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Bacteria form an intense portion of reading and learning for students enrolled in microbiology education. As a part of the foundational course outline of bacteriology, bacterial classification is a significant topic of discussion. The purpose of our study was to analyze whether bacterial classification can be taught with a phylogenetic tree approach that might be more engaging and beneficial to student learners of microbiology. This methodology is unique compared to the conventional approach applied in introductory lectures of bacteriology that relies on morphology and Gram-staining to classify bacteria. The participants of this study were students enrolled in a two-semester medical school bridge program that offers a Master's degree in Pre-clinical Sciences. We presented bacterial origin and classification in the light of evolution and used a phylogenetic tree to signify clinically relevant groups of bacteria. Students were also taught the traditional bacterial classification using Gram stains and morphology. Both methods of classification were delivered in a didactic classroom session considering equal time spent and utilizing the same format. An online survey was distributed to the students after the session to collect their feedback. The results from the survey showed that 74% of participants would prefer learning bacterial classification using a combined approach that includes both Gram-staining and morphology as well as the phylogenetic tree. When asked if the study of bacterial classification through an evolutionary tree diagram is a clear and concise way of understanding bacteria, 79% of the students either agreed or strongly agreed with this statement. Interestingly, the alternative phylogenetic tree approach was considered more engaging and regarded as a means to expand the clinical knowledge of bacteria by 78% and 71% of the students, respectively. Overall, our study strongly supports the use of tree-based classification as an additional method to improve the learning of medically important groups of bacteria at varying levels of education.

In today's world, technology plays a significant role in shaping our daily interactions and how we connect with the world. The rapid advancements in technology have influenced many sectors, particularly education, where integrating technology is now seen as essential rather than just a luxury. As a result, the education field has adapted over time to keep up with innovations and their potential to improve the teaching and learning environment. The incorporation of technology into education has evolved from introducing computer systems in classrooms to the adoption of smartboards, tablets, and e-learning platforms. The rise of Virtual Reality (VR) technology has also opened up possibilities for hands-on learning experiences that allow students to explore and practice skills in ways that traditional teaching methods cannot. VR technology enables students to interact with content in a way that fosters a sense of presence and immersion, which can improve knowledge retention. In fields, like science, engineering, medicine, arts, and language learning, VR applications have shown promise in boosting student engagement and enhancing skills within a controlled learning environment. However, the widespread adoption of VR technology in education faces challenges. One significant obstacle is the cost of acquiring VR equipment and software which can strain budgets. Additionally, the availability of high-quality content for VR platforms poses a barrier for educators seeking to integrate VR into their teaching practices. This article delves into the use of Virtual Reality in education, and how VR can influence student learning outcomes in applications such as medicine, science, arts and language learning. Apart from the advantages of VR, the article also discusses the obstacles that are impeding the use of VR in education including concerns about costs, standardizing content and the necessity for training and support for educators. As VR technology advances and becomes widely available, it stands ready to revolutionize the landscape by offering learning opportunities that were previously beyond imagination. Through this technology, education can introduce a world of possibilities that nurture curiosity, creativity and a lifelong enthusiasm for learning.

This quantitative study assessed infographics' perceptions, preferences, and effectiveness as a learning tool among Pakistani undergraduate medical students. The research focused on understanding the impact of infographics on knowledge acquisition, comprehension of complex medical concepts, and bridging the gap between theoretical learning and clinical practice. The study utilised a self-evaluated questionnaire developed through a meticulous literature review, self-evaluation, and expert input. The questionnaire covered demographics, perceptions, preferences, effectiveness in knowledge acquisition, impact on understanding complex medical concepts, and linking theoretical learning to clinical practice. The research was conducted at Shahida Islam Medical College, Lodhran, Punjab, Pakistan, and involved undergraduate medical students across various academic years. Data collection occurred between November 10 and November 30, 2023, with 229 participants. Quantitative analysis was conducted using SPSS, involving one-sample t-test, paired samples t-test, independent samples t-test, Pearson correlation, and multiple regression analysis to address specific hypotheses. Findings indicate a strong positive perception and preference for infographics among undergraduate medical students. Infographics were perceived as effective in enhancing knowledge acquisition, positively impacting the understanding of complex medical concepts, and bridging the gap between theoretical learning and clinical practice. Statistical analyses supported these perceptions, demonstrating significant relationships and explaining variance in students' perceptions and knowledge acquisition. This study highlights the substantial role of infographics as valuable tools in medical education, emphasising their positive impact on undergraduate medical students' learning experiences. The findings support the integration of infographics into medical curricula to enhance knowledge acquisition, comprehension, and application in real-life clinical settings.

The aim is to investigate the effects of delivering group-based personalized teaching via an electronic performance support system (EPSS) in an online medical informatics course on medical students' academic achievement and community of inquiry levels. The basic working principle of EPSS is to provide the most appropriate teaching methods to the educator, according to the students' variables and learning outcomes. The research design of this study involved a quasi-experimental pretest-posttest design with a control group and the qualitative research method of answers to follow-up questions. While the students in the experimental group were taught various teaching approaches (flipped classroom, brain storming, case-based learning, debate and think-pair-share), the students in the control group were taught directly by online lessons according to direct instruction method. It was seen that the experimental procedure had a positive effect on both the academic achievement and community of inquiry levels of the experimental group compared to the control group. Besides, students in the experimental group reported that the lessons were more effective when they were enjoyable, motivating, focused on discussion and research, and were taught through cases. The group personalized teaching method used in this study could be a guide for future studies.

The relationship between ethical dispositions and scientific and academic ethics is important in understanding how individuals' general ethical values influence their behavior in the academic setting. Examining this relationship by considering personality, which is one of the important individual characteristics, will be useful in developing strategies to prevent ethical violations and encourage ethical behavior in the academic world. This study aims to investigate the relationships between medical students' personality traits, ethical position, and levels of scientific ethics. 363 medical faculty students from various grade levels participated in the study, which used a relational survey model. "Five Factor Personality Inventory", "Ethical Position Scale" and "Scientific Ethics Scales" were used to collect the data of the study. The analysis of the research data was carried out with SEM analysis in AMOS Program. The study's conclusions indicate that medical faculty students had a high level of scientific ethics and ethical position. Additionally, a five-factor personality test revealed that the students exhibited a high degree of variability in the areas of conscientiousness, agreeableness, and openness to new ideas. Medical students' ethical position and personality traits significantly predicted their perceptions of scientific ethics.

Underestimating the important role that disability plays in our growing world, the environment, and our inter-dependent economies is no longer acceptable. Far from being placed in a subaltern position, disability plays a significant role in theory and research development in the most recent waves of initiatives addressing work, resources, and the impact of climate (Berman-Bieler et al., 2023; Olusanya et al., 2023; Stein et al., 2023; Tampubolon, 2023). However, various foundational elements across global disability policies center around disabled peoples' material support needs (Bailie et al, 2023; Fisher et al., 2023) and the impact of disabled peoples' labor market employability across the world's economies (Pinilla-Roncancio & Gallardo, 2023; Revillard, 2023). The articles in this Special Issue of the "Journal of Postsecondary Education and Disability" show us how some of these realities of "what is" can be disrupted, and we are honored to provide our unique perspective piece in response. We focus on the nuanced power dynamics often prevalent, albeit looked over, in the purpose of research by unpacking who decides when equity and justice have been met. We do so to engage future disabled possibilities in STEMM.

The purpose of this study was to investigate the ethical tendencies of medical faculty students, their unethical use of information and communication technologies, and their attitudes toward digital ethics in terms of certain variables. The study was designed using a relational survey model. The research group consisted of 335 medical faculty students studying at a state university in Turkey. Data were collected using the "Personal Information Form," the "Ethical Tendencies Scale," Information and Communication Technologies Ethics Scale," and "Attitude towards Digital Ethics Scale." The data analysis revealed that medical faculty students' digital ethical attitudes and ethical tendencies were at a high level and positive, while their unethical use of information and communication technologies was at a very low level. The study's findings indicated that there were gender-related differences in medical students' unethical use of ICT. In addition, there were significant differences in the ethical tendencies of the participating students based on the variable of year of study. Lastly, medical students' unethical use of information and communication technologies were significantly affected by their ethical tendencies and attitudes towards digital ethics.

The landscape of medical specialty choice is dynamic, undergoing significant changes as students' progress through undergraduate and graduate medical training. These shifts are influenced by various factors, with financial considerations becoming increasingly relevant among medical students' preferences. This study conducts a retrospective analysis of specialty match rates and physician compensation, suggesting a potential trend where primary care fields, though fundamental to healthcare, appear less competitive and often associated with less financial reward compared to other specialties. The existence of this disparity is not without consequences. It contributes significantly to the ongoing and anticipated primary care physician shortages. This situation requires a comprehensive approach to tackle the complex factors influencing medical students' career choices. Understanding these dynamics is critical for healthcare policy and planning. This paper investigates how financial considerations sway medical students' specialty choices, emphasizing the economic disparities between primary care and other specialties.

Validation is needed for any newly developed model or framework because it requires several real-life applications. The investment made into e-learning in medical education is daunting, as is the expectation for a positive return on investment. The medical education domain requires data-wise implementation of e-learning as the debate continues about the fitness of e-learning in medical education. The domain seldom employs frameworks or models to evaluate students' performance in e-learning contexts. However, when utilized, the Kirkpatrick evaluation model is a common choice. This model has faced significant criticism for its failure to incorporate constructs that assess technology and its influence on learning. This paper aims to assess the efficiency of a model developed to determine the effectiveness of e-learning in medical education, specifically targeting student performance. The model was validated through Delphi-based Expert Judgement Techniques (EJT), and Cronbach's alpha was used to determine the reliability of the proposed model. Simple Correspondence Analysis (SCA) was used to measure if stability is reached among experts. Fourteen experts, professors, senior lecturers, and researchers with an average of 12 years of experience in designing and evaluating students' performance in e-learning in medical education participated in the evaluation of the model based on two rounds of questionnaires developed to operationalize the constructs of the model. During the first round, the model had 64% agreement from all experts; however, 100% agreement was achieved after the second round, with all statements achieving an average of 52% strong agreement and 48% agreement from all 14 experts; the evaluation dimension had the most substantial agreements, next to the design dimension. The results suggest that the model is valid and may be applied as Key Performance Metrics when designing and evaluating e-learning courses in medical education.

Learning in a clinical environment is central to a health professionals' educational journey including Dentistry. Implementation of curriculum within the clinical learning environment (CLE) prepares dental undergraduates for professional practice. Evaluation is an important part of curriculum design which provides the evidence to support improvements and continuous development. Engaging learners in evaluation process creates a learner centered approach which has well documented benefits to inform educators if learning needs are being met from their perspective. To explore dental student's perceptions of their CLE to evaluate the implementation of the Bachelor of Dental Surgery (BDS) curriculum. Four focus groups were undertaken with a total of 16 participants to explore their learning experiences. Students were asked to identify what they perceived as enablers and barriers which affect their learning and make suggestions for improvement. Transcripts of audio data were thematically analyzed, coded and themes identified. The themes identified related to teachers' attributes and improvements in physical facilities that enable their learning and pressure to perform the required quantity of clinical procedures, perceived inadequate supervision of chairside teaching, and lack of specific feedback on performance. Suggestions for improvements provided useful insights on issues related to perceived challenges. Learning could be improved by exploring quality of consultations over quantity to mitigate low patient availability, lack of treatment materials to meet clinical procedure requirements, and utilising simulation to gain valuable experience. Finally, developing small units of dental communities of practice (CoP) to facilitate learning opportunities could enhance the learner's experience.

While program-level learning objectives are required for medical school accreditation, session-level learning objectives are not, although many institutions use them. Most pre-clerkship basic science medical educators (PCBSMEs) do not have formal pedagogy training, so it is unknown when PCBSMEs learn about learning objectives or how they communicate them to students. A questionnaire was designed to phenomenologically explore these aspects during PCBSMEs' time as a student and as an educator. Qualitative data underwent inductive thematic analysis and generated two descriptive themes. Theme Educator Experiences describes how respondents learned about and used learning objectives as a student and as an educator. Theme Educator Communications describes how PCBMSEs communicate with students about using learning objectives. The relationship between themes suggest learning occurs following Bandura's Social Cognitive Theory. Findings indicate potential obstacles preventing implementation or communication about learning objectives, regardless of training. Strategies to proactively expose PCBSMEs to pedagogical concepts regarding learning objectives are recommended.

This article describes the findings of a study on the correlations between English as second language (ESL) motivation, understood as a product of the stimulus appraisal system, and writing proficiency in English among undergraduate Indian ESL learners. The principal objective of the study was to analyze the correlation between the undergraduate Indian ESL learner's motivational sub-checks/constructs, constituted using the stimulus appraisal (SA) theory of affect, and their writing proficiency in English. Additionally, it also attempted to understand the influence of sex and academic disciplines on the correlations. An ESL motivation survey was conducted using a modified version of the Attitude and Motivation Test Battery (Gardner, 1985) on students (N>350) studying in undergraduate programs in the academic disciplines of engineering, humanities, and medical sciences selected using criterion-based sampling, followed by a writing proficiency test in English. It was observed that need/compatibility factors did not significantly correlate with ESL writing proficiency in any of the three subsamples. ESL classroom-related factors within the pleasantness/novelty construct, on the other hand, significantly correlated with ESL writing proficiency. It is hoped that the insights obtained in the study should potentially help design more empirically informed pedagogical methods of ESL teaching.

This article discusses how a new APRS service-learning model was implemented in a new service-learning project in the traditional Chinese medicine (TCM) orthopedics curriculums at three Hong Kong institutions. The APRS model adopting flipped learning approach consists of four cyclic stages, including Application, Practice, Reflection and Self-regulated learning. Qualitative and quantitative findings in this study reveal that TCM students gained confidence in applying discipline knowledge/skills and improved in various areas, including cross-cultural competence, communication, problem-solving and collaboration. Drawing evidence from this study, possible factors contributing to positive impacts on student learning in the APRS model are the "strong connectivity" (including clear alignment with programme, profession, institutional missions and traditional Chinese philosophy "xiushen"), "reinforced motivation" (student autonomy and buy in) and "structured organisation" (strong network among participating parties and use of a centralised electronic platform). The APRS service-learning model is a culture-based approach helping students reconnect Confucian "xiushen" to the discipline knowledge and the real-life application in the Hong Kong context. This model may also be applicable to other Asian contexts where the Confucian culture prevails.

Community outreach and service-learning are common components of medical and health profession programs. Outreach programs can provide diverse service-learning opportunities for students to work collaboratively with their communities. Many educational accrediting bodies require service-learning activities for students. The discipline of anatomy is uniquely suited for outreach as it engages students with the community and provides relevant, health-related educational materials and information. Anatomy is often a general interest to many and can aid in the promotion of students pursuing health professions careers. The objective of this work is to describe three unique anatomical outreach programs that integrate components of community service, service-learning, and/or pathway program initiatives in innovative ways. These programs are presented to inspire and/or be adapted in other medical or health professions programs. Variety in these programs range from duration, target audience age, resource and financial requirements, and necessary collaborations. The authors provide tips for success and potential pitfalls to consider. These three examples serve as successful, contemporary, and diverse approaches to anatomical outreach that can be implemented into medical or health professions education programs.

The Accelerate Cancer Education (ACE) summer research program at The University of Kansas Cancer Center (KUCC) is a six-week, cancer-focused, summer research experience for high school students from historically marginalized populations in the Kansas City metropolitan area. Cancer affects all populations and continues to be the second leading cause of death in the United States, and a large number of disparities impact racial and ethnic minorities, including increased cancer incidence and mortality. Critically, strategies to bolster diversity, equity, inclusion, and accessibility are needed to address persistent cancer disparities. The ACE program offers an educational opportunity for a population of students who otherwise would not have easy access onto a medical center campus to make connections with cancer physicians and researchers and provides a vital response to the need for a more diverse and expansive oncology workforce. Students grow their technical, social, and professional skills and develop self-efficacy and long-lasting connections that help them matriculate and persist through post-secondary education. Developed in 2018, the ACE program has trained 37 high school junior and senior students. This article describes the need for and how we successfully developed and implemented the ACE program.

Introduction: In Australia, 54.3% of medical students are women yet they remain under-represented in stereotypical perspectives of medicine. While potentially transformative, generative artificial intelligence (genAI) has the potential for errors, misrepresentations and bias. GenAI text-to-image production could reinforce gender biases making it important to evaluate DALL-E 3 (the text-to-image genAI supported through ChatGPT) representations of Australian medical students. Method: In March 2024, DALL-E 3 was utilised via GPT-4 to generate a series of individual and group images of medical students, specifically Australian undergraduate medical students to eliminate potential confounders. Multiple iterations of images were generated using a variety of prompts. Collectively, 47 images were produced for evaluation of which 33 were individual characters and the remaining 14 images were comprised of multiple (5 to 67) characters. All images were independently analysed by three reviewers for apparent gender and skin tone. Consequently, 33 feature individuals were evaluated and a further 417 characters in groups were evaluated (N = 448). Discrepancies in responses were resolved by consensus. Results: Collectively (individual and group images), 58.8% (N = 258) of medical students were depicted as men, 39.9% (N = 175) as women, 92.0% (N = 404) with a light skin tone, 7.7% (N = 34) with mid skin tone and 0% with dark skin tone. The gender distribution was a statistically significant variation from that of actual Australian medical students for individual images, for group images and for collective images. Among the images of individual medical students (N = 25), DALL-E 3 generated 92% (N = 23) as men and 100% were of light skin tone (N = 25). Conclusion: This evaluation reveals the gender associated with genAI text-to-image generation using DALL-E 3 among Australian undergraduate medical students. Generated images included a disproportionately high proportion of white male medical students which is not representative of the diversity of medical students in Australia. The use of DALL-E 3 to produce depictions of medical students for education or promotion purposes should be done with caution.

Understanding the potential transformation brought about by integrating the flipped classroom methodology with rich and dynamic learning platforms like the Metaverse, in terms of usability, students' academic performance, and intrinsic motivation, holds critical importance for adopting innovative strategies in the field of education. This study describes an attempt to integrate flipped learning method into a medical English course by using an active learning strategy supported by a Metaverse-based environment. Therefore, the present study aims to compare the synchronous online flipped medical English classroom supported by a Metaverse-based platform and the conventional medical English classroom supported by the synchronous distance education and to examine the effectiveness of Metaverse-powered synchronous online flipped learning on medical students' academic achievement. For this purpose, a mixed method was used to conduct the study. A quasi-experimental design was adopted for the quantitative dimension of the research. The students in the experimental group engaged in the activities with the help of the Spatial AR environment, a Metaverse platform enhanced with three-dimensional (3D) objects and allowing peer interaction, In the qualitative aspect of the study, the data were collected through a focus group interview, in which a semi-structured interview form was used. The participants of the study consisted of 100 first-year medical students at a state university in Türkiye. The results revealed that the experimental group students outperformed the control group students regarding academic achievement. In addition, the mean score of male students was higher than that of female students in the experimental group. As a result of the qualitative data analysis, eight themes emerged from the created codes. Students stated that learning medical English through the flipped classroom supported by Metaverse-based technology was enjoyable and that it increased their interest. Regarding learning outcomes, the most prominent benefits were permanent learning, comprehending the subject easily, deep learning, and embodying abstract concepts. Concerning language skills, students expressed that synchronous online flipped learning assisted by Metaverse-based technology helped develop their reading and listening skills as well as to learn new vocabulary. On the other hand, some students reported negative thoughts about the Metaverse platform due to technical problems and about flipped classroom activities because they found some of them time-consuming. The present study suggested that synchronous online flipped medical teaching model assisted by the Metaverse could positively affect the academic achievement of students. However, it is recommended to investigate the most effective practices that will meet the needs of students in different contexts.

Modern medical training consists largely of lecture-based instruction and in vivo or video modeling of specific skills. Other instructional methods, such as teaching with acoustical guidance (TAGteach), have rarely been evaluated. In this study, we compared teaching with tactile guidance, or tactile TAGteach in which a vibratory stimulus is delivered to indicate a correct response, with video modeling and self-evaluative video feedback to teach four participants two medical skills: simple interrupted suture and endotracheal intubation. The results showed that both instructional methods improved performance. However, three participants met the mastery criterion in the tactile TAGteach condition first, although this instructional method required more time to train the skills. We discuss the implications of these findings for training skills to medical practitioners.

In recent decades, a noticeable trend has emerged in medical and dental schools to adjust their curricula to promote learning strategies and habits geared towards long-term knowledge retention. This systematic review therefore sought to examine whether different teaching methods influence students' preferred learning approaches (deep, strategic, and surface approach) and indirectly affect their academic performance. Furthermore, it provides a comprehensive overview of the inconsistencies evident in previous literature regarding the relationship between learning approaches and academic performance of medical and dental students. A thorough search across eight databases yielded 49 relevant studies published between the years 2000 and 2023. The majority of studies revealed that whilst deep and strategic learners tend to excel at medical or dental school, surface learners appear to struggle under intense workload and pressure. Hence, a common consensus emerged amongst the existing literature that there is a relative benefit in attempting to guide students towards deep and strategic learning habits and to minimise surface-related learning strategies. However, results also conveyed that merely modifying the teaching methods used in medical and dental schools has limited merit. As such, the results emphasised the lack of a 'one-size-fits-all' teaching method. Common factors influencing learning approaches were subsequently identified, and based on these findings, an outlook was put forth to integrate a cognitive neuroscience approach into higher education. These directions for future investigations aim to help students reach their full potential by understanding the processes underlying efficient learning and by being mindful of respective encouraging and discouraging factors.

Whilst many studies have explored academic identity construction, very few take a comparative perspective to examine the various ways of constructing academic identities within and across different disciplines. This paper analyses a key policy document used for evaluating academics' performance along with semi-structured interviews with 37 academics from Chemical Sciences, Medical Sciences, Nursing and Education working in a research-intensive New Zealand university. The use of Foucault's theoretical construct of games of truth provides a novel perspective to investigate the ways in which academics in different disciplines play the academic 'game' and how this might affect their construction of an academic identity. Our analysis suggests that the path into academia is a key factor in their trajectory of academic formation. The study suggests three types of 'valid' academics. It problematises the standardised definition and evaluation of academics and offers contextualised, multiple, dynamic and agential understandings of being and becoming set up through the interplay of forces arising from disciplinary, institutional, professional and personal spheres.

In modern medical curricula, embryology is typically taught through lectures, with a few institutions providing tutorials. The use of 3-D videos or animations enables students to study these embryological structures and how they change with time. The aim of this study was to assess the quality of cardiac embryology videos available on YouTube. A systematic literature review regarding the use of YouTube in teaching or learning cardiac embryology identified no papers that examined this specific question, and next, a systematic search of YouTube was performed. A total of 1200 cardiac embryology videos were retrieved using 12 specific search terms, with 370 videos retrieved under two or more search terms and excluded. A further 511 videos were excluded under additional, specific criteria. The remaining 319 videos were evaluated with the YouTube Video Assessment Criteria (UTvAC), with 121 rated as "useful." Videos on YouTube are uploaded with a wide audience in mind, from children to cardiologists, and content control is imperfect. Multiple videos were identified as duplicates of videos from original channels, typically without attribution. While 49 videos showed operations or human material, none contained an ethical statement regarding consent, and only 10 of these included an age restriction or graphical advisory. While there are useful videos for medical students studying cardiac embryology on YouTube, intuitive search strategies will also identify many with irrelevant content and of variable quality. Digital competence and search strategies are not innate skills, so educators should teach students to assess information so as to avoid overload or "filter failure."

Case-based learning (CBL) is a student-centered pedagogy where medical students are given a real-world clinical problem. At St George's University of London (SGUL), anatomy academics can volunteer to facilitate CBL sessions for pre-clinical undergraduate medical students. The major benefits of facilitating CBL sessions from the perspective of a non-medically qualified early career anatomy academic (ECAA) include exposure to clinical cases that help the academic develop an understanding over key clinical cases at the context of clinical anatomy and other disciplines including physiology, pathology, and pharmacology. Furthermore, facilitating CBL sessions assists in the acquisition of basic knowledge over history taking, the conduction of clinical examinations, the investigations performed for the diagnosis of a condition as well as how it is managed. The major benefits of facilitating CBL sessions from the perspective of a medically qualified ECAA include staying in touch with the clinical aspect of medicine and becoming familiar with the country's healthcare system and its professional standards. Perceived benefits shared by both the non-medically and medically qualified ECAA include the opportunity to become familiar with the structure and key elements of the pre-clinical medical curriculum as well as gain experience in facilitating small group teaching sessions. Overall, facilitating CBL sessions can help non-medically and medically qualified ECAAs in different contexts that may help them with their individual career goals, can encourage collaborative discussions between clinical and non-clinical anatomy academics as well as help bridge the gap between the anatomy teaching approaches employed by non-medically qualified and medically qualified anatomy academics.

Gross anatomy is a crucial course in medical school; it sets the foundation for future coursework and is highly valued by clinicians. While both medical students and faculty recognize the importance of pre-medical school anatomy experience, few medical schools require it as a prerequisite. Consequently, medical school gross anatomy courses have a diverse range of prior anatomy experience among students. Prior studies have shown mixed results regarding the impact of pre-medical school anatomy experience on medical school gross anatomy performance, often using final exam scores as the metric of analysis. In this study, we investigated the relationship between pre-medical school anatomy experience and medical school gross anatomy performance among students at New York Institute of Technology, College of Osteopathic Medicine. We surveyed students from all four matriculated years and analyzed their individual anatomy laboratory exam scores and final anatomy laboratory course scores. We found that students with prior anatomy experience performed significantly better on the first anatomy laboratory exam, leading to an overall positive effect on their final anatomy laboratory score. However, this advantage seemed to diminish in subsequent exams, suggesting that students without prior experience rapidly adjusted to the course challenges. Students with prior anatomy experience felt more prepared for the anatomy course, reported lower stress levels, and believed they had an advantage over peers without prior experience. Our study highlights the importance of pre-medical school anatomy experience, particularly for early performance in the anatomy course.

Teaching physiology can be challenging as students are initially required to understand basic and abstract concepts. Thus students typically view physiology as a "difficult" subject and place an emphasis on rote learning and memorization. Here, we attempted to address this knowledge gap by introducing a pedagogical intervention into the neurophysiology lesson plan of first-year medical and health physiology students at the University of La Reunion. This intervention aimed to better link abstract concepts (e.g., saltatory conduction) and a pathological disorder (multiple sclerosis), together with a discussion of a specific therapeutic intervention (fampridine). Students were required to complete readings (focused on neurophysiology aspects) and two online quizzes before two scheduled in-person lectures. They could also pose questions on a dedicated online forum. Thereafter, the in-person lectures discussed questions posted on the online forum, provided feedback on poorly answered questions (from the online quizzes), and dealt with questions posed by students attending classes. Student feedback regarding the pedagogic intervention was assessed by an anonymous online survey. This survey revealed that the pedagogical intervention was positively received. For example, 94% of respondents agreed the course was well developed, while 80% indicated that the pedagogical intervention was beneficial in terms of their understanding of basic and abstract neurophysiology concepts. Together, this pedagogical intervention was enthusiastically received by the students who better understood how basic nerve physiology concepts fit into the broader context and that such an understanding can result in the development and the roll-out of unique therapeutic interventions for multiple sclerosis.

It is essential for modern medical students to continuously enhance their clinical thinking abilities. This study aims to evaluate the efficacy of the combined World Café discussion and case-based learning (CBL) approach within the clinical thinking training course. The clinical thinking training course incorporated the combined World Café discussion and CBL approach. The assessment of the accuracy and rationality of clinical symptoms, medical examination, pathological processes, diagnostic results, diagnostic basis, and drug use was conducted through case-related queries. Feedback from students and instructors regarding the teaching content, teaching process, and teaching effect was gathered through questionnaires. The findings indicate that the students achieved high marks in all assessed areas, including clinical symptoms, medical examination, pathological processes, diagnostic results, diagnostic basis, and drug use. The feedback from students and instructors on the teaching content, teaching process, and teaching effect was positive. Medical educators can use our findings to implement the combined World Café discussion and CBL mode to enhance student engagement.

The concepts of metacognitive reflection, reflection, and metacognition are distinct but have undergone shifts in meaning as they migrated into medical education. Conceptual clarity is essential to the construction of the knowledge base of medical education and its educational interventions. We conducted a theoretical integrative review across diverse bodies of literature with the goal of understanding what metacognitive reflection is. We searched PubMed, Embase, CINAHL, PsychInfo, and Web of Science databases, including all peer-reviewed research articles and theoretical papers as well as book chapters that addressed the topic, with no limitations for date, language, or location. A total of 733 articles were identified and 87 were chosen after careful review and application of exclusion criteria. The work of conceptually and empirically delineating metacognitive reflection has begun. Contributions have been made to root metacognitive reflection in the concept of metacognition and moving beyond it to engage in cycles of reflection. Other work has underscored its affective component, transformational nature, and contextual factors. Despite this merging of threads to develop a richer conceptualization, a theory of how metacognitive reflection works is elusive. Debates address whether metacognition drives reflection or vice versa. It has also been suggested that learners evolve along on a continuum from thinking, to task-related reflection, to self-reflection, and finally to metacognitive reflection. Based on prior theory and research, as well as the findings of this review, we propose the following conceptualization: Metacognitive reflection involves heightened internal observation, awareness, monitoring, and regulation of our own knowledge, experiences, and emotions by questioning and examining cognition and emotional processes to continually refine and enhance our perspectives and decisions while thoughtfully accounting for context. We argue that metacognitive reflection brings a shift in perspective and can support valuable reconceptualization for lifelong learning.

As trainees resist social harm and injustice in medicine, they must navigate the tension between pushing too hard and risking their reputation, or not enough and risking no change at all. We explore the discernment process by examining what trainees attend to moments before and while they are resisting to understand how they manage this tension. We interviewed 18 medical trainees who shared stories of resisting social harm and injustice in their training environments. Interviews were analyzed using open and focused coding using Vinthagen and Johansson's work, which conceptualizes resistance as a dynamic process that includes an individual's "subjectivity" within a larger system, the "context" in which they find themselves, and the "interactions" they have with others. We framed these acts as an individuals' attempt to undermine power, while also being entangled with that power and needing it for their efforts. When deciding on how and whether to resist, trainees underwent a cost-benefit analysis weighing the potential risk against their chances at change. They considered how their acts may influence their relationship with others, whether resisting would damage personal and programmatic reputations, and the embodied and social cues of other stakeholders involved. Trainees undergo a dynamic assessment process in which they analyze large amounts of information to keep themselves safe from potential retaliation. It is by attending to these various factors in their environment that trainees are able to keep their acts "professional", and continue to do this challenging work in medical education.

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

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

Health professions education (HPE) research in the General Practice domain (GP-HPE) is vital for high-quality healthcare. Collaboration among GP-HPE researchers is crucial but challenging. Formulating a research agenda, involving stakeholders, and fostering inter-institutional collaboration can address these challenges and connect educational research and practice. We used Q-methodology to explore perspectives on GP-HPE research of participants from all Dutch postgraduate GP training institutes. Participants individually sorted statements based on the relevance of future GP-HPE research for educational practice. Data analysis comprised inverted factor analysis, rotation, and qualitative interpretation of configurations of all statements. The National Meeting on Educational Research took a participatory approach. We included 73 participants with diverse involvement in GP-HPE research. We identified five distinct perspectives, each representing a research focus area for developing and innovating GP education: the clinician scientist, the socially engaged GP, the specific GP identity, the GP as an entrepreneur, and the GP engaged in lifelong learning. The resulting five perspectives align with General Practice hallmarks. Q-methodology and a participatory approach facilitated collaboration among stakeholders. Successful inter-institutional collaboration requires a common goal, neutral leadership, participant commitment, regular meetings, audit trail support, process transparency, and reflexivity. Future research should address evidence gaps within these perspectives. Using Q-methodology turned out to be valuable for compiling a national research agenda for GP-HPE research. The research process helped to cross boundaries between researchers in different institutions, thus putting inter-institutional collaborative advantage center stage. Our approach could provide a conceivable procedure for HPE researchers worldwide.

The learning environment (LE) includes social interactions, organizational culture, structures, and physical and virtual spaces that influence the learning experiences of students. Despite numerous studies exploring the perception of healthcare professional students (HCPS) of their LE, the validity evidence of the utilized questionnaires remains unclear. This scoping review aimed to identify questionnaires used to examine the perception of undergraduate HCPS of their LE and to assess their validity evidence. Five key concepts were used: (1) higher education; (2) questionnaire; (3) LE; (4) perception; and (5) health professions (HP). PubMed, ERIC, ProQuest, and Cochrane databases were searched for studies developing or adapting questionnaires to examine LE. This review employed the APERA standards of validity evidence and Beckman et al. (J Gen Intern Med 20:1159-1164, 2005) interpretation of these standards according to 5 categories: content, internal structure, response process, relation to other variables, and consequences. Out of 41 questionnaires included in this review, the analysis revealed a predominant emphasis on content and internal structure categories. However, less than 10% of the included questionnaires provided information in relation to other variables, consequences, and response process categories. Most of the identified questionnaires received extensive coverage in the fields of medicine and nursing, followed by dentistry. This review identified diverse questionnaires utilized for examining the perception of students of their LE across different HPs. Given the limited validity evidence for existing questionnaires, future research should prioritize the development and validation of psychometric measures. This will ultimately ensure sound and evidence-based quality improvement measures of the LE in HP education programs.

Human dissections in the current medical curriculum are conducted using a checklist approach to prioritize the exposure of anatomical structures. In this setting, anatomy educators are labored to enhance their engagement during the dissection. To address this issue, we considered the current medical education pedagogies and identified a novel approach of studio-based learning (SBL) for application in a Human Dissection Workshop. This study aimed to (1) evaluate students' perceptions of SBL, (2) appraise the impact of SBL on anatomical knowledge learning, and (3) interpret the results of a validated questionnaire. Workshop participants were recruited from Year 2 medical students at the Chinese University of Hong Kong from the 2020 and 2021 cohorts. Fifty-one students participated in the workshop (N = 24 [2020], N = 27 [2021]), and 50 of them completed the postworkshop questionnaire rated on a 5-point Likert scale. Nineteen items were validated using a factor analysis. The interpretation of the questionnaire results demonstrated the different learning outcomes of the workshop, which included (1) enhancing students' knowledge and spatial understanding of anatomical structures, (2) strengthening students' appreciation of gross pathologies and clinical relevance, and (3) promoting higher-order thinking skills. To our knowledge, this is the first study to introduce SBL in medical education. The successful implementation of the workshop reflects the promising potential of SBL for enhancing human dissection and supplementing the medical curriculum.

Teaching human histology is part of understanding the tissues of the human body and, therefore, it is part of the training curriculum of all health courses. The increase in technologies and active teaching methodologies has a positive impact on student learning, as it reduces the challenges present in the subject. Therefore, this work aimed to compare the performance of students in the histology discipline, when compared to traditional teaching methodology and its association with game-based learning and a basic histology teaching platform. Three classes of the medical course were selected between the years 2022 and 2023, each of which was separated into a group. One group did not have access to any platform, being called the Traditional Group (TG), a group that used Kahoot!, being called the Kahoot Group (KG), and a group that used the teaching platform, being called the Histoatlas Group (HG). Both KG and HG groups showed greater effectiveness in learning and improved performance, when compared to TG. These improvements in KG and HG were also highlighted as learning aids and easy to use. KG students performed better in the practical test when comparing groups. However, this difference was not observed in the students' averages. However, students pointed out the relevance of trying to improve the traditional teaching methodology. Therefore, this study points out that, even though the traditional teaching methodology is efficient in the student's teaching and learning process, there is a need on the part of students to make the subject more dynamic.

Dental anatomy education for dental technology students should be developed in alignment with digital dental laboratory practices. We hypothesized that a virtually assisted sketching-based dental anatomy teaching module could improve students' acquisition of skills essential for digital restoration design. The second-year dental technology curriculum included a novel virtual technology-assisted sketching-based module for dental anatomy education. Pre- and post-course assessments evaluated students' skill sets and knowledge bases. Computer-aided design (CAD) scores were analyzed after one year to assess how the skills students developed through this module impacted their subsequent CAD performance. Participants who undertook the dental sketching-based teaching module demonstrated significantly improved theoretical knowledge of dental anatomy, dental aesthetic perception, and spatial reasoning skills. A partial least squares structural equation model indicated that the positive effects of this module on subsequent CAD performance were indirectly mediated by dental aesthetic perception, spatial reasoning, and practice time. A virtually assisted sketching-based dental anatomy teaching module significantly improved students' acquisition of skills and knowledge and positively mediated dental technology students' CAD performance.

3D scanning and printing technologies are quickly evolving and offer great potential for use in gross anatomical education. The use of human body donors to create digital scans and 3D printed models raises ethical concerns about donor informed consent, potential commodification, and access to and storage of potentially identifiable anatomical reproductions. This paper reviews available literature describing ethical implications for the application of these emerging technologies, existing published best practices for managing and sharing 2D imaging, and current adherence to these best practices by academic body donation programs. We conclude that informed consent is paramount for all uses of human donor and human donor-derived materials and that currently there is considerable diversity in adherence to established best practices for the management and sharing of 3D digital content derived from human donors. We propose a new and simplified framework for categorizing donor-derived teaching materials and the corresponding level of consent required for digital sharing. This framework proposes an equivalent minimum level of specific consent for human donor and human donor-derived materials relative to generalized, nonidentical teaching materials (i.e., artificial plastic models). Likewise, we propose that the collective path forward should involve the creation of a centralized, secure repository for digital human donor 3D content as a mechanism for accumulating, regulating, and controlling the distribution of properly consented human donor-derived 3D digital content that will also increase the availability of ethically created human-derived teaching materials while discouraging commodification.

This study assesses the acceptability, appropriateness, feasibility, and efficacy of a novel asynchronous video-based intervention for teaching respiratory physiology and anatomy to medical students in resource-limited settings. A series of short video lectures on pleural anatomy, pulmonary physiology, and pathophysiology was created using Lightboard and screen capture technology. These were uploaded to YouTube and Google Drive and made available to 1st-3rd year medical students at two Latin American universities for 1 week. Employing a parallel-convergent mixed methods design, we conducted surveys, focus groups, interviews, and pre/post testing for qualitative and quantitative data. Thematic Analysis was used to analyze qualitative data and McNemar's test for quantitative analysis. Seventy-six students participated. The videos' short format, interactivity, and Lightboard style were highly valued for their flexibility, time efficiency, and educational impact. Students recognized their clinical relevance and trusted their content, suggesting potential applicability in similar settings. Despite infrastructure and connectivity challenges, the use of flexible streaming and downloadable options facilitated learning. Survey results indicated high levels of feasibility (99%), appropriateness (95%), and acceptability (95%), with significant knowledge gains observed (37% correct pre-test answers vs. 56% post-test, p < 0.0001). Our findings demonstrate high acceptability, appropriateness, feasibility, and efficacy of a targeted asynchronous education centered on short-format videos in resource-limited settings, enabling robust learning despite local barriers. Flexible access is key for overcoming localized barriers. Taking an adaptive, learner-centered approach to content creation and delivery to address constraints was pivotal to success. Our modular videos could serve as versatile models for flexible education in resource-constrained settings.

Collaborative skills are crucial in knowledge-rich domains, such as medical diagnosing. The Collaborative Diagnostic Reasoning (CDR) model emphasizes the importance of high-quality collaborative diagnostic activities (CDAs; e.g., evidence elicitation and sharing), influenced by content and collaboration knowledge as well as more general social skills, to achieve accurate, justified, and efficient diagnostic outcomes (Radkowitsch et al., 2022). However, it has not yet been empirically tested, and the relationships between individual characteristics, CDAs, and diagnostic outcomes remain largely unexplored. The aim of this study was to test the CDR model by analyzing data from three studies in a simulation-based environment and to better understand the construct and the processes involved (N = 504 intermediate medical students) using a structural equation model including indirect effects. We found various stable relationships between individual characteristics and CDAs, and between CDAs and diagnostic outcome, highlighting the multidimensional nature of CDR. While both content and collaboration knowledge were important for CDAs, none of the individual characteristics directly related to diagnostic outcome. The study suggests that CDAs are important factors in achieving successful diagnoses in collaborative contexts, particularly in simulation-based settings. CDAs are influenced by content and collaboration knowledge, highlighting the importance of understanding collaboration partners' knowledge. We propose revising the CDR model by assigning higher priority to collaboration knowledge compared with social skills, and dividing the CDAs into information elicitation and sharing, with sharing being more transactive. Training should focus on the development of CDAs to improve CDR skills.

