Medical Education Online最新文献

When clinician-educators and medical education researchers use and discuss medical education research, they can advance innovation in medical education as well as improve its quality. To facilitate the use and discussions of medical education research, we created a prefatory visual representation of key medical education research topics and associated experts. We conducted one-on-one virtual interviews with medical education journal editorial board members to identify what they perceived as key medical education research topics as well as who they associated, as experts, with each of the identified topics. We used content analysis to create categories representing key topics and noted occurrences of named experts. Twenty-one editorial board members, representing nine of the top medical education journals, participated. From the data we created a figure entitled, Medical Education Research Library. The library includes 13 research topics, with assessment as the most prevalent. It also notes recognized experts, including van der Vleuten, ten Cate, and Norman. The key medical education research topics identified and included in the library align with what others have identified as trends in the literature. Selected topics, including workplace-based learning, equity, diversity, and inclusion, physician wellbeing and burnout, and social accountability, are emerging. Once transformed into an open educational resource, clinician-educators and medical education researchers can use and contribute to the functional library. Such continuous expansion will generate better awareness and recognition of diverse perspectives. The functional library will help to innovate and improve the quality of medical education through evidence-informed practices and scholarship.

India has been historically challenged by an insufficient and heterogeneously clustered distribution of healthcare infrastructure. While resource-limited healthcare settings, such as major parts of India, require multidisciplinary approaches for improvement, one key approach is the recruitment and training of a healthcare workforce representative of its population. This requires overcoming barriers to equity and representation in Indian medical education that are multi-faceted, historical, and rooted in inequality. However, literature is lacking regarding the financial or economic barriers, and their implications on equity and representation in the Indian allopathic physician workforce, which this review sought to describe. Keyword-based searches were carried out in PubMed, Google Scholar, and Scopus in order to identify relevant literature published till November 2023. This state-of-the-art narrative review describes the existing multi-pronged economic barriers, recent and forthcoming changes deepening these barriers, and how these may limit opportunities for having a diverse workforce. Three sets of major economic barriers exist to becoming a specialized medical practitioner in India - resources required to get selected into an Indian medical school, resources required to pursue medical school, and resources required to get a residency position. The resources in this endeavor have historically included substantial efforts, finances, and privilege, but rising barriers in the medical education system have worsened the state of inequity. Preparation costs for medical school and residency entrance tests have risen steadily, which may be further exacerbated by recent major policy changes regarding licensing and residency selection. Additionally, considerable increases in direct and indirect costs of medical education have recently occurred. Urgent action in these areas may help the Indian population get access to a diverse and representative healthcare workforce and also help alleviate the shortage of primary care physicians in the country. Discussed are the reasons for rural healthcare disparities in India and potential solutions related to medical education.

Academics in medicine are frequently asked to serve on panels to discuss their clinical, research, education, administrative or personal expertise. While panel discussions are often the highlight of a conference or event, in the medical literature, there is very little published on how an individual can effectively prepare and present as an expert panelist. This paper offers guidelines that will enable academics to prepare, deliver, and engage in active dialogue during a panel discussion. Specific tactics include how to accept invitations to serve on a panel, conducting pre-panel conference meetings and background research, preparing concise opening statements and new insights, connecting with the audience, answering questions in a collaborative spirit, and debriefing after the panel. These guidelines will be valuable to any individual invited to serve on a panel discussion and will promote future panelists in engaging in constructive and fulfilling dialogue, with the ultimate goal of leaving the audience with a greater understanding of the topic of discourse.

Introduction: People who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, and other sexual/gender minorities (LGBTQ+) may experience discrimination when seeking healthcare. Medical students should be trained in inclusive and affirming care for LGBTQ+ patients. This narrative literature review explores the landscape of interventions and evaluations related to LGBTQ+ health content taught in medical schools in the USA and suggests strategies for further curriculum development.

