International Journal of Medical Education最新文献

{"title":"Cultural competence in United States medical education: a scoping review of implementation and evaluation practices.","authors":"Neeti Swami, Haley Lewsey, Angelica Nibo, Radha Patel, Stephanie Stroever, Lauren Cobbs","doi":"10.5116/ijme.69c3.e171","DOIUrl":"https://doi.org/10.5116/ijme.69c3.e171","url":null,"abstract":"<p><strong>Objectives: </strong>The objective is to identify what is needed in Cultural Competence Curricula in medical schools and suggest a framework for evidence-based curricula that can be flexibly applied.</p><p><strong>Methods: </strong>We conducted a scoping literature review of Cultural Competence Curricula in United States medical schools. After reviewing 160 articles, 77 met inclusion criteria for analysis. We collected qualitative data on curricula described in each article to analyze elements of curriculum structure, evaluation, and study design.</p><p><strong>Results: </strong>Our results illustrate a high prevalence of structure styles conducive for quality learning, including longitudinality, integration, incorporation into clinical training, and experiential learning. The most common method for evaluating student learning was student self-evaluation with few programs performing reevaluations or utilizing patients as evaluators. Of knowledge, attitudes and skills, skills were least evaluated. Curricula with higher self-reported efficacy used a greater proportion of self-evaluations, while ones with lower self-reported efficacy used more external evaluations. Quasi-experimental study designs were more common in curricula with high self-reported efficacy.</p><p><strong>Conclusions: </strong>Curriculum developers across the world can improve implementation of Cultural Competency Curricula by maximizing the quantity of structural components, having higher quality of evaluation, and connecting with the local community surrounding their medical school. To develop a robust curriculum, we encourage longitudinal multi-component learning in integrated courses evaluated via experimental and quasi-experimental study designs.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"17 ","pages":"26-41"},"PeriodicalIF":1.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a self-determination theory-informed coaching framework for the transition to residency.","authors":"Margaret Wolff, Matthew Kelleher, Luan Lawson, Noriko Anderson, William B Cutrer, Benjamin Kinnear, Cindy Lai, Chemen Neal, Archana Pradhan, Maya Sardesai, Sally Santen, Jean Klig","doi":"10.5116/ijme.69af.f143","DOIUrl":"https://doi.org/10.5116/ijme.69af.f143","url":null,"abstract":"<p><strong>Objectives: </strong>To develop and content-validate a consensus-based, Self-Determination Theory (SDT)-informed single-session coaching framework for the transition from medical school to residency (TTR).</p><p><strong>Methods: </strong>We conducted a modified Delphi study with 13 medical educators from 11 U.S. medical schools, purposively sampled for diversity of geography, institutional type, and coaching infrastructure. Eligibility required experience coaching in medical education. Using a nominal group technique, panelists generated 125 prompts and 12 skills across the coaching arc (opening, exploring, planning, closing). Duplicates were consolidated by consensus rules. In Round 1, panelists rated items on a 1-10 scale; consensus was >80% rating 9-10. In Rounds 2-3, binary yes/no voting determined inclusion or exclusion. Quantitative analysis included medians, interquartile ranges, and Kendall's coefficient of concordance (W) for Round 1. Qualitative comments were analyzed with rapid content analysis to guide revisions.</p><p><strong>Results: </strong>All panelists completed each round (100% retention). In Round 1, 17 questions and 2 skills met consensus (median = 9, IQR 0-1; W = 0.78). Round 2 retained 2 questions and 1 skill, and excluded 62 items. Round 3 added 6 questions and 1 skill, yielding a final framework of 25 prompts and 4 skills. Prompts were distributed across phases (opening 5, exploring 9, planning 7, closing 4) and mapped to SDT needs (autonomy 9, competence 8, relatedness 8). Panelists affirmed clarity, feasibility, and acceptability for non-coach faculty.</p><p><strong>Conclusions: </strong>This consensus-derived framework provides a pragmatic, SDT-grounded tool for coaching at the TTR. Future studies should evaluate feasibility, fidelity, and learner outcomes.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"17 ","pages":"20-25"},"PeriodicalIF":1.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring stress and coping skills of medical students: a repeated cross-sectional cohort study.","authors":"David W Musick, Tracey M Criss, Mariah J Rudd, R Brock Mutcheson, Daniel Harrington, Aubrey L Knight","doi":"10.5116/ijme.6984.a86a","DOIUrl":"https://doi.org/10.5116/ijme.6984.a86a","url":null,"abstract":"<p><strong>Objectives: </strong>To examine stressors and coping skills as reflected in the student population at a southeastern United States medical school, including identifying key stressors over time and coping mechanisms used.</p><p><strong>Methods: </strong>Repeated cross-sectional cohort, mixed-methods study conducted between 2016 and 2022 at a four-year medical school program. Participants were students from seven classes, with two classes providing data during each of their four years of medical school. A census sampling approach was used, with survey data collected annually from each class across four years.  Two surveys were used:  the Perceived Stress Scale (PSS) and a modified Coping Orientation to Problems Experienced (COPE) Inventory.  Open-text questions captured qualitative responses. Statistical analysis included Welch's t-tests, Pearson correlations, and Cronbach's alpha reliability testing. Qualitative data were examined through inductive thematic analysis.</p><p><strong>Results: </strong>Students reported moderate levels of perceived stress across all four years with fluctuations identified by year of study. There were no statistically significant differences in perceived stress based on student gender; however, qualitative findings identified gender differences related to coping strategies. Thematic analysis of qualitative data revealed three recurring categories of stressors: academic workload, residency application and match pressures, and personal life challenges. Stressors shifted from academic in the pre-clinical years to career concerns during the clinical years.</p><p><strong>Conclusions: </strong>This study highlights the presence of stress throughout medical school and underscores the importance of adaptive coping strategies and the need for phase-specific interventions to support student well-being. Future research should evaluate the effectiveness of interventions in reducing stress across training stages.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"17 ","pages":"10-19"},"PeriodicalIF":1.9,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managerial perceptions of core competencies for healthcare middle managers in Bahrain and Saudi Arabia: a qualitative study.","authors":"Ahmed Mohamed Al Ansari","doi":"10.5116/ijme.6957.fb46","DOIUrl":"https://doi.org/10.5116/ijme.6957.fb46","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify and compare the perceptions of senior, middle, and frontline managers regarding the core competencies required for effective healthcare middle managers in Bahrain and Saudi Arabia. It also explored how these competencies can inform competency-based leadership development programs globally.</p><p><strong>Methods: </strong>A qualitative descriptive design was adopted. Twenty-seven participants from healthcare and medical education institutions in Bahrain and Saudi Arabia were purposively selected across three hierarchical levels: senior (n = 6, 22%), middle (n = 10, 37%), and frontline (n = 11, 41%). Semi-structured interviews were conducted virtually, audio-recorded, transcribed verbatim, and analyzed thematically using Braun and Clarke's six-step framework. Credibility was strengthened through member checking, peer debriefing, and an audit trail.</p><p><strong>Results: </strong>Five overarching competency domains emerged in the study. They include personality, managerial skills, work ethics, mental ability and interaction. Personality, integrity, and organizational ability were the most frequently cited traits (93%). Managerial and social competencies such as time management (90%), teamwork (83%), communication (70%), and decision-making (60%) were emphasized across all managerial levels. Senior managers prioritized strategic agility and ethics, whereas frontline managers stressed interaction and communication. These patterns reflect the dual operational and relational demands of middle management in healthcare.</p><p><strong>Conclusions: </strong>Successful healthcare middle managers require a balanced integration of technical proficiency, ethical integrity, interpersonal competence, and adaptability. Embedding these domains into competency-based leadership training could enhance organizational performance and strengthen healthcare governance across the region.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"17 ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146051952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faculty development and career success in clinical teaching.","authors":"Anna YuQing Huang, Wan-Yu Yeh, Ezra Jiyang Lin, Jen-Feng Liang, Ying-Ying Yang, Po-Ting Hsu, Chia-Chang Huang, Shiau-Shian Huang, Stephen J H Yang, Chen-Huan Chen","doi":"10.5116/ijme.693a.e41b","DOIUrl":"10.5116/ijme.693a.e41b","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the effectiveness of overall faculty development (FD) programs in terms of three indicators of successful careers of clinical teachers (CTs): positive feedback (on personality traits or teaching skills) from students, teaching awards, and scholarly publications.</p><p><strong>Methods: </strong>Data on student feedback, number of teaching awards, number of scholarly publications, and sum of FD participation hours in a teaching hospital with 23 clinical departments and 623 clinical faculty members (2019-2021) were collected and analyzed using Spearman's rank-order correlation coefficient (r_s) and independent-samples t-tests (with Welch's correction where appropriate).</p><p><strong>Results: </strong>The sum of FD hours was significantly associated with positive feedback from students (r_s = 0.15, p = .001) but not with teaching awards or publications. Furthermore, faculty members with more FD hours on research skills received better positive feedback from students regarding personal traits or teaching skills (Cohen's d = 0.60, 95% CI [0.34, 0.86], p < .001) and more teaching awards (Cohen's d = 0.34, 95 % CI [0.13, 0.55], p = .010) but did not have a greater number of publications (Cohen's d = 0.15, 95% CI [-0.07, 0.36], p = .780) than those with lower research FD hours. In addition, the number of teaching awards was significantly associated with positive feedback from students regarding personal traits (r_s = 0.92, p < .001) or teaching skills (r_s = 0.93, p < .001), and publication quantity (r_s = 0.13, p < .001) was markedly correlated with the number of teaching awards.</p><p><strong>Conclusions: </strong>FD activities may provide positive impacts on CTs in terms of feedback from students and teaching awards but do not directly impact scholarly publications. However, faculty members who received teaching awards and positive feedback from students may have better scholarly publication performance.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"16 ","pages":"203-211"},"PeriodicalIF":1.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12768577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing creativity and pragmatism: insights from a curriculum for interprofessional learning at Linköping University.","authors":"Maria Kvarnström, Susanne Kvarnström, Elin A Karlsson","doi":"10.5116/ijme.6931.a9c2","DOIUrl":"10.5116/ijme.6931.a9c2","url":null,"abstract":"<p><strong>Objectives: </strong>This study explores the application of the current curriculum, launched in 2016, for interprofessional learning (IPL) at the Faculty of Medicine and Health Sciences at Linköping University, Sweden.</p><p><strong>Methods: </strong>Perceptions from students, teachers and key persons (n=19) were investigated with focus groups and individual interviews. The interviews explored perceptions of curriculum design, implementation, and interprofessional learning activities. A four-dimensional framework for curriculum development and evaluation constituted the theoretical lens for the analysis. Specifically, a qualitative directed content analysis was used.</p><p><strong>Results: </strong>Four overarching categories were identified. 1) \"Aiming towards high quality healthcare professionals working together naturally\", included the arguments for IPL within healthcare and why the curriculum revision was conducted. 2) \"Comprehending how to work in a group, a team, and an interprofessional team\", related to the desired learning outcomes and competencies. 3) \"All on board? - The search for meaningful learning activities for students and teachers that the programs embrace\", reflected on how learning activities were designed and experienced. 4) \"Enhancing legitimacy and the provision of organizational prerequisites for the curriculum\", described the organisational structures for enhancing the legitimacy of the IPL curriculum, as well as the role of teachers.</p><p><strong>Conclusions: </strong>This study emphasizes balancing pedagogical innovation with pragmatic considerations for successful curriculum application. The findings highlight the need for experienced teachers, organisational support, and meaningful learning activities that align with both program-specific and interprofessional outcomes. Despite challenges, the current curriculum at Linköping University shows potential as a model for integrating interprofessional learning into health professions education.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"16 ","pages":"192-202"},"PeriodicalIF":1.9,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12756881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting the role of international developmental-behavioural paediatric fellowship training: a developing country's perspective.","authors":"Jun Jean Ong, Ranjini S Sivanesom, Ashikin Mohd Nordin, Wee Vien Khoo, Gehan Roberts","doi":"10.5116/ijme.6923.3f20","DOIUrl":"10.5116/ijme.6923.3f20","url":null,"abstract":"","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"16 ","pages":"188-191"},"PeriodicalIF":1.9,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12700667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotion regulation strategies of experienced oncology nurses: a qualitative study.","authors":"Yuji Iwama","doi":"10.5116/ijme.6921.a243","DOIUrl":"10.5116/ijme.6921.a243","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to elucidate, through qualitative analysis, the cognitive processes by which experienced oncology nurses regulate their emotions when facing anxiety and emotional conflict in communication with patients.</p><p><strong>Methods: </strong>We employed a qualitative exploratory design using semi-structured individual interviews with six certified oncology nurses in Japan. Participants were recruited via snowball sampling and provided written informed consent. Interviews were conducted in Japanese using a pre-tested interview guide; audio data were transcribed verbatim. Data were analyzed with the Steps for Coding and Theorization (SCAT) method. Metacognitive theory-distinguishing metacognitive knowledge and metacognitive regulation-guided interpretation of the findings.</p><p><strong>Results: </strong>Analysis of 38 theoretical descriptions yielded two overarching themes: (1) anxiety and conflict in communication with cancer patients, and (2) metacognitive emotion-regulation strategies. The latter comprised two subthemes: (a) patient-oriented cognitive strategies (e.g., linguistic adjustments, trust-building, facilitating patients' self-regulation), and (b) self-oriented cognitive restructuring (e.g., reframing dilemmas, monitoring and modulating one's own emotional responses). These processes reflected deliberate monitoring and regulation of thinking and feelings to sustain constructive engagement with patients.</p><p><strong>Conclusions: </strong>Experienced oncology nurses use metacognition to recognize, interpret, and flexibly regulate emotions in challenging interpersonal situations. Educational implications include integrating structured metacognitive reflection alongside empathy and mindfulness training to cultivate durable, transferable coping skills. Future studies should examine this approach in diverse clinical contexts, include larger and cross-cultural samples, and evaluate longer-term outcomes in nurses' emotional resilience and clinical practice.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"16 ","pages":"181-187"},"PeriodicalIF":1.9,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12700670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faculty perceptions of microlearning in health professions education: a mixed method analysis of implementation factors.","authors":"Nilesh Kumar Mitra, Norah Htet Htet, Vasudeva Rao Avupati, Fabian Davamani, Pamela David, Ker Woon Choy, Vishna Devi Nadarajah","doi":"10.5116/ijme.68ff.c63e","DOIUrl":"10.5116/ijme.68ff.c63e","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to explore the preparedness of faculty in health professions education at three Malaysian universities by assessing their perceptions of basic concepts in microlearning as well as factors affecting effective content construction and digital format preferences.</p><p><strong>Methods: </strong>An explanatory sequential mixed-method approach was used to systematically analyse faculty perceptions by integrating quantitative and qualitative findings. A total of 121 faculty members voluntarily completed the online survey. A qualitative exploratory study was conducted with 20 selected staff members, followed by a thematic analysis. Descriptive and analytical statistics, including Pearson's chi-square test, were used to analyse the data.</p><p><strong>Results: </strong>The survey revealed that 95.9% (n=116) of faculty members agreed that microlearning is ideal for the acquisition of microcontent with single learning outcomes. The optimal duration should be between 3 and 5 minutes. Strong associations [χ²(16, N=121) =33.17, p=0.007] between time duration and content size and content size and form of knowledge [χ²(16, N=121) =28.79, p=0.025] were observed in chi-square goodness-of-fit test. Microcontent of a single learning outcome, chunking of content, cognitive load, and degree to which topic connects with the media used emerged as primary sub-themes. Challenges in adapting skills to construct engaging microlearning content were highlighted.</p><p><strong>Conclusions: </strong>The study provides a microlearning framework for health professional educators to consider the complexity of content, its format, and integration with suitable digital tools. Future research should explore how combinations of microlearning and other instructional formats optimise learning outcomes.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"16 ","pages":"172-180"},"PeriodicalIF":1.9,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12700666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What supports applicants' reasons for becoming physicians: a thematic analysis of their beliefs and statements.","authors":"Shunsuke Kimura, Fumitaka Tanemura, Satoshi Kodama, Hiroshi Nishigori","doi":"10.5116/ijme.68f3.9b51","DOIUrl":"10.5116/ijme.68f3.9b51","url":null,"abstract":"<p><strong>Objectives: </strong>To address the problem of medical school applicants' lying about their reasons for becoming physicians in the admissions process, this study aims to explore the grounds for their reasons by distinguishing between their beliefs and statements.</p><p><strong>Methods: </strong>The participants, recruited by convenience sampling, were 15 medical students and physicians who had entered graduate-entry programs of medical schools in Japan. We conducted individual semi-structured online interviews in 2020 and performed a reflexive thematic analysis.</p><p><strong>Results: </strong>We generated five themes regarding the grounds for applicants' reasons in their beliefs: consistency with past interests, experience of being underprivileged, experience of family disease, parental influence, and no grounds; four themes regarding the grounds for applicants' true reasons in their statements: consistency with actual past interests, actual experience of being underprivileged, actual experience of family disease, and actual experience of being powerless for patients; and four themes regarding the grounds for applicants' untrue reasons in their statements: consistency with actual or fictional past interests, actual experience of family disease, fictional parental influence, and convenient origin.</p><p><strong>Conclusions: </strong>This study is the first to distinguish between applicants' beliefs and statements and analyze the grounds for their reasons for becoming physicians. The findings propose a reconstruction of the concept of reasons for becoming physicians and suggest that admissions committees may be able to verify applicants' reasons in their statements by asking them to present the grounds for them.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"16 ","pages":"163-171"},"PeriodicalIF":1.9,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12700664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}