 06/07/2023]
Abstract
BACKGROUND Developing self-regulated learning in preclinical settings is important for future lifelong learning. Previous studies indicate professional identity formation, i.e., formation of self-identity with internalized values and norms of professionalism, might promote self-regulated learning. We designed a professional identity formation-oriented reflection and learning plan format, then tested effectiveness on raising self-regulated learning in a preclinical year curriculum. METHODS A randomized controlled crossover trial was conducted using 112 students at Jichi Medical University. In six one-day problem-based learning sessions in a 7-month pre-clinical year curriculum, Groups A (n = 56, female 18, mean age 21.5y ± 0.7) and B (n = 56, female 11, mean age 21.7y ± 1.0) experienced professional identity formation-oriented format: Group A had three sessions with the intervention format in the first half, B in the second half. Between-group identity stages and self-regulated learning levels were compared using professional identity essays and the Motivated Strategies for Learning Questionnaire. RESULTS Two-level regression analyses showed no improvement in questionnaire categories but moderate improvement of professional identity stages over time (R2 = 0.069), regardless of timing of intervention. CONCLUSIONS Professional identity moderately forms during the pre-clinical year curriculum. However, neither identity nor self-regulated learning is raised significantly by limited intervention.
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Affiliation(s)
- Yasushi Matsuyama
- Medical Education Center, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Motoyuki Nakaya
- The department of Psychology and Human Developmental Sciences, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Japan
| | - Jimmie Leppink
- Hull York Medical School, University of York, Heslington, York, UK
| | - Cees van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine, and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Yoshikazu Asada
- Center for Information, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Adam Jon Lebowitz
- Department of General Education, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Teppei Sasahara
- Department of Infection and Immunity, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Yu Yamamoto
- Division of General Medicine, Center for Community Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Masami Matsumura
- Division of General Medicine, Center for Community Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Akira Gomi
- Department of Pediatric Neurosurgery, Jichi Children’s Medical Center Tochigi, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Shizukiyo Ishikawa
- Medical Education Center, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
| | - Hitoaki Okazaki
- Medical Education Center, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi Japan
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Infortuna C, Gratteri F, Benotakeia A, Patel S, Fleischman A, Muscatello MRA, Bruno A, Zoccali RA, Chusid E, Han Z, Battaglia F. Exploring the Gender Difference and Predictors of Perceived Stress among Students Enrolled in Different Medical Programs: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186647. [PMID: 32933068 PMCID: PMC7558788 DOI: 10.3390/ijerph17186647] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/27/2020] [Accepted: 08/30/2020] [Indexed: 01/02/2023]
Abstract
Female medical students seem to experience higher level of perceived stress. Moreover, there is a lack of research examining perceived stress in students enrolled in different medical programs. We analyzed the association between temperament traits, optimism, self-esteem, and perceived stress of students pursuing a Doctor of Medicine (MD) degree and students pursuing a Doctor of Podiatric Medicine (DPM) degree. A cross-sectional study was conducted of two cohorts: allopathic medical students (N = 154) and the podiatric medical students (N = 150). Students anonymously completed the Perceived Stress Scale (PSS-10), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto Questionnaire (TEMPS-A), Rosenberg Self-Esteem Scale, and Life Orientation Test—Revised (LOT-R). We analyzed differences in the two cohort of students and predictors of perceived stress. There were no differences in the overall perception of stress between both cohorts (allopathic medical students: 18.83 ± 0.56; podiatric medical students: 19.3 ± 0.72; p = 0.4419). Women reported higher perceived stress in both programs (allopathic medical students: p = 0.0.038; podiatric medical students: p = 0.0.038). In both allopathic and podiatric medical students, the cyclothymic temperaments and anxious traits were positive predictors while hyperthymic temperaments and optimism traits were negative predictors of perceived stress. The level of perceived stress experienced by students pursuing different doctoral degrees in healthcare is similar. Regardless of the curriculum differences, female students experience higher perceived stress and there is evidence for similarities in predictors amongst allopathic and podiatric medical students.
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Affiliation(s)
- Carmenrita Infortuna
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, 98124 Messina, Italy; (C.I.); (F.G.); (M.R.A.M.); (A.B.); (R.A.Z.)
| | - Francesco Gratteri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, 98124 Messina, Italy; (C.I.); (F.G.); (M.R.A.M.); (A.B.); (R.A.Z.)
| | - Andrew Benotakeia
- Department of Medical Sciences and Neurology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ 07110, USA; (A.B.); (Z.H.)
| | - Sapan Patel
- Department of Pre-Clinical Sciences, New York College of Podiatric Medicine, New York, NY 10035, USA; (S.P.); (A.F.); (E.C.)
| | - Alex Fleischman
- Department of Pre-Clinical Sciences, New York College of Podiatric Medicine, New York, NY 10035, USA; (S.P.); (A.F.); (E.C.)
| | - Maria Rosaria Anna Muscatello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, 98124 Messina, Italy; (C.I.); (F.G.); (M.R.A.M.); (A.B.); (R.A.Z.)
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, 98124 Messina, Italy; (C.I.); (F.G.); (M.R.A.M.); (A.B.); (R.A.Z.)
| | - Rocco Antonio Zoccali
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Policlinico Universitario, University of Messina, 98124 Messina, Italy; (C.I.); (F.G.); (M.R.A.M.); (A.B.); (R.A.Z.)
| | - Eileen Chusid
- Department of Pre-Clinical Sciences, New York College of Podiatric Medicine, New York, NY 10035, USA; (S.P.); (A.F.); (E.C.)
| | - Zhiyong Han
- Department of Medical Sciences and Neurology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ 07110, USA; (A.B.); (Z.H.)
| | - Fortunato Battaglia
- Department of Medical Sciences and Neurology, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ 07110, USA; (A.B.); (Z.H.)
- Correspondence: ; Tel.: +1-9737619605
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Hollis AC, Streeter J, Van Hamel C, Milburn L, Alberti H. The new cultural norm: reasons why UK foundation doctors are choosing not to go straight into speciality training. BMC MEDICAL EDUCATION 2020; 20:282. [PMID: 32854721 PMCID: PMC7450803 DOI: 10.1186/s12909-020-02157-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 07/17/2020] [Indexed: 05/29/2023]
Abstract
BACKGROUND The number of UK foundation doctors choosing to go straight into speciality training has fallen drastically over the last 10 years: We sought to explore and understand the reasons for this change. METHODS We undertook semi-structured interviews with 16 foundation year two doctors, who had not applied to speciality training, from two regional foundation schools. Transcripts were thematically analysed. RESULTS The reasons that foundation doctors are choosing not to go straight into speciality training centre around the themes of feeling undervalued, career uncertainty and a new cultural norm. They report major feelings of uncertainty regarding career choice at such an early stage of their profession and this challenge was magnified by a perceived lack of flexibility of training and the growing normality of taking time out from training. Trainees feel a lack of support in planning and undertaking an "FY3" year and being helped back into the workforce. Trainees overwhelmingly reported that they feel undervalued by their employers. Importantly, however, not going into training directly was not always a reflection of dissatisfaction with training. Many trainees spoke very positively about their planned activities and often saw a break in training as an excellent way to recharge, develop skills and prepare for the rest of their careers in medicine. CONCLUSIONS Taking a year or more out of training after foundation years has become the new cultural norm for UK junior doctors and reasons for this include feeling undervalued, career uncertainty and the perception that this is now "normal". Exploring these factors with participants has generated a number of recommendations related to improving the workplace environment, allowing more flexibility in training and supporting those who chose to take an FY3.
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Affiliation(s)
- Alexander Conor Hollis
- UK Foundation Programme Office St Chad's Court, 213 Hagley Road, Edgbaston, Birmingham, B16 9RG, UK.
- , Address: Flat 305, 89 Branston Street, Birmingham, B186BU, UK.
| | - Jack Streeter
- School of Medical Education, Cookson Building, Newcastle University, Medical School, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Clare Van Hamel
- UK Foundation Programme Office St Chad's Court, 213 Hagley Road, Edgbaston, Birmingham, B16 9RG, UK
| | - Louise Milburn
- School of Medical Education, Cookson Building, Newcastle University, Medical School, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
| | - Hugh Alberti
- School of Medical Education, Cookson Building, Newcastle University, Medical School, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
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Zhao X, Goldman E, Banani T, Kline K, Brown K, Lee J, Jurjus RA. The process of curricular integration and its effects on anatomical knowledge retention. Clin Anat 2020; 33:960-968. [PMID: 32449191 DOI: 10.1002/ca.23632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Integration has been recognized as an important aspect of medical education. After transitioning from a discipline-specific to a systems-based preclinical curriculum, we examined faculty perceptions of the integrated approach and also whether it would lead to better anatomy knowledge retention. METHODS To understand faculty perspectives, we reviewed curricular materials, interviewed block directors, and observed educational sessions. We analyzed knowledge retention through a 27-question anatomy test, comparing scores from the last class of the discipline-based curriculum and the first two classes of the integrated curriculum. RESULTS Planning integrated content involves purposeful ordering, is challenging for faculty, and requires additional resources. Evaluation of the integrated approach for anatomy content demonstrated a significant increase in knowledge retention (p = .012; 56.28% vs. 63.98% for old vs. new curriculum). CONCLUSIONS This study helps the understanding of what is required for curricular integration. Our anatomy evaluation results corroborated the view that contextually embedded information is easier to learn and retain.
