Search

Aim: Test educational interventions to increase the quality of care in telemedicine., Background: Telemedicine (TM) has become an essential tool to practise medicine around the world. However, education to address clinical skills in TM remains an area of need globally across the health professions. We aim to evaluate the impact of a pilot online learning platform (OLP) and standardized coaching programme on the quality of medical student TM clinical skills., Methods: A randomized pilot study was conducted with fourth-year medical students (n = 12). All participants engaged in video-recorded standardized patient (SP) simulated encounters to assess TM clinical skills before and after the intervention. Participants were randomized to either the OLP or OLP + Virtual Coaching Institute (VCI) intervention cohort. Quantitative and qualitative data were collected to address self-reported skills, attitudes, and self-efficacy before the 1st SP encounter and after the 2nd SP encounter. SP encounter recordings were scored by two blinded non-investigator raters based on a standardized rubric to measure the change in TM care delivered pre- and post-intervention. Statistical analysis of quantitative data included descriptive statistics and mixed effects ANOVA., Findings: Recruitment and retention of participants exceeded expectations, pointing to significant enthusiasm for this educational opportunity. Self-reported skills and scored simulation skills demonstrated significant improvements for all participants receiving the interventions. Both OLP and VCI interventions were well received, feasible, and demonstrated statistically significant efficacy in improving TM clinical skills. Participants who received coaching described more improvements in self-efficacy, confidence, and overall virtual clinical skills. This study provides evidence that virtualized clinical learning environments can positively impact the development of TM clinical skills among medical students. As TM continues to evolve, the implementation of innovative training approaches will be crucial in preparing the next generation of healthcare professionals for the demands of modern healthcare delivery.

Background: The use of technology in medical education has been increasing with more students exposed to some form of online learning or tutorials, under the umbrella of virtual learning (VL). Many programmes, particularly those involving virtual reality, have centred on practical skills, such as surgical techniques or anatomical knowledge, rather than communication. The study presented here examined the feasibility and acceptability of a VL module developed to aid communication when handling angry patients and their relatives., Methods: Participants were 4th and 5th year medical students at the Brighton and Sussex Medical School. Students were randomly allocated to receive training about having angry conversations in a clinical setting via virtual reality headset or desktop application. Prior to the intervention, everyone completed the SE12 self-efficacy questionnaire, a 5-item confidence measure, and free-response study specific survey. Following the module, they completed another study specific survey, with fixed and free responses, the confidence measure, along with the UTAUT2 questionnaire on acceptance and use of technology. Quantitative data was analysed descriptively, conceptual content analysis was applied to free responses. Participants received a £25 voucher for their time., Results: Twenty students took part in the project. Scores on the SE12 did not differ significantly between intervention arms. Confidence improved across all five categories - recognising responses that diffuse or exacerbate anger, identifying anger signals, remaining calm in hostile situations, moving forward with empathy, and applying techniques to different situations. Responses to the UTAUT2 indicated acceptance of VL, including the psychological safety it provides. Nineteen categories for free text responses were developed via content analysis. Participants spoke frequently about the challenges of navigating anger. There was initial apprehension VL would not feel realistic, though this was largely reversed post-intervention. Students expressed preference for a combination of VL, whichever modality, and face-to-face teaching, recognising benefits of both., Conclusion: Students found the training to be acceptable, providing them with tangible skills. There should be a consideration as to how to incorporate VL, with a mix of face-to-face practice for added realism., Trial Registration: Clinical trial number not applicable., Competing Interests: Declarations. Ethics approval and consent to participate: The research has been approved by the Brighton and Sussex Medical School Research Governance and Ethics Committee (RGEC). The ethical review application number of the study is ER/RMLS21/10. All participants provided written informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Teaching renal physiology is problematic in many medical schools since conventional passive learning might not be effective. Active learnings including flipped classroom (FC) have been introduced to medical education including renal physiology topic recently, but no study regarding long-term outcomes has been reported., Approach: Two classes of second-year medical students were compared. The former class studied with conventional lecture and the latter class studied with FC. Our FC includes asynchronous instructor-made recorded lectures that students can study according to their pace and available time, followed by synchronous case discussions related to the lecture topic. There were post-test quizzes for all recorded lectures along with the given explanation of the answers after finishing each quiz. Short-term topic understanding and long-term knowledge retention assessed with summative examination and end-of-preclerkship comprehensive examination, respectively, were compared. Attitude towards FC was also assessed., Evaluation: Students in the FC group performed better in both summative examination (70.1 ± 8.9 vs. 62.8 ± 9.9, p < 0.001, a total score of 90) and comprehensive examination (6.5 ± 2.2 vs. 5.9 ± 1.8, p < 0.001, a total score of 11). Most students agreed that FC should be applied despite the increased stress level and that the post-test quizzes were very helpful. Intriguingly, the multivariate analysis showed that male students performed better than female students for both examinations., Implications: Well-designed FC is a promising and highly effective method in renal physiology teaching. Cautions for the instructor include students' stress and gender differences in academic performance. Well-designed FC is a promising and highly effective method in renal physiology teaching., (© 2025 Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Objective: To examine the medical students' awareness of laparoscopic surgery as well as assess the perceived importance of laparoscopic simulation training, and its impact on students' confidence, career aspirations, proficiency, spatial skills, and physical tolerance., Design: Descriptive and comparative study using pre- and post-training assessments., Setting: Simulation training sessions centred on laparoscopic surgery techniques., Participants: Medical students in year three (n = 49) participated in laparoscopic simulation training sessions., Results: Before the simulation training, 85.7% of students were unaware of laparoscopy, with females being less familiar than males (96.3% vs. 72.8%). 85.7% believed mastering laparoscopy was crucial before training, and 81.6% believed simulation training could enhance surgical skills. A disparity existed in this belief between the sexes, with 91% of males and 74.1% of females seeing the value in such training for skill improvement. Pretraining, males (54.5%) were more confident than females (26%) in mastering laparoscopy. Post-training, confidence increased for both groups, and the percentage of students wishing to pursue a surgical career also rose from 50% to 72.7%. Despite initial disparities in the time spent on training modules between males and females, both groups achieved similar proficiency levels by the end of the training. Although females initially lagged in spatial awareness and skills, post-training results showed significant improvement, matching their male counterparts. 26.5% of students experienced physical fatigue post-training, with a higher percentage of females (33.3%) reporting fatigue than males (18.2%). Regarding concentration during simulations, 81.8% of males could maintain focus compared to 48.2% of females., Conclusions: Laparoscopic simulation training effectively improved the understanding, confidence, and surgical skills of medical students, with evident benefits in shaping their career aspirations. While both genders exhibited significant gains, female students faced challenges in terms of physical tolerance and initial spatial awareness. However, their post-training achievements mirrored those of their male peers, highlighting the effectiveness and importance of such simulation training programmes., (© 2024 John Wiley & Sons Ltd.)

Background: The acquisition of practical skills is a key objective of medical education. Improving knowledge and skills is essential for early diagnosis of patients suffering from neuromuscular (NM) diseases., Approach: Multimedia tools have proved to be useful and effective for learning clinical skills. We developed a video to learn the NM examination, the main pathological signs and their semiological value. We developed a video to learn the NM examination, the main pathological signs and their semiological value., Evaluation: Twenty-seven medical students (group A) watched the NM video. A control group (B, n = 15) watched a control video on OMS examination. Both groups filled out NM and control questionnaires before and after watching the video. Group A significantly improved their score on the NM questionnaire (6.36 ± 1.62 vs. 9.12 ± 0.69, p < 0.001) but not on the control questionnaire. Group B significantly improved the score on the control questionnaire (6.03 ± 1.39 vs. 8.22 ± 1.12, p < 0.0001) but not on the NM questionnaire. Students self-scored their NM knowledge at 5/10 and 7.4/10 on a visual analogue scale (VAS) before and after watching the NM video. The overall usefulness of the NM video was scored 8.7/10. Students considered it useful for learning the NM examination, illustrating rare semiological signs, preparing for practical evaluations and reinforcing self-confidence., Implications: Didactic videos can be used to complement classical teaching to improve the learning of practical skills and to strengthen students' self-confidence. They can also be useful for other medical disciplines and health professionals, improving the recognition and management of these rare diseases., (© 2025 Association for the Study of Medical Education and John Wiley & Sons Ltd.)

There remains an urgent need for expanded genomics training in undergraduate medical education, especially as genetic and genomic assessments become increasingly important in primary care and routine clinical practice across specialties. Physician trainees continue to report feeling poorly prepared to provide effective consultation or interpretation of genomic test results. Here we report on the development, pilot implementation, and evaluation of an elective offering for pre-clinical medical students called the Sanford Precision Health Scholars Immersive Learning Experience (PHS), which was designed leveraging genetic counseling expertise as one means to address this need. This 9-week course, piloted in Fall 2021 at UC San Diego, afforded students the opportunity to build technical skills and competencies in clinical genomics while identifying, addressing, and engaging with pervasive health disparities in genomics. Interactive exercises focused students' learning on strategies for empathic and compassionate patient interactions while supporting the application of concepts and knowledge to future practice. Upon completion of the course, participants reported increases in confidence related to skills required for clinical genomics practice. Drawing on learnings from this pilot implementation, recommendations for refining the program include deepening pedagogical engagement with ethical issues, expanding the offering to trainees across health professions, including pharmacy students, and incorporating an optional experiential learning component. Educational offerings, like PHS, that are designed with the input of genetic counseling expertise may ease pressures on the genetic counseling profession by building a more genomic-literate healthcare workforce that can better support efforts to expand access for patients., (© 2024 The Authors. Journal of Genetic Counseling published by Wiley Periodicals LLC on behalf of National Society of Genetic Counselors.)

Background: Due to the declining interest among medical students in pursuing a surgical career, the impact of demographic changes and the technical challenges, there is an increasing need to attract medical students to the surgical profession. Against this backdrop, a teaching project was developed to familiarize medical students with minimally invasive surgical techniques early in the preclinical education, thereby increasing the interest in surgery., Material and Methods: Within the framework of the regular anatomical dissection course the following modules on laparoscopic surgery were integrated: (1) clinical lecture on the technique and application of laparoscopy, (2) exploratory live laparoscopy on a body donor and (3) practical exercises on laparoscopic trainers. The impact of this teaching project on the interest in a surgical career and on the clinical anatomical understanding was evaluated among 295 participating medical students., Results: The evaluation revealed a pronounced gender-independent interest in learning surgical skills early in the preclinical study phase. The teaching project led to a significantly increased interest in pursuing a surgical career. Moreover, the incorporation of laparoscopic teaching modules into the preclinical anatomy course enhanced the learning motivation and understanding of clinically relevant topographic anatomy., Conclusion: The integration of practical surgical content into preclinical anatomical education can increase the attractiveness of surgical disciplines and simultaneously optimize teaching of anatomy. Longitudinal studies are required to examine the sustainability of these clinical teaching modules in career decisions of medical students., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: M. Heimke, T. Heinze, J. Baumann, B. Kurz, I. Alkatout und T. Wedel geben an, dass kein Interessenkonflikt besteht. Der Körperspender wurde über das Körperspendewesen des Anatomischen Instituts der Christian-Albrechts-Universität zu Kiel nach vorheriger schriftlicher Einwilligung zur Verwendung für Lehr- und Forschungszwecke rekrutiert. Alle Personen, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre Einwilligung gegeben., (© 2024. The Author(s).)

Background: Most postgraduate medical education tracks are faculty-led and emphasise teaching skills. A peer-to-peer medical education track focused on curriculum development and scholarship is notably underrepresented in the literature, especially within graduate medical education. To address these gaps, a 2-year Distinction in Medical Education (DIME) track was developed. The aim of this report was to (1) describe the inception and structure of the DIME track, (2) assess the effectiveness of a peer-to-peer instructional model and (3) evaluate the track's success in generating scholarly work in medical education., Approach: Residents engage in structured workshops using a flipped classroom approach. Interactive sessions utilising Kern's Curriculum allow first-year DIME participants to learn principles of curricular development. As residents transition into their second year, they are responsible for facilitating and leading curricular development workshops, transforming from learners to teachers. Each participant also designs and executes a scholarly project focused on medical education with longitudinal mentorship., Evaluation: Since 2020, five cohorts (n = 20) have participated in the DIME track. We evaluated the program using a mixed-methods approach. Quantitative analysis showed that 10 resident-led projects were integrated into undergraduate medical education and seven into graduate medical education curricula. Qualitative feedback from surveys and focus groups identified key themes, emphasising the value of the program's core components., Implications: DIME's success goes beyond teaching skills; it involves learning and teaching the principles of curricular development to peers as well as applying principles of curricular development to tangible scholarly projects. The track's focus on educational scholarship is a measurable outcome., (© 2024 The Author(s). The Clinical Teacher published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Purpose: The objective structured clinical examination (OSCE) assesses clinical competence in health sciences education. There is little research regarding the reliability and validity of using an OSCE during the transition from undergraduate to graduate medical education. The goal of this study was to measure the reliability of a unique 2-rater Entrustable Professional Activity (EPA)-based OSCE format for transition to internship using generalizability theory for estimating reliability., Method: During the 2018 to 2022 academic years, 5 cohorts of interns (n = 230) at the University of Iowa Hospital and Clinics participated in a 6-station OSCE assessment delivered during orientation. A univariate and multivariate generalizability study (G study) was conducted on the scores generated by the 3 cases in the orientation OSCE that shared the 2-rater format. This analysis was supplemented with an associated decision study (D study)., Results: The univariate G study for the cases that used a simulated patient and a faculty rater demonstrated that this OSCE generated a moderately reliable score with 3 cases. The D study showed that increasing the OCSE to 12 cases yielded a mean score reliable enough ( G = 0.76) for making high-stakes normative decisions regarding remediation and readiness to practice. The universe score correlation between 2 types of raters was 0.398. The faculty ratings displayed a larger proportion of universe (true) score variance and yielded a more reliable ( G = 0.433) score compared with the standardized patient ratings ( G = 0.337)., Conclusions: This study provides insight into the development of an EPA-based OSCE. The univariate G study demonstrated that when using the 2 rater types, this assessment could generate a moderately reliable score with 3 cases. The multivariate G study showed that the 2 types of raters assessed different aspects of clinical skills, and faculty raters were more reliable., (Copyright © 2024 the Association of American Medical Colleges.)

Abstract: Although most students complete Step 1 before clerkships, some institutions delay the exam until after clerkships. The change to pass/fail grading adds additional complexity that should be considered when deciding about exam timing. Both early and late administration may affect learning outcomes, learner behavior, student well-being, and residency match success. Step 1 completion before clerkships promotes learning outcomes (e.g., integration and mastery of foundational material), may encourage students to focus on the curriculum, and may better prepare students for clinical science exams (CSEs). However, delaying the exam ensures that students maintain foundational knowledge and may encourage clinical educators to demonstrate basic science illustrations. An early Step 1 may affect learner behavior by allowing clerkship students to focus on clinical learning. The associated National Board of Medical Examiners performance report may also be used for Step 2 and CSE preparation. However, delaying Step 1 allows greater scheduling flexibility based on developmental milestones. Administration of Step 1 before clerkships removes a significant stressor from the clinical year and decompresses the residency application period. However, a delayed Step 1 reduces the pressure on students to engage in numerous extracurricular and research activities to distinguish themselves due to the pass/fail change. An early Step 1 exam may also lead to improved CSE performance, which is often linked to clerkship honors criteria, an increasingly valuable distinction for residency match success after the change to pass/fail. In contrast, delaying Step 1 is associated with higher first-time pass rates, which may be especially important for students at risk for failure. Medical educators and students should collaboratively approach the question of Step 1 timing, considering these factors within the context of the medical school program, curricular constraints and priorities, and students' individual needs and goals., (Copyright © 2024 Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.)

Purpose: For accelerated 3-year MD (3YMD) pathways to be fully adopted in medical education, a comprehensive analysis of outcome data is needed. This study includes 7 accelerated 3YMD graduating classes at NYU Grossman School of Medicine (NYUGSOM) and reports on outcomes from both medical school and internship compared with their 4-year MD (4YMD) counterparts., Method: Outcomes across the undergraduate-graduate medical education continuum for the first 7 classes of NYUGSOM graduates (matriculated from 2013-2019) from the accelerated 3YMD (n = 136) and 4YMD pathways (n = 681) were compared. For the internship outcomes, 3YMD interns were compared with 4YMD interns who graduated from NYUGSOM and all 4YMD interns (4YMD graduates from NYUGSOM and any other medical school) at NYUGSOM residencies., Results: Accelerated 3YMD students were approximately 5 months older at admission and had higher multiple mini-interview scores than 4YMD students. Overall, accelerated 3YMD students performed similarly to 4YMD students during medical school and internship. Significant differences included higher performance by 3YMD students on preclerkship exams and lower performance on Steps 1 and 2 (average: 5.6 and 5.4 fewer points, respectively) and the physical examination portion of the NYUGSOM Comprehensive Clinical Skills Exam. Internship data indicated comparable team assessments across all residencies, statistically significant higher performance on Step 3 when compared with all 4YMD interns, and, in internal medicine, comparable clinical reasoning between 3YMD and all 4YMD interns. When comparing 3YMD interns to all 4YMD interns in the internal medicine residency program, 3YMD interns had a statistically significantly higher performance on milestones., Conclusions: The outcomes from 7 years of graduating accelerated 3YMD students at NYUGSOM show similar performance in medical school and early residency to 4YMD graduates. Long-term study of accelerated 3YMD students from NYUGSOM and other medical schools is needed to further validate the success of this innovative medical education pathway., (Copyright © 2024 the Association of American Medical Colleges.)

Context.—: With increasing availability of immediate patient access to pathology reports, it is imperative that all physicians be equipped to discuss pathology reports with their patients. No validated measures exist to assess how pathology report findings are communicated during patient encounters., Objective.—: To pilot a scoring rubric evaluating medical students' communication of pathology reports to standardized patients., Design.—: The rubric was iteratively developed using the Pathology Competencies for Medical Education and Accreditation Council for Graduate Medical Education pathology residency milestones. After a brief training program, third- and fourth-year medical students completed 2 standardized patient encounters, presenting simulated benign and malignant pathology reports. Encounters were video recorded and scored by 2 pathologists to calculate overall and item-specific interrater reliability., Results.—: All students recognized the need for pathology report teaching, which was lacking in their medical curriculum. Interrater agreement was high for malignant report scores (intraclass correlation coefficient, 0.65) but negligible for benign reports (intraclass correlation coefficient, 0). On malignant reports, most items demonstrated good interrater agreement, except for discussing the block (cassette) summary, explaining the purpose of the pathology report, and acknowledging uncertainty. Participating students (N = 9) felt the training was valuable given their limited prior exposure to pathology reports., Conclusions.—: This pilot study demonstrates the feasibility of using a structured rubric to assess the communication of pathology reports to patients. Our findings also provide a scalable example of training on pathology report communication, which can be incorporated in the undergraduate medical curriculum to equip more physicians to facilitate patients' understanding of their pathology reports., (© 2025 College of American Pathologists.)

Background: The current medical and nursing curricula place little emphasis on palliative and end-of-life care. Consequently, students are less comfortable in communicating about topics related to death and dying when providing palliative and end-of-life care. Death cafés utilizes a facilitator-led small group to encourage conversations about death and dying to take place alongside food and beverages in a safe environment. In light of the presence of death taboos, there is a need to understand how medical and nursing students perceive the incorporation of a death café within the undergraduate program., Objectives: This study aimed to explore the perceptions of medical and nursing students regarding the utility and feasibility of incorporating death cafés into their undergraduate education., Design: A qualitative study was conducted., Methods: This study was conducted in one medical school in a university in Singapore. Participants above the ages of 18 years, pursuing a full time undergraduate medical or nursing program were invited. A purposive sampling approach using the maximum variation sampling technique to enhance representativeness was used to select the participants based on their sociodemographic and academic variables. A total of 32 medical and nursing students were included in the study. Online individual interviews were conducted. The interviews were then transcribed and analyzed using qualitative content analysis., Results: Three main categories were developed from the content analysis: (1) Perceptions of death cafés, (2) Features of a death café, and (3) Contents of a death café conversation. Participants viewed the death café as a platform for conversations surrounding death and dying. Several features such as the presence of a facilitator and discussions to be held in small groups were surfaced. The proposed topics to be discussed ranged from communication skills, coping with death encounters, and understanding more about the concepts of palliative care., Conclusion: Medical and nursing students view death cafes as a feasible and potential approach in learning pallative and end-of-life care. The use of a faciliator-guided small group discussion on topics such as coping with death, communication techniques and concepts of palliative care are proposed. Further work is needed to examine how the death café method can potentially impact students' confidence and skills in managing palliative and end-of-life care., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Clinical electives are a compulsory part of many medical courses, enabling students to gain exposure to foreign health systems. The COVID-19 pandemic led to a surge in the development in virtual elective programmes, for which there had been a sparse evidence base. This is the first systematic review assessing the implementation, advantages and disadvantages of virtual elective programmes for medical students., Methods: The systematic review was conducted in accordance with PRISMA guidelines. Databases were searched, capturing results from the past 10 years for original evaluations of electives where medical students engaged in a fully virtual programme with another institution, with no restrictions on location. Descriptive, quantitative and qualitative data were extracted by two independent reviewers., Results: Fourteen articles were included for review. All the articles were published between 2020 and 2023. All studies were conducted in the United States of America. The average length of the virtual electives in the studies was 3 weeks, and a variety of teaching formats including virtual clinics, seminars and one-on-one meetings were implemented. Logistical considerations and challenges in delivering virtual electives included the variability in students' learning styles, reduction in patient interactions and technological challenges., Discussion: Most included studies derived that these virtual electives would play a role in the future, possibly replacing in-person electives. Positive attributes of virtual electives included increasing diversity of social backgrounds, high student satisfaction and interest and reducing harms to the environment. However, further research is required to thoroughly evaluate the efficacy of virtual electives in medical education., (© 2024 The Author(s). The Clinical Teacher published by Association for the Study of Medical Education and John Wiley & Sons Ltd.)

Introduction: We introduced a BINGO game as an active learning strategy for pulmonary, renal, and endocrine physiology, aiming to enhance student engagement and application of physiology knowledge., Methods: Each BINGO tutorial utilized a template featuring 50-60 questions aligned with prior learning events, was delivered to 90 second-year medical students, and lasted 50-80 minutes. Iterative improvements, including revealing correct answers and a polling system, were implemented based on student feedback. Sessions required BINGO materials, prizes, and, in one iteration, polling software. Postsession surveys assessed perceptions and engagement via a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree ). Thematic analysis of feedback informed iterative improvements while t tests compared responses across sessions., Results: Of the 90 students participating, between 31 and 47 (34%-52%) responded to each postevent survey. Students reported high engagement (average: 4.4) and perceived effectiveness of time spent (average: 4.1) across BINGO games. The games were rated as effective educational tools (average: 4.2) and valuable for applying physiology knowledge (average: 4.4) on diverse topics (average: 4.4). Students expressed a desire for continued BINGO use in future tutorials (average: 4.2). Statistical analysis revealed no significant differences among the three iterations., Discussion: Students valued iterative changes based on their feedback, such as revealing correct answers after questions. The pulmonary survey led to implementing this change in the renal BINGO tutorial, and the renal survey prompted further improvements in the endocrine tutorial, addressing the need for sufficient explanation of correct answers. Students also appreciated the abundance of practice questions provided., (© 2025 Grellinger et al.)

Background: Japan faces a health care delivery challenge due to physician maldistribution, with insufficient physicians practicing in rural areas. This issue impacts health care access in remote areas and affects patient outcomes. Educational interventions targeting students' career decision-making can potentially address this problem by promoting interest in rural medicine. We hypothesized that community-based problem-based learning (PBL) using real-patient videos could foster students' understanding of community health care and encourage positive attitudes toward rural health care., Objective: This study investigated the impact of community-based PBL on medical students' understanding and engagement with rural health care, focusing on their knowledge, skills, and career orientation., Methods: Participants were 113 fourth-year medical students from Chiba University, engaged in a transition course between preclinical and clinical clerkships from October 24 to November 2, 2023. The students were randomly divided into 16 groups (7-8 participants per group). Each group participated in two 3-hour PBL sessions per week over 2 consecutive weeks. Quantitative data were collected using pre- and postintervention questionnaires, comprehension tests, and tutor-assessed rubrics. Self-assessment questionnaires evaluated the students' interest in community health care and their ability to envision community health care settings before and after the intervention. Qualitative data from the students' semistructured interviews after the PBL sessions assessed the influence of PBL experience on clinical clerkship in community hospitals. Statistical analysis included median (IQR), effect sizes, and P values for quantitative outcomes. Thematic analysis was used for qualitative data., Results: Of the 113 participants, 71 (62.8%) were male and 42 (37.2%) female. The total comprehension test scores improved significantly (pretest: median 4.0, IQR 2.5-5.0; posttest: median 5, IQR 4-5; P<.001; effect size r=0.528). Rubric-based assessments showed increased knowledge application (pretest: median 8, IQR 7-9; posttest: median 8, IQR 8-8; P<.001; r=0.494) and self-directed learning (pretest: median 8, IQR 7-9; posttest: median 8, IQR 8-8; P<.001; r=0.553). Self-assessment questionnaires revealed significant improvements in the students' interest in community health care (median 3, IQR 3-4 to median 4, IQR 3-4; P<.001) and their ability to envision community health care settings (median 3, IQR 3-4 to median 4, IQR 3-4; P<.001). Thematic analysis revealed key themes, such as "empathy in patient care," "challenges in home health care," and "professional identity formation.", Conclusions: Community-based PBL with real-patient videos effectively enhances medical students' understanding of rural health care settings, clinician roles, and the social needs of rural patients. This approach holds potential as an educational strategy to address physician maldistribution. Although this study suggests potential for fostering positive attitudes toward rural health care, further research is needed to assess its long-term impact on students' career trajectories., (©Kiyoshi Shikino, Kazuyo Yamauchi, Nobuyuki Araki, Ikuo Shimizu, Hajime Kasai, Tomoko Tsukamoto, Hiroshi Tajima, Yu Li, Misaki Onodera, Shoichi Ito. Originally published in JMIR Medical Education (https://mededu.jmir.org), 31.01.2025.)

Background and Objectives: Assessing and improving academic writing skills is a crucial component of higher education. To support students in this endeavor, a comprehensive self-assessment toolkit was developed to provide personalized feedback and guide their writing improvement. The current study aimed to rigorously evaluate the validity and reliability of this academic writing self-assessment toolkit., Methods: The development and validation of the academic writing self-assessment toolkit involved several key steps. First, a thorough review of the literature was conducted to identify the essential criteria for authentic assessment. Next, an analysis of medical students' reflection papers was undertaken to gain insights into their experiences using AI-powered tools for writing feedback. Based on these initial steps, a preliminary version of the self-assessment toolkit was devised. An expert focus group discussion was then convened to refine the questions and content of the toolkit. To assess content validity, the toolkit was evaluated by a panel of 22 medical student participants. They were asked to review each item and provide feedback on the relevance and comprehensiveness of the toolkit for evaluating academic writing skills. Face validity was also examined, with the students assessing the clarity, wording, and appropriateness of the toolkit items., Results: The content validity evaluation revealed that 95% of the toolkit items were rated as highly relevant, and 88% were deemed comprehensive in assessing key aspects of academic writing. Minor wording changes were suggested by the students to enhance clarity and interpretability. The face validity assessment found that 92% of the items were rated as unambiguous, with 90% considered appropriate and relevant for self-assessment. Feedback from the students led to the refinement of a few items to improve their clarity in the context of the Persian language. The robust reliability testing demonstrated the consistency and stability of the academic writing self-assessment toolkit in measuring students' writing skills over time., Conclusion: The comprehensive evaluation process has established the academic writing self-assessment toolkit as a robust and credible instrument for supporting students' writing improvement. The toolkit's strong psychometric properties and user-centered design make it a valuable resource for enhancing academic writing skills in higher education., Competing Interests: Declarations. Ethics approval and consent to participate: The study was approved by the local ethics council of Shiraz University of Medical Sciences (decree code: IR.SUMS.REC.1403.240). We made every effort to adhere to ethical principles in our research design and implementation: Informed Consent: We secured written consent from all participants, ensuring they were fully informed about the study's objectives, methodology, and the intended use of the data collected. Voluntary Participation: Participants were informed of their right to withdraw from the study at any time without any negative consequences, thereby ensuring their autonomy throughout the process. Confidentiality and Anonymity: We maintained the anonymity and confidentiality of all participants. All data collected was de-identified prior to analysis to further protect participants' identities. Data Security: Data was stored securely and was accessible only to the research team to guarantee the privacy of participants. Minimal Risk: The study involved minimal risk to participants, as it focused exclusively on their feedback concerning the self-assessment toolkit, without introducing interventions or collecting sensitive personal data. Beneficence: Our research aimed to enhance academic writing assessment and instruction, ultimately benefitting future students and educators through improved educational practices. Justice: We ensured that all eligible participants had equal opportunities to contribute to the study, promoting equitable participation. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objectives: Traditionally, patients have had passive roles in medical education; however, there have been increasing efforts to partner with communities to create authentic representation of laypeople in medical education. Communities' perspectives of these initiatives have rarely been reported in the literature. This study explores the perspectives of members of community-based organisations (CBOs) who were partnered with a community engagement programme for intercalating medical students at Imperial College London., Design: A qualitative study using semistructured interviews was conducted, employing reflexive thematic analysis., Setting: London, UK., Participants: A total of five participants (one member from five CBOs who agreed to participate) were interviewed for this study. The selection criterion was direct involvement in the community engagement programme., Results: Three key themes were identified aligning with the core principles of co-production: building partnership, reciprocity in partnership and maintenance of relationship. Partnership development was influenced by the CBOs' perception of students which caused power differentials in the development of learning plans. Reciprocity refers to a multidirectional benefit pathway resulting from the community involvement programme, which had short-term and anticipated long-term effects. Relationships built were maintained via a service evaluation report, and participants discussed how attitudes of academic institutions towards collaboration influence communities' ability to participate in medical education., Conclusions: The perspectives of CBOs reported in this study demonstrate that factors important to partnership development in community-engaged medical education are consistent with the key principles of co-production. Supported by literature, the findings emphasise that community involvement can be linked to social accountability and sustainable health practice. Provided that the possible risks/challenges are appropriately identified and mitigated to facilitate co-productive partnerships between stakeholders, the involvement of CBOs in medical education has the potential to provide benefits for communities, students and educational institutions., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background/aims: Ophthalmology is an under-represented specialty in many medical school curriculums resulting in reduced confidence in medical students and clinicians when dealing with eye conditions. Our study evaluates the impact of a simulation-based education (SBE) workshop to train medical students in ophthalmology., Methods: Second-year medical students were invited to participate in a two-day (eight-hour) simulation-based ophthalmology workshop. Standardised patients, free-to-use simulators, and low-cost eye models were used to teach eye anatomy, physiology, pathologies, skills (slit-lamp, ophthalmoscopy etc.), and eye procedures (cataract surgery, eye lasers etc.). Learners filled questionnaires to evaluate their ophthalmology interest, confidence, and knowledge before the workshop, immediately after the workshop, and three months later. They also answered a feedback survey on the workshop's quality and usefulness immediately after the workshop., Results: Nine students, including six females and three males, participated in the workshop. Pre-workshop, learners' mean self-reported confidence in dealing with ophthalmology patients was 1.8/5 and mean self-reported interest in pursuing an ophthalmology residency was 2.6/5 on a Likert-scale-based questionnaire (on a scale of 1-5). Learners scored a mean of 8.4/15 on an ophthalmology knowledge questionnaire with fifteen questions. Post-workshop (immediate), their mean self-reported confidence was 3.4/5 (p = 0.0001), interest in pursuing an ophthalmology residency was 3.2/5 (p = 0.022), and score on the ophthalmology questionnaire was 13/15 (p = 0.0001). Three months later, students' self-reported mean confidence was 3.2/5 (p = 0.0001), the likelihood of choosing ophthalmology residency was 2.8/5 (p = 0.59), and score on the ophthalmology knowledge questionnaire was 11/15 (p = 0.006). The feedback survey showed that all students found the workshop relevant, comprehensive, easy to understand, and that they gained knowledge/skills applicable to their future clinical practice., Conclusions: A small group SBE ophthalmology workshop improves learners' knowledge, skills, and confidence using an approach they find interesting, with low cost and time investment., Trial Registration: Not applicable., Competing Interests: Declarations. Ethics approval and consent to participate: The study was approved by the institutional ethics review board of Thunder Bay Regional Health Sciences Centre (TBRHSC) on 26-04-2022. We obtained informed consent to participate from all the participants. Consent for publication: Not applicable. Competing interests: Dr. Bansal receives grant funding from the Northern Ontario Academic Medicine Association (NOAMA). Dr. Bhambhwani receives research grant support from the Northern Ontario Academic Medicine Association (NOAMA) and Orbis Canada. He has received research support from iCare Inc and Eyenuk Inc and honorariums from Roche Inc and Bayer Inc in the past., (© 2025. The Author(s).)

Study Objective: Student-centered learning and unconventional teaching modalities are gaining popularity in medical education. One notable approach involves engaging students in producing creative projects to complement the learning of preclinical topics. A systematic review was conducted to characterize the impact of creative project-based learning on metacognition and knowledge gains in medical students., Methods: A systematic search was conducted using MEDLINE and Embase via Ovid, PubMed, CINAHL, Web of Science, Cochrane CENTRAL, and Scopus from January 1st, 1995, to July 6th, 2023. Studies using quantitative, qualitative, or mixed-methods approaches that explored the impact of creative project-based lessons on medical students' educational outcomes were included. Two investigators independently screened the titles and abstracts and extracted data from included articles. A narrative synthesis was conducted to summarize study designs and outcome measures. Content analysis was conducted to generate codes and themes. Study quality was assessed using the Mixed Methods Appraisal Tool in view of the range of study types employed., Results: The review included 17 studies published between 2010 to 2022. These studies implemented various creative project interventions such as handicraft models, drawings, and concept maps covering multiple topics, including anatomy, histopathology, and fundamental sciences. The identified themes of Enhanced Learning, Collaborative Learning, and Deep Learning led to further themes of Student Engagement, Student Disengagement, and Faculty Engagement. Collaborative learning involves students working in teams and benefitting from effective mentorship. Creative projects facilitated deep learning objectives via interdisciplinary learning and promoted new ways of perceiving concepts. Learning was enhanced through increased interactivity, high conceptual fidelity and improved knowledge retention., Conclusion: Creative projects undertaken by medical students exhibit attributes that facilitate the acquisition of collaborative and deep learning objectives through self-directed learning, cognitive load modulation, and metacognitive behaviours. Faculty mentorship and group learning amongst peers facilitate these processes, although challenges such as high task demands, cognitive and emotional intensiveness, and mismatch with students; professional identities remain. Overall, students and faculty received these interventions well, thus, warranting further exploration for uses in medical curricula., Trial Registration: Not applicable as this study is a systematic review., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Purpose: Given the importance of musculoskeletal knowledge but the limited orthopaedic instruction offered in medical school, our Orthopaedic Surgery Department developed a three-week clerkship for interested students. This study assesses the clerkship's impact on medical student musculoskeletal knowledge through administration of the Freedman and Bernstein Basic Cognitive Musculoskeletal Examination., Methods: Medical students enrolled in the orthopaedic surgery clerkship between February 2019 and May 2024 were asked to participate in pre- and post-clerkship surveys using the Freedman and Bernstein Basic Cognitive Musculoskeletal Examination. Raw and weighted scores were computed according to the guidelines provided by Freedman and Bernstein. Averaged scores were used to compute mean pre- and post-test scores., Results: There were 64 responses to the pre-test and 33 responses to the post-test. The mean pre-test weighted score was 54% with 12 students (18.8%) passing. The mean post-test score was 70% with 17 students (51.5%) passing. Raw scores showed that musculoskeletal knowledge improved from pre-test (M = 55.13, SD = 19.90) to post-test (M = 70.22, SD = 14.70; p < .001). The results comparing weighted scores showed that the participants' musculoskeletal knowledge also improved from pre-test (M = 52.86, SD = 21.12) to post-test (M = 67.11, SD = 19.02; p < .001)., Conclusion: While students demonstrated improved musculoskeletal knowledge after completing our institution's orthopaedic surgery clerkship, almost half of the students did not pass the post-test. Most of the students who did not pass the post-test expressed definite or possible interest in pursuing an orthopaedic surgery residency., Competing Interests: Declarations. Ethics approval and consent to participate: As the study involved a quality improvement project to evaluate the educational impact of the clerkship, institutional review board approval from our institution’s IRB was not required. Consent was not required and all participants were informed that completing both pre- and post-clerkship surveys was voluntary and would not affect their surgery rotation evaluations. The authors were not part of the three-week clerkship discussed in this paper. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: A mastery of life-threatening trauma procedures is important for medical students aiming to become proficient physicians. Thus, this study compares the effectiveness of deliberate practice with that of conventional lecture methods in teaching such students these essential skills., Methods: A randomized controlled trial was conducted with 48 first- to third-year medical students at the Faculty of Medicine Vajira Hospital at Navamindradhiraj University (Thailand). The participants were randomly assigned to either the deliberate practice group (n = 24) or the conventional lecture group (n = 24). The primary outcome was the students' scores on the Objective Structured Clinical Examination (OSCE), whereas the secondary outcome was their overall grades. Moreover, analysis of covariance (ANCOVA) was used to control for the impacts of gender and academic year., Results: The deliberate practice group had significantly higher OSCE scores (mean = 69.79, SD = 9.49) than did the conventional lecture group (mean = 51.38, SD = 14.59), with a p value of 0.000002. Additionally, the deliberate practice group had no clear failures or seven good passes, whereas the conventional lecture group had five clear failures and no good passes. Moreover, the ANCOVA results indicated that the type of training had a significant positive effect on the students' examination scores, independent of gender and academic year (F (4, 43) = 7.44, p = 0.0001)., Conclusion: Deliberate practice is significantly more effective than the conventional lecture method in teaching life-threatening trauma procedures to medical students. The implication of these findings is that implementing deliberate practice in medical education can enhance the competencies of students, improve their preparedness for real-world clinical settings, and produce better patient outcomes. However, future research should examine the broader applications and long-term benefits of this method in medical training., Trial Registration: TCTR20240816009., Competing Interests: Declarations. Ethics approval and consent to participate: This research project was approved by the Vajira Institutional Review Board, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University. This study was conducted in accordance with relevant guidelines such as the Declaration of Helsinki. Informed consent was obtained from all participants who took part in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Introduction: Traditionally, clinical education has combined classroom theory with hospital-based practical experiences. Over the past 50 years, simulation-based training, particularly virtual reality (VR), has gained prominence for its flexibility and scalability. This article describes the development, implementation and evaluation of a VR-based brain death diagnostic training module at the University of Münster over a three-year period., Methods: A multidisciplinary team developed the VR scenario to simulate a realistic intensive care unit, in line with German guidelines for brain death diagnosis. The module includes a tutorial and a preparatory video podcast to accommodate varying levels of VR experience. The course maintained its former small-group format, integrating VR to replace a manikin-based brain death examination. A randomized pilot study compared the traditional and VR-based approaches., Results: Feedback from over 800 students indicated a strong preference for VR training, with a significant increase in perceived competence in brain death diagnosis. The VR module also increased the individual training time and provided more varied clinical scenarios than traditional methods. Continuous feedback led to iterative improvements, including reflex simulations and improved hardware management., Discussion: The VR-based training was well received, demonstrating its potential to revolutionize medical education by providing immersive, realistic simulations. Challenges such as initial hardware adaptation and high personnel costs were addressed through comprehensive tutorials and structural adjustments. The success of this module has led to the development of additional VR courses, optimizing the use of hardware and justifying the initial investment., Conclusion: The integration of VR into medical education at the University of Münster has proven effective, enhancing student engagement and competence in brain death diagnosis. The positive outcomes suggest a promising future for VR in medical education, highlighting the importance of innovative tools in the preparation of future medical professionals. Efforts are continuing to broaden the application and accessibility of VR-based training., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2025 The Author(s).)

Introduction: High-value cost-conscious care (HVCCC) education has been shown to reduce wasteful health care spending. Incorporating HVCCC into a medical school curriculum can be challenging due to limited curricular time. We explored the feasibility of medical students creating HVCCC peer education within existing platforms at a single urban academic medical school. We reasoned that curricular changes could improve student knowledge, attitudes, and competency with HVCCC within 2 hours and 25 minutes of curricular time., Methods: First-year medical student attitudes and understanding regarding HVCCC were evaluated via a survey before and after the delivery of a mixed asynchronous and in-person HVCCC curriculum created by two medical student peers. The curricula comprised three spaced asynchronous online sessions targeting HVCCC skill development followed by a gamified 90-minute clinical skills lab where students competed to determine the correct diagnosis at the lowest cost., Results: One hundred and twenty-three medical students (out of 145 first-year medical students) completed the presurvey and indicated willingness to participate in the educational innovation, and 54 completed both surveys. Forty-two percent of students agreed/strongly agreed that the curriculum was effective/strongly effective at promoting cost-effective care. Sixty-five percent of students agreed they would likely use these resources during their clinical rotations. Comfort accessing HVCCC resources improved from 4% precurriculum to 41% postcurriculum. There was no significant difference in HVCCC knowledge pre- and postsurvey., Discussion: This educational innovation demonstrated the feasibility of a peer-developed HVCCC curriculum in preclinical education that minimally impacted curricular time and improved student comfort in accessing cost-effective resources., (© 2025 Eapen et al.)

Introduction: Stigmatizing attitudes held by health care professionals against individuals with substance use disorder (SUD) result in worse clinical outcomes. Story-listening has been shown to help mitigate bias for medical trainees. We created a narrative-based small-group facilitated discussion between medical students and an individual in recovery from SUD through a direct partnership with a community peer-recovery organization., Methods: All session materials were formulated in direct partnership with the community organization. After completing prework, second-year medical students engaged in a 1.5-hour facilitated discussion with a community member in recovery and one attending physician preceptor. Student perceptions of the session and SUD were evaluated using open-ended and Likert-scale questions through an online survey. Community members engaged in their own postsession debrief., Results: One hundred twenty-four second-year medical students, 16 attending physician preceptors, and 10 community members in recovery participated in the session. Students agreed or strongly agreed that they appreciated the session format (92%), that they learned something new about SUD (83%), and that the session was applicable to their future career (92%). Students appreciated the small-group format and hearing someone's lived experience/perspective. Community members expressed how the session helped humanize health care providers and had interest in participating in future sessions., Discussion: Working in direct partnership with a local community organization to create an intimate narrative-based educational experience for medical students is feasible, appreciated by medical student participants, and mutually beneficial to community members and can facilitate positive changes in student knowledge and, potentially, bias regarding SUD., (© 2025 Sorkow et al.)

The psychiatric interview serves as the cornerstone of psychiatric practice. It is therefore essential that we find effective ways of teaching students how to conduct a psychiatric interview. The present paper arises from two faculty members at Memorial University of Newfoundland and Labrador considering how to improve the quality of teaching of the psychiatric interview to preclerkship undergraduate medical students, before they begin the clinical portion of their training. The interview is taught in discrete pieces initially (e.g., discussing confidentiality, screening for suicidal ideation, taking a history for depressive disorders, etc.) before being assembled into a whole interview.The sessions are led by psychiatrists and residents who play the role of the patient. They use prewritten cases but can improvise to challenge or direct the students. Students receive real time feedback. The flexibility allows for students to repeat and vary their approach in response to feedback.Anonymous course evaluations showed improvement in student satisfaction with the new psychiatry clinical skills teaching. Prior to implementing the new approach student satisfaction was at 3.9/5. With the new method scores improved to 4.7/5 and 4.5/5 in the following two years. Clinical skills OSCE scores remained stable with modest improvement following implementation. The class average was 8.5 in the year prior to implementation and were 9.1, 8.6 and 8.8 in the years following. As a side benefit, the approach lent itself well to being delivered remotely so it continued to function well during the disruption resulting from COVID-19., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval was sought and granted by the Newfoundland and Labrador Health Research Ethics Board (HREB), Reference # 2024.041. The HREB operates according to the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS2), ICH Guidance E6: Good Clinical Practice Guidelines (GCP), the Health Ethics Authority Act (HREA Act) and applicable laws and regulations. The ethical approval granted by the HREB included a request for waiver of consent. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests. Authors’ information: T.H. and A.L. and practicing psychiatrists and full-time faculty members of the Memorial University of Newfoundland Faculty of Medicine., (© 2024. The Author(s).)

Background: Oral general course (OGC) is a basic subject of medical education. The implementation of multidisciplinary team (MDT) meets the individual needs of patients. Based on the concept of MDT, this study combined the theory and practice of flipped classroom teaching method to evaluate the teaching effect, so as to provide a basis and reference for the thinking transformation of medical students to clinicians., Methods: The participants of the study were 760 clinical undergraduates in OGC training in Hainan Medical University from 2021 to 2023. A total of 760 students were divided into a control group and an observation group of 380 cases, each using the random number table method. The control group used traditional teaching methods, the observation group adopted the MDT combined with flipped classroom teaching model and organized dental postgraduates team to participate in the teaching task. A unified assessment of the teaching outcomes was conducted after 1 semester study duration., Results: The basic theory, independent learning ability and case analysis scores of the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). Except there was no statistically significant difference in literature searching ability between the two groups (P > 0.05), the other indicators of teaching satisfaction in the observation group were higher than those in the control group, and the difference was statistically significant (P < 0.05). The postgraduates team gave relatively good feedback to the MDT combined flipped classroom teaching model., Conclusion: MDT combined flipped classroom teaching model had outstanding effect in OGC, this student-centered teaching method was a beneficial supplement to their clinical thinking and practical ability, and worth further promotion., Trial Registration: Not applicable., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval for this study was obtained from the Ethics Committee of School Stomatology of Hainan Medical University. All methods were performed in accordance with the relevant guidelines and regulations. Informed consent was obtained from all subjects involved in this study. This study adhered to the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Objectives: We aimed to determine if shared decision-making (SDM) self-assessment of a standardized patient (SP) scenario was reliable, specifically whether students' communication resulted in each SP-student pair reporting internally consistent final treatment choices. We hypothesized student self-assessment would differ from SP and faculty assessment indicating a need for multisource feedback., Methods: In this observational case study from 2016-2017, all third-year post-clerkship medical students received evidence-based treatment options for sinusitis and SDM lectures followed by a SP encounter on sinusitis. Students, faculty, and SPs then completed a 9-question assessment covering SDM skills, perceived empathy, and final treatment choice. Mean self-assessment was compared to faculty and SP scores using paired t-test. Effectiveness of SDM communication was assessed as rate of treatment agreement, defined as percent of student-SP pairs reporting consistent final treatment choices., Results: Compared to SPs (M = 23.4, SD = 3.6), 120 students (M = 22.6, SD = 3.1) reported lower mean SDM skills, t (119) = 2.25, p = .027. Conversely, SPs (M = 8.0, SD = 1.5) compared to students (M = 8.5, SD = 1.1) reported lower mean empathy, t (119) = 3.43, p < .001.  Faculty ratings of students' SDM (M = 22.7, SD = 3.5) and empathy (M = 8.3, SD = 1.7) was not statistically different than students' ratings, t (119) = 0.46, p = .645 and t (119) = 1.40, p = .164 respectively. Seventeen (14%) student-SP pairs reported different final treatment choices., Conclusions: We demonstrated the limitations of self-perception of SDM and empathy skills, highlighting the importance of multisource feedback for assessing trainee communication skills. Disagreement between student-SP pairs on perceived final treatment choice underscores the need for ongoing SDM practice.

Background: In contemporary medical education, it is essential to raise student involvement and active participation in the learning process. By contrasting small-group peer learning modules with teacher-led conventional tutorial sessions, we aim to provide insights into their respective influences on learning outcomes and the overall learning experience among 150 first-year medical students., Methods: Each group consisted of 50 students. These students were further divided into two groups and a pretest was administered on the day of the session. One group engaged in conventional tutorials, while the other participated in a peer learning module. Post-tests and session feedback were provided after each session., Results: Results from the posttest revealed advancement in both learning approaches compared to the pretest. Compared to tutorials, the level of progress was much higher following peer learning with a p-value of < 0.05. Participants felt that while the tutorials helped them cover the full subject and saved time, they occasionally got monotonous and there was little active engagement. Students who participated in the peer learning method said that while interaction aided in a better learning experience, improved communication skills, and had more active participation, there was less time for discussion and some group members were reticent and ineffective in explaining the concepts., Conclusions: The peer learning module is thought to be superior to conventional tutorial classes since it promises active involvement from all students, promotes greater learning, and aids in skill improvement, thus assisting students to help each other in gaining insight into the process of active learning., Competing Interests: Declarations. Ethical approval and consent to participate: We confirm that our study was conducted in full compliance with the ethical principles outlined in the Declaration of Helsinki. Ethical approval for the study was obtained from the Institutional Ethics Committee of PES Institute of Medical Sciences and Research, Kuppam (PESIMSR/IHEC/42), and all participants provided informed consent prior to their inclusion in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: Suicide is a preventable public health concern, yet suicide remains a leading cause of death for Americans. Physicians are well positioned to screen for and address suicidality. It is important to provide formal suicide education during medical school so that physicians are better prepared to address this topic with their patients. The goal of this workshop was to improve medical student self-assessment of knowledge and comfort managing patients with suicidality., Methods: This was a 2.5-hour multimodal workshop developed for formal third-year medical student suicide education that included: flipped learning with a preworkshop presentation; experiential learning, scaffolding, reflection, and feedback with two standardized patient encounters; think-pair-share with small- and large-group discussion; and a facilitator-led large-group didactic., Results: Of the 105 third-year medical students who completed the workshop in the first half of the 2023-2024 academic year, 84% (88/105) completed the presurvey and 70% (73/105) completed the postsurvey. Prior to the workshop, on a 5-point Likert scale (1 = not at all , 5 = extremely ), respondents rated their knowledge regarding suicide assessment as 2.2 and their comfort managing suicidality as 2.6. This improved to 4.0 and 3.9, respectively, on the postworkshop survey. Students felt the workshop was helpful and relevant., Discussion: Future work should involve identifying if this reported self-improvement transfers to clinical skill advancement and, if so, measuring the clinical impact of this innovation for patients. Furthermore, assessing if this self-reported improvement in knowledge and comfort managing suicidality is long-lasting should be explored., (© 2025 Chardavoyne et al.)

Bedside teaching is a common teaching modality in undergraduate and postgraduate curricula and involves students being supervised in a clinical interaction at a patient's bedside by a more senior clinician. Following the clinical encounter, the students and teacher discuss the case and students' consultation skills. This is of particular value in teaching paediatrics to medical students, for whom paediatrics is an unfamiliar environment, and the approach to consultation is very different to usual adult practice. Junior doctors are often tasked with teaching medical students, either in structured bedside teaching sessions during formal teaching roles, or in ad hoc sessions with students shadowing on clinical placements. As paediatrics may be unfamiliar to the junior doctors themselves, offering teaching to medical students may cause some anxiety in their own ability and knowledge. This article provides doctors in paediatrics with an insight into the evidence base underlying paediatric bedside teaching, including model structures for bedside teaching and debriefing after the session, with the aims of improving their confidence in undertaking these sessions and improving their learners' and their own yield of learning., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: Self-Directed Learning (SDL) is a theory of andragogy in which adult learners take their own initiative to identify and tailor their individual learning process and outcomes. In undergraduate medical education, SDL aims to develop medical students into lifelong learners. This study aims to estimate the overall effectiveness of self-directed learning compared to traditional didactic learning (TDL)., Methods: We performed a systematic review and meta-analysis according to the PRISMA statement. A systematic search was used across PubMed, Scopus, Embase and Google Scholar to identify peer-reviewed articles spanning from January 1, 2014, to May 30, 2024. Key words used were "self-directed learning" AND "undergraduate medical education." Forest plots were generated with the Open Meta-analyst Software, comparing SDL and TDL., Results: A total of 2,955 titles and abstracts were screened for eligibility, of which 95 articles met the eligibility criteria for full-text review. Following a more detailed screening, 19 articles met the criteria for inclusion in the systematic review and 14 articles met the criteria for inclusion in the meta-analysis. The systematic review included 2,098 students while the meta-analysis included 1,792 students. The overall mean difference for all studies was 2.399, 95% CI [0.121-4.678], and I 2  = 98.56%., Conclusion: Self-directed learning compared to traditional didactic learning is an effective learning strategy in medical undergraduate education and has the potential to aid in students' learning and improve their cognitive performance. Moreover, SDL nurtures qualities such as autonomy, curiosity, and self-regulation, which are essential for success in the ever-evolving field of medicine., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Physicians must be leaders more than ever with innumerable challenges. Despite this need, there is a paucity of consistent leadership development (LD) from medical student to staff physician. Military medicine has additional challenges-working within a large health care organization, constant turnover, working in a variety of contexts-that make the need for LD even more pressing. The purpose of this paper is to describe the LD life cycle for military undergraduate and graduate medical education (UME and GME), providing examples for other organizations while identifying steps to meet the future needs in military medicine. The Health Professions Scholarship Program produces over 75% of graduates for military medicine each year. Yet, since learners are dispersed throughout civilian medical schools any LD results in a heterogeneous experience. Uniformed Services University has a 4-year LD program required for all students as well as other opportunities for leadership professional growth. Military GME programs are unique, requiring a military unique curriculum to prepare graduates for their initial assignments. Military unique curriculum vary, but include clinical topics relevant to military medicine as well as leadership. There is no Military Healthcare System-wide leadership curriculum used by everyone at this time. Based on these UME and GME approaches to LD, there have been multiple lessons learned formed on the authors experience and published literature: learners do not typically see themselves as leaders; learners want applicable curriculum with less lecturing and more application and discussion; programs are often siloed from one another and sharing curriculum content does not typically occur; no one-size-fits-all model. On the basis of the lessons learned and the current state of UME and GME leadership education, there are 5 recommendations to enhance UME and GME leadership programs: (1) develop a Health Professions Scholarship Program Leadership Curriculum; (2) develop a MHS GME Leadership Curriculum; (3) integrate UME and GME Leadership Curricula; (4) develop faculty to teach leadership; and (5) conduct research on UME and GME in military and share lessons learned. We suggest a roadmap for strengthening LD within military medicine and civilian institutions., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Medical training in India is experiencing a paradigm shift. The competency-based medical education (CBME) for undergraduate medical training was adopted from the admission session 2019. The Indian Medical Graduate (IMG) was identified under CBME, by explicitly documenting its roles viz. clinician, professional, communicator, leader and life-long learner. In the recently released amended guidelines, two additional roles of IMG have been added. Looking at the roles of the IMG, it can be inferred that professionalism is one of the core roles assigned to IMG, and most other roles like - clinician, leader, and communicator fall under the broad definition of role as professional. It is argued that the objective of the curriculum should not only be to equip the students for identifying their professional roles but to support them to develop their professional identities. The potential of the CBME to equip the teachers and students to develop the professional identity of students is adequately supported by literature. However, the professional identity of IMG has not been defined to date, and no structured framework to develop this professional identity of the undergraduate students in the Indian context is available. The conceptual paper is an effort to define the professional identity of IMG and provide a framework to develop their professional identity.

Background: Reflection fosters self-regulated learning by enabling learners to critically evaluate their performance, identify gaps, and make plans to improve. Feedback, in turn, provides external insights that complement reflection, helping learners recognize their strengths and weaknesses, adjust their learning strategies, and enhance clinical reasoning and decision-making skills. However, reflection alone may not produce the desirable effects unless coupled with feedback. This study aimed to investigate the impact of feedback integrated reflection on meaningful learning and higher order MCQ score among under-grade medical students., Objective: To evaluate the impact of feedback-integrated reflection versus reflection alone on higher-order MCQ scores among undergraduate medical students in a gynecology clinical setting., Methods: A randomized controlled trial was conducted with 68 final-year medical students randomly assigned to a study group (feedback-integrated reflection) and a control group (reflection alone). Both groups completed a pre-test, followed by six daily teaching sessions on gynecology topics. Participants engaged in written reflections after each session, and the study group additionally received individualized feedback. Independent sample t-tests were used to compare pre and post-test scores between the groups, while paired t-tests assessed within-group improvements., Results: Pre-test scores were comparable between the study group (11.68 ± 2.60, 38.93%) and the control group (11.29 ± 2.38, 37.15%; P = 0.52). Post-test scores showed a significant improvement in the study group (20.88 ± 2.98, 69.32%) compared to the control group (15.29 ± 2.66, 51.00%; P = 0.0001). The percentage gain in learning was 35.43% for the control group (reflection alone) and 78.77% for the study group (feedback-integrated reflection). The normalized learning gain (NLG) was calculated to compare the effectiveness of the intervention (feedback-integrated reflection) with that of the control (reflection alone). The study group demonstrated a mean normalized learning gain of 69.07%, compared to 29.18% in the control group. The net learning gain, calculated as the difference in normalized learning gains between the study and control groups, was found to be 39.89%., Conclusion: The findings highlight the effectiveness of feedback-integrated reflection versus reflection alone in fostering deeper learning by improving higher-order MCQ scores in a gynecologic setting in the undergraduate medical education., Trial Registration: This trial was registered retrospectively on 27th July 2024. Trial registration no is CTU/07/2024/010/RMU., Competing Interests: Declarations. Ethical approval and consent to participate: Ethical approval was taken from Rawalpindi medical university (Ref no:341/IREF/RMU/2023)and Riphah international university (appl: Riphah/IRC/ 23/3034). Informed consent was obtained from all individual participants included in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objective: Community-engaged immersive rural experiences were limited during the COVID-19 pandemic when online learning was instigated across medical institutions globally. This study aimed to explore the impact of online learning on medical students' satisfaction levels and intentions to practice in a rural area after graduation., Design, Setting and Participants: We conducted a natural quasi-experimental longitudinal retrospective cross-sectional study during 2011-2022 for all Australian domestic medical students who undertook a Rural and Remote Medicine (RRM) placement at the University of Queensland. Anonymous administrative course evaluation data were collected for the same two questions in each cohort over 12 years, between 2011 and 2022., Outcome Measures: Change in students' intention to pursue a rural medical career and teaching and placement satisfaction levels was determined. Longitudinal data illustrated trends in students' intention and overall satisfaction across cohorts before and during COVID-19 disruptions., Results: 2695 students participated in the surveys with an average response rate of 81%. Intention levels remained steady between 2011 and 2019, during which students experienced a consistent face-to-face orientation and rural placement immersion. During the COVID-19 disruption phase, primarily in 2020 and 2021, students' intention to pursue a rural medical career significantly decreased when online-only learning placements were implemented, with only 25% of students in the most impacted rotation indicating a strong positive intention, compared with a previous steady 75%. Comparatively, students' satisfaction with the RRM programme remained steady across all the years at about 85-90%., Conclusions: There appears to be a detrimental impact of a lack of immersive community-engaged education experiences on medical student's intention to pursue a rural medical career. This natural experiment demonstrates that while online learning maintains student satisfaction levels, it lacks value and authenticity and does not inspire students to consider future rural careers. The value of face-to-face and immersive community-engaged experiences is fundamentally an important contributor to inspiring students to work in rural areas in the future., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Introduction: In this report, we present a cardiac ultrasound training module for medical student learners. The module assists medical students in developing foundational skills in image acquisition, identification of normal cardiac ultrasound anatomy, and demonstration of professionalism when performing the associated OSCE exam., Methods: We delivered the module across a 2-week cardiology rotation. On the first day, participants completed a pretest, a 1-hour introductory tutorial including a drawing exercise, and 1-hour of supervised practice with ward patients. Following supervised practice, participants were provided with an ultrasound machine for self-directed practice over the remainder of the clinical rotation. On the final day, participants completed a posttest and module evaluation. Pre- and posttest OSCE scores were compared to assess participants' cardiac ultrasound skills., Results: A total of 121 students completed the module, of whom 116 completed the pre- and posttest. Median OSCE scores improved from 6 to 24 out of 39 ( p < .001). Before the module, 9% of participants agreed or strongly agreed they were able to identify cardiac anatomy on an ultrasound of the heart, which increased to 98% after the module. Following the module, 92% of participants agreed or strongly agreed that ultrasound training helped with other learning on the cardiology rotation., Discussion: We demonstrated that a brief training session followed by self-directed ward-based practice improved cardiac ultrasound skills in undergraduate medical students. Participants felt more confident identifying cardiac anatomy, and a large proportion felt the ultrasound training helped with other learning objectives on the cardiology rotation., (© 2025 Beck et al.)

The health disparities between rural and urban populations in Australia, driven by socioeconomic, environmental, and healthcare access factors, highlight the urgent need for rural-focused medical education. The Melbourne Medical School's Rural Health Discovery program addresses this need by integrating adult learning principles within a redesigned curriculum that includes the Rural Health Foundations and Integrating Rural Health topics. These Discovery topics engage medical students from diverse backgrounds through a blend of self-directed learning, problem-solving, and immersive clinical placements in rural settings. By aligning with andragogical principles-such as fostering autonomy, practical relevance, and experiential learning-the program prepares students for the unique demands of rural healthcare practice. Students are introduced to the complexities of rural health, including the social determinants affecting rural communities, through asynchronous modules, case studies, and team-based learning. This innovative curriculum, which is flexible and inclusive of rural and metropolitan students, represents a strategic model for promoting rural healthcare careers, addressing workforce shortages, and ensuring equitable health outcomes for underserved communities., Competing Interests: Declarations. Ethics approval: Ethics approval is not necessary for this manuscript. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objectives: This study aimed to explore the views and expectations of medical students and faculty members on blended learning following university-wide teaching reforms, focusing on its influence on self-directed learning (SDL) and educational effectiveness., Design: A qualitative study employing grounded theory methodology with semistructured individual and group interviews., Setting: A tertiary medical university after institution-wide educational reforms., Participants: One administrator, 11 faculty members and 30 third-year preclinical medical students were recruited to participate in the study., Results: The analysis of faculty and student perceptions yielded two core categories from faculty and three from students. Faculty highlighted the comparison between face-to-face and online instruction, emphasising the influence of students' learning attitudes, SDL abilities, teachers' beliefs and teaching strategies on blended learning outcomes. Students shared their learning preferences and challenges with SDL, identifying learning attitudes, teaching management and learning methods as key factors impacting blended learning success., Conclusions: The study highlights that teachers' positive beliefs enhance blended learning success, while fostering students' self-directed skills and learning attitudes, along with addressing challenges and needs, is key to effective strategies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: Visual Thinking Strategies (VTS) is an evidence-based pedagogical approach that uses art analysis and structured inquiry to enhance observation, critical thinking, and teamwork, especially in medical training for clinical skills development. This study aimed to compare the short-term and delayed follow-up effects of integrating Visual Thinking Strategies and Visual Thinking Activity (VTA) tasks based on the PRISM Model with Observation Exercises (OE) on medical students' observation skills, including the number of observations, number of words used, and time spent describing observations., Method: This pre- and post-test experimental study with a control group was conducted among first-year medical students at Gonabad University of Medical Sciences during the 2023-2024 academic year. Forty-four students participated in the intervention group, receiving VTS and VTA tasks, while 45 students formed the control group, engaging in OE alone. Observation skills were assessed using standardized art images (short-term) and real-world clinical exposure (delayed follow-up) through measures of total observations, number of words used, and time spent describing observations. Descriptive statistics, analysis of one-way ANOVA/ANCOVA, and independent t-tests were employed for data analysis., Results: In the short-term evaluation, the intervention group demonstrated significantly higher performance in the total number of observations (p = 0.001, Adjusted Partial Eta2 = 0.12), number of words used to describe art images (p = 0.001, Adjusted Partial Eta2 = 0.21), and time spent analyzing images (p < 0.001, Adjusted Partial Eta2 = 0.17) compared to the control group. However, after one month in a clinical exposure, no significant differences were found between the groups in the total number of observations (p = 0.62) and number of words used (p = 0.64). Nevertheless, the intervention group spent significantly more time describing their clinical observations (p = 0.04, Effect Size = 0.44)., Conclusion: The findings highlight the significant role of VTS in enhancing medical students' observation skills. While both interventions were equally effective in the delayed follow-up and real-world settings regarding the total number of observations and words used, the VTS and VTA approach led to a notable increase in the time spent on observation descriptions. This conclusion warrants further investigation in future studies., Competing Interests: Declarations. Ethics approval and consent to participate: The Ethical Committee of Tehran University Medical Sciences granted ethical clearance for the study (ethics code: IR.TUMS.MEDICINE.REC.1402.094). Study participants received comprehensive information regarding the research objectives, ethical guidelines, and their rights, leading to their informed and voluntary engagement. Consent was documented through participants’ signatures, affirming their understanding and agreement. Confidentiality and anonymity were upheld in the utilization of the data for scholarly discourse and publication. Participants retained the right to discontinue their involvement at any stage, with the assurance that all data and findings would be exclusively applied to research endeavors. Furthermore, the study’s methodology and execution adhered strictly to the Helsinki Declaration’s ethical standards. Consent for publication: We obtained the consent from all participants to present their images. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objective: This study examines a novel teaching model that integrates the development and use of a Medical Cloud Dictionary with project-based learning (PBL). We investigate whether this integrated approach improves teaching effectiveness, enhances student learning outcomes, and reduces teaching pressure compared to traditional PBL., Methods: One hundred student volunteers were randomly assigned to an experimental group (n = 50) and a control group (n = 50). Both groups studied seven respiratory-disease-related modules over a single semester (4 months). The experimental group utilized a PBL approach enhanced by the Medical Cloud Dictionary, which provided organized, up-to-date medical information and facilitated collaboration. The control group received traditional PBL-based teaching. Student performance was assessed using theoretical exams, comprehensive case analyses, and clinical practice reports. Feedback questionnaires and interviews were conducted with the experimental group's students and teachers. Statistical analyses included a Mann-Whitney U-test and chi-square tests to compare outcomes between groups., Results: The experimental group demonstrated significantly higher overall scores than the control group (Mann-Whitney U = 22037.5, p < 0.001). Their pass rate reached 100% vs. 98.6% in the control group (χ²=10.145, p < 0.05), and their excellence rate was 22.9% vs. 2.9% (χ²=62.477, p < 0.001). Feedback indicated improved learning efficiency, enhanced independent learning, and reduced teaching pressure. Both students and teachers expressed a desire to continue and expand the integrated mode., Conclusion: Integrating a Medical Cloud Dictionary with PBL can stimulate students' academic engagement, improve their mastery of medical knowledge and practical skills, and foster a stronger desire for independent learning. It also qualitatively enhances teaching quality and strengthens teacher-student relationships. Overall, this integrated teaching model can improve the quality and effectiveness of medical education, benefiting both teachers and students., Competing Interests: Declarations. Ethics approval and consent to participate: Approved by the Ethics Committee of the First Clinical Medicine School of Guangdong Pharmaceutical University [Approval No.202301221]. Written informed consent was obtained from all participants. Consent for publication: All authors consent to publication. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Medical students often struggle to engage with and retain complex pharmacology topics during their preclinical education. Traditional teaching methods can lead to passive learning and poor long-term retention of critical concepts., Objective: This study aims to enhance the teaching of clinical pharmacology in medical school by using a multimodal generative artificial intelligence (genAI) approach to create compelling, cinematic clinical narratives (CCNs)., Methods: We transformed a standard clinical case into an engaging, interactive multimedia experience called "Shattered Slippers." This CCN used various genAI tools for content creation: GPT-4 for developing the storyline, Leonardo.ai and Stable Diffusion for generating images, Eleven Labs for creating audio narrations, and Suno for composing a theme song. The CCN integrated narrative styles and pop culture references to enhance student engagement. It was applied in teaching first-year medical students about immune system pharmacology. Student responses were assessed through the Situational Interest Survey for Multimedia and examination performance. The target audience comprised first-year medical students (n=40), with 18 responding to the Situational Interest Survey for Multimedia survey (n=18)., Results: The study revealed a marked preference for the genAI-enhanced CCNs over traditional teaching methods. Key findings include the majority of surveyed students preferring the CCN over traditional clinical cases (14/18), as well as high average scores for triggered situational interest (mean 4.58, SD 0.53), maintained interest (mean 4.40, SD 0.53), maintained-feeling interest (mean 4.38, SD 0.51), and maintained-value interest (mean 4.42, SD 0.54). Students achieved an average score of 88% on examination questions related to the CCN material, indicating successful learning and retention. Qualitative feedback highlighted increased engagement, improved recall, and appreciation for the narrative style and pop culture references., Conclusions: This study demonstrates the potential of using a multimodal genAI-driven approach to create CCNs in medical education. The "Shattered Slippers" case effectively enhanced student engagement and promoted knowledge retention in complex pharmacological topics. This innovative method suggests a novel direction for curriculum development that could improve learning outcomes and student satisfaction in medical education. Future research should explore the long-term retention of knowledge and the applicability of learned material in clinical settings, as well as the potential for broader implementation of this approach across various medical education contexts., (© Tyler Bland. Originally published in JMIR Medical Education (https://mededu.jmir.org).)

Introduction: Medical ethics teaching is one of the pillars of medical education. Ethical reasoning learning (ERL) is one of the means of teaching medical ethics., Objective: The aim of our study was to evaluate the pedagogical interest and the students' perceptions of ERL in directed teaching in internal medicine among fifth-year students., Methods: This was a cross-sectional study conducted in the Internal Medicine Department of Habib Thameur Hospital during one academic year. The pedagogical interest and the student's perception were evaluated by comparing a pre-test and a post-test filled in by the students, respectively, before and after an ERL session., Results: Our study included 44 students. Before the ERL session, almost two-thirds of the students (63.6%) found the ERL to be "extremely interesting" in medical training and practice. This extremely high level of educational interest in the ERL was statistically associated with previous participation in ERL sessions among our students. Prior to the ERL session, just over four-fifths of the students (84.1%) had a "favourable" perception of the ERL. After the ERL session, our study noted an improvement in students' pedagogical interest in ERL. Our study also showed an improvement in students' perceptions of the ERL. The improvement in students' pedagogical interest and perception of ERL exceeded 80% after the session., Conclusion: Our study concluded that there was a significant pedagogical interest and a favourable perception of the students' point of view regarding the ERL in internal medicine- directed teaching among fifth-year medical students.

Introduction: Ultrasound is important in heart diagnostics, yet implementing effective cardiac ultrasound requires training. While current strategies incorporate digital learning and ultrasound simulators, the effectiveness of these simulators for learning remains uncertain. This study evaluates the effectiveness of simulator-based versus human-based training in Focused Assessed with Transthoracic Echocardiography (FATE)., Materials and Methods: This single-centre, prospective, randomised controlled study was conducted during an extracurricular FATE workshop (approximately 420 min) for third-year medical students. Participants were randomly assigned to the study group (training solely on simulators) or the control group (training on human subjects). Both groups completed a theory test and a self-assessment questionnaire before the course (T 1 ) and at the end of the training (T 2 ). At T 2 , all participants also completed two Direct Observation of Procedural Skills (DOPS) tests-one on the simulator (DOPS Sim ) and one on humans (DOPS Human )., Results: Data from 128 participants were analysed (n = 63 study group; n = 65 control group). Both groups exhibited increased competency between the T 1 and T 2 self-assessments and theory tests (p < 0.01). In the DOPS Human assessment at T 2 , the control group performed significantly better (p < 0.001) than the study group. While motivation remained consistently high among both groups, the study group rated their "personal overall learning experience" and the "realistic nature of the training" significantly worse than the control group (p < 0.0001). Both groups supported the use of ultrasound simulators as a "supplement to human training" (study: 1.6 ± 1.1 vs. control: 1.7 ± 1.2; p = 0.38), but not as a "replacement for human training" (study: 5.0 ± 2.3 vs. control: 5.4 ± 2.1; p = 0.37)., Conclusion: Both simulator- and human-based training effectively developed theoretical and practical skills in FATE. However, the simulator group demonstrated significantly poorer performance when applying their skills to human subjects, indicating limitations in the transferability of this simulator-based training to real-life patient care. These limitations of simulator-based ultrasound training should be considered in future training concepts., Clinical Trial Number: Not Applicable., Competing Interests: Declarations. Ethics approval and consent to participate: The approval for the study was waived by the local ethics committee of the State medical association of Rhineland-Palatinate (“Ethik-Kommission der Landesärztekammer Rheinland-Pfalz”, Mainz, Germany). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed written consent was obtained from all the participants. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests. Authors’ information: J. M. W. is resident in internal medicine and coordinator of the student ultrasound education program of the University Medical Center Mainz. He has more than 10 years of experience in the didactic field and has also worked on the topic of ultrasound training methods in his doctoral thesis. He is a member of the DEGUM, EFSUMB and GMA., (© 2024. The Author(s).)

In the modern medical education system, teaching of clinical neurology in outpatient settings is crucial for training future neurologists. The neurology outpatient clinic is a pivotal setting for both initial consultations and follow-up visits. It plays a significant role in the prevention, diagnosis, treatment, and ongoing monitoring of neurological disorders, and is a critical platform for clinical education. Under the guidance of experienced physicians during their clinical rotations, medical students enhance their clinical reasoning ability and skills by learning about the diagnosis and treatment of neurological diseases, thereby laying a solid foundation for becoming competent doctors. Despite the advancements in this field, there is a lack of comprehensive reports on the current status and challenges of teaching neurology in outpatient settings. This gap significantly impedes the development of scientific policies to improve teaching standards. We need to clarify the existing issues to develop effective strategies, such as actively embracing advanced educational achievements and experiences, continuously refining teaching models and methods, and enhancing the quality of education, to cultivate more outstanding medical professionals. This article summarizes the current state and issues of teaching clinical neurology in outpatient settings, and analyzes countermeasures to provide a foundation for future practice and study., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: In 2020, the AAMC created telemedicine competencies to guide curriculum and assessment development. Most available curricula are designed for clinical medical students or graduate trainees, and few offer opportunities for individualized, timely feedback and participation in pediatric simulated encounters., Methods: We designed a hybrid curriculum to provide preclinical medical students with the knowledge and skills necessary to perform telemedicine encounters. The curriculum incorporated both an asynchronous online learning module and a synchronous skills workshop (1.5-2 hours) with real-time feedback from both simulated participants (SPs) and faculty. Both qualitative and quantitative methodology was used in curriculum evaluation. We invited faculty members to participate in semi-structured interviews to explore their experiences with the curriculum. We surveyed students on both general perceptions of the online module and SP workshops and knowledge on telemedicine gained from participation. Student telemedicine skills checklists from the SP workshops were also reviewed., Results: Approximately 140 students participated in the curriculum each year in 2021 and 2022. Students demonstrated significant increases in self-reported knowledge in telemedicine after the curriculum ( p < .001), and students were satisfied with curriculum content and design. Themes that emerged from faculty semi-structured interviews related to perceptions of the curriculum. Areas of strength on the telemedicine student skills checklist were establishing rapport, optimizing presence on video, and demonstrating empathy in a virtual space., Discussion: As telemedicine becomes integral to clinical practice, early training is essential. This telemedicine curriculum for preclinical medical students provides a comprehensive multimodal foundation in virtual communication and physical examination skills., (© 2025 Costich et al.)

The increasing prevalence of diabetes mellitus worldwide necessitates that medical undergraduates acquire a deep understanding of the disease to ensure accurate diagnosis and effective management. Traditional teaching methods, while foundational, often lack the interactive elements that enhance student engagement and knowledge retention. This study aimed to evaluate the effectiveness of a novel educational board game, "Diabe-teach," in enhancing knowledge retention among medical students compared with conventional self-study methods. A randomized controlled design involving 56 preclinical medical students at Dubai Medical College for Girls was used. The participants were randomly assigned to either the game-based learning group or the control group, with both groups receiving identical instructional materials on diabetes. Knowledge retention was assessed via pre- and post-test scores, whereas student engagement and perceptions were measured via a feedback survey. The results indicated that while both groups showed significant improvement in post-test scores (p < .001), the game-based group demonstrated a notably greater frequency of correct responses and a greater tendency to recognize knowledge gaps, as evidenced by the increased "I do not know" responses compared with incorrect guesses in the control group. Feedback from the game-based learning group highlighted enhanced confidence, improved communication skills, and a preference for the gamified approach over traditional methods. The findings suggest that the "Diabe-teach" board game is an effective tool for teaching complex medical concepts, fostering both knowledge retention and critical self-assessment among students. These results contribute to the growing body of literature on game-based learning, supporting its potential as a valuable adjunct to traditional medical education methods. Further research could explore the application of this approach across other medical disciplines., Competing Interests: Declarations. Ethics approval and consent to participate: The Dubai Medical College for Girls Institutional Review Board approved this study (Ref No: IBR2022-23-F-17). Informed consent was obtained from all participants in the study and conformed to the principles outlined in the 1964 Declaration of Helsinki. Consent for publication: Yes. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objective: To explore the differences in the effectiveness of various teaching methods combining online and offline modes in paediatric medical education., Methods: Fourth-year medical paediatric students at our university in 2020 were randomly divided into three groups: a control group, experimental group 1, and experimental group 2, with 30 students in each group. The control group received traditional teaching, experimental group 1 received a combination of online and offline teaching using two methods simultaneously, and experimental group 2, in addition to the methods used in experimental group 1, engaged in real-case teaching in the ward. The teaching outcomes were evaluated through theoretical exams, clinical skills assessments, and questionnaires., Results: Experimental groups 1 and 2 were superior to the control group concerning theoretical examination and overall scores (P < 0.05). Experimental group 2 was superior to experimental group 1 and the control group in clinical skills examination scores (P < 0.05). The satisfaction rate for the questionnaire was highest in experimental group 2 (P < 0.05)., Conclusion: The combined use of various teaching methods with online and offline modes is more effective than using traditional teaching methods only in paediatric education. It enhances the overall competence of paediatric students, especially in terms of improving clinical skills, and is well-received by both students and teachers., Competing Interests: Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of The First Affiliated Hospital of Xinxiang Medical University. The approval number is EC-024-002. Written informed consent was obtained from all participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Obtaining a full understanding of the anatomical structure of the eyeball and the contents within the eye plays a crucial role in learning eye diseases. However, it can be challenging for beginners to quickly learn, memorize, and apply this anatomical knowledge. To improve the teaching of ocular anatomy and help students overcome learning difficulties in ophthalmology clerkship, Zhongshan Ophthalmic Center developed an integrated ocular anatomy course comprising three main components: 'online preview,' 'lecture,' and 'wetlab dissection'., Methods: Fifty-five fourth-year medical students from Sun Yat-sen University were recruited for this study. The impact of the integrated course was evaluated through three in-class quizzes (T1: pre-teaching assessment, T2: post-wetlab training, and T3: end of clerkship) and assessments of students' self-confidence levels. Additionally, students' course evaluations were gathered via a questionnaire survey. Statistical analyses were conducted via ANOVA and the Kruskal-Wallis test., Results: The integration course significantly improved the mean scores of post-teaching tests (67.08 ± 10.27 vs. 74.36 ± 12.75 vs. 78.81 ± 12.70, P < 0.0001) and the students' self-confidence scores (P < 0.0001). Fifty-four participants were satisfied with the integrated anatomy course (79.3% strongly agreed, 18.2% more agreed). Fifty-two participants agreed (76.4% strongly agreed, 18.2% more agreed) that the course could help them better understand the anatomy of the eye., Conclusions: This integrated ocular anatomy course can aid students in better understanding and retaining the anatomy and function of ocular structures, serving as a valuable adjunct teaching strategy that can be further applied to ophthalmology clerkship., Competing Interests: Declarations. Ethics approval and consent to participate: All animal procedures were conducted in accordance with the ethical guidelines published by the International Council for Laboratory Animal Science (ICLAS) and Directive 2010/63/EU in Europe. Informed consent was obtained from all study participants. Ethical approval (2021KYPJ084) was obtained from the Institutional Review Board of Zhongshan Ophthalmic Center (IRB-ZOC-SYSU). To protect participant anonymity, no identifying information was collected. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Introduction: In regions with significant Mandarin-speaking populations, language discordance in health care poses considerable challenges. Previous studies have shown that patients with language-concordant providers had higher ratings of satisfaction and trust. Despite this, there is a shortage of Mandarin-speaking primary care physicians in California. Thus, it is imperative for medical schools to offer education in medical Mandarin., Methods: We implemented a medical Mandarin summer course at the University of California, Irvine, School of Medicine. The course targeted medical students with existing Mandarin fluency and used a flipped classroom model, spanning three sessions focusing on medical history, symptomatology, and medical conditions. Sessions consisted of a 2-hour interactive Zoom class starting with an interactive presentation to practice Mandarin medical terminology and cultural competency learned at home. Students were then paired in breakout rooms to practice patient interviewing. Pre- and postcourse evaluations were given to assess language confidence (Likert scale) and competence (graded terminology exam)., Results: Seventeen students participated in the course and had increased ratings in comfort in taking a medical history in Mandarin ( p = .001) and cultural competency ( p = .05), as well as increased exam scores ( p =.01), when comparing pre- and postcourse evaluations., Discussion: Adding medical language training to existing medical school curricula can cultivate a more linguistically competent health care workforce, ultimately improving patient satisfaction and outcomes. This pilot course demonstrates a feasible approach to addressing linguistic diversity in health care and can be replicated at other institutions to train language-concordant physicians., (© 2024 Li et al.)