Search

Background: How state opioid policy environments with multiple concurrent policies affect opioid prescribing to individuals with acute pain is unknown. Objective: To examine how prescription drug monitoring programs (PDMPs), pain management clinic regulations, initial prescription duration limits, and mandatory continued medical education affected total and high-dose prescribing. Design: A county-level multiple-policy difference-in-difference event study framework. Subjects: A total of 2,425,643 individuals in a large national commercial insurance deidentified claims database (aged 12–64 years) with acute pain diagnoses and opioid prescriptions from 2007 to 2019. Main Measures: The total number of acute pain opioid treatment episodes and number of episodes containing high-dose (> 90 morphine equivalent daily dosage (MEDD)) prescriptions. Key Results: Approximately 7.5% of acute pain episodes were categorized as high-dose episodes. Prescription duration limits were associated with increases in the number of total episodes; no other policy was found to have a significant impact. Beginning five quarters after implementation, counties in states with pain management clinic regulations experienced a sustained 50% relative decline in the number of episodes containing > 90 MEDD prescriptions (95 CIs: (Q5: − 0.506, − 0.144; Q12: − 1.000, − 0.290)). Mandated continuing medical education regarding the treatment of pain was associated with a 50–75% relative increase in number of high-dose episodes following the first year-and-a-half of enactment (95 CIs: (Q7: 0.351, 0.869; Q12: 0.413, 1.107)). Initial prescription duration limits were associated with an initial relative reduction of 25% in high-dose prescribing, with the effect increasing over time (95 CI: (Q12: − 0.967, − 0.335). There was no evidence that PDMPs affected high-dose opioids dispensed to individuals with acute pain. Other high-risk prescribing indicators were explored as well; no consistent policy impacts were found. Conclusions: State opioid policies may have differential effects on high-dose opioid dispensing in individuals with acute pain. Policymakers should consider effectiveness of individual policies in the presence of other opioid policies to address the ongoing opioid crisis. [ABSTRACT FROM AUTHOR]

Background: Ophthalmoscopy is an essential skill for medical trainees, however, trainees commonly report feeling uncomfortable with this skill. The purpose of this study is to determine the utility of a low-cost simulator in improving medical student's comfort and proficiency with direct ophthalmoscopy. Methods: An easy to assemble simulator was constructed using low-cost materials. First and second year medical students at the University of British Columbia were recruited. Participants in the Simulator group completed a survey to rate their competency using a direct ophthalmoscope prior to a practice session with the simulator. The Control group had no simulator session. Both groups then took part in the regularly scheduled clinical session and were assessed by a preceptor on their proficiency using an evidence-based rubric. The Simulator Group completed a post session survey about their perceived proficiency with an ophthalmoscope. Results: The Simulator group had 14 participants and the Control group had 103 participants. Participants in the Simulator group self-reported significant increases (p < 0.05) in their perceived competence across all domains surveyed including overall comfort and visualizing the optic disc. There were no significant differences in proficiency rated by a preceptor between the Simulator and Control groups (7.21 vs 7.06 out of 10; p = 0.572). Conclusions: This study demonstrates that a low-cost simulator is an accessible and valued method for improving student's perceived competence and comfort in ophthalmoscopy. While this study did not show the simulator results in higher proficiency, rated by an evaluator, future studies can focus on more robust measures of skill acquisition and larger sample size. [ABSTRACT FROM AUTHOR]

Purpose: The recognition of adverse drug reactions (ADRs) is an important part of daily clinical work. However, medical education in this field is mostly drug-based and does not address adequately the complexity of this field regarding individual risk factors and polypharmacy. This study investigates the potential of the web-based serious game SeeMe (side-effect exposure—medical education) in pharmacological education of medical students to improve the recognition of relevant ADRs. Methods: One hundred fifty-seven medical students were recruited to evaluate the serious game SeeMe. SeeMe was developed to improve knowledge and recognition of ADRs in clinical practice. Players take on the role of a physician trying to understand fictional patients with ADRs. Before and after an 8-week playing period, an evaluation was carried out through a pre- and post-questionnaire and a pre- and post- knowledge test. Results: The students achieved significantly better results in the knowledge test, as almost twice as many exam-relevant questions were answered correctly (p < 0.001). The serious game had a positive effect on the students' perception of the importance of ADRs. Conclusion: This study demonstrates the potential of web- and case-based fictional serious games in medical education. The improved recognition of side effects represents a crucial step for education and training in clinical pharmacology. Future versions of the serious game may take this further and focus on training in the treatment of ADRs and their relevance in various healthcare professions. [ABSTRACT FROM AUTHOR]

Purpose of review: This review presents a critical appraisal of the current state of simulation-based education in neurocritical care, including a brief summary of its supporting conceptual frameworks and its emergence as a tool for quality improvement and patient safety. We discuss technological developments that will expand the uses of simulation within the field and/or lower entry costs. Recent findings: Simulation-based educational interventions have improved learner performance in simulation-based assessments of interpretation of continuous electroencephalography (as well as management of acute stroke and status epilepticus. Three recent studies demonstrate improved door-to-needle times for thrombolytics in acute ischemic stroke after simulation-based training, especially when such training focuses on interprofessional teamwork. Simulation can also be used to teach safety analysis and to identify patient safety threats. Summary: Access to simulation and its application is growing in neurocritical care. More rigorous, multicenter studies are required to demonstrate translational outcomes for improved patient care. [ABSTRACT FROM AUTHOR]

In this editorial the editor considers the twin issues of replicability and reproducibility in health professions education research, and notes challenges and opportunities that scholars in the field face in attending to the replicability and reproducibility of the work they produce. [ABSTRACT FROM AUTHOR]

This column is intended to address the kinds of knotty problems and dilemmas with which many scholars grapple in studying health professions education. In this article, we address the dilemma of engaging with foundational works versus depending on summary articles. We argue that an over-dependence on secondary sources can lead to prejudices and unquestioned assumptions, and limit the constructive development of our field. We urge health professions education scholars to honour the original literature not just for their own learning and understanding, but so that the field can move forward in developing theory and methodology. [ABSTRACT FROM AUTHOR]

Serious games, as a learning resource, enhance their game character by embedding game design elements that are typically used in entertainment games. Serious games in its entirety have already proven their teaching effectiveness in different educational contexts including medical education. The embedded game design elements play an essential role for a game's effectiveness and thus they should be selected based on evidence-based theories. For game design elements embedded in serious games used for the education of medical and healthcare professions, an overview of theories for the selection lacks. Additionally, it is still unclear whether and how single game design elements affect the learning effectiveness. Therefore, the main aim of this systematic review is threefold. Firstly, light will be shed on the single game design elements used in serious games in this area. Second, the game design elements' underlying theories will be worked out, and third, the game design elements' effectiveness on student learning outcome will be assessed. Two literature searches were conducted in November 2021 and May 2022 in six literature databases with keywords covering the fields of educational game design, serious game, and medical education. Out of 1006 initial records, 91 were included after applying predefined exclusion criteria. Data analysis revealed that the three most common game design elements were points, storyline, and feedback. Only four underlying theories were mentioned, and no study evaluated specific game design elements. Since game design elements should be based on theories to ensure meaningful evaluations, the conceptual GATE framework is introduced, which facilitates the selection of evidence-based game design elements for serious games. [ABSTRACT FROM AUTHOR]

While explicit conceptual models help to inform research, they are left out of much of the health professions education (HPE) literature. One reason may be the limited understanding about how to develop conceptual models with intention and rigor. Group concept mapping (GCM) is a mixed methods conceptualization approach that has been used to develop frameworks for planning and evaluation, but GCM has not been common in HPE. The purpose of this article is to describe GCM in order to make it more accessible for HPE scholars. We recount the origins and evolution of GCM and summarize its core features: GCM can combine multiple stakeholder perspectives in a systematic and inclusive manner to generate explicit conceptual models. Based on the literature and prior experience using GCM, we detail seven steps in GCM: (1) brainstorming ideas to a specific "focus prompt," (2) preparing ideas by removing duplicates and editing for consistency, (3) sorting ideas according to conceptual similarity, (4) generating the point map through quantitative analysis, (5) interpreting cluster map options, (6) summarizing the final concept map, and (7) reporting and using the map. We provide illustrative examples from HPE studies and compare GCM to other conceptualization methods. GCM has great potential to add to the myriad of methodologies open to HPE researchers. Its alignment with principles of diversity and inclusivity, as well as the need to be systematic in applying theoretical and conceptual frameworks to practice, make it a method well suited for the complexities of contemporary HPE scholarship. [ABSTRACT FROM AUTHOR]

China hosts around 68,000 international medical students (IMSs) primarily from lower income countries in Africa and Asia, who have the potential to contribute to international medical services. Understanding how these IMSs make career decisions can help better address the issue of global medical workforce shortage. However, such research is limited. Our study aims to explore the career decision-making process of China-educated IMSs, the challenges they experienced and the strategies they employed. In this exploratory qualitative study, we conducted semi-structured interviews with IMSs educated in China in 2022 using purposeful sampling. Twenty virtual one-on-one interviews were conducted, and data were analysed through directed qualitative content analysis. Cognitive Information Processing (CIP) theory was applied as the guiding framework for organising and analysing the data. The career decision-making process of the participants generally followed the stages of decision-making cycle in CIP theory, with a combination of urgent migration decisions and specialisation considerations adding layers of complexity to their career trajectories. Identified challenges encompassed lack of knowledge about oneself and career options, lack of decision-making skills, concerns of contextual complexities that limited the career decision-making process, low motivation and negative thoughts. Specific challenges due to their role as IMSs arose, which were related to career information access, self-capability evaluation, degree accreditation, employment competitiveness and mental states. Participants' proposed strategies were categorised into personal and institutional aspects, providing insights into addressing these challenges. This study substantiates and expands the application of the CIP theory within the sphere of the particular cultural and educational context of IMSs educated in China. It highlights the significance of integrating migration decision-making into career guidance for IMSs, and contributes to the literature by proposing an evidence-based tiered career intervention programme for IMSs. [ABSTRACT FROM AUTHOR]

Introduction: Research in various areas indicates that expert judgment can be highly inconsistent. However, expert judgment is indispensable in many contexts. In medical education, experts often function as examiners in rater-based assessments. Here, disagreement between examiners can have far-reaching consequences. The literature suggests that inconsistencies in ratings depend on the level of performance a to-be-evaluated candidate shows. This possibility has not been addressed deliberately and with appropriate statistical methods. By adopting the theoretical lens of ecological rationality, we evaluate if easily implementable strategies can enhance decision making in real-world assessment contexts. Methods: We address two objectives. First, we investigate the dependence of rater-consistency on performance levels. We recorded videos of mock-exams and had examiners (N=10) evaluate four students' performances and compare inconsistencies in performance ratings between examiner-pairs using a bootstrapping procedure. Our second objective is to provide an approach that aids decision making by implementing simple heuristics. Results: We found that discrepancies were largely a function of the level of performance the candidates showed. Lower performances were rated more inconsistently than excellent performances. Furthermore, our analyses indicated that the use of simple heuristics might improve decisions in examiner pairs. Discussion: Inconsistencies in performance judgments continue to be a matter of concern, and we provide empirical evidence for them to be related to candidate performance. We discuss implications for research and the advantages of adopting the perspective of ecological rationality. We point to directions both for further research and for development of assessment practices. [ABSTRACT FROM AUTHOR]

Medical educator portfolios (MEP) are increasingly recognized as a tool for developing and documenting teaching performance in Health Professions Education. However, there is a need to better understand the complex interplay between institutional guidelines and how teachers decode those guidelines and assign value to teaching merits. To gain a deeper understanding of this dynamic, this study employed a sociological analysis to understand how medical educators aspiring to professorships use MEPs to display their teaching merits and how cultural capital is reflected in these artefacts. We collected 36 medical educator portfolios for promotion from a large research-intensive university and conducted a deductive content analysis using institutional guidelines that distinguished between mandatory (accounting for the total body of teaching conducted) and optional content (arguing for pedagogical choices and evidencing the quality, respectively). Our analysis showed that the portfolios primarily included quantifiable data about teaching activities, e.g., numbers of students, topics and classes taught. Notably, they often lacked evidence of quality and scholarship of teaching. Looking at these findings through a Bourdieusian lens revealed that teachers in this social field exchange objectified evidence of hours spent on teaching into teaching capital recognized by their institution. Our findings highlight how institutional guidelines for MEPs construct a pedagogical battlefield, where educators try to decode and exchange the "right" and recognized teaching capital. This indicates that MEPs reflect the norms and practices of the academic field more than individual teaching quality. [ABSTRACT FROM AUTHOR]

Despite the increasing implementation of formative assessment in medical education, its' effect on learning behaviour remains questionable. This effect may depend on how students value formative, and summative assessments differently. Informed by Expectancy Value Theory, we compared test preparation, feedback use, and test-taking motivation of medical students who either took a purely formative progress test (formative PT-group) or a progress test that yielded study credits (summative PT-group). In a mixed-methods study design, we triangulated quantitative questionnaire data (n = 264), logging data of an online PT feedback system (n = 618), and qualitative interview data (n = 21) to compare feedback use, and test-taking motivation between the formative PT-group (n = 316), and the summative PT-group (n = 302). Self-reported, and actual feedback consultation was higher in the summative PT-group. Test preparation, and active feedback use were relatively low and similar in both groups. Both quantitative, and qualitative results showed that the motivation to prepare and consult feedback relates to how students value the assessment. In the interview data, a link could be made with goal orientation theory, as performance-oriented students perceived the formative PT as not important due to the lack of study credits. This led to low test-taking effort, and feedback consultation after the formative PT. In contrast, learning-oriented students valued the formative PT, and used it for self-study or self-assessment to gain feedback. Our results indicate that most students are less motivated to put effort in the test, and use feedback when there are no direct consequences. A supportive assessment environment that emphasizes recognition of the value of formative testing is required to motivate students to use feedback for learning. [ABSTRACT FROM AUTHOR]

Integrative medicine, need to be inoffensive, effective, and of quality (World Health Organization). In 2010, the American Society of Teachers of Family Medicine approved 19 competencies for teaching integrative medicine to residents. In 2018, the University of Rennes created a course: "Integrative Medicine and Complementary Therapies". Up until then, the only feedback from the courses was the students' opinions. We investigated the impact on medical students' social representation. We performed a sociological analysis of students' social representations before and after the course. The social representation is based on the way an individual creates his or her universe of beliefs and ideas. After hearing, "What word or group of words comes to mind when you hear people speak of integrative medicine and complementary therapies?", students were asked to provide 5 words/phrases, rank their importance, and show their attitude towards these words/phrases. The frequency and importance of these words/phrases were used to construct social representations (with central cores, and primary and secondary peripheries) before and after the course. Among the 101 students registered, 59 provided complete responses before and 63 after the course. Before, the central core comprised "hypnosis" and "alternative medicine", while after: "complementary care" and "global care". We only identified first periphery before the course: "acupuncture" and "homeopathy". 4 new contrasting elements: "integration with conventional treatment", "patient's choice", "personalisation of care", and "caring relationship of trust". This teaching course positively affected students' social representation of integrative medicine, and might promote their use during future practices. [ABSTRACT FROM AUTHOR]

Longitudinal academic advising (AA) and coaching programs are increasingly implemented in competency based medical education (CBME) to help residents reflect and act on the voluminous assessment data they receive. Documents created by residents for purposes of reflection are often used for a second, summative purpose—to help competence committees make decisions—which may be problematic. Using inductive, thematic analysis we analyzed written comments generated by 21 resident-AA dyads in one large internal medicine program who met over a 2 year period to determine what residents write when asked to reflect, how this aligns with what the AAs report, and what changes occur over time (total 109 resident self-reflections and 105 AA reports). Residents commented more on their developing autonomy, progress and improvement than AAs, who commented far more on performance measures. Over time, residents' writing shifted away from intrinsic roles, patient care and improvement towards what AAs focused on, including getting EPAs (entrustable professional activities), studying and exams. For EPAs, the emphasis was on getting sufficient numbers rather than reflecting on what residents were learning. Our findings challenge the practice of dual-purposing documents, by questioning the blurring of formative and summative intent, the structure of forms and their multiple conflicting purposes, and assumptions about the advising relationship over time. Our study suggests a need to re-evaluate how reflective documents are used in CBME programs. Further research should explore whether and how documentation can best be used to support resident growth and development. [ABSTRACT FROM AUTHOR]

Medical students' efforts to learn person-centered thinking and behavior can fall short due to the dissonance between person-centered clinical ideals and the prevailing epistemological stereotypes of medicine, where physicians' life events, relations, and emotions seem irrelevant to their professional competence. This paper explores how reflecting on personal life experiences and considering the relevance for one's future professional practice can inform first-year medical students' initial explorations of professional identities. In this narrative inquiry, we undertook a dialogical narrative analysis of 68 essays in which first-year medical students reflected on how personal experiences from before medical school may influence them as future doctors. Students wrote the texts at the end of a 6-month course involving 20 patient encounters, introduction to person-centered theory, peer group discussions, and reflective writing. The analysis targeted medical students' processes of interweaving and delineating personal and professional identities. The analysis yielded four categories. (1) How medical students told their stories of illness, suffering, and relational struggles in an interplay with context that provided them with new perspectives on their own experiences. Students formed identities with a person-centered orientation to medical work by: (2) recognizing and identifying with patients' vulnerability, (3) experiencing the healing function of sharing stories, and (4) transforming personal experiences into professional strength. Innovative approaches to medical education that encourage and support medical students to revisit, reflect on, and reinterpret their emotionally charged life experiences have the potential to shape professional identities in ways that support person-centered orientations to medical work. [ABSTRACT FROM AUTHOR]

This study examined the relationship between motivation, performance accomplishment, and persistence as a mediator among medical students. Quantitative and qualitative data were collected through a two-stage sequential design to investigate the hypothesised model. A sample of 645 medical undergraduates participated in the quantitative stage, responding to an electronically structured questionnaire. Confirmatory factor analysis and structural equation modelling were utilised to analyse the data and assess the fit of the conceptual model. In the qualitative stage, semi-structured interviews were conducted with a purposeful sample of twelve medical students, and thematic analysis was employed to explore the qualitative findings. The results indicated a well-fitting model, with significant positive relationships observed among motivation, persistence, and performance accomplishment. Notably, including persistence as a mediator reinforced the relationship between motivation and performance achievement. The qualitative data supported and further emphasised the importance of persistence in the medical student population. The findings have practical implications for medical students, educators, and universities, highlighting the significance of promoting and enhancing learners' persistence. Suggestions for future research include developing additional statistical models, conducting experimental studies, and undertaking longitudinal investigations. By expanding the understanding of the relationships between motivation, persistence, and performance accomplishment, future studies can contribute to developing effective interventions and strategies to support medical students in their educational journey. [ABSTRACT FROM AUTHOR]

Purpose: To identify the impact of endovascular simulator training and shadowing in interventional radiology on medical students' self-assessed IR knowledge. Moreover, the sequence of the teaching methods and its influence on the self-assessed IR knowledge is investigated. Materials and Methods: A total of 19 fourth-year medical students participated in this study. Eleven students completed shadowing live cases first and endovascular simulator training the following day. Eight students completed the teaching in reversed order. Questionnaires were completed before and after each teaching method. The students assessed their knowledge of instruments and materials, steps of the Seldinger technique, and aortography on a Likert scale (1 = "I do not agree at all," 5 = "I fully agree"). Results: After simulator training, the students stated a significant increase in perceived knowledge compared with baseline (p < 0.001). Shadowing led to a significant improvement regarding the items "knowledge of instruments and materials" (3.2 vs. 3.8, p = 0.008) and "steps of the Seldinger technique" (3.7 vs. 3.9, p = 0.046). Self-assessed knowledge after simulator training increased significantly more regarding Seldinger technique compared with shadowing (+ 1.2 vs. + 0.2, p < 0.001). Simulator training before shadowing was significantly more effective regarding the increase in "knowledge of the steps of aortography" compared with the reverse sequence (+ 2.0 vs. + 0.9, p = 0.041). Conclusion: Endovascular simulator training and shadowing are both feasible tools to improve medical students' perceived knowledge of interventional radiology. When organizing teaching, simulator training before shadowing can have a positive impact on self-assessed knowledge. [ABSTRACT FROM AUTHOR]

Introduction: Radiation oncology is a pivotal modality in the treatment of hematologic malignancies. To enable state-of-the-art patient care, structured education during residency is essential. However, given the lack of detailed data, the scope of educational opportunities available to trainees remains elusive. This prompted our group to perform a national survey amongst radiation oncology residents in Germany assessing the status quo of competences in the treatment of lymphoma and leukemia patients. Furthermore, areas of potential improvement were identified to further the goal of competence-based education for residents. Methods: A survey-based analysis was conducted to assess the knowledge and competence of radiation oncology residents in Germany regarding hematological malignancies. A decisive questionnaire covering demographics, self-assessment of competences, and areas for improvement was developed in adaption of a survey by the Association of Residents in Radiation Oncology and distributed amongst 1439 members of the German Society of Radiation Oncology. Responses were collected anonymously via an online survey tool and analyzed using descriptive statistics and chi-square tests. Results: A total of 59 complete and 22 partial responses were collected, yielding a 5.6% response rate. Participants' competence varied, with notable experience gaps in pediatric cases, proton therapy, and large-field techniques like total-skin irradiation or pediatric total body irradiation. While participants felt confident in treatment planning and patient counseling, they showed deficiencies in the definition of the planning target volume for modern involved site radiotherapy. Resources for education included national and international guidelines, scientific reviews, and textbooks. Board-certified radiation oncologists and physicians from specialized lymphoma centers demonstrated higher overall competence levels. Conclusion: This survey highlights the diversity of resident education regarding hematological malignancies in German radiation oncology programs. Knowledge gaps exist in key areas, including pediatric cases and specialized techniques. Competence-based education, interactive teaching formats, and rotations to specialized centers are potential strategies to address these gaps. The study contributes to the understanding of the federal educational landscape, underscoring the need for standardized and comprehensive training to ensure optimal patient care in hematological malignancies within the context of radiation oncology. Further research and collaborations are warranted to enhance training and expertise in this critical domain. [ABSTRACT FROM AUTHOR]

Understanding research designs is crucial for cardiothoracic surgeons to enhance their clinical practice and decision-making. This article provides a comprehensive overview of different research study types, including observational and experimental studies, and their relevance to cardiothoracic surgery. Detailed explanations of cohort, case–control, and cross-sectional studies, as well as various types of randomized controlled trials, are presented. Key terms and concepts like bias, validity, and reliability are discussed. Practical case examples from the literature illustrate the application of these research designs, aiding clinicians in selecting the appropriate study design for their research questions. [ABSTRACT FROM AUTHOR]

Despite the increased adoption of robotic surgery across various specialities, medical students and early-career doctors have limited exposure. This study aims to assess the feasibility and acceptability of a hands-on surgical robotics workshop for those early-career medics. 26 participants with minimal prior exposure to robotic surgery attended a workshop using the Versius© robotic surgical system and Virtual Reality simulation platforms. We analysed pre-workshop registration form and post-workshop feedback form utilising mixed quantitative and qualitative approach. Pre-workshop registration revealed motivations and barriers to attending surgical robotics courses. Post-workshop evaluations showed significant improvements in self-assessment scores, familiarity with robotic surgery, and confidence in using the technology. All participants expressed a strong enthusiasm for greater access to robotic surgery education and 84% of participants strongly agreed this workshop increased their interests in surgical specialities. The study also highlighted the perceived ease of use of robotic systems compared to laparoscopic instruments and explored the potential of virtual reality in surgical training. Further efforts are needed for better integration of robotic surgery training into medical curricula to prepare future surgeons for the evolving surgical landscape. [ABSTRACT FROM AUTHOR]

Copyright of Manuelle Medizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Antimicrobial resistance (AMR) is a major public health problem affecting both current and future generations. Development of resistance to the commonly available antibiotics has been directly linked to their irrational use. The World Health Organization (WHO) has clearly stated on the Global Strategy on AMR, judicious antibiotic use as well as adequate knowledge and awareness about AMR, as important tools in curbing the existing problem. Therefore, this study aimed to explore the level of knowledge among accredited drug dispensing outlet (ADDO) dispensers on factors contributing to irrational use of antibiotics among Tanzanian pediatric patients. Methods: A qualitative study employing focused group discussions was conducted among 6–10 ADDO dispensers with at least 6 months dispensing experience in 14 regions between July and August 2020. Thematic analysis was used to analyze the data. Results: Findings from this study indicate that the ADDO dispensers have adequate knowledge on antimicrobial resistance. Participants were aware of the general meaning and the use of antimicrobials. They were aware that antimicrobials are used for treating infections caused by microbes such as bacteria, fungi, and viruses. Participants knew AMR increases health related costs and that the increasing burden of AMR is not an outcome of a specific group of people such as health care providers or patients, rather a contribution of many factors that bring change in microorganism behavior. Despite this knowledge, participants felt that most of the private health care facilities are profit-oriented; they practice polypharmacy to maximize profit rather than focusing on providing quality health services. Participants revealed that dose shortage after symptomatic relief strongly contributes to AMR. Lastly, the ADDO dispensers expressed that continuous medical education and community education to patients is necessary in the efforts to fight against AMR. Conclusions: To mitigate the increasing AMR burden in our society, integrated interventions must include both communities, ADDOs as first point of contact and other healthcare providers. Periodic refresher training with an emphasis on proper practices is crucial to help the dispensers transform their knowledge into action. Responsible authorities should ensure that ADDOs and other private health care facilities adhere to regulations. [ABSTRACT FROM AUTHOR]

Basic science educators play a significant role in medical and health professions curricula, particularly in the biomedical science components. Although the shift from basic scientists to educators seems promising, no study has yet explored the transition process from the perspective of basic scientists themselves, especially in the early stages of their transition. An anonymous survey with voluntary participation was administered to all basic scientists in National University of Singapore (NUS) Yong Loo Lin School of Medicine. The survey aimed to identify the perceived challenges faced by basic scientists transitioning to basic science educators in medical and health professions education. This study consisted of Likert scale questions, followed by one multiple-choice question and two open-ended questions. Twenty-one basic scientists either postdoctoral fellows or instructors, completed the study. The study found that gaps in clinical content and experience, along with teaching pedagogy and training were among the major concerns for basic scientists aspiring to be basic science educators. These challenges and shortcomings could potentially be addressed by providing them with clinical shadowing opportunities, education mentorship and teaching training. Since most respondents lacked teaching experience, the results might differ if the majority had been involved in teaching within medical and health professions education. Nonetheless, it is important to understand and acknowledge the challenges and concerns experienced by basic scientists and examine how they can navigate them in the process of their transition to teaching medical and health professions. This also provides opportunities for personal reflection and development so that basic science educators will be more prepared for greater challenges and the ever-changing demands of contemporary medical and health professions education. [ABSTRACT FROM AUTHOR]

Objectives: While flipped classroom instruction has repeatedly shown efficacy in undergraduate medical education, evidence for its utility in procedural domains remains sparse. This holds particular significance for surgical subspecialties such as otolaryngology, which have limited time in undergraduate medical curricula. We designed a novel airway management skills simulation course with a flipped classroom approach and evaluated its efficacy in a pilot study. Methods: A simulation course was designed to provide instruction in seven airway management skills: bag valve mask ventilation, laryngoscopy, intubation, cricothyroidotomy, tracheotomy, and tracheostomy care. Publicly available YouTube videos were selected as pre-learning materials. Participating students completed surveys before the pre-learning assignment and after completion of the simulation center workshop. Results: Sixteen students participated in the workshop, and data was collected from 14 participants. Learners reported significant improvements in knowledge regarding all covered skills except tracheotomy; mean self-rated knowledge improved from 2.9 to 5.8 (p < 0.001) on a scale from 0 to 10. Significant increases in self-reported confidence in performing all seven skills were also observed, with an overall increase from 1.1 to 5.7 (p < 0.001). Students also rated all elements of the workshop highly, including a prevailing belief that the pre-learning materials markedly enhanced their learning. Conclusion: Our novel framework for skills-based education using a flipped classroom approach demonstrated remarkable efficacy in improving learner knowledge and self-reported confidence regarding airway management skills. This educational design, including the use of high-quality, publicly available pre-learning videos, has significant implications for undergraduate medical education in surgical subspecialties. [ABSTRACT FROM AUTHOR]

Purpose: 360° immersive videos may be useful in procedure-based healthcare settings. We hypothesized that extended reality (XR) neonatal intubation education is a feasible alternative to live demonstration in skill and knowledge transfer. Methods: This was a prospective single center evaluation of an educational XR intubation video using Premature Anne™ (Laerdal Medical, Stavanger, Norway) comparing to a live demonstration. Participants were randomly allocated to either live demonstration or XR group. Each group received 20 min of teaching from the pediatric respiratory care education specialist, either in person or in video format. Intubation success, knowledge and skill acquisition were measured using a questionnaire and checklist. Results: We had a total of 23 participants, XR (n = 11) and live demonstration (n = 12). The groups were heterogeneous in experience level.The XR group was successful at intubating 73% of the time (n = 8), which was not significantly different to the live demonstration group 58% (n = 7) (p = 0.667). For patients who achieved intubation, there was no difference between groups in the mean time to successful intubation; 98 s (SD 73) for the XR group and 65 s (SD 22) for the live demonstration group (p = 0.685).When comparing scores between groups there were no statistically significant differences regarding knowledge scores (p = 0.514), skill scores (p = 0.826) and total scores (p = 0.926). Conclusion: These preliminary findings indicated no significant differences between the XR and live demonstration groups in terms of intubation success, knowledge acquisition, skill performance, total scores or time to successful intubation. [ABSTRACT FROM AUTHOR]