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Affiliation(s)
- Xian Zhao
- Division of Pediatric Emergency Medicine, Children's National Health System, Washington, District of Columbia, USA
| | - Ellen Goldman
- Department of Human and Organizational Learning, Graduate School of Education and Human Development, George Washington University, Washington, District of Columbia, USA
| | - Tara Banani
- Department of Anatomy and Cell Biology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Kathleen Kline
- Office of Medical Education, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Kirsten Brown
- Department of Anatomy and Cell Biology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Juliet Lee
- Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Rosalyn A Jurjus
- Department of Anatomy and Cell Biology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
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Forero DA, Majeed MH, Ruiz-Díaz P. Current trends and future perspectives for medical education in Colombia. MEDICAL TEACHER 2020; 42:17-23. [PMID: 31491350 DOI: 10.1080/0142159x.2019.1659944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Colombia is the second largest country in South America. In this article, we provide an overview of medical education in Colombia, including a description of existing public and private medical schools and available undergraduate and postgraduate programs. Medical education in Colombia has evolved through time, following international trends. In addition to 61 undergraduate medical programs, there are 529 postgraduate clinical, 30 PhD, and 131 Master programs in health sciences in Colombia. We identify current challenges and highlight future perspectives for medical education in Colombia.
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Affiliation(s)
- Diego A Forero
- PhD Program in Health Sciences, School of Medicine, Universidad Antonio Nariño, Bogotá, Colombia
- Laboratory of NeuroPsychiatric Genetics, Biomedical Sciences Research Group, School of Medicine, Universidad Antonio Nariño, Bogotá, Colombia
| | - Muhammad Hassan Majeed
- Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Paola Ruiz-Díaz
- Academic Unit for Education Sciences, Universidad Piloto de Colombia, Bogotá, Colombia
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Abstract
This paper aims to describe and analyze medical education in Brazil, a history of over 200 years. As in most European countries and influenced by the Flexner Report, an undergraduate medical course in Brazil takes 6 years. Recently, medical education research has been advocating a shift from a teacher-centered and hospital-based approach to student-centered and community-based education. Nevertheless, a huge variation exists among Brazilian medical schools. The physicians' supply program known as "More Physicians" has strongly impacted the number of medical schools in Brazil, which is growing rapidly. Professors of medicine from several institutions and other stakeholders have alerted authorities to the risks of operating so many schools without adequate time to prepare teachers, clinician-educators, curricula, and sufficient pedagogical structure to ensure quality medical education. The possibility of an imminent catastrophe in medical education has united stakeholders in pursuit of a guarantee of quality maintenance. This effort has resulted in the creation of an independent accreditation system approved by the World Federation of Medical Education. The study of the unbalanced relationship between stakeholders in medical education in Brazil until now has provided valuable information concerning the importance of having their roles and limits clear. It is possible that these findings might be replicable around the world.
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Schwartz CC, Ajjarapu AS, Stamy CD, Schwinn DA. Comprehensive history of 3-year and accelerated US medical school programs: a century in review. MEDICAL EDUCATION ONLINE 2018; 23:1530557. [PMID: 30376794 PMCID: PMC6211283 DOI: 10.1080/10872981.2018.1530557] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 05/23/2018] [Accepted: 09/14/2018] [Indexed: 05/13/2023]
Abstract
Within the context of major medical education curricular reform ongoing in the United States, a subset of schools has re-initiated accelerated (3-year) medical education. It would be helpful for education leaders to pause and consider historical reasons such accelerated medical schools were started, and then abandoned, over the last century to proactively address important issues. As no comprehensive historical review of 3-year medical education exists, we examined all articles published on this topic since 1900. In general, US medical educational curricula began standardizing into 4-year programs in the early 1900s through contributions from William Osler, Abraham Flexner, and establishment of the American Medical Association (AMA) Council of Medical Education (CME). During WWII (1939-1945), accelerated 3-year medical school programs were initiated as a novel approach to address physician shortages; government incentives were used to boost the number of 3-year medical schools along with changed laws aiding licensure for graduates. However, this quick solution generated questions regarding physician competency, resulting in rallying cries for oversight of 3-year programs. Expansion of 3-year MD programs slowed from 1950s to 1960s until federal legislation was passed between the 1960s and the 1970s to support training healthcare workers. With renewed government financial incentives and stated desire to increase physician numbers and reduce student debt, a second rapid expansion of 3-year medical programs occurred in the 1970s. Later that decade, a second decline occurred in these programs, reportedly due to discontinuation of government funding, declining physician shortage, and dissatisfaction expressed by students and faculty. The current wave of 3-year MD programs, beginning in 2010, represents a 'third wave' for these programs. In this article, we identify common societal and pedagogical themes from historical experiences with accelerated medical education. These findings should provide today's medical education leaders a historical context from which to design and optimize accelerated medical education curricula.