Methods: PubMed, ERIC, and Education Research Complete databases were systematically searched for peer-reviewed articles on LGBTQ+ health in medical student education in the USA published between 1 January 2011-6 February 2023. Articles were screened for eligibility and data was abstracted from all eligible articles. Data abstraction included the type of intervention or evaluation, sample population and size, and key outcomes.

Results: One hundred thirty-four articles met inclusion criteria and were reviewed. This includes 6 (4.5%) that evaluate existing curriculum, 77 (57.5%) study the impact of curriculum components and interventions, 36 (26.9%) evaluate student knowledge and learning experiences, and 15 (11.2%) describe the development of broad learning objectives and curriculum. Eight studies identified student knowledge gaps related to gender identity and affirming care and these topics were covered in 34 curriculum interventions.

Conclusion: Medical student education is important to address health disparities faced by the LGBTQ+ community, and has been an increasingly studied topic in the USA. A variety of curriculum interventions at single institutions show promise in enhancing student knowledge and training in LGBTQ+ health. Despite this, multiple studies indicate that students report inadequate education on certain topics with limitations in their knowledge and preparedness to care for LGBTQ+ patients, particularly transgender and gender diverse patients. Additional integration of LGBTQ+ curriculum content in areas of perceived deficits could help better prepare future physicians to care for LGBTQ+ patients and populations.

Assigning students to work in permanent teams is a design principle in Team-based learning (TBL). It has been assumed that a stable team composition supports the emergence of collaborative problem-solving and learning: when students became more familiar with each other, they shared more information and resolved discrepancies together, which in turn stimulated knowledge acquisition and comprehension. However, this assumption had not been probed by a randomized controlled trial with performance assessment as an outcome. In an online course for second term medical students, 50% of the students were reassigned to new teams for each of the 24 problems to be solved during four classes, thus precluding familiarity. The learning outcome was assessed shortly after the third of four classes by a domain knowledge test. Whether TBL teams were permanent or temporary did not affect the score of a domain knowledge test. As expected, participation in online TBL improved the domain knowledge test results. Overall, the permanent team seems to be less important for cognitive learning outcomes than previously assumed, but this may depend on the specific educational setting. However, team familiarity may still be important for team decision-making. As clinical reasoning in the medical workplace often involves collaborating in changing teams, future research on TBL should focus on how to utilize this format to prepare medical students for decision-making and optimal learning outcomes under these conditions.

Teaching is an essential skill for future doctors. Peer-assisted learning (PAL)-where students take up a teaching role at an early stage of their training-is widely used in medical curricula. No studies have explored the long-term perceived impact of peer teaching. Therefore, we aimed to determine how former peer teachers reflected on PAL and its perceived long-term impact. In this longitudinal descriptive study, we conducted 42 semi-structured interviews with 11 former peer teachers at the University of Antwerp. Five of them were interviewed 6 months after PAL; 6 of them 9 years after PAL. This latter group was also interviewed during PAL in a previous study. We conducted secondary analyses of previously collected interviews, consistently comparing the findings with new data gathered from the current interviews. Using realist thematic analysis, topic summary themes were generated. Former peer teachers reflected on their PAL experience with a lot of satisfaction. Those meanwhile working as residents are still passionate about teaching. Peer teachers experienced a gain in clinical examination- and professional skills in the long-term, facilitating a smoother transition to their internship. Our findings suggest that PAL selects diverse but committed students. The longitudinal data demonstrate how PAL initiates or stimulates different skills in diverse students, including public speaking, teaching, time management, and self-efficacy in specific clinical skills. Regarding the chicken-and-egg question, our study encompasses both longitudinal cases illustrating the pre-existing skill theory and cases demonstrating how achieved competences were induced by PAL. Former peer teachers experienced long-term benefits of PAL, which eased their transition into the internship. PAL has the potential to ignite a lasting passion for teaching, providing diverse and unique learning opportunities not only for the most talented and 'pre-selected' medical students but also for a range of dedicated future clinicians.