Speaking up during inpatient medical rounds involves medical trainees voicing ideas, concerns, or information when unprompted for the benefit of patient care and education. Medical residents encounter a unique set of considerations regarding the decision to speak up during rounds. However, little is known about the role of trainees' emotions in speaking up in this context. The objective of this study was to explore the role of emotions in speaking up behaviours among medical residents during inpatient medical rounds. We conducted interviews with 21 medical residents inquiring about perspectives on speaking up. We developed a framework for classifying emotions, which consisted of valence (positive or negative), moral emotions (condemning, self-conscious, suffering, or praising), and non-moral emotions (fear, love, schadenfreude). Interview transcripts were deductively coded and analyzed to identify patterns of emotions and their drivers in the context of speaking up during rounds. Medical residents shared a range of positively- and negatively-valenced emotions in association with speaking up during rounds. We identified five types of emotions in speaking up during rounds that were commonly experienced by residents: praising emotions, self-conscious emotions, condemning emotions, suffering emotions, and fear. Specific drivers of these emotions were identified and classified into workplace, relational, patient-related, or personal factors. Ultimately, we found that medical residents experience both positive and negative emotions that influence speaking up behaviours during inpatient rounds. Further exploration into the role that emotions play in speaking up on inpatient medical rounds may provide valuable insights for medical education research and teaching practices. [ABSTRACT FROM AUTHOR]

Interpersonal violence (IPV) recognition is vital to patient-centered care. Previous educational efforts have incorporated IPV into undergraduate medical education in the form of standardized patient encounters and IPV screening and awareness, but no semester-long elective that offers an intersectional approach to trauma-informed care and incorporates local advocacy groups and resources currently exists. The aim of this elective was to address the gap in IPV education in current medical school curricula and equip first-year medical students with the skills and knowledge of trauma-informed approaches in healthcare settings. We implemented a Trauma and Violence Informed Care (TVIC) elective for first-year medical students at the University of Colorado School of Medicine during Fall 2022. Seventeen first-year medical students enrolled in the elective. In this 13-week program, students met twice weekly for 1 hour sessions consisting of lectures, group discussions and role-playing activities. Learning objectives addressed IPV, intersectionality, mandatory reporting, survivors' rights and resources, and vicarious trauma. To assess course impact, surveys with Likert scale and free-response questions were distributed. Responses were analyzed using paired T-tests and content analysis. All students completed the surveys. There was significant difference (p < 0.05) in student comfort and knowledge for the following topics: Skills & Abilities, Intersectionality, Resources, System Based Processes, and Course Logistics. A TVIC elective positively impacts medical student comfort and skills around IPV patient care. More educational efforts are needed to address this curricular gap. [ABSTRACT FROM AUTHOR]

Background: Myalgic encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a challenging disease pattern and has gained increasing scientific and public interest in recent years due to the Corona pandemic and Long-Covid. The aim of this study was to investigate (1) medical students' health-related control beliefs, (2) students' awareness and views about ME/CFS at the beginning of their medical education, and (3) to examine whether there are correlations between students' health-related control beliefs and their views about ME/CFS. Methods: A cross-sectional online-survey was conducted in October 2020 with all new medical students at the Ludwig Maximilian University of Munich and the Technical University Munich. Results: A total of 251 students completed the survey, representing a response rate of 27.0% (251/929). The examined health related locus of control of the students was predominantly internal oriented. Students' awareness about ME/CFS at the beginning of their medical education were found to be low: 46,8% (117/250) of the students surveyed disagreed that they have heard or read about ME/CFS and 81,6% (204/250) disagreed that they feel sufficiently well informed about the disease. A possible correlation between students' health-related locus of control and their views regarding ME/CFS-specific issues was found: The higher the students' internal locus of control, the less they favored a strict separation of mental and physical suffering in medical practice, the less they believed that psychological causes for an illness should only be sought when no physically objective causes could be found, and the less they agreed that there is no indication for therapy if a disease is not objectively detectable. Conclusions: As ME/CFS is a medical challenge and increasingly relevant in medical practice, the fact that 50% of medical students have never heard of this disease underscores the need for awareness and education. We found that the majority students in the sample largely have an internal health related locus of control. They rate their own influence on their health higher than those with an externally oriented control conviction. [ABSTRACT FROM AUTHOR]

Objective: Robotic surgical approaches are increasingly utilized; however, standard medical school curricula omit this topic. This study examines the need for robotic-specific surgical education from the medical students' perspective. Design: A 10-question web-based survey was designed to assess factors including class year, intended specialty, exposure to robotic surgery, and perceived necessity for robotic surgery education. The survey was validated by small group of surgical residents. Setting: This study was conducted at a busy tertiary academic center. Participants: Survey was distributed to 425 post-core clerkship medical students. Results: Out of 79 respondents (18.5% response rate), 71% had some exposure to robotic surgery. The majority (72%) of respondents, regardless of their intended specialty, agreed on the necessity to learn about robotic surgery. Respondents identified terminology, proper patient counseling, and bedside assisting skills as potential topics to incorporate in robotic surgery medical school curricula. Conclusions: Medical students irrespective of their intended specialty favor robotic surgery specific education. These findings underscore the need to incorporate robotics education into core medical school curricula. [ABSTRACT FROM AUTHOR]

Objectives: To elucidate the research training exposure of radiology residents across ESR country members. Methods: A 30-question survey was constructed by the Radiology Trainee Forum and was distributed among residents and subspecialty fellows of countries members of the ESR. The survey examined the training environment, the status of research training and publications among trainees, the conditions under which research was conducted, and the exposure to activities such as grant proposal preparation and manuscript reviewing. Descriptive statistics and the chi-square test were used to assess the responses to survey questions and evaluate factors related to these responses. Results: A total of 159 participants from 29 countries provided fully completed questionnaires. Only 12/159 trainees already had a PhD degree and nearly half had never published a PubMed-indexed manuscript (76/159, 47.8%). Among those who published their papers during radiology training, most did so in the first or second year of residency (n = 26 and n = 20 participants, respectively). Most participants (79%) did not receive further statistical training during residency, fifty-five out of 159 (34.59%) respondents never had any guidance/training on how to read a paper and 58 out of 159 (36.48%) had never been encouraged to participate in any research. Most of them had worked after hours to carry out research at least a few times (47/159, 29.56%) or always (82/159, 51.57%). Conclusion: Analysis of research training among radiology trainees was performed. Areas for improvement were identified that can prompt changes in training curricula to prepare a highly competent European workforce. Critical relevance statement: This survey has identified deficits in research training of radiology residents across countries members of ESR, pinpointing areas for improvement to fortify the future of radiology in Europe. Key Points: Research exposure and training of radiology residents varies across countries and members of ESR. Radiology residents largely lack systematic research training, dedicated research time, and guidance. Areas for improvement in research training of radiology residents have been identified, aiding the fortification of radiology research across Europe. [ABSTRACT FROM AUTHOR]

Building expertise in climate and planetary health among healthcare professionals cannot come with greater urgency as the threats from climate change become increasingly apparent. Current and future healthcare professionals—particularly internists—will increasingly need to understand the interconnectedness of natural systems and human health to better serve their patients longitudinally. Despite this, few national medical societies and accreditation bodies espouse frameworks for climate change and planetary health–related education at the undergraduate (UME), graduate (GME), and continuing (CME) medical education level. As a community of medical educators with an enduring interest in climate change and planetary health, the Society of General Internal Medicine (SGIM) recognizes the need to explicitly define structured educational opportunities and core competencies in both UME and GME as well as pathways for faculty development. In this position statement, we build from the related SGIM Climate and Health position statement, and review and synthesize existing position statements made by US-based medical societies and accreditation bodies that focus on climate change and planetary health–related medical education, identify gaps using Bloom's Hierarchy, and provide recommendations on behalf of SGIM regarding the development of climate and planetary health curricula development. Identified gaps include (1) limited systematic approach to climate and planetary health medical education at all levels; (2) minimal emphasis on learner-driven approaches; (3) limited focus on physician and learner well-being; and (4) limited role for health equity and climate justice. Recommendations include a call to relevant accreditation bodies to explicitly include climate change and planetary health as a competency, extend the structural competency framework to climate change and planetary health to build climate justice, proactively include learners in curricular development and teaching, and ensure resources and support to design and implement climate and planetary health–focused education that includes well-being and resiliency. [ABSTRACT FROM AUTHOR]

Background: We used two 3D ultrasound volumes of fetal heads at 13 weeks to create live-size 3D-printed phantoms with a view to training or assessment of diagnostic abilities for normal and abnormal nuchal translucency measurements. The phantoms are suitable for use in a water bath, imitating a real-life exam. They were then used to study measurement accuracy and reproducibility in examiners of different skill levels. Methods: Ultrasound scans of a 13 + 0-week fetus were processed using 3D Slicer software, producing a stereolithography file for 3D printing. The model, crafted in Autodesk Fusion360™, adhered to FMF guidelines for NT dimensions (NT 2.3 mm). Additionally, a model with pathologic NT was designed (NT 4.2 mm). Printing was performed via Formlabs Form 3® printer using High Temp Resin V2. The externally identical looking 3D models were embedded in water-filled condoms for ultrasound examination. Eight specialists of varying expertise levels conducted five NT measurements for each model, classifying them in physiological and abnormal models. Results: Classification of the models in physiological or abnormal NT resulted in a detection rate of 100%. Average measurements for the normal NT model and the increased NT model were 2.27 mm (SD ± 0.38) and 4.165 mm (SD ± 0.51), respectively. The interrater reliability was calculated via the intraclass correlation coefficient (ICC) which yielded a result of 0.883, indicating robust agreement between the raters. Cost-effectiveness analysis demonstrated the economical nature of the 3D printing process. Discussion: This study underscores the potential of 3D printed fetal models for enhancing ultrasound training through high inter-rater reliability, consistency across different expert levels, and cost-effectiveness. Limitations, including population variability and direct translation to clinical outcomes, warrant further exploration. The study contributes to ongoing discussions on integrating innovative technologies into medical education, offering a practical and economical method to acquire, refine and revise diagnostic skills in prenatal ultrasound. Future research should explore broader applications and long-term economic implications, paving the way for transformative advancements in medical training and practice. [ABSTRACT FROM AUTHOR]

Residents are actively involved in patient assessment and all aspects of patient care, and they are critical in providing nutritional support education and treatment for patients with cancer. This study aims to assess the nutritional knowledge and performance of resident physicians, providing insights into existing gaps in awareness and practices related to cancer nutrition. A total of 300 resident physicians undergoing standardized residency training in China participated in this study. An anonymous online questionnaire covering demographic characteristics, nutritional knowledge, clinical practice, and training requirements was designed and administered through the "Wenjuanxing" platform. Data were collected from June 1, 2023, to July 31, 2023. Among the participants, only 40.00% demonstrated adequate knowledge of cancer nutrition, and merely 32.00% exhibited proficient performance in nutritional care. Socio-demographic analysis revealed that residents without affiliations and those specializing in obstetrics and gynecology had superior knowledge, while surgery specialists showed significantly worse performance. Most participants expressed a lack of exposure to cancer nutrition education during academic and standardized residency training. The study highlights the demand for enhanced education and the preference for case-based teaching methods. The findings underscore an urgent need for comprehensive oncology nutrition education within China's standardized residency training. Targeted interventions and curriculum enhancements are essential to improve medical talent development and enhance patient care outcomes in oncology. The study emphasizes the critical role of practical, case-based teaching methods in addressing identified gaps in nutritional knowledge and practices among resident physicians. [ABSTRACT FROM AUTHOR]

Background: The teaching and assessment of clinical-practical skills in medical education face challenges in adequately preparing students for professional practice, especially in handling emergency situations. This study aimed to evaluate the emergency medical competencies of junior doctors using Virtual Reality (VR)-based scenarios to determine their preparedness for real-world clinical situations. Methods: Junior doctors with 0–6 months of professional experience participated in one of three VR-based emergency scenarios. These scenarios were designed to test competencies in emergency medical care. Performance was automatically assessed through a scenario-specific checklist, and participants also completed self-assessments and a clinical reasoning ability test using the Post-Encounter Form. Results: Twenty-one junior doctors participated in the study. Results showed that while general stabilization tasks were performed well, there were notable deficiencies in disease-specific diagnostic and therapeutic actions. On average, 65.6% of the required actions were performed correctly, with no significant variance between different scenarios. Participants achieved an average score of 80.5% in the Post-Encounter-Form, indicating a robust ability to handle diagnostic decisions. Self-assessments did not correlate significantly with objective measures of competency, highlighting the subjective nature of self-evaluation. Conclusion: VR-based simulations can provide a detailed picture of EMC, covering both diagnostic and therapeutic aspects. The findings of this pilot study suggest that while participants are generally well-prepared for routine tasks, more focus is needed on complex case management. VR assessments could be a promising tool for evaluating the readiness of new medical professionals for clinical practice. [ABSTRACT FROM AUTHOR]

Chat Generative Pretrained Transformer (ChatGPT; OpenAI) is a state-of-the-art large language model that can simulate human-like conversations based on user input. We evaluated the performance of GPT-4 V in the Japanese National Clinical Engineer Licensing Examination using 2,155 questions from 2012 to 2023. The average correct answer rate for all questions was 86.0%. In particular, clinical medicine, basic medicine, medical materials, biological properties, and mechanical engineering achieved a correct response rate of ≥ 90%. Conversely, medical device safety management, electrical and electronic engineering, and extracorporeal circulation obtained low correct answer rates ranging from 64.8% to 76.5%. The correct answer rates for questions that included figures/tables, required numerical calculation, figure/table ∩ calculation, and knowledge of Japanese Industrial Standards were 55.2%, 85.8%, 64.2% and 31.0%, respectively. The reason for the low correct answer rates is that ChatGPT lacked recognition of the images and knowledge of standards and laws. This study concludes that careful attention is required when using ChatGPT because several of its explanations lack the correct description. [ABSTRACT FROM AUTHOR]

Introduction: Entrustable professional activities (EPAs) are one way to assess competencies, and are designed to bridge the gap between theoretical competencies and real world clinical practice. Aims: This was a systematic review which aims to answer the question: "Which EPAs related to Emergency Medicine are described for medical schools?". Methods: We included original qualitative, interventional and observational studies (cross-sectional, case-control, and cohort studies) that described EPAs relevant to Emergency Medicine for Medical School. The search strategy was created using a combination of keywords and standardized index terms related to EPAs and Emergency Medicine. Results: The search strategy identified 991 citations. After screening the titles and abstracts, we identified 85 potentially relevant studies. After the full-text review, a total of 11 reports met the criteria for inclusion. Conclusion: Recognizing a patient requiring urgent or emergent care and initiating evaluation and management is the most common EPA related to Emergency Medicine described at Medical Schools. Use of EPAs is associated with increased student satisfaction and improved competences. However, there is a lack of undergraduate EM specific EPAs being systematically developed and published, and this should be an area to be explored in future studies. [ABSTRACT FROM AUTHOR]

The advent of artificial intelligence (AI) revolutionizes the ways of working in many areas of business and life science. In Medical Affairs (MA) departments of the pharmaceutical industry AI holds great potential for positively influencing the medical mission of identifying and addressing unmet medical needs and care gaps, and fostering solutions that improve the egalitarian and unbiased access of patients to treatments worldwide. Given the essential position of MA in corporate interactions with various healthcare stakeholders, AI offers broad possibilities to support strategic decision-making and to pioneer novel approaches in medical stakeholder interactions. By analyzing data derived from the healthcare environment and by streamlining operations in medical content generation, AI advances data-based prioritization and strategy execution. In this review, we discuss promising AI-based solutions in MA that support the effective use of heterogenous information from observations of the healthcare environment, the enhancement of medical education, and the analysis of real-world data. For a successful implementation of such solutions, specific considerations partly unique to healthcare must be taken care of, for example, transparency, data privacy, healthcare regulations, and in predictive applications, explainability. [ABSTRACT FROM AUTHOR]

The article discusses the standardized nuclear medicine residency training program in China. The program, known as Standardized Training for Resident Doctors (STRD), was implemented in 2014 and follows a "5 + 3" model, with five years of undergraduate medical education followed by three years of residency training in the chosen specialty. The Nuclear Medicine Residency Training Program (NMRTP) in China aims to provide essential knowledge and skills in nuclear medicine over a three-year period. The program includes training in various departments related to nuclear medicine, such as oncology and cardiology, and emphasizes both theoretical and clinical knowledge. The article suggests that more specialized training and additional subspecialty training may be needed in the future to meet the growing demand for nuclear medicine professionals. [Extracted from the article]

Background: Simulation-based training plays a significant role in surgical education, especially in minimally invasive pediatric surgery and urology. This study aimed to evaluate a novel 3D-printed model as training tool for endoscopic injection of bulking agent. Methods: Forty-three attendees and ten teaching faculty members were invited to complete a post hoc questionnaire after completing training sessions using the Fish Tank Simulation Model (FTSM). The survey consisted of a 7-question 5-point Likert scale to assess the model's realism (face validity) and its effectiveness as training tool (content validity). Results: Regarding the training status, 20/53 (37.7%) participants were fellow and/or specialist in pediatric surgery and 33/53 (62.3%) were surgeons in training. Their level of confidence in endoscopic injection procedure was defined as novice (< 10 procedures per year) in 33/53 (62.3%), intermediate (10–20 procedures per year) in 10/53 (18.9%), and expert (> 20 procedures per year) in 10/53 (18.9%). Regarding both face validity and content validity assessments, no statistically significant differences were found between scores given by novice vs intermediate/expert groups. Similarly, no statistically significant differences emerged between scores given by participant vs faculty groups assessing the content validity of the FTSM. The FTSM was considered a good teaching tool for beginners by 44/53 (83%) and for pediatric surgeons/urologists by 38/53 (71.7%). Conclusions: The 3D-printed Fish Tank Simulation Model proved to be a valuable, high-fidelity, easily accessible, cost-effective, hygienic, and domestic-use training tool for pediatric surgeons/urologists conducting the procedure. The model's user-friendly design and realistic environment enhanced learning opportunities for trainees, regardless of their experience level or training status. Nevertheless, further development is necessary, particularly in enhancing the realism of the ureteral hiatus and reproducing more complex anatomy, to make it beneficial for the training of advanced surgeons. [ABSTRACT FROM AUTHOR]

"Competence" is a longstanding value of American biomedicine. One underidentified corollary of competence is efficiency: at once a manifestation of competence, a challenge to competence, and a virtue in its own right. We will explore the social construction of efficiency in US undergraduate medical education through an analysis of its sociocultural and technological landscapes. We present qualitative data from two allopathic medical school field sites in the Midwestern United States, where medical students' careful selection of certain learning resources and overall perspectives on the curriculum underscore their focus on efficiency and pragmatic approaches to knowledge. In the discussion, we consider the ethical implications of physician efficiency, as well as future trajectories for the study of efficiency in the medical social sciences, bioethics, and medical education. We posit that efficiency is at the theoretical heart of US medical practice and education: a finding that has wide-reaching implications for how researchers conceptualize the enterprise of biomedicine across cultural contexts and interpret the lived experiences of physicians, medical students, and other clinicians. [ABSTRACT FROM AUTHOR]

The European Council of Legal Medicine (ECLM) is the body established in 1992 to represent practitioners forensic & legal medicine and is composed of delegates of the countries of the European Union (EU) and from other countries which form part of Europe to a current total of 34 member countries. The aims of this study were to determine the current status of undergraduate forensic & legal medicine teaching in the curriculum of medical studies in ECLM countries and to use the results of this study to determine whether it would be appropriate to develop new guidelines and standards for harmonising the content of undergraduate forensic medicine training across ECLM member countries. A detailed questionnaire was sent to all individuals or organisations listed on the ECLM contact database. Responses were received from 21 of 33 countries on the database. These responses showed considerable emphasis on undergraduate teaching of forensic medicine in all countries with the exception of Belgium and the United Kingdom. There was great general consistency in the subjects taught. The data from this survey provide a baseline which should assist in developing a strategy to harmonise forensic & legal medicine undergraduate training in member countries of the ECLM. The ECLM is now in a good position to establish a pan-European working group to coordinate a consensus document identifying an appropriate and modern core undergraduate forensic medicine curriculum that can be presented to the medical education authorities in each country, and which can be adapted for local requirements, based on available personnel, the forensic medicine structure in the country, and most importantly, the needs of the local population. [ABSTRACT FROM AUTHOR]

Conducting external post-mortem examinations is an essential skill required of physicians in various countries, regardless of their specialization. However, the quality of these examinations has been a subject of continuous debates, and notable errors were reviled. In response to these shortcomings, a virtual reality (VR) application was developed at Halle's medical department in Germany, focusing on the scene of discovery and the completion of death certificates. The initial trial of this VR application in 2020 involved 39 students and 15 early-career professionals. Based on the feedback, the application underwent improvements and was subsequently introduced to the medical department in Dresden, Germany, in 2022. Its primary objective was to showcase the VR training's adaptability and scalability across various educational structures and levels of medical expertise. Out of 73 students who participated, 63 completed the evaluation process. 93.1% (n = 58) of the evaluators reported increased confidence in conducting external post-mortem examinations, and 96.8% (n = 61) felt more assured in filling out death certificates, crediting this progress to the VR training. Additionally, 98.4% (n = 62) believed that repeating forensic medical aspects in their coursework was crucial, and 96.8% (n = 61) viewed the VR examination as a valuable addition to their academic program. Despite these positive responses, 91.6% (n = 55) of participants maintained that training with real corpses remains irreplaceable due to the insufficiency of haptic feedback in VR. Nevertheless, the potential for enhancing the VR content and expanding the training to additional locations or related disciplines warrants further exploration. [ABSTRACT FROM AUTHOR]

Despite the ubiquity of healthcare simulation and the humanities in medical education, the two domains of learning remain unintegrated. The stories suffused within healthcare simulation have thus remained unshaped by the developments of narrative medicine and the health humanities. Healthcare simulation, in turn, has yet to utilize concepts like co-construction and narrative competence to enrich learners' understanding of patient experience alongside their clinical competencies. To create a conceptual bridge between these two fields (including narrative-based inquiry more broadly), we redescribe narrative competence via Ronald Heifetz's distinction of "technical" and "adaptive" challenges outlined in his adaptive leadership model. Heifetz, we argue, enriches learners' self-understanding of the unique demands of cultivating narrative competence, which can be both elucidated on the page and tested within the charged yet supportive simulation environment. We introduce Co-constructive Patient Simulation (CCPS) to demonstrate how working with simulated patients can support narrative work by drawing on the clinical vicissitudes of learners in the formulation and enactment of case studies. The three movements of CCPS—resensing, retelling, and retooling—told through learner experiences, describe the affinities and divergences between narrative medicine's sequence of attention, representation, and affiliation; Montello's three forms of narrative competence (departure, performance, change), and Heifetz's three steps (observe, interpret, and intervene) of adaptive leadership. [ABSTRACT FROM AUTHOR]

Background: Although thoracic surgery is a challenging and versatile surgical specialty, a shortage of qualified and motivated thoracic surgery residents is expected in the coming years. In the inpatient setting, a shortage of approximately 7300 surgeons is expected. Therefore, there is an urgent need to attract more interested young medical students and improve the medical training of our next generation of surgeons. Methods: To assess the current nationwide status quo among medical students, an online survey with 39 questions on participant demographics, medical education, interest in surgical and thoracic surgery training, and attractiveness of residency was designed. Results: In all, 224 questionnaires were analyzed. Overall, there was a high level of interest in (thoracic-) surgery at the start of training. It should be noted that one third of the respondents did not know that the 'thoracic surgeon' is an independent specialist. This statement raises further questions about the presence of thoracic surgery in medical studies. When asked about typical characteristics that students associate with thoracic surgery, the majority answered 'a high level of practical activity'. The main reason they gave for not pursuing further surgical training was the unfavorable work-life balance. Conclusion: Students know exactly what they want for their future and where surgery has its weaknesses. They want transparent and practical training, a work-life balance, and recognition of their work and themselves. [ABSTRACT FROM AUTHOR]

Large language models (LLMs) offer transformative opportunities in bioinformatics education for medical students by creating interactive experiences. The integration of LLMs enhances educational outcomes through providing accessible code templates, clarifying the function of coding elements, and assisting in error troubleshooting. Here, we demonstrate the practical applications of LLMs with a case study on transcriptome sequencing data processing, a vital component of medical research. However, the reliability of the content that LLMs generate requires rigorous validation. Ensuring the accuracy and appropriateness of the LLM-generated information requires integrating innovative LLMs with traditional educational methods to prepare medical students effectively for future challenges in bioinformatics. [ABSTRACT FROM AUTHOR]

In this editorial the editors consider the ideals and realities of high and low stakes assessments in clinical workplaces, the impact of these assessments on clinical workplace learning, and the clash between authenticity in assessment and authenticity in learning. [ABSTRACT FROM AUTHOR]

Consumer and community involvement (also referred to as patient and public involvement) in health-related curricula involves actively partnering with people with lived experience of health and social care systems. While health professions education has a long history of interaction with patients or consumers, a shift in the way consumer and community engage in health-related education has created novel opportunities for mutual relationships valuing lived experience expertise and shifting traditional education power relations. Drawing on a mixed methods design, we explored consumer and community involvement practices in the design and delivery of health-related education using the capability, opportunity, motivation and behaviour framework (COM-B). In our results, we describe educator capabilities, opportunities and motivations, including identifying barriers and enablers to consumer and community involvement in health-related education. Educators have varying philosophical reasons and approaches for involving consumers and community. There is a focus on augmenting student learning through inclusion of lived and living experience, and on mutual transformative learning through embedding lived experience and co-creating learning. How these philosophical positionings and motivations shape the degree by which educators involve consumers and community members in health-related curricula is important for further understanding these educational partnerships within universities. [ABSTRACT FROM AUTHOR]

This paper reports the findings of a Canada based multi-institutional study designed to investigate the relationships between admissions criteria, in-program assessments, and performance on licensing exams. The study's objective is to provide valuable insights for improving educational practices across different institutions. Data were gathered from six medical schools: McMaster University, the Northern Ontario School of Medicine University, Queen's University, University of Ottawa, University of Toronto, and Western University. The dataset includes graduates who undertook the Medical Council of Canada Qualifying Examination Part 1 (MCCQE1) between 2015 and 2017. The data were categorized into five distinct sections: demographic information as well as four matrices: admissions, course performance, objective structured clinical examination (OSCE), and clerkship performance. Common and unique variables were identified through an extensive consensus-building process. Hierarchical linear regression and a manual stepwise variable selection approach were used for analysis. Analyses were performed on data set encompassing graduates of all six medical schools as well as on individual data sets from each school. For the combined data set the final model estimated 32% of the variance in performance on licensing exams, highlighting variables such as Age at Admission, Sex, Biomedical Knowledge, the first post-clerkship OSCE, and a clerkship theta score. Individual school analysis explained 41–60% of the variance in MCCQE1 outcomes, with comparable variables to the analysis from of the combined data set identified as significant independent variables. Therefore, strongly emphasising the need for variety of high-quality assessment on the educational continuum. This study underscores the importance of sharing data to enable educational insights. This study also had its challenges when it came to the access and aggregation of data. As such we advocate for the establishment of a common framework for multi-institutional educational research, facilitating studies and evaluations across diverse institutions. This study demonstrates the scientific potential of collaborative data analysis in enhancing educational outcomes. It offers a deeper understanding of the factors influencing performance on licensure exams and emphasizes the need for addressing data gaps to advance multi-institutional research for educational improvements. [ABSTRACT FROM AUTHOR]

Many important questions in health professions education require datasets that are built from several sources, in some cases using data collected for a different purpose. In building and maintaining these datasets, project leaders will need to make decisions about the data. While such decisions are often construed as technical, there are several normative concerns, such as who should have access, how the data will be used, how products resulting from the data will be shared, and how to ensure privacy of the individuals the data is about is respected, etc. Establishing a framework for data governance can help project leaders in avoiding problems, related to such matters, that could limit what can be learned from the data or that might put the project (or future projects) at risk. In this paper, we highlight several normative challenges to be addressed when determining a data governance framework. Drawing from lessons in global health, we illustrate three kinds of normative challenges for projects that rely on data from multiple sources or involved partnerships across institutions or jurisdictions: (1) legal and regulatory requirements, (2) consent, and (3) equitable sharing and fair distribution. [ABSTRACT FROM AUTHOR]

Purpose Along with other industries, healthcare is becoming increasingly digitized. Our study explores how the field of academic medicine is preparing for this digital future. Method Active strategic plans available in English were collected from faculties of medicine in Canada (n = 14), departments in medical schools (n = 17), academic health science centres (n = 23) and associated research institutes (n = 5). In total, 59 strategic plans were subjected to a practice-oriented form of document analysis, informed by the concept of sociotechnical imaginaries. Results On the one hand, digital health is discursively treated as a continuation of the academic medicine vision, with expansions of physician competencies and of research institutes contributions. These imaginaries do not necessarily disrupt the field of academic medicine as currently configured. On the other hand, there is a vision of digital health pursuing a robust sociotechnical future with transformative implications for how care is conducted, what forms of knowledge are prioritized, how patients and patienthood will be understood, and how data work will be distributed. This imaginary may destabilize existing distributions of knowledge and power. Conclusions Looking through the lens of sociotechnical imaginaries, this study illuminates strategic plans as framing desirable futures, directing attention towards specific ways of understanding problems of healthcare, and mobilizing the resources to knit together social and technical systems in ways that bring these visions to fruition. There are bound to be tensions as these sociotechnical imaginaries are translated into material realities. Many of those tensions and their attempted resolutions will have direct implications for the expectations of health professional graduates, the nature of clinical learning environments, and future relationships with patients. Sociology of digital health and science and technology studies can provide useful insights to guide leaders in academic medicine shaping these digital futures. [ABSTRACT FROM AUTHOR]