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Affiliation(s)
- Christine C. Schwartz
- Departments of Anesthesia (DAS), Biochemistry (DAS), Pharmacology (DAS), University of Iowa, Iowa City, IA, USA
| | - Aparna S. Ajjarapu
- Departments of Anesthesia (DAS), Biochemistry (DAS), Pharmacology (DAS), University of Iowa, Iowa City, IA, USA
| | - Chris D. Stamy
- Departments of Anesthesia (DAS), Biochemistry (DAS), Pharmacology (DAS), University of Iowa, Iowa City, IA, USA
| | - Debra A. Schwinn
- Departments of Anesthesia (DAS), Biochemistry (DAS), Pharmacology (DAS), University of Iowa, Iowa City, IA, USA
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Abstract
BACKGROUND In Brazil, most medical schools do not offer trauma surgery in their undergraduate curriculum. The Trauma Leagues arose in Brazil as an important promoter of trauma education and stimulated activities related to surgical skills and practices. In recent decades, studies have demonstrated that the number of surgical residency applicants has decreased worldwide. Strategies to motivate medical students to choose surgery are needed. OBJECTIVE To evaluate the impact of participation in the Unicamp Trauma League (UTL) during a 20-year period in the choice for a surgical career. METHODS The study included 276 students in a Brazilian university hospital who were part of the Trauma League. Research of records in universities and medical societies about the specialties chosen during residency were evaluated. A Likert questionnaire was sent to participants to evaluate the impact of participating in the Trauma League in the student's professional career. RESULTS The questionnaire was answered by 76% of the participants. Of those, 38.4% chose general surgery. About 55.1% did not know what medical career to choose when joined the league. Participation in the league had an influence on specialty choice in 79.1% of the students. Of those choosing surgery, 93.2% believed that participating in the league had positively influenced their career choice. Overall, 93.1% believed that participating in the league provided knowledge and information that the medical school curriculum was not able to provide. CONCLUSION Participation in Trauma League has been an effective strategy to encourage medical students to choose a career in general surgery in Campinas, Brazil.
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Heckman KM, Kim RB, Lee A, Chang E, Matusko N, Reddy RM, Hughes DT, Sandhu G. Surgeons have an opportunity to improve teaching quality through feedback provision. J Surg Res 2018; 229:164-168. [PMID: 29936985 DOI: 10.1016/j.jss.2018.02.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/21/2018] [Accepted: 02/27/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Medical student evaluations of faculty are increasingly incorporated into promotion and tenure decisions, making it imperative to understand learner perceptions of quality teaching. Prior work has shown that students value faculty responsiveness in the form of feedback, but faculty and students differ in their perceptions of what constitutes sufficient feedback. The innovative minute feedback system (MFS) can quantify responsiveness to students' feedback requests. This study assessed how feedback provision via MFS impacts teaching quality scores. MATERIALS AND METHODS This retrospective observational study compared average faculty teaching quality scores with faculty's percentage response to student feedback requests via the MFS. The data were generated from the core surgical clerkship for third-year medical students at the University of Michigan Medical School. The relationship between average teaching quality scores and response percentage was assessed by weighted regression analysis. RESULTS Two hundred thirty-seven medical students requested feedback via MFS, and 104 faculty were evaluated on teaching quality. The mean faculty feedback response percentage was 55.78%. The mean teaching quality score was 4.27 on a scale of 1 to 5. Teaching quality score was significantly correlated with response percentage (P < 0.001); for every 10% increase in response percentage, average teaching quality score improved by 0.075. Average teaching quality score was not significantly associated with response time (P = 0.158), gender (P = 0.407), or surgical service (P = 0.498). CONCLUSIONS Medical students consider responsiveness to feedback requests an important component of quality teaching. Furthermore, faculty development focused on efficient and practical feedback strategies may have the added benefit of improving their teaching quality.
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Affiliation(s)
| | - Renaid B Kim
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Anderson Lee
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Emma Chang
- University of Michigan, Ann Arbor, Michigan
| | - Niki Matusko
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | | | - David T Hughes
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Gurjit Sandhu
- Department of Surgery, University of Michigan, Ann Arbor, Michigan; Department of Learning Health Sciences, University of Michigan, Ann Arbor, Michigan
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Weggemans MM, van Dijk B, van Dooijeweert B, Veenendaal AG, ten Cate O. The postgraduate medical education pathway: an international comparison. GMS JOURNAL FOR MEDICAL EDUCATION 2017; 34:Doc63. [PMID: 29226231 PMCID: PMC5704606 DOI: 10.3205/zma001140] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 03/01/2017] [Accepted: 05/09/2017] [Indexed: 05/24/2023]
Abstract
An at first sight seemingly coherent, global medical workforce, with clearly recognizable specialities, subspecialties and primary care doctors, appears at a closer look quite variable. Even within the most progressive countries as to the development of medical education, with educators who regularly meet at conferences and share major journals about medical education, the differences in structures and regulations are big. This contribution focuses on the preparation, admission policy, duration, examinations, and national competency frameworks in postgraduate speciality training in Germany, the USA, Canada, the UK, Australia and the Netherlands. While general objectives for postgraduate training programs have not been very clear, only recently competency-frameworks, created in a limited number of countries, serve harmonize objectives. This process appears to be a challenge and the recent creation of milestones for the reporting on progress of individual trainees (in the US and in Canada in different ways) and the adoption of entrustable professional activities, a most recent concept that is quickly spreading internationally as a framework for teaching and assessing in the clinical workplace is an interesting and hopeful development, but time will tell whether true harmonization across countries will happen.
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Affiliation(s)
- Margot M. Weggemans
- University Medical Centre Utrecht, Centre for Research and Development of Education, Utrecht, The Netherlands
| | - Bruce van Dijk
- University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | | | - Olle ten Cate
- University Medical Centre Utrecht, Centre for Research and Development of Education, Utrecht, The Netherlands
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Zavlin D, Jubbal KT, Noé JG, Gansbacher B. A comparison of medical education in Germany and the United States: from applying to medical school to the beginnings of residency. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2017; 15:Doc15. [PMID: 29051721 PMCID: PMC5617919 DOI: 10.3205/000256] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/04/2017] [Indexed: 11/30/2022]
Abstract
Both Germany and the United States of America have a long tradition of science and medical excellence reaching back as far as the nineteenth century. The same tribute must be paid to the medical educational system in both countries. Despite significant initial similarities and cross-inspiration, the paths from enrolling in a medical university to graduating as a medical doctor in Germany and the US seem to have become much different. To fill a void in literature, the authors’ objective therefore is to delineate both structures of medical education in an up-to-date review and examine their current differences and similarities. Recent medical publications, legal guidelines of governmental or official organizations, articles in media, as well as the authors’ personal experiences are used as sources of this report. Tuition loans of over $200,000 are not uncommon for students in the US after graduating from medical schools, which are often private institutions. In Germany, however, the vast majority of medical universities are tax-funded and, for this reason, free of tuition. Significant differences and surprisingly multiple similarities exist between these two systems, despite one depending on government and the other on private organizations. Germany currently employs an integrated medical curriculum that typically begins right after high school and consists of a 2-year long pre-clinical segment teaching basic sciences and a 4-year clinical segment leading medical students to the practical aspects of medicine. On the other hand, the US education is a two-stage process. After successful completion of a Bachelor’s degree in college, an American student goes through a 4-year medical program encompassing 2 years of basic science and 2 years of clinical training. In this review, we will address some of these similarities and major differences.
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Affiliation(s)
- Dmitry Zavlin
- Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, Houston, TX, USA
| | - Kevin T Jubbal
- Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Jonas G Noé
- Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Bernd Gansbacher
- Institute of Molecular Immunology & Experimental Oncology, Technical University Munich, Munich, Germany
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Klement BJ, Paulsen DF, Wineski LE. Implementation and modification of an anatomy-based integrated curriculum. ANATOMICAL SCIENCES EDUCATION 2017; 10:262-275. [PMID: 28009487 DOI: 10.1002/ase.1676] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 11/18/2016] [Accepted: 11/19/2016] [Indexed: 06/06/2023]
Abstract
Morehouse School of Medicine elected to restructure its first-year medical curriculum by transitioning from a discipline-based to an integrated program. The anatomy course, with regional dissection at its core, served as the backbone for this integration by weaving the content from prior traditional courses into the curriculum around the anatomy topics. There were four primary goals for this restructuring process. Goal 1: develop new integrated courses. Course boundaries were established at locations where logical breaks in anatomy content occurred. Four new courses were created, each containing integrated subject content. Goal 2: establish a curriculum management team. The team consisted of course directors, subject specialists, and a curriculum director. This team worked together to efficiently manage the new curriculum. Goal 3: launch contemporary examination and question banking methods. An electronic system, in which images could be included, was implemented for examinations and quizzes, and for storing and refining questions. Goal 4: ensure equitable distribution of standardized examinations and course grading systems among all courses. Assessments included quizzes, in-course examinations, and National Board of Medical Examiners® (NBME® ) Subject Examinations. A standard plan assigned the contribution of each to the final course grade. Significant improvement was seen on subject examinations. Once the obstacles and challenges of integration were overcome, a robust and efficient education program was developed. The curriculum is expected to continue evolving and improving, while retaining full regional dissection as a core element. Anat Sci Educ 10: 262-275. © 2016 American Association of Anatomists.