Background: Online instruction within higher education is a growing trend. Asynchronous online courses vary widely in design elements. Research is needed to evaluate the impact of course design on student outcomes. A large, asynchronous undergraduate medical terminology course was modified to increase authentic language use, student interaction, formative feedback, retrieval practice, and metacognition. The purposes of this study were to describe modified course design elements and evaluate the impact of modifications on student outcomes compared with a standard course implemented concurrently.

Methods: This prospective, quasi-experimental study included 494 students (modified course, n = 277; standard course, n = 217). Measures included student participation, performance, course satisfaction, self-efficacy (SE), and engagement.

Results: Participation in assignments was high (88-94%). Students in both courses experienced growth in SE for medical terminology use. Students in the modified course earned significantly higher course grades and reported higher satisfaction levels. No significant differences in SE or exam scores were found between courses. Marginal significance was found for increased behavioral engagement for students in the modified course.

Conclusions: Modifications based on language learning and learning science principles were feasible to implement within a large, asynchronous online medical terminology course. Modifications resulted in greater student satisfaction and improved course grades. Exam performance was not significantly different between the modified and standard courses. Future research should focus on modifications preparing students for summative assessments.

With the vigorous development of ChatGPT and its application in the field of education, a new era of the collaborative development of human and artificial intelligence and the symbiosis of education has come. Integrating artificial intelligence (AI) into medical education has the potential to revolutionize it. Large language models, such as ChatGPT, can be used as virtual teaching aids to provide students with individualized and immediate medical knowledge, and conduct interactive simulation learning and detection. In this paper, we discuss the application of ChatGPT in anatomy teaching and its various application levels based on our own teaching experiences, and discuss the advantages and disadvantages of ChatGPT in anatomy teaching. ChatGPT increases student engagement and strengthens students' ability to learn independently. At the same time, ChatGPT faces many challenges and limitations in medical education. Medical educators must keep pace with the rapid changes in technology, taking into account ChatGPT's impact on curriculum design, assessment strategies and teaching methods. Discussing the application of ChatGPT in medical education, especially anatomy teaching, is helpful to the effective integration and application of artificial intelligence tools in medical education.

Gender disparities are prevalent in the neurosurgical field, particularly for female trainees, despite the growing demand for neurosurgeons. The situation is bleaker in low-and middle-income countries, where gender disparities among neurosurgical trainees have not been evaluated. We aimed to gauge the gender differences in opportunities and perceptions of neurosurgery training in Pakistan by comparing responses between males and females. A nationwide web-based survey was conducted in Pakistan, covering 22 College of Physicians and Surgeons of Pakistan (CPSP) accredited neurosurgery training programs. Convenience sampling was used with a pilot-tested questionnaire. Data analysis was performed using SPSS version 26. A total of 120 trainees participated in our survey. The mean age of the participants was 30.4 ± 4.1 years, with 29.2% females and 70.8% males. Concerns about gender equity were more among females (34.3%) than males (27.1%). Poor work-life balance was reported by more females (34.3%) than males (30.6%). Burnout due to working hours was strongly agreed by more females (54.3%) than males (35.3%). More females (40%) acknowledged sufficient mentorship opportunities versus males (25%). Female respondents (65.7%) worked 50-100 hours per week, less than males (69.4%). Satisfaction with surgical exposure was lower among females (2.9%) compared to males (18.8%). More females reported access to teaching courses (82.9% vs. 77.6% males) and neurosurgical conferences (85.7% vs. 80.0% males), cadaver workshops (17.1% vs. 12.9% males), morbidity and mortality meetings (88.6% vs. 82.4% males), case-based sessions (82.9% vs. 75.3% males), and radiology discussions (82.9% vs. 74.1% males). Our study highlights substantial gender gaps in neurosurgical training, concerns over working hours, burnout, mentorship, work-life balance, and gender equity. These findings underscore the necessity for interventions to rectify these disparities and foster gender equity in neurosurgical training.