International Journal of Medical Education最新文献

{"title":"Core components of an anti-racist approach among health professions educators: an integrative review.","authors":"Amelie Blanchet Garneau, Patrick Lavoie, Vanessa Sit, Catherine Laurent Sédillot","doi":"10.5116/ijme.64e9.b6b4","DOIUrl":"10.5116/ijme.64e9.b6b4","url":null,"abstract":"<p><strong>Objectives: </strong>This integrative literature review aimed to identify the core elements of an anti-racist approach among health professions educators.</p><p><strong>Methods: </strong>We searched five databases CINAHL (EBSCOhost), ERIC (ProQuest Dissertations & Thesis Global), EMBASE (Ovid), MEDLINE (Ovid), and Web of Science (Social Sciences Citation Index, Citation Index Expanded) in March 2021. The search strategy combined concepts related to anti-racist pedagogies in the context of health professions education by educators in any capacity. From 1,755 results, we selected 249 manuscripts published in English or French between 2008 and 2021 based on titles and abstracts. After reviewing the full texts, we selected the 48 most relevant sources. We extracted data regarding knowledge, skills, and attitudes in reference to anti-racist approaches or surrogate terms. Within each category, we grouped similar data using a conceptual map.</p><p><strong>Results: </strong>Analysis of the selected sources revealed that, for health professions educators, engaging in an anti-racist pedagogical approach requires more than incorporating racialized perspectives and content into the classroom. It rather rests on three interrelated components: developing a critical understanding of power relationships, moving toward a critical consciousness, and taking action at individual and organizational levels.</p><p><strong>Conclusions: </strong>This review sheds light on knowledge, attitudes and skills that educators must deploy to adopt an anti-racist approach competently. This approach is a learned, intentional, and strategic effort in which health professions educators incorporate anti-racism into their teaching and apply anti-racist values to their various spheres of influence. This ongoing process strives for institutional and structural changes and requires whole-system actions.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"14 ","pages":"131-136"},"PeriodicalIF":3.1,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10284950","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 the COVID-19 Pandemic Taught Medical Educators in the Caribbean about Online Clinical Teaching","authors":"Sandra D. Reid, Bidyadhar Sa, