教育学最新文献

NEW & NOTEWORTHY A medical school faculty member deals with the blow dealt by a student's public, all-caps dismissal of her physiology textbook.

The interpretation of the electrocardiogram (ECG) is a core competency for medical students and is traditionally taught using paper ECG tracings and physical calipers. As clinical practice increasingly shifts toward digital ECG records, the use of physical calipers on computer screens has become impractical, often leading students to rely passively on automated machine-generated interpretations. To address this gap, we developed ECGSight, an open-source, interactive application built with R and Shiny. ECGSight functions as a digital caliper, enabling users to upload any ECG image, calibrate time and voltage scales, and measure ECG segments and intervals with an intuitive click-and-drag interface. The application provides instant measurements, automatically calculates heart rate and corrected QT (QTc) intervals, and supports active learning through hands-on digital ECG analysis. By facilitating accurate ECG measurement in a digital environment, ECGSight bridges the gap between traditional skill-based learning and contemporary electronic clinical workflows.NEW & NOTEWORTHY ECGSight is an open-source, interactive digital caliper application developed with R and Shiny for measuring ECG segments and intervals from digital ECG images. It restores active, measurement-based learning that is often lost when students rely on automated ECG interpretations on screens. By shifting ECG education from passive viewing to deliberate skill engagement, the tool helps students better understand ECG scaling, interval boundaries, and clinical variability in a digital environment.

Introduction: Metacognitive accuracy-the extent to which individuals' perceptions of their knowledge align with actual performance-is critical in clinical decision making. Overconfidence can lead to diagnostic errors, while insufficient confidence may delay decisions or prompt unnecessary testing, increasing health care costs. Although longitudinal knowledge assessments with spaced repetition have been shown to improve learning and knowledge transfer, their impact on metacognition remains underexplored. This study investigates changes in confidence under different spaced repetition strategies in a large cohort of family physicians.

Methods: Data were drawn from the American Board of Family Medicine's Continuous Knowledge Self-Assessment, a longitudinal assessment administered quarterly. Participants rated their confidence on a 6-point scale after each question. In total, 16,751 physicians who completed assessments at baseline, quarter 6, and quarter 10 were included. Participants were randomized to control or intervention groups receiving repeated or clone questions at various intervals. One-sample t tests assessed confidence changes for questions initially answered incorrectly but subsequently answered correctly. Multivariate regression controls demographic factors.

Results: Confidence increased significantly for repeated questions, with moderate effect sizes in single repetition groups and large effect sizes in two-time repetition groups. Clone questions also showed gains, though smaller in magnitude. After adjusting for clinician demographics, male and younger physicians generally reported higher confidence.

Discussion: Spaced repetition enhances both learning and metacognitive accuracy. Two spaced repetitions yielded larger gains. These findings support incorporation of metacognitive-enhancing strategies into CME to improve clinician self-assessment and potentially reduce diagnostic error.

Abstract: A participatory arts- and narrative-based approach for knowledge translation was utilized in a rare disease educational session at a medical conference, combining stakeholder storytelling with the presentation of relevant empirical evidence and frameworks to deepen clinicians' understanding of patient and caregiver quality of life. Before the conference, patient/caregiver perspectives were solicited via a six-word story creative writing prompt (n = 94); during the session, clinicians utilized these stories to cocreate three visual pieces representing the complexity of patient and caregiver experiences and symbolizing the common threads that appear when many "rare" experiences come together. Session attendees reported highly positive feedback, with most clinicians reporting that the knowledge gained from the session would result in a change in their clinical practice. We propose arts- and narrative-based approaches hold great promise for centering patient voices in health care education.

Introduction: Well-calibrated diagnostic performance requires feedback on decisions. Emergency department and urgent care (ED/UC) clinicians infrequently receive diagnostic performance feedback. We explored clinician experience with self-directed diagnostic performance review compared with diagnostic safety expert review.