Background: Individuals with intellectual disabilities experience barriers to quality healthcare. To reduce this disparity, equipping medical trainees with the knowledge and skills required for treating this patient population is critical. Our aim is to describe the breadth of instructional interventions and identify gaps in intellectual disability medical education curricula. Method: Using scoping review methods, the intellectual disability programmes described in 27 articles were evaluated and their coverage of the six core competencies on disability for health care education was examined. Results: The most frequently represented core competencies were disability conceptual frameworks, professionalism and communication, and clinical assessment, which were, in most programmes, fulfilled by activities involving individuals with intellectual disabilities. Uneven competency coverage warrants consideration. Conclusions: Considerable variabilities exist in medical school curricula on intellectual disabilities. Using core competencies on disability for health care education for curricular design and evaluation would provide a coherent training experience in this important area.

Egypt currently holds the record for the most retractions in the continent of Africa according to the Retraction Watch database, and the 2nd highest of countries in the Middle East. The purpose of this study was to analyse the retracted medical publications from Egyptian affiliations, in order to delineate specific problems and solutions. We examined databases including Pubmed, Google Scholar and others, for all retracted medical publications that were conducted in an Egyptian institution, up to the date of August 31st 2022. We observed for the reason(s) for retraction, number of citations of the retracted work, the length of time between publication and retraction, and where the work was published (journal, publisher and impact factor). 68 retractions were identified. Most retractions were from the speciality of Obstetrics and Gynecology (n = 22), followed by Anesthesia (n = 7). The top 3 reasons for retraction were unreliable results, FFP level misconduct, and duplicate publication. The number of retractions significantly increased over the years, especially in 2022. When taking into account the number of medical publications per institution, the institute with the highest rate of retractions was Mansoura University, while the lowest rate was Cairo University. The number of retracted medical Egyptian publications continues to increase over time, although they represent a small portion of the overall body of Egyptian medical research. Future studies on retracted articles should employ a methodology that considers the institutions where the studies were conducted. This could allow a better understanding of specific problems in certain countries or regions.

To determine factors affecting successful research and publication among medical students, a cross-sectional survey study was carried out at four Thai medical schools during 2018-2022. Medical students who had previously performed research under research advisors' supervision and their research advisors were included. There were 120 participants, 78 medical students and 42 research advisors. The most common problems reported by the students were student's lack of knowledge of research design (78%) and research topic (53%), while the most common problems reported by the advisors were student's lack of knowledge of research topic (55%) and how to prepare documents for ethics committee approval (48%). The promoting factors for research success commonly reported by the students and advisors were "an advisor helps with protocol writing and reviewing the manuscript", "research teaching in the curriculum", "provision of an example of a written ethics committee protocol", and "arranging a special session so that advisors can talk to students about their research of interest". Among the 78 participating students, 20 (26%) had successfully published their research in journals. These 20 students were more likely than those without publications to be from an institute that had a special research project or conference for medical students (20% vs. 0%,) and to suggest that teaching protocol writing helped in promoting research success (70% vs. 43%). These findings suggest that teaching research, a special research project or conference for medical students, and faculty development of research advising could potentially increase the success rate of students' research publications.

Digital transformation in education and relevant calls for action are recognised global priorities aimed to support education and training in the digital age. The experiences from the emergency remote teaching during the COVID-19 pandemic and recent research findings reveal relevant advantages, challenges, as well as different students and teaching staff perspectives which should be carefully considered and integrated into institutional strategies and policies to improve and enrich students' learning experience. The present study aimed to explore health sciences students' perspectives on online teaching and learning (T&L) in four domains--"Satisfaction", "Motivation", "Interaction" and "Challenges", and to identify the preferred T&L models or tools. A total of 1,041 responses were collected, including 476 dental medicine (45.7%), 399 pharmacy (38.3%), and 166 medical students (15.9%). Overall "Satisfaction" was quite high (4.0 ± 1.2; out of 5), followed by satisfactory Interaction (3.4 ± 1.4), whereas "Motivation" was quite low on average (3.0 ± 1.5). "Challenges" in online T&L were not markedly expressed (3.0 ± 1.6). The majority of students (46.6%) opted for the blended model as the preferred T&L model. Moodle lessons were perceived as the most useful online T&L tool (45.5% of students), followed by video materials (32.2%). Other T&L tools which require more active student's role, such as short test/quiz, and group or team assignment were declared as less favourable. The findings from the current study may contribute to raising the awareness of academic staff and higher institutions management about the student attitudes and needs related to online T&L and inform institutional planning, decision-making and policy development.

Lack of access to STEMM mentors has been identified as a critical barrier to biomedical research careers, leading to a lack of diversity in this field. To address such a barrier, the National Institutes of Health invested funds to support institutions in developing research immersion programs to provide "underrepresented" students with mentored research experiences. While providing access and opportunity for research experiences is an important equity endeavor, a focus solely on broadening participation neglects the role of institutions in perpetuating hegemonic views of science. Institutions often fail to recognize how entanglements of affect and emotion shape youth experiences in these programs and work to (de)legitimize their sense of belonging in science and perpetuate the notion of science as for an exclusive few. In this paper, we describe findings from a project aimed at understanding the entanglement of emotion and affect in a research immersion program and how these entanglements shaped participants' sense of belongingness in the program and research more broadly. Drawing on a poststructural feminist framework, we come to understand how individual histories and emotional experiences with racial and gender stereotypes work at the meta-affective level to contract feelings of belongingness in science for students.

Relationships that involve a physician and a non-physician professional spouse face many challenges that are similar to those experienced by dual career marriages. However, there are unique demands that are associated with physicians who are married to other professionals. One such challenge is the task of navigating their multiple familial and professional roles. This present study explores how physicians who are married to other professionals confront and navigate the complex environment that is often characteristic of work-family issues in this population. Employing an exploratory qualitative design, 34 heterosexual individuals (17 couples) completed in-depth qualitative interviews. These dyadic interviews included 10 male physicians and 7 female physicians. A multisystemic approach was employed to explore themes that emerged. One major theme, contextual appreciation of the physician's work demands, and three sub-themes: familial support, non-traditional parenting and domestic roles, and paid help, emerged. These data provide important information for the medical education of physicians with specific emphasis on navigating multiple familial and professional roles when part of dual career marriages. Findings provide implications for physician vitality/health, medical education, and continuing education with a focus on physician marriages.

Authenticity in simulation-based learning is linked to cognitive processes implicated in learning. However, evidence on authenticity across formats is insufficient. We compared three case-based settings and investigated the effect of discontinuity in simulation on perceived authenticity. In a quasi-experiment, we compared formats of simulation in the context of medical education. All formats simulated anamnestic interviews with varying interactant and task representations using highly comparable designs. Interactants (patients) were simulated by (a) live actors (standardized patients), (b) live fellow students (roleplays), or (c) question menus and videoclips (virtual patients). The continuity of simulations varied. We measured perceived authenticity with three subscales: Realness, Involvement, and Spatial Presence. We employed confirmatory factor analysis (CFA) to assess measurement invariance across settings and analysis of variance on authenticity ratings to compare the effects of setting and discontinuous simulation. CFA supported the assumption of invariance. Settings differed in Realness and Spatial Presence but not Involvement. Discontinuous simulations yielded significantly lower ratings of authenticity than continuous simulations. The compared simulation modalities offer different advantages with respect to their perceived authenticity profiles. Lower levels of interactivity and reduced subtask representation do not necessarily lead to lower ratings of perceived authenticity. Spatial Presence can be as high for media-based simulation as for roleplays. Discontinuation of simulations by offering scaffolding impairs perceived authenticity. Scaffolds may be designed to avoid discontinuation of simulation to uphold perceived authenticity.

Learning in the workplace supports physicians in developing competences to ensure quality medical care. As such, learning in the workplace is essential for physicians' life-long professional development. Notwithstanding its importance, research on physicians' learning in the workplace and the corresponding motivational drivers is limited. In this study, 17 semi-structured interviews were conducted to explore experienced physicians' learning activities and their motivation for learning in the workplace. In addition, it was examined whether differences could be noted in learning in the workplace depending on physicians' experience, specialism, gender or the type of hospital they work in. Concepts from learning in the workplace and motivation theories, i.e. learning activities in the workplace, self-determination theory and achievement goal theory, guided the data analysis, and an inductive analysis was conducted as well. Results revealed various learning activities for instance but not limited to: learning by asking colleagues for feedback, asking for help while performing particular medical actions, helping students while conducting their assignments or observing colleagues. Besides, the participants indicated different motives for learning. Physicians reported that they are motivated to properly perform their job, they enjoy learning and/or like learning in relation to solving challenging cases. The study shows that participants' differences in motivation can be related to seniority and the type of hospitals physicians are employed in.

A detailed, unbiased perspective of the inter-relations among medical fields could help students make informed decisions on their future career plans. Using a data-driven approach, the inter-relations among different medical fields were decomposed and clustered based on the similarity of their working environments. Publicly available, aggregate databases were merged into a single rich dataset containing demographic, working environment and remuneration information for physicians across Canada. These data were collected from the Canadian Institute for Health Information, the Canadian Medical Association, and the Institute for Clinical Evaluative Sciences, primarily from 2018 to 2019. The merged dataset includes 25 unique medical specialties, each with 36 indicator variables. Latent Profile Analysis (LPA) was used to group specialties into distinct clusters based on relatedness. The 25 medical specialties were decomposed into seven clusters (latent variables) that were chosen based on the Bayesian Information Criterion. The Kruskal-Wallis test identified eight indicator variables that significantly differed between the seven profiles. These variables included income, work settings and payment styles. Variables that did not significantly vary between profiles included demographics, professional satisfaction, and work-life balance satisfaction. The 25 analyzed medical specialties were grouped in an unsupervised manner into seven profiles via LPA. These profiles correspond to expected and meaningful groups of specialties that share a common theme and set of indicator variables (e.g. procedurally-focused, clinic-based practice). These profiles can help aspiring physicians narrow down and guide specialty choice.

Teaching equitable clinical practice is of critical importance, yet how best to do so remains unknown. Educators utilize implementation science frameworks to disseminate clinical evidence-based practices (EBP). The Health Equity Implementation Framework (HEIF) is one of these frameworks, and it delineates how health equity may be concomitantly assessed and addressed in planning the implementation of an EBP. The HEIF therefore lays a strong foundation to understand and explain barriers and facilitators to implementation through an equity lens, making it well-suited for use by medical educators. Three equity-focused frames of reference within the model include (1) the clinical encounter, (2) societal context, and (3) culturally relevant factors, herein referred to as domains. The HEIF provides a structure for prospective and retrospective assessment of how EBP are taught and ultimately incorporated into clinical practice by trainees, with specific attention to delivering equitable care. We present three examples of common topics in internal medicine, contextualized by the three equity domains of the HEIF. We additionally acknowledge the limitations of this framework as a research tool with complex features that may not be suitable for brief teaching in the clinical environment. We propose a 360-degree learner assessment to ensure implementation of this framework is successful. By encouraging trainees to explore the narrative experiences of their patients and examine their own implicit biases, the HEIF provides a structure to address gaps in knowledge about delivering equitable care.

Simulation is accepted as an effective method of learning procedural skills. However, the translational outcomes of skills acquired through simulation still warrants investigation. We designed this study to assess if skills laboratory training in addition to bedside learning (intervention group [IG]) would provide better learning results than bedside learning alone (control group [CG]) in the context of venipuncture training. This prospective, cluster-randomized, single-blind study took place at the Faculty of Medicine, University of Kelaniya, Sri Lanka. Seventeen clusters of second-year medical students were randomly assigned to either IG or CG. The IG trained on venipuncture in the skills laboratory, receiving instruction after modified Payton's Four Step Method. Following the training, students of both IG and CG underwent bedside learning for one month. Afterward, students of both groups performed venipuncture on actual patients in a clinical setting. An independent, blinded assessor scored students' performance using the Integrated Procedural Protocol Instrument (IPPI) and a checklist. Patients assessed students' performance with the Communication Assessment Tool (CAT). Eight and nine clusters were randomized to the intervention and control groups, respectively. IG completed significantly more single steps of the procedure correctly (IG: 19.36 ± 3.87 for checklist items; CG: 15.57 ± 4.95; p < 0.001). IG also scored significantly better on IPPI ratings (median: IG: 27 (12) vs. CG: 21 (8); p < 0.001). Rated by patients, students' communication skills did not significantly differ between the two groups. Simulation-based venipuncture training enabled students to perform the procedure on actual patients with a higher technical accuracy than students who learned venipuncture at the bedside. Students were able to transfer the skills acquired through venipuncture training at the skill laboratory to the bedside.

Medical improvisation (improv) applies theater principles and techniques to improve communication and teamwork with health professionals (HP). Improv curricula have increased over time, but little is known about best practices in curricula development, implementation, and assessment. We sought to complete a state-of-the-art review of medical improv curricula to teach HP learners communication skills. A literature search of MEDLINE and 8 other databases on HP medical education and medical improv communication curricula occurred. We screened 1869 articles published from 2012 to 2022. Seventeen articles were selected for extraction and synthesis. Common curricular goals included improving interprofessional, interpersonal, and empathetic communication. Curricula often lacked alignment between learning objectives and improv exercises. Sessions occurred once (65%) or were longitudinal (35%). Only 24% reported a full description of their intervention. Few reported details on the content of curricula. Evaluations often focused on feasibility and acceptability. Heterogeneity exists in the development, implementation, and assessment of improv curricula. Low-quality evidence was provided to support the use of medical improv to teach communication skills to HP learners. Improv curricula were feasible, and acceptable to learners. We offer recommendations to guide future medical improv curricula development.