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Affiliation(s)
- Brenda J Klement
- Department of Medical Education, Morehouse School of Medicine, Atlanta, Georgia
| | - Douglas F Paulsen
- Department of Pathology and Anatomy, Morehouse School of Medicine, Atlanta, Georgia
| | - Lawrence E Wineski
- Department of Pathology and Anatomy, Morehouse School of Medicine, Atlanta, Georgia
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Wasson LT, Cusmano A, Meli L, Louh I, Falzon L, Hampsey M, Young G, Shaffer J, Davidson KW. Association Between Learning Environment Interventions and Medical Student Well-being: A Systematic Review. JAMA 2016; 316:2237-2252. [PMID: 27923091 PMCID: PMC5240821 DOI: 10.1001/jama.2016.17573] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Concerns exist about the current quality of undergraduate medical education and its effect on students' well-being. OBJECTIVE To identify best practices for undergraduate medical education learning environment interventions that are associated with improved emotional well-being of students. DATA SOURCES Learning environment interventions were identified by searching the biomedical electronic databases Ovid MEDLINE, EMBASE, the Cochrane Library, and ERIC from database inception dates to October 2016. Studies examined any intervention designed to promote medical students' emotional well-being in the setting of a US academic medical school, with an outcome defined as students' reports of well-being as assessed by surveys, semistructured interviews, or other quantitative methods. DATA EXTRACTION AND SYNTHESIS Two investigators independently reviewed abstracts and full-text articles. Data were extracted into tables to summarize results. Study quality was assessed by the Medical Education Research Study Quality Instrument (MERQSI), which has a possible range of 5 to 18; higher scores indicate higher design and methods quality and a score of 14 or higher indicates a high-quality study. FINDINGS Twenty-eight articles including at least 8224 participants met eligibility criteria. Study designs included single-group cross-sectional or posttest only (n = 10), single-group pretest/posttest (n = 2), nonrandomized 2-group (n = 13), and randomized clinical trial (n = 3); 89.2% were conducted at a single site, and the mean MERSQI score for all studies was 10.3 (SD, 2.11; range, 5-13). Studies encompassed a variety of interventions, including those focused on pass/fail grading systems (n = 3; mean MERSQI score, 12.0), mental health programs (n = 4; mean MERSQI score, 11.9), mind-body skills programs (n = 7; mean MERSQI score, 11.3), curriculum structure (n = 3; mean MERSQI score, 9.5), multicomponent program reform (n = 5; mean MERSQI score, 9.4), wellness programs (n = 4; mean MERSQI score, 9.0), and advising/mentoring programs (n = 3; mean MERSQI score, 8.2). CONCLUSIONS AND RELEVANCE In this systematic review, limited evidence suggested that some specific learning environment interventions were associated with improved emotional well-being among medical students. However, the overall quality of the evidence was low, highlighting the need for high-quality medical education research.