Methods: Single-center, cohort study of pediatric ED/UC clinician self-directed case review involving possible diagnostic errors (DxEs). Participants reviewed their care of patients admitted within 10 days of an index ED/UC visit at risk of DxEs. The Revised Safer Dx provided structure for DxE identification and was compared with expert review by two diagnostic safety experts using Cohen kappa. Participants also reported their experience using the Revised Safer Dx.

Results: During the 1-year study period, 187 patients at risk of DxEs received index visit care from 260 ED/UC eligible clinicians. Seventy-one clinicians submitted reviews for 97 patient-clinician encounters (37.4% response rate). Agreement on the presence of DxEs ranged from 84.8% to 87.5%; Cohen kappa for expert 1 = 0.51 (95% confidence interval = 0.25-0.76); expert 2 = 0.54 (95% confidence interval = 0.17-0.92) indicating moderate agreement. More than 60% of participants agreed that the Revised Safer Dx provided a useful framework for reviewing diagnostic performance regardless of the presence of a DxE. Participants self-identifying a DxE were significantly more likely to have altered their diagnostic approach than those who did not (75.0% vs 5.7%; P < .001).

Discussion: ED/UC clinicians performing self-directed structured review for DxEs demonstrated moderate agreement with diagnostic safety experts indicating this method may aid diagnostic reasoning calibration. Promoting self-directed reviews may improve feedback delivery among ED/UC clinicians.

Introduction: Traditional evaluation models, often linear and outcome-focused, are increasingly inadequate for the complexities of modern medical education, which demands more comprehensive and nuanced assessment approaches.

Methods: A standardized continuing professional development activity evaluation instrument was developed and implemented. An iterative process was performed, using a repeat Rasch analysis, to improve reliability of the evaluation instrument. Category Probability Curves and Test Information Function were generated by the Rasch analysis to refine the construction of the assessment. All educational activities completed between 2022 and 2024 were eligible for inclusion. The study incorporated a diverse range of educational activities and included multiple health care professions.

Results: The pilot analysis included 250 educational activities with 26,554 individual learners completing evaluations for analysis. Initial Rasch findings demonstrated a need to remove redundancies and change from a five to four-point rating scale. The final instrument validation included 21 activities and 529 learners. Improvement was seen in reliability after modifications, with an increase in Cronbach alpha from 0.72 to 0.80.

Discussion: Use of psychometrics to improve assessments can yield a more reliable and less redundant evaluation instrument. This research demonstrates a psychometrically informed, flexible evaluation tool that can inform future educational efforts and serve as a data driven metric to enhance the quality of continuing professional development programs.

Abstract: Point-of-care ultrasound proficiency requires the integration of spatial anatomic knowledge, technical hands-on image acquisition, and the ability to interpret images and incorporate findings into clinical decision-making. Effectively teaching these skills requires a structured approach. This article presents a comprehensive framework for designing a point-of-care ultrasound course tailored to continuing professional development. We demonstrate how applying the learning theories of cognitivism, behaviorism, and constructivism can facilitate the educational experience. In addition, we offer guidance on maintaining learner engagement, organizing didactic sessions, and delivering standardized feedback.

Introduction: E-cigarettes (Vapes) represent the most common form of tobacco used by adolescents, with one out of every 29 (3.5%) middle school students and one in every 13 (7.8%) of high school students vaping daily. This project aimed to increase vape screening and prevention education in youth visits at pediatric practices, to increase provider comfort with the topic of vaping, and to evaluate this educational process.

Methods: A provider training and resource modules (talking points, billing codes, and shareable parent/teen-tailored resources) were developed. Providers ( N = 32) completed an anonymous pre/postsurvey regarding their knowledge, comfort levels, barriers, and practices related to teen vaping. Key-informant interviews ( N = 20) were conducted to identify barriers and seek solutions to incorporate risk counseling into daily practice. Monthly meetings were held to achieve Continuous Quality Improvement (CQI) in pediatric practices. The frequency of providing vaping information in the Depart Summary was monitored.

Results: Reported barriers to providing vape prevention counseling, including lack of knowledge, lack of resources, discomfort with topic, and patient resistance, were significantly reduced after participation. Time constraints continued to be the greatest barrier to preventive counseling. Physicians who indicated they often or always provide vape prevention information during a visit increased from 9 to 50 percent. Average resources provided increased from 1 to 94 per month.

Discussion: Tailored provider-training and resources increased physician knowledge of and confidence with the topic of vaping as well as the frequency of screening and preventive guidance provided to teens and their families.

Academic and scientific Olympiads have been used as educational tools since the late nineteenth century, fostering students' interest, creativity, and critical thinking. However, their application in medical education remains limited. In this context, Brazilian medical students created the Medical Olympiad (OMED), a nationwide, student-led initiative designed to promote active and collaborative learning, foster clinical reasoning, and enhance academic engagement. Despite the long-standing use of Olympiads in basic education, their educational impact in medical school has been minimally investigated. This cross-sectional study evaluated the educational impact of OMED by examining its influence on participants' intrinsic motivation and their perceptions of its academic benefits. A structured questionnaire was administered to students after the first phase of the fourth edition of OMED (held in 2024) and completed by 677 participants. Participation was predominantly driven by intrinsic and other self-determined forms of motivation. Postevent assessments indicated that OMED has strong potential to promote the internalization of motivation and to enhance students' overall motivation to study. Participants also reported that the Olympiad supported knowledge acquisition and consolidation, self-assessment of strengths and weaknesses, and the development of clinical reasoning, suggesting that OMED effectively achieved its educational objectives.NEW & NOTEWORTHY This study provides the first empirical evaluation of a student-led medical Olympiad within undergraduate medical education. By analyzing responses from 677 participants, it demonstrates that such initiatives can foster intrinsic motivation and enhance academic outcomes. Although academic Olympiads are well established in basic education, their use and educational impact in medical training have been largely unexplored. These findings highlight the substantial educational potential of student-driven, competition-based learning environments in medical education.

The rise of generative artificial intelligence (AI) has accelerated content creation across sectors, including education and academia. While these tools can streamline workflows and support learning, their use by students to complete assignments poses risks to academic integrity. This case study quantitatively evaluated the vulnerability of existing coursework assessments and exams to cheating using generative AI. Specifically, we compared ChatGPT-4's performance to student grades on 131 assessments from 40 modules in the School of Biological and Environmental Sciences at a UK University. ChatGPT excelled in "exam-like" assessments, including coursework-associated tests, exams (particularly those involving multiple choice), and, at some levels of study, in essay-style assessments. Conversely, AI performance and hence vulnerability were low on assessments requiring in-class data collection, collaboration, or the creation of reports, posters, or presentations. Overall, ChatGPT-produced work was often superficial and vague but better than expected, posing risks to assessing learning in all fields within the biological sciences, including physiology. While generative AI holds promise as a tool to help students understand, organize, and structure, it raises concerns around misuse. Designing creative, individualized tasks that require genuine intellectual engagement is essential, with greater emphasis on ethical conduct and the importance of integrity. Synthesizing information across multiple biological scales and applying clinical or experimental scenarios is recommended to develop higher-order physiological reasoning in students. Continuous, collaborative monitoring of generative AI performance on assessments should become part of routine assessment design and evaluation, given the continuous development and improvement of these tools. In cases where basic knowledge testing remains necessary, reversion to in-person examinations is recommended to replace online testing.NEW & NOTEWORTHY This study reveals that current assessments in biological and environmental sciences are highly vulnerable to generative artificial intelligence (AI) misuse, which threatens assessment validity. ChatGPT-4 either outperformed or approximated students in exam-style testing and on some essay assignments but struggled with tasks involving data collection, collaboration, and presentations. The authors recommend redesigning assessments to require deeper reasoning, ethical engagement, and clinical or experimental application, alongside ongoing monitoring of AI capabilities and increased use of in-person exams.