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AbstractSingapore, located strategically at the meeting point of the Malacca Strait and the South China Sea, has established itself as a global financial and economic hub. Despite its small geographical size, Singapore is home to over 5 million people from diverse cultural backgrounds. The city-state’s medical education landscape has evolved significantly over the past century. Originally, Singapore had only one undergraduate medical school, the NUS Yong Loo Lin School of Medicine, established in 1905. Over time, this institution has grown into Singapore’s largest and oldest medical school. NUS Medicine’s vision centres on developing highly competent, values-driven, and inspired healthcare professionals to transform the practice of medicine and improve health worldwide. A curriculum overhaul in 2020 introduced new educational components to prepare future healthcare professionals for the challenges of Singapore’s resilient healthcare system. This includes proficiency in integrated care, collaboration across disciplines, and leveraging AI and data science in clinical decision-making. The introduction of a common curriculum in August 2023 for Medicine, Nursing, Dentistry, and Pharmacy undergraduates further aligns with Singapore’s 'Healthier SG' vision, ensuring that graduates are well-equipped to meet the evolving needs of the healthcare landscape. The common curriculum aims to address professional hierarchies and foster interprofessional collaboration among students from diverse academic backgrounds. By promoting frequent interaction and a team-oriented mindset, the curriculum seeks to instil a collective approach to healthcare, emphasising the importance of interprofessional practice in achieving the broader goals of healthcare delivery. This paper describes the reforms that took place and how the challenges were mitigated in a research-intensive top-ranked academic medical institution. This strategic alignment of medical education with national healthcare priorities underscores NUS Medicine’s commitment to transforming medical practice and improving health outcomes in Singapore and beyond. [ABSTRACT FROM AUTHOR]

Background The Infectious Diseases Society of America (IDSA) developed the Core Antimicrobial Stewardship (AS) Curriculum to meet the increasing demand for infectious diseases (ID) providers with AS expertise. Notable diversity in implementation approaches has been observed among ID fellowship programs using the curriculum. We sought to describe individual approaches and develop a curriculum implementation roadmap. Methods We surveyed ID fellowship programs that had previously implemented the IDSA Core AS curriculum. The survey included questions regarding program characteristics, curriculum participants and presentation format, resources and barriers, and implementation strategies. Commonly reported program features were summarized in the context of the self-reported implementation strategies. Implementation guides were developed based on the most common characteristics observed. Results Of 159 programs that had purchased the curriculum, 37 responded, and 34 (21%) were included in the analysis. The curriculum was primarily taught by AS physicians (85%) and AS pharmacists (47%). The most common conference structure was a longitudinal conference series (32%), and eLearning was the most common presentation format. Limited AS faculty time (76%) and limited first-year fellow availability (62%) were frequently reported as barriers, and dedicated AS curricular time was a resource available to most programs (67%); implementation guides were created for these 3 program features. Conclusions Programs reported a variety of implementation barriers and resources, with several common themes emerging, allowing for the development of tailored curriculum planners for 3 commonly observed program characteristics. This work will equip fellowship programs with curriculum implementation strategies and guide future enhancements of the IDSA Core and Advanced AS curricula. [ABSTRACT FROM AUTHOR]

Aim: The Japanese government defined integrative/integrated medicine (IM) as "medical practice led by physicians, cooperating with other specialists." Therefore, the basics of comprehensive medical education should be provided in medical universities. We investigated the situation of IM with special reference to Kampo medicines in the national core curricula, national examination standards and the syllabuses for lectures published on the universities' websites. Methods: In the published documents regarding the core curriculum, national examination standards and syllabuses in the academic year 2018, we analyzed whether they include IM. Results: Four kinds of universities offered "Kampo medicine" (Japanese traditional herbal medicine) as their core curriculum. Pharmaceutical universities included "health food", and nursing universities included "alternative medicine". National examination standards for dentists and pharmacists included Kampo medicine, but those for doctors and nurses did not. In the syllabuses of medical universities, 85% included Kampo medicine, but the percentage for IMs was low. The situation was similar in dental universities. All pharmaceutical universities included Kampo medicines and health foods; other IMs were low. The number for all IMs in nursing universities was lower than half. Conclusion: Based on the definition of IM in this paper, we investigated the actual situation of IM education including Kampo in all universities. There were considerable differences between all the faculties. For medical doctor, the Kampo medicines listed in the model core curriculum that are not included in the national examination standard should be rectified. For pharmacists, it is important to deepen the educational contents in this field. [ABSTRACT FROM AUTHOR]

Background: Problem-Based Learning (PBL) has become an integral part of medical student education for preclinical curricula, but few studies have evaluated the benefits of a PBL curriculum for clinical education. This study aims to assess the 1-year experience after implementing a resident-led PBL program for the third-year (MS3) surgery clerkship and compare students' self-reported preparedness following PBL sessions to traditional faculty-led lectures. Methods: Surgical faculty and residents developed a PBL curriculum to address common topics in surgical education. Pandemic requirements necessitated a switch from in-person to virtual sessions during the experience. Students enrolled in the MS3 surgical clerkship were asked to participate in a survey. Demographics and clerkship data were obtained. Quality of PBL and faculty-led lectures were assessed using a ten-point Likert scale, and standard statistical analyses were performed. Results: During the study period, 165 students rotated through surgery, of which 129 (78%) responded to the survey (53% female, 59% white). PBLs were held in-person (53%), exclusively virtual (32%) or hybrid (15%) platforms. In-person PBLs were preferred to faculty-led lectures for preparing students for NBME examinations (6.9 vs 6.0), oral examinations (7.8 vs 6.3), and surgical cases (6.3 vs 5.8), all P <.001. Virtual PBLs were also preferred to lectures for preparing students for NBME examinations (6.8 vs 5.8, P <.001) and surgical cases (5.6 vs 4.8, P =.05). Conclusions: PBL is a valuable adjunct for medical student education. Resident-led PBLs were preferred to faculty-led lectures for preparing students for examinations and clerkship experiences and may be useful adjuncts to clinical education. [ABSTRACT FROM AUTHOR]

Asylum medicine clinics that train clinicians to conduct forensic medical and mental health evaluations (FME) have proliferated in the United States, but there is still significant unmet need in training. We created a 12-week curriculum to develop the core skills needed to conduct effective, trauma-informed FME. Our course used a “flipped classroom” model; participants reviewed didactics in advance from a national, peer-reviewed training program, the Asylum Medicine Training Initiative, and used in-class time for case-based practice as experiential learning. Participants completed feedback surveys after each session in addition to pre-and post-course assessments. Sixteen clinicians with diverse geographic, professional, and demographic backgrounds participated in the course from January-March 2023. The three key themes that emerged from qualitative feedback were high participant satisfaction with the course model; participant desire for additional opportunities for practice; and participant desire for community-building. Post-course surveys showed that most participants felt only “somewhat comfortable” with the core skills emphasized in the course. Taken together, these findings suggest that curricula in asylum medicine should focus on experiential learning, skills practice, and building longitudinal mentorship. This curriculum is an innovative educational model that differs from the traditional didactic training that has been the mainstay in asylum medicine education. The curriculum is replicable and can be tailored to local environments or broad virtual communities. [ABSTRACT FROM AUTHOR]

The letter to the editor discusses the integration of telemedicine into clinical training to address challenges in the outpatient setting. While pre-recorded telemedicine consultations can optimize learning, they may not fully meet curriculum requirements. The authors suggest revising the curriculum to align with the realities of the patient population. The use of telemedicine consultations for live-streamed, student-led interactions is highlighted as beneficial for developing essential skills in healthcare delivery. [Extracted from the article]

Introduction: There has been a significant change noticed in the way in how anatomy is taught and learned in last two decades. The use of teaching approaches such as body painting, peer physical examination, medical imaging, and virtual anatomy software in the teaching and learning of living anatomy was made possible by advancements in medical technology. This study focuses on a review of the historical context and contemporary developments in teaching and learning of live and surface anatomy with a special emphasis on its pedagogical elements, some opinions of medical educationists, and undergraduates. Conclusions: It is suggested that living anatomy be included as a core subject in the curriculum. Learning about living anatomy will be improved in an integrated and pertinent framework with the inclusion and execution of teaching and learning modalities such as body painting, peer physical examination, medical imaging, and virtual anatomy software. [ABSTRACT FROM AUTHOR]

Background: Most of the medical schools in Saudi Arabia are currently evolving their curricula in accordance with the most recognized medical education trends worldwide. Undergraduate medical school's curriculum should be compatible with community health needs. Therefore, the study aims to explore the current contents of Saudi undergraduate medical curricula and to check if the core topics that were internationally recognized were implemented in their curriculum. Methodology: An online questionnaire was designed and sent to 37 deans of medical schools in Saudi Arabia. The deans or the vice-deans in charge of the curriculum were asked to complete the pre-designed questionnaire, which assessed the status of inclusion of the core topics in the curriculum of their affiliated schools. Each listed core topic was evaluated according to five options for each subject: not included, separate required course, part of the required course, separate elective course, and part of an elective course. Results: Twenty four out of 37 (65%) Saudi medical schools completed the survey questionnaire. Almost all core topics, such as communication skills, evidence-based medicine, patient safety, professionalism were included in the curricula of Saudi medical schools as separate required courses or as part of required courses or elective courses. Complementary and alternative medicine and the history of medicine were the topics least taught in Saudi medical colleges, as 25% of the schools did not include them in their curricula. Conclusion: The majority (65%) of the internationally recognized core topics were included in the Saudi undergraduate medical curricula. Evidence-based medicine, complementary medicine, the Saudi healthcare system, patient safety, and professionalism/medical ethics should be part of compulsory credited courses in all Saudi undergraduate medical curricula. [ABSTRACT FROM AUTHOR]

• The 3rd ESTRO-EFOMP core curriculum (CC) for Medical Physics Experts (MPE) in radiotherapy is presented. • The CanMED competencies for MPE are introduced as a core part of the updated CC. • Recommendations for the pre-education and the MPE training programme are provided. • The CC allows for adaptation to each EU country needs while maintaining a high-level education for MPE. • The CC can contribute to further harmonization of MPE training in Europe. To update the 2011 ESTRO-EFOMP core curriculum (CC) for education and training of medical physics experts (MPE)s working in radiotherapy (RT), in line with recent EU guidelines, and to provide a framework for European countries to develop their own curriculum. Since September 2019, 27 European MPEs representing ESTRO, EFOMP and National Societies, with expertise covering all subfields of RT physics, have revised the CC for recent advances in RT. The ESTRO and EFOMP Education Councils, all European National Societies and international stakeholders have been involved in the revision process. A 4-year training period has been proposed, with a total of 240 ECTS (European Credit Transfer and Accumulation System). Training entrance levels have been defined ensuring the necessary physics and mathematics background. The concept of competency-based education has been reinforced by introducing the CanMEDS role framework. The updated CC includes (ablative) stereotactic-, MR-guided- and adaptive RT, particle therapy, advanced automation, complex quantitative data analysis (big data/artificial intelligence), use of biological images, and personalized treatments. Due to the continuously increasing RT complexity, more emphasis has been given to quality management. Clear requirements for a research project ensure a proper preparation of MPE residents for their central role in science and innovation in RT. This updated, 3rd edition of the CC provides an MPE training framework for safe and effective practice of modern RT, while acknowledging the significant efforts needed in some countries to reach this level. The CC can contribute to further harmonization of MPE training in Europe. [ABSTRACT FROM AUTHOR]

Background: A curriculum is a fundamental tool for educators, and teaching bioethics is fundamental to good medical practice. Studies report a lack of consensus on the teaching of bioethics in undergraduate medicine, and a critical issue is that there remain no minimum curricular parameters. This study performed an analysis between the bioethics curricula of the medical schools of Brazil and Portugal and UNESCO's Core Curriculum, in addition to proposing key criteria for designing a core bioethics curriculum. Methods: This is a cross-sectional, descriptive study that analyzes the bioethics curricula of the medical schools in Brazil and in Portugal. The design of the study includes a qualitative summative content analysis-based approach and a quantitative analysis by means of descriptive statistics. Results: Bioethics is taught in both Brazil and Portugal in a diversified way. The results showed that 65.5% of the medical schools analyzed provided at least the 30-h minimum workload recommended by the UNESCO Core Curriculum. Furthermore, bioethics sporadically offered at the end of the medical program in the vast majority of schools studied. Conclusions: The most important points to take away from this study are the diversity of the curricular structure of bioethics courses and the lack of formalization of bioethics in the curricula of medical schools in Brazil and Portugal. Given the value of bioethics in clinical practice, we propose that medical schools in Portugal and Brazil update their curricula to encompass minimum criteria, which should be similar to one another and based on common sources, but which should also be tailored to each culture. [ABSTRACT FROM AUTHOR]

Introduction: The lack of attention to transgender and gender diverse (TGD) people in undergraduate medical education (UME) is a point of concern, particularly among medical students. A project was undertaken to develop a UME curriculum framework for teaching the healthcare needs of TGD people. Methods: Using a modified Delphi methodology, four rounds of surveys were presented to an expert stakeholder group that included content experts, generalist physicians, UME teaching faculty, and medical students. Questions covered what content should be taught, who should teach the content, and how much time should be dedicated for this teaching. Once the Delphi process was complete, feedback on the provisional framework was sought from members of the TGD community to ensure it represented their needs and perspectives. Results: 71 panel members and 56 community members participated in the study. Core values included the scope of the framework, and topics such as inclusivity, and safety in practice and in teaching. The framework included terminology, epidemiology, medical and surgical treatment, mental health, sexual and reproductive health, and routine primary care. There was also guidance on who should teach, time to be allocated, and the learning environment. Discussion: There is a clear need to train tomorrow's doctors to provide competent and respectful healthcare services to and for TGD patients. Although local factors will likely shape the way in which this framework will be implemented in different contexts, this paper outlines a core UME-level curriculum framework for Canada and, potentially, for use in other parts of the world. [ABSTRACT FROM AUTHOR]

Background: The journal club is a long-standing pillar of medical education and medical practice, although its components and format are quite variable. In addition, selecting literature for discussion must strike a delicate balance between reviewing seminal and durable articles with that of emerging evidence, all while complementing a residency curriculum. Although the critical appraisal of literature is a fundamental skill of the practicing physician, a universal curriculum has not yet been optimized to facilitate journal club.Objective: We sought to design and implement a comprehensive, complementary, and evidence-based journal club curriculum that was modular in design, reproducible, and effective at generating participation.Methods: Our novel curricular design incorporates many evidence-based components, including optimizing the learning environment, providing ease of access to resources, and using educational methodology that immerses learners in the experience in a structured manner. In addition, the curriculum complements, but does not duplicate, the core residency curriculum. In 2020, we analyzed our data, using descriptive and comparative statistical methods.Results: We demonstrated significant improvement in common metrics used to analyze the efficacy of the journal club, including attendance and participation. Significant improvements were seen in both resident and attending participation.Conclusions: Our design methods used resources easily available to our residency program and commonly available to others, with minimal time and resource cost. Further study is required to measure long-term educational outcomes. [ABSTRACT FROM AUTHOR]

Background: Despite an abundant literature advocating that social determinants of health (SDH) be taught during undergraduate medical education, there are few detailed descriptions of how to design and implement longitudinal core curricula that is delivered to all students and accomplishes this goal. Methods: In this paper, we describe the design and implementation of a social medicine curriculum at the University of Vermont's Larner College of Medicine (UVM Larner). Using Kern's principles, we designed a longitudinal curriculum that extends through both preclinical and clinical training for all students and focused on integrating SDH material directly into basic science and clinical training. Results: We successfully developed and implemented two primary tools, a "Social Medicine Theme of the Week" (SMTW) in preclinical training, and SDH rounds in the clinical setting to deliver SDH content to all learners at UVM Larner. Conclusions: Extensive student-faculty partnerships, robust needs assessment, and focusing on longitudinal and integrated SDH content delivery to all students were key features that contributed to successful design and implementation. [ABSTRACT FROM AUTHOR]

Literature points to the existent diversity in medical graduate courses' curriculums, reinforcing the need to systematise and deepen more studies in this area with the aim of qualifying the formation of our future professionals. This study aims to understand the methods used in the teaching of Bioethics in medical graduation worldwide. It was characterised as an integrative review and the databases used were Pubmed, Scopus and Web of Science. In total 2993 articles were identified and 72 met the pre-selected criteria and were included in the review. The characteristics of teaching bioethics that stood out the most in the analysis were: teaching still very heterogeneous between different universities, use of various methodologies in the process of teaching/learning, teaching disconnected from the medical practice of students showing the need to integrate the curriculum with clinical practice and challenges of teaching-learning process. Most of the studies in this review lead us to understand that there is still no minimum parameters on the ideal method to teach bioethics, suggesting that it may affect the feeling of unpreparedness felt by students in face of ethical issues in clinical practice, despite the theoretical basis acquired. [ABSTRACT FROM AUTHOR]

Background: In Japan, sexual and gender minorities (SGM) remain stigmatized, provoking hospital access barriers and health disparities from judgmental care. Japan's Western-influenced introduction of SGM course content into medical education for future physicians addresses these disparities, although often perfunctorily and inconsistently. Objective: To examine the prevalence and characteristics of medical education curriculum with respect to SGM patients, we surveyed medical schools. Methods: A medical education faculty member from each of 80 Japanese medical schools received double postcards to identify relevant SGM coursework. Upon acknowledgement, 43 schools received seven-item anonymous questionnaires in March 2018. Survey results were analyzed from the perspective of three of the qualities and abilities required of a physician – Patient Care, Knowledge for Practice, and Professionalism from Japan's Medical Core Curriculum – to develop recommendations for outcomes-based SGM curriculum through the lens of Van Melle's medical education framework. Results: The response rate was 46%, with 22 schools providing SGM lectures mostly to first- and third-year students. Obstetrics and Gynecology, Neuropsychiatry, and Introduction to Medicine lectures were the top three subjects offering SGM lectures, primarily consisting of basic knowledge of SGM and Differences in Sex Development. Several lectures addressed the health challenges of SGM. Primary reasons for not offering SGM lectures were lack of suitable instructors or no school policies. Conclusions: Students can best experience the humanity of SGM patients and employ more appropriate diagnostic practices and modes of treatment with targeted curriculum to address SGM health disparities and inclusion of SGM patients in clinical practice training. To disseminate SGM education in Japanese medical schools, development of qualified instructors and policies is essential, employing currently active experts. The Van Melle reforms framework can guide in the development of recommended tailored learning experiences and lectures for improved and expanded SGM education, integrating appropriate coursework within current medical core curriculum structure. [ABSTRACT FROM AUTHOR]

The need for comprehensive core curricula in medical education regarding the health of persons with disabilities has been identified by disability scholars for many years and was recently reinforced by our research indicating Canadian physicians lack knowledge of the social model of disability, and their legal duty to ensure accommodation for persons with disabilities to have equal access to health. The purpose of the current research is to investigate the existence of core medical education curricula devoted to the health of persons with disabilities and determine whether persons with disabilities were involved as curricular designers and educators. A comprehensive literature search of all academic sites found few papers reporting on such curricula, and the time devoted to these curricula was small. Only one medical school internationally was found to have persons with disabilities playing a major role as curricular designers. Further problematic was that "disability" tended to be portrayed by non-disabled professional actors hired as standardized patients (SPs), and only occasionally by actors with disabilities but in scripted SP roles distant from their lived experience. We contend that if persons with disabilities designed medical curricula, non-disabled SPs would be replaced by persons with disabilities as medical educators, sharing their own lived experiences. Another alternative in replacing professional able-bodied actor SPs is the novel education method of digital storytelling, with disabled persons sharing their lived experiences. Another immediate opportunity exists in Canada in the newly developing competency-based curricula for prominent core competencies to be designed and taught by persons with disabilities. [ABSTRACT FROM AUTHOR]

• The content and values espoused in the ESTRO Core Curriculum are endorsed across diverse geopolitical and sociocultural regions. • This may be a result of wide representation in the curriculum development process. • Barriers to curricular implementation are identified at the organizational and systems level. • Future opportunities to address these implementation challenges include advocacy for educational resources as well as the creation of online educational materials including assessment tools. Global curricula exist across medical specialties however, the factors which influence their implementation are not well understood. The purpose of this study is to report the perceived factors that impact the implementation of the ESTRO Core Curriculum. An anonymous, 37-item, survey was designed and distributed to the Presidents of the National Societies who have endorsed the ESTRO Core Curriculum (n = 29). The survey addressed perceptions about implementation factors related to context, process and curriculum change. The data was summarized using descriptive statistics. Twenty-six (90%) National Societies completed the survey. One respondent perceived that the values of the training system of their country would be incompatible with the proposed ESTRO Core Curriculum. The most common contextual barriers to implementation was a lack of support from the government (57%), a lack of internal organizational support (35%) and a 'poor fit' between the ESTRO Core Curriculum and the broader political and economic context (35%). Perceived implementation process barriers included insufficient numbers of faculty (44%), poor coordination between the government and training institutions (48%), and a lack of an influential person leading the implementation (44%). Two barriers related to curriculum change were a lack of funding and lack of assessment tools. The content and values espoused in the ESTRO Core Curriculum are endorsed across diverse geopolitical and sociocultural regions. Barriers to curricular implementation are identified at the organizational and systems level and include insufficient teaching faculty, lack of coordination and the need for influential leadership. [ABSTRACT FROM AUTHOR]

In Japan, the Model Core Curriculum for Medical Education, which is the National Model COre CUrriculum for Undergraduate Medical Education, was first published in 2001 and has since been revised to meet the needs of an aged society and the global standardization of medical education. A new quality and ability "Generalism," which is a comprehensive attitude toward patients, has been added to this revision of the model core curriculum. In this letter, we propose an educational strategy for generalism. [ABSTRACT FROM AUTHOR]

Negative capability or tolerance for uncertainty is important for primary care physicians. The 2022 edition of the Model Core Curriculum for Medical Education also states that the content of professionalism is to "keep thinking about unanswerable questions." [ABSTRACT FROM AUTHOR]

Introduction: The focus of public attention and health policy is increasingly being drawn to patient safety. According to studies, more than 30,000 patients die each year as a result of medical errors. To date, learning objectives such as patient safety have not played a role in the core curriculum for medical education in Germany. The National Com- petence-Based Catalogue of Learning Objectives for Undergraduate Medical Education contains a total of 13 learning objectives relating to this subject. Methods: In a descriptive study, learning content was implemented within the "Operative Medicine" study block offered by the Faculty of Medicine at Universität Hamburg. The definition and occurrence of errors as well as strategies for dealing with and avoiding errors were set as the learning objectives for an interactive lecture, problem-based learning PBL) case as well as the bedside teaching on anaesthesiology. Students were able to evaluate the lecture directly. During the simulator session on anaesthesia, the safety-relevant information that students requested from patients was compared with the questions asked by a control group in the previous trimester. Results: The topic of patient safety could be integrated into the "Operative Medicine" curriculum through a number of minor changes to classes. The accounts of personal experiences and importance assigned to the subject were considered positive, while content perceived as redundant was criticised. In the simulator, the students appeared to request more comprehensive preoperative safety-relevant information than the control group. Conclusion: The subject's relevance, positive feedback and trend towards a change in behaviour in the simulator lead the authors to deem introduction of the topic of patient safety a success. [ABSTRACT FROM AUTHOR]

This paper reports on a study of how liminality relates to the facilitation of reflective practice in professional education. Liminality refers to sites and positions that exhibit 'in-betweenness', or bordering positions, that might draw together different institutional conditions. The present project aims to examine the role of liminality in professional educational practice with a specific focus upon how liminality may support student reflection. Using a qualitative and comparative research approach, we analysed interview and observational data from police education and a medical programme. Observations and interviews explore practices of collective interactional (and hence observable) reflection at sites that are characterised by ‘betweenness’ of work and education. Findings indicate that situations that afford reflection are characterised by a sense of undeterminedness in terms of either the subject, space or activity. Thus, we conclude that there is some evidence that liminality affords reflection, but also that liminality and underminedness are fragile states that are not easily organised in a professional education curriculum. [ABSTRACT FROM AUTHOR]

Abstract Introduction This article discusses a blueprint for a sexual health communication curriculum to facilitate undergraduate medical student acquisition of sexual history taking skills and includes recommendations for important elements of a thorough sexual history script for undergraduate medical students. Aim To outline the fundamentals, objectives, content, timing, and teaching methods of a gold standard curriculum in sexual health communication. Methods Consensus expert opinion was documented at the 2012, 2014, and 2016 Summits in Medical Education in Sexual Health. Additionally, the existing literature was reviewed regarding undergraduate medical education in sexual health. Main Outcome Measures This article reports expert opinion and a review of the literature on the development of a sexual history taking curriculum. Results First-year curricula should be focused on acquiring satisfactory basic sexual history taking skills, including both assessment of sexual risk via the 5 Ps (partners, practices, protection from sexually transmitted infections, past history of sexually transmitted infections, and prevention of pregnancy) as well as assessment of sexual wellness—described here as a sixth P (plus), which encompasses the assessment of trauma, violence, sexual satisfaction, sexual health concerns/problems, and support for gender identity and sexual orientation. Second-year curricula should be focused on incorporating improved clinical reasoning, emphasizing sexual history taking for diverse populations and practices, and including the impact of illness on sexual health. Teaching methods must include varied formats. Evaluation may be best as a formative objective structured clinical examination in the first year and summative in the second year. Barriers for curriculum development may be reduced by identifying faculty champions of sexual health/medicine. Clinical Implications Medical students will improve their skills in sexual history taking, which will ultimately impact patient satisfaction and clinical outcomes. Future research is needed to validate this proposed curriculum and assess the impact on clinical skills. Strengths & Limitations This article assimilates expert consensus and existing clinical guidelines to provide a novel structured approach to curriculum development in sexual health interviewing in the pre-clinical years. Conclusion The blueprint for developing sexual history taking skills includes a spiral curriculum with varied teaching formats, incorporation of a sexual history script that incorporates inquiry about sexual wellness, and longitudinal assessment across the pre-clinical years. Ideally, sexual health communication content should be incorporated into existing clinical interviewing and physical examination courses. Rubin ES, Rullo J, Tsai P, et al. Best Practices in North American Pre-Clinical Medical Education in Sexual History Taking: Consensus From the Summits in Medical Education in Sexual Health. J Sex Med 2018;15:1414–1425. [ABSTRACT FROM AUTHOR]

Background/Objectives Although skin disease and skin cancers cause significant morbidity and mortality in Australia, limited time is dedicated to dermatology teaching in most medical courses. The aim of this study was to define the current state of dermatology teaching in Australian medical schools with a view to developing a national core curriculum for dermatology. Methods An electronic questionnaire was circulated to the dermatology teaching leads and relevant medical program coordinators of the 18 medical schools in Australia. Results Replies were received from 17 medical schools. Dermatology was included as part of the core curriculum in 15 schools. Time set aside for dermatology teaching varied, as reflected by the number of lectures delivered (0-21, mean 5, median 3) and minimum clinics attended (0-10, mean 1.2, median 0). Only four medical schools had a compulsory clinical attachment in dermatology. Furthermore, satisfying requirements in dermatology was mentioned in the university examination regulations in only six schools. Certain core learning outcomes were addressed in most schools, including the structure and function of the skin, common conditions such as atopic dermatitis and psoriasis and cutaneous malignancies. However, there were important omissions, ranging from common problems like dermatophyte infections and drug reactions to the recognition of dermatological emergencies. Conclusions These results are a compelling impetus to improve current standards of dermatology teaching, learning and assessment. The introduction of a national core curriculum would provide guidelines for dermatology teaching in medical schools, enabling the more effective utilisation of available time for key learning outcomes. [ABSTRACT FROM AUTHOR]

Communication ability is one of the core requirements of doctors' competency. Teaching communication to medical students and junior doctors has attracted much attention. With the challenge of escalating demands, the status of training communication skills has been promoted in the past several decades. The training content was integrated with other courses and various pedagogic approaches have been applied and proved to be effective. Practical strategies and mixed types were highly recommended. However, there are still many problems, including the fragmentation of the training, insufficient practice, inadequate qualified teachers, case adaptation, course localization and impediment from the environment. This paper proposes some suggestions to solve the problems. [ABSTRACT FROM AUTHOR]

Patients expect physicians to be lifelong learners who are able to interpret and evaluate diagnostic tests, and most medical schools list the development of lifelong learning in their program objectives. However, lecture is the most often utilized form of teaching in the first two years and is considered passive learning. The current generation of medical students has many characteristics that should support active learning pedagogies. The purpose of this study was to analyze student and faculty perceptions of active learning in an integrated medical curriculum at the second-year mark, where students have been exposed to multiple educational pedagogies. The first hypothesis of the study was that faculty would favor active learning methods. The second hypothesis was that Millennial medical students would favor active learning due to their characteristics. Primary faculty for years 1 and 2 and second-year medical students were recruited for an e-mail survey consisting of 12 questions about active learning and lecture. Students perceived that lecture and passive pedagogies were more effective for learning, whereas faculty felt active and collaborative learning was more effective. Students believed that more content should be covered by lecture than faculty. There were also significant differences in perceptions of what makes a good teacher. Students and faculty both felt that lack of time in the curriculum and preparation time were barriers for faculty. The data suggest that students are not familiar with the process of learning and that more time may be needed to help students develop lifelong learning skills. [ABSTRACT FROM AUTHOR]

The core curriculum of the University of Split School of Medicine (USSM) sets the standards for knowledge, skills, and attitudes that medical students should acquire. Clinical rotations as the final act of acquiring clinical skills at the USSM consist of four courses: Emergency (3 ECTS); Internal Medicine (5 ECTS); Surgery (5 ECTS); and Mother and Child (5 ECTS), and are organized in the sixth academic year involving 540 hours. In a group of two, students spend time in outpatient clinics of the University Hospital of Split, the Emergency Department of Split-Dalmatia County, and on other teaching bases. A traditional rotation involves a supervising faculty member (mentor) making assignments and working with a limited number of medical students. Students work as part of the medical team and actively participate in diagnosing and treating the patient by applying the knowledge they have acquired and improving their clinical skills to enable them to practice independently. In addition, students participate in interactive seminars where they are expected to apply their knowledge in managing clinical cases. Seminars are organized in the form of problem-based learning (PBL). Finally, the formative OSCE with immediate feedback is performed at the end of the Clinical rotations to evaluate students’ clinical competence when taking the history, performing the physical examination, and in clinical reasoning. Internal SWOT analysis performed following the student’s survey revealed that acquisition of skills and knowledge in small groups of students, thorough familiarization with the hospital treatment protocol of the patient, a unique opportunity for the student to participate actively under the supervision of the mentors in the patient care in different clinical scenarios, and flexibility of performing practical from clinical rotations that do not require additional material costs for the USSM and/or the University Hospital of Split are the main strengths. On the other hand, mentors are not paid for this work, and they are overloaded with regular clinical work. Variability in the quality of clinical rotation between departments and the disproportion in duration and scope of individual components are the main weaknesses. Differences in organization of clinical skills and capacity across medical schools are acknowledged. Still, constant improvement and steps toward in clinical decision-making of future physicians become a crucial features of the core curriculum of medical schools. [ABSTRACT FROM AUTHOR]

Setting standards in undergraduate medical education is a crucial but still developing research area in Croatia. Improvement and innovation in teaching and education are primary goals of the University of Zagreb School of Medicine program. A definite step in this direction was made by the introduction of the 6-year longitudinal course Fundamentals of Medical Skills (FMS) in 2011. The course content follows the core curriculum subjects. FMS is focused on communication as well as practical and clinical skills. It delivers content through a combination of simulation on mannequins, role-play and meet-my-patient scenarios. The course involves 212 tutors and 1,800 students (sds) in each academic year. It comprises practical skills such as washing hands; basic, advanced, paediatric and trauma life support; drawing blood; urinary catheter and nasogastric tube insertion; intravenous/ intramuscular/subcutaneous injection; out-of-hospital labour; immobilisation; clinical case simulations; roleplaying situations and standardised patients – all with the aim to prepare sds for residency or clinical practice as graduated junior doctors. Participants get the opportunity to experience the advantages of teaching methods including practical, clinical and communication skills by participating in prepared scenarios. The Calgary-Cambridge model was adopted and sds are expected to take an active role in the learning process. The same tutor follows a group of 10 sds throughout all six years, for 30 teaching hours per each academic year. Tutor/mentor characteristics are also an important component of the process. They should have basic core teaching skills, be trained for their role and provide high-quality education. Standardisation of the teaching is ensured by two-day courses for tutors, followed by pre-course training every academic year, teaching session plans and a tutors’ guidebook including a detailed teaching plan, materials, aims and learning outcomes. Each year ends with an exam comprising 3 Objective Structured Clinical Examination (OSCE) stations. Assessing sds’ and tutors’ attitudes toward learning is essential. Their feedback provides awareness as to which aspects of the course could be enhanced or changed. In five generations 83.7% sds found the course useful, 92.9% favoured practical over communication skills, 86.5% preferred to be taught on patients, 62.4% were able to use the skills acquired through FMS in other courses during the study, 82.3% found practical skills more useful in the higher years and reported implementation of the skills acquired through FMS in other courses during their study, 75.2% found that more time for practice on mannequins would be desirable. However, they appeared to underestimate the importance of communication skills. 78% preferred OSCE stations to traditional oral exams. Among lecturers’ qualities, knowledge (89.4%), communication skills (75.2%) and approachability (73%) were most valued. [ABSTRACT FROM AUTHOR]

A medical school in China engaged in reform in 2009 by adapting the medical curriculum of the University of Chicago, USA. Freshmen volunteered for the reform and 50 were randomly selected while the rest remained in the traditional curriculum. In 2014 a study was conducted to determine whether the views of traditional and reform curriculum students on their respective educational experience differed and to identify reform areas that needed improvement. A survey was administered to graduating students to gauge their views on basic science and clinical science education, clerkships, general medical education, and readiness for residency training. Frequency distributions, Mann-Whitney U tests, and Chi-squared tests were used for analysis. Reform curriculum students were more positive about their basic science and clinical science instruction. Clerkships were only somewhat satisfactory to students in both curricula. Reform curriculum students were more likely than those following the traditional curriculum to consider instruction in clinical decision-making and patient care as 'adequate'. Instruction in population health was considered inadequate by the majority of students. Reform curriculum students were more confident about their preparedness for residency. The traditional curriculum was in need of reform. Reform has been effectively implemented and has increased student confidence and satisfaction with their education although there is room for improvement. [ABSTRACT FROM AUTHOR]

Background: To present learning outcomes in clinical communication for a Core Curriculum for medical undergraduate students in Latin America, Portugal and Spain (LAPS-CCC) and to establish an expert network to support a transnational implementation. Methods: Through an iterative process, an international group of 15 experts developed an initial set of learning outcomes following a review and discussion of relevant international and local literature. A two-round Delphi survey involving 46 experts from 8 countries was performed. Quantative and qualitative analisis permited the definition of the final consensus. Results: The initial proposal included 157 learning outcomes. The Delphi process generated 734 comments and involved the modification, deletion and addition of some outcomes. At the end of the process, a consensus was reached on 136 learning outcomes grouped under 6 competency domains with a high overall acceptance (95.1 %). Conclusions: The learning outcomes of this proposal provide a guide to introduce, support and develop communication curriculae for undergraduate medical studies in the countries involved or in other Spanish- or Portuguese-speaking countries. [ABSTRACT FROM AUTHOR]

This article discusses the core curriculum for behavioral science, from the perspective of psychology, recommended by the Japanese Society of Behavioral Medicine and seeks to explain how the curriculum can be effectively implemented in medical and health-related departments. First, the content of the core curriculum is reviewed from the perspective of psychology. We show that the curriculum features both basic and applied components and that the basic components are closely related to various aspects of psychology. Next, we emphasize two points to aid the effective delivery of the curriculum: 1) It is necessary to explain the purpose and significance of basic components of behavioral science to improve student motivation; and 2) it is important to encourage student self-efficacy to facilitate application of the acquired knowledge and skills in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Medical schools have been making efforts to develop their own problem-based learning (PBL) approaches based on their educational conditions, human resources and existing curriculum structures. This study aimed to explore a new framework by integrating the essential features of PBL and coaching psychology applicable to the undergraduate medical education context. Methods: A participatory research design was employed. Four educational psychology researchers, eight undergraduate medical school students and two accredited PBL tutors participated in a four-month research programme. Data were collected through participatory observation, focus groups, semi-structured interviews, workshop documents and feedback surveys and then subjected to thematic content analysis. The triangulation of sources and member checking were used to ensure the credibility and trustworthiness of the research process. Results: Five themes emerged from the analysis: current experience of PBL curriculum; the roles of and relationships between tutors and students; student group dynamics; development of self-directed learning; and coaching in PBL facilitation. On the basis of this empirical data, a systematic model of PBL and coaching psychology was developed. Conclusions: The findings highlighted that coaching psychology could be incorporated into the facilitation system in PBL. The integrated framework of PBL and coaching psychology in undergraduate medical education has the potential to promote the development of the learning goals of cultivating clinical reasoning ability, lifelong learning capacities and medical humanity. Challenges, benefits and future directions for implementing the framework are discussed in this paper. [ABSTRACT FROM AUTHOR]

Background: As a non-invasive and readily available diagnostic tool, ultrasound is one of the most important imaging techniques in medicine. Ultrasound is usually trained during residency preferable according to German Society of Ultrasound in Medicine (DEGUM) standards. Our curriculum calls for undergraduate training in ultrasound of medical students in their 4th year of undergraduate education. An explorative pilot study evaluated the acceptance of this teaching method, and compared it to other practical activities in medical education at Muenster University. Methods: 240 medical students in their 4th year of undergraduate medical education participated in the training and completed a pre- and post-questionnaire for self-assessment of technical knowledge, self-assurance of the procedure, and motivation in performing ultrasound using a Likert scale. Moreover, students were asked about their interest in pursuing a career in internal medicine. To compare this training to other educational activities a standardized online evaluation tool was used. A direct observation of procedural skills assessment (DOPS) for the first time applied on ultrasound aimed to independently assess the success of our teaching method. Results: There was a significant increase in technical knowledge and self-assurance (p < 0.001) of the students' self-assessments. The clinical relevance and self-motivation of the teaching were evaluated positively. The students' DOPS results demonstrated proficiency in the understanding of anatomic structures shown in ultrasonographic images, including terminology, machine settings, and transducer frequencies. Conclusions: Training ultrasound according to certified DEGUM standards was successful and should be offered in undergraduate medical education. The evaluation of the course affirmed the necessity, quality and clinical relevance of the course with a top ranking score of hands-on training courses within the educational activities of the Medical Faculty of Muenster. [ABSTRACT FROM AUTHOR]

Education in nursing is the process of acquiring or imparting particular knowledge or skills of patients and healthy people within the authority of nurses resulting from its role. It is also the quality and level of education in relation to the needs and its relevant condition. The nurse should master a core curriculum of the educational process with its stages if she wants to educate patients so as they could reach planned aims and positive changes in their lives. In the feedback she obtains the information about the patient knowledge, attitudes and skills. Education in nursing is of a great importance to improve the quality of life of an individual and a group and is an important aspect of nursing practice. [ABSTRACT FROM AUTHOR]

This article focuses on the culture of human interchange, which is included as a component of the implicit curriculum in the current EPAS. It presents the use of the implicit curriculum concept in teacher and medical education as a context for its application to social work education. The authors argue that professional behaviors taught in the explicit curriculum of the classroom need to be consciously reinforced in the many venues and through the ongoing interpersonal relations throughout the educational environment. The article identifies the challenges that movement in this direction would create but which the implicit curriculum standard mandates us to address. [ABSTRACT FROM AUTHOR]

Abstract: There has been little improvement in the survival of patients with oral cancer despite advances in treatment, and late presentation of the disease is one reason for this poor outcome. Research and experience tell us that tuition in medical schools about examination of the oral cavity is poor. We aimed to ascertain the opinions and experience of students regarding this in our institution by dissemination of a web-based anonymous questionnaire that focused on education about examination of the oral cavity and experience in carrying it out. From a cohort of 600 students 458 (76%) responded. A total of 334 (73%) had not been taught how to examine the oral cavity, 372 (81%) had had no experience of doing so in patients, and only 13/86 (15%) felt confident to diagnose a carcinoma of the lip or oral cavity. Eighty-nine percent felt that the tuition given had not been adequate. Examination of the oral cavity cannot be considered part of the core clinical curriculum, and medical schools and departments of oral and maxillofacial surgery urgently need to embrace the introduction of the necessary skills. [Copyright &y& Elsevier]

Background Novel strategies in medical education including the flipped classroom, test-enhanced learning, and gaming have proven to be effective for preclinical learners but little is known about their efficacy in post-graduate education. We implemented an educational tool in our Infectious Diseases (ID) Fellowship Training program called TACO (To Assess Cognitive Operations) Tuesday that utilizes aspects of the flipped classroom, test-enhanced learning, and gaming to improve ID fellow engagement, satisfaction, knowledge retention, and board examination preparation in association with a weekly ID core didactic curriculum. Methods One to three multiple choice clinical vignettes were emailed to ID fellows the day prior to their weekly didactic lecture. The first fellow to answer all questions correctly was the winner for the week. The correct answer choices along with detailed rationales were distributed to all fellows at the end of the week. After one year of using this educational tool, we surveyed fellows to evaluate its impact on their engagement with the weekly didactic sessions, self-perception of content retention, and sense of preparation for the ID board examination. Results We had a response rate of 82% with 9 of 11 fellows polled participating. Of those, two-thirds attempted to answer the multiple-choice questions prior to lecture and most (77%) reviewed the correct answer choices and rationales weekly. All participants felt the educational tool helped improve their engagement with the lectures and half felt it increased overall satisfaction with their educational experience. The majority felt the tool increased content retention and their level of preparation for the ID board examination. Implementation of this tool was associated with a higher mean IDSA in-training examination score compared with scores from the previous year (518 vs 469). Conclusion ID fellows found that an educational tool utilizing a flipped classroom, test-enhanced learning, and gaming in association with a weekly core didactic curriculum increased their engagement, satisfaction, knowledge retention, and board examination preparation. Future studies will investigate the impact of this tool on knowledge retention and ID board examination scores within our institution as well as across institutions. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Objective: The importance of anatomy education in clinical practice is well known. Nevertheless. clinical practice changes globally and there is no international standard for anatomy education and educational methods used. Defining national needs for curriculum updates and anatomy content may be needed for planning future studies. In this study. we aimed to determine the importance of anatomy and its place in daily clinical practice from active Turkish physicians' perspective. Methods: Demographic data and importance of anatomy in clinical practice were evaluated by an 1' item questionnaire following ethical approval (number:'645, date:29.11.2018). Results: There were 1524 respondents. The respondents were; specialists (57.29%), general physcians (22.7%), asistants (12.07%), and academic staff (7.94%). Anatomy education was important for diagnostic/radiologic methods (mean:4.34), final diagnosis (mean:4.34), physical examination (mean:4.31), and differential diagnosis (mean:4.07) for clinical practice. The importance for communication with colleagues (mean: 3.94), story/symptomatology (mean:3.67) and communication with patients (3.21) steps were relatively low. Thematic analysis of free-text responses for physicians who think that anatomy education should continue during specialization revealed three main themes: timing, content, and format of anatomy education. Conclusion: Anatomy was an important topic for Turkish physicians in daily clinical practice especially for diagnostic/radiologic methods and physical examination. We believe our results may be helpful to update and enrich the course contents in undergraduate medical education. Focusing on radiological, cross-sectional, superficial, and interventional aspects of anatomy should be planned. In this context, a review of the National Medical Core Curriculum and integration of basic medical sciences into it could be considered. [ABSTRACT FROM AUTHOR]

Background Journal club is a standard component of residency education. Journal club focuses on review and interpretation of the medical literature with varying degrees of evidence-based medicine (EBM) education. Objectives To evaluate learning of EBM principles with an EBM curriculum implemented as a component of journal club. EBM competency was established using the Fresno test, a validated 12-question instrument of short-answer and essay-style questions to assess competency in EBM. Methods An EBM curriculum was implemented that consisted of a focus on EBM topics (e.g., study validity, bias, confidence intervals, search strategies) using a structured journal club format using a peer instruction model. The Fresno test was used prior to and after the implementation of the first year of this curriculum to measure effectiveness of the intervention. A hierarchical multivariable model using generalized estimating equations was used to account for repeated measures in the primary outcome of change in total Fresno test score. Results The total test scores did not increase significantly (105.4 vs. 120.9, p = 0.058) in the before–after analysis. The only subscore showing improvement was interpretation of study validity (32.1 vs. 40.4 points, p = 0.03). Attendance was significantly associated with Fresno test score, with those attending ≥ 6/11 sessions (55%) scoring 28.2 points higher ( p = 0.003), and those attending fewer than six sessions scoring only 1.9 points higher ( p = 0.81) than in the preintervention group. Conclusion An EBM curriculum implemented as part of journal club improves performance on the Fresno test among residents who attended at least six journal club sessions. [ABSTRACT FROM AUTHOR]