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Affiliation(s)
- Lauren T. Wasson
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY
| | - Amberle Cusmano
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY
| | - Laura Meli
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY
| | - Irene Louh
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY
| | - Louise Falzon
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY
| | | | - Geoffrey Young
- Association of American Medical Colleges, Washington, D.C
| | - Jonathan Shaffer
- Department of Psychology, College of Liberal Arts and Sciences, University of Colorado at Denver
| | - Karina W. Davidson
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY
- NewYork-Presbyterian Hospital, New York, NY
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Stoddard HA, Brownfield ED, Churchward G, Eley JW. Interweaving Curriculum Committees: A New Structure to Facilitate Oversight and Sustain Innovation. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:48-53. [PMID: 26266463 DOI: 10.1097/acm.0000000000000852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Undergraduate medical education curricula have increased in complexity over the past 25 years; however, the structures for administrative oversight of those curricula remain static. Although expectations for central oversight of medical school curricula have increased, individual academic departments often expect to exert control over the faculty and courses that are supported by the department. The structure of a governance committee in any organization can aid or inhibit that organization's functioning. In 2013, following a major curriculum change in 2007, the Emory University School of Medicine (EUSOM) implemented an "interwoven" configuration for its curriculum committee to better oversee the integrated curriculum. The new curriculum committee structure involves a small executive committee and 10 subcommittees. Each subcommittee performs a specific task or oversees one element of the curriculum. Members, including students, are appointed to two subcommittees in a way that each subcommittee is composed of representatives from multiple other subcommittees. This interweaving facilitates communication between subcommittees and also encourages members to become experts in specific tasks while retaining a comprehensive perspective on student outcomes. EUSOM's previous structure of a single committee with members representing individual departments did not promote cohesive management. The interwoven structure aligns neatly with the goals of the integrated curriculum. Since the restructuring, subcommittee members have been engaged in discussions and decisions on many key issues and expressed satisfaction with the format. The new structure corresponds to EUSOM's educational goals, although the long-term impact on student outcomes still needs to be assessed.
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Affiliation(s)
- Hugh A Stoddard
- H.A. Stoddard is assistant dean for medical education research and associate professor of medicine, Emory University School of Medicine, Atlanta, Georgia. E.D. Brownfield is assistant dean for medical education and professor of medicine, Emory University School of Medicine, Atlanta, Georgia. G. Churchward is assistant dean for medical education and student affairs and professor of microbiology and immunology, Emory University School of Medicine, Atlanta, Georgia. J.W. Eley is executive associate dean for medical education and student affairs and professor of hematology and medical oncology, Emory University School of Medicine, Atlanta, Georgia
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Whelan A, Leddy JJ, Mindra S, Matthew Hughes JD, El-Bialy S, Ramnanan CJ. Student perceptions of independent versus facilitated small group learning approaches to compressed medical anatomy education. ANATOMICAL SCIENCES EDUCATION 2016; 9:40-51. [PMID: 26040541 DOI: 10.1002/ase.1544] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 02/27/2015] [Accepted: 04/30/2015] [Indexed: 05/23/2023]
Abstract
The purpose of this study was to compare student perceptions regarding two, small group learning approaches to compressed (46.5 prosection-based laboratory hours), integrated anatomy education at the University of Ottawa medical program. In the facilitated active learning (FAL) approach, tutors engage students and are expected to enable and balance both active learning and progression through laboratory objectives. In contrast, the emphasized independent learning (EIL) approach stresses elements from the "flipped classroom" educational model: prelaboratory preparation, independent laboratory learning, and limited tutor involvement. Quantitative (Likert-style questions) and qualitative data (independent thematic analysis of open-ended commentary) from a survey of students who had completed the preclerkship curriculum identified strengths from the EIL (promoting student collaboration and communication) and FAL (successful progression through objectives) approaches. However, EIL led to student frustration related to a lack of direction and impaired completion of objectives, whereas active learning opportunities in FAL were highly variable and dependent on tutor teaching style. A "hidden curriculum" was also identified, where students (particularly EIL and clerkship students) commonly compared their compressed anatomy education or their anatomy learning environment with other approaches. Finally, while both groups highly regarded the efficiency of prosection-based learning and expressed value for cadaveric-based learning, student commentary noted that the lack of grade value dedicated to anatomy assessment limited student accountability. This study revealed critical insights into small group learning in compressed anatomy education, including the need to balance student active learning opportunities with appropriate direction and feedback (including assessment).
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Affiliation(s)
- Alexander Whelan
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - John J Leddy
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Sean Mindra
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Safaa El-Bialy
- Department of Innovation in Medical Education, Division of Clinical and Functional Anatomy, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Christopher J Ramnanan
- Department of Innovation in Medical Education, Division of Clinical and Functional Anatomy, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Holtzman KZ, Swanson DB, Ouyang W, Dillon GF, Boulet JR. International variation in performance by clinical discipline and task on the United States medical licensing examination step 2 clinical knowledge component. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2014; 89:1558-1562. [PMID: 25250743 DOI: 10.1097/acm.0000000000000488] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To investigate country-to-country variation in performance across clinical science disciplines and tasks for examinees taking the Step 2 Clinical Knowledge (CK) component of the United States Medical Licensing Examination. METHOD In 2012 the authors analyzed demographic characteristics, total scores, and percent-correct clinical science discipline and task scores for more than 88,500 examinees taking Step 2 CK for the first time during the 2008-2010 academic years. For each examinee and score, differences between the score and the mean performance of examinees at U.S. MD-granting medical schools were calculated, and mean differences by country of medical school were tabulated for analysis of country-to-country variation in performance by clinical discipline and task. RESULTS Controlling for overall performance relative to U.S. examinees, results showed that international medical graduates (IMGs) performed best in Surgery and worst in Psychiatry for clinical discipline scores; for clinical tasks, IMGs performed best in Understanding Mechanisms of Disease and worst in Promoting Preventive Medicine and Health Maintenance. The pattern of results was strongest for IMGs attending schools in the Middle East and Australasia, present to a lesser degree for IMGs attending schools in Europe, and absent for IMGs attending Caribbean medical schools. CONCLUSIONS Country-to-country differences in relative performance were present for both clinical discipline and task scores. Possible explanations include differences in learning outcomes, curriculum emphasis and clinical experience, standards of care, and culture, as well as the effects of English as a second language and relative emphasis on preparing students to take the Step 2 CK exam.
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Affiliation(s)
- Kathleen Z Holtzman
- Ms. Holtzman is director, Assessment and International Operations, American Board of Medical Specialties, Chicago, Illinois. Dr. Swanson is vice president, Assessment Programs Unit, National Board of Medical Examiners, Philadelphia, Pennsylvania. Ms. Ouyang is measurement analyst, Measurement Consulting Services Unit, National Board of Medical Examiners, Philadelphia, Pennsylvania. Dr. Dillon is vice president, Assessment Programs Unit, National Board of Medical Examiners, Philadelphia, Pennsylvania. Dr. Boulet is associate vice president, Research and Data Resources, Foundation for Advancement of International Medical Education and Research, Philadelphia, Pennsylvania
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Benor DE. A new paradigm is needed for medical education in the mid-twenty-first century and beyond: are we ready? Rambam Maimonides Med J 2014; 5:e0018. [PMID: 25120918 PMCID: PMC4128589 DOI: 10.5041/rmmj.10152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The twentieth century witnessed profound changes in medical education. All these changes, however, took place within the existing framework, suggested by Flexner a century ago. The present paper suggests that we are approaching a singularity point, where we shall have to change the paradigm and be prepared for an entirely new genre of medical education. This suggestion is based upon analysis of existing and envisaged trends: first, in technology, such as availability of information and sophisticated simulations; second, in medical practice, such as far-reaching interventions in life and death that create an array of new moral dilemmas, as well as a change in patient mix in hospitals and a growing need of team work; third, in the societal attitude toward higher education. The structure of the future medical school is delineated in a rough sketch, and so are the roles of the future medical teacher. It is concluded that we are presently not prepared for the approaching changes, neither from practical nor from attitudinal points of view, and that it is now high time for both awareness of and preparation for these changes.
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Affiliation(s)
- Dan E. Benor
- Professor Emeritus, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
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Larkin TA, McAndrew DJ. Factors influencing students' decisions to participate in a short "dissection experience" within a systemic anatomy course. ANATOMICAL SCIENCES EDUCATION 2013; 6:225-231. [PMID: 23213067 DOI: 10.1002/ase.1323] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 09/11/2012] [Indexed: 06/01/2023]
Abstract
Changes in medical education have affected both curriculum design and delivery. Many medical schools now use integrated curricula and a systemic approach, with reduced hours of anatomy teaching. While learning anatomy via dissection is invaluable in educational, professional, and personal development, it is time intensive and supports a regional approach to learning anatomy; the use of prosections has replaced dissection as the main teaching method in many medical schools. In our graduate-entry medical degree, we use an integrated curriculum, with prosections to teach anatomy systemically. However, to not exclude dissection completely, and to expose students to its additional and unique benefits, we implemented a short "Dissection Experience" at the beginning of Year 2. Students attended three two-hour anatomy sessions and participated in dissection of the clinically relevant areas of the cubital fossa, femoral triangle, and infraclavicular region. This activity was voluntary and we retrospectively surveyed all students to ascertain factors influencing their decision of whether to participate in this activity, and to obtain feedback from those students who did participate. The main reasons students did not participate were previous dissection experience and time constraints. The reasons most strongly affecting students' decisions to participate related to experience (lack of previous or new) and new skill. Students' responses as to the most beneficial component of the dissection experience were based around practical skills, anatomical education, the learning process, and the body donors. We report here on the benefits and practicalities of including a short dissection experience in a systemic, prosection-based anatomy course.
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Affiliation(s)
- Theresa A Larkin
- Division of Medical Sciences, Graduate School of Medicine, University of Wollongong, New South Wales, Australia.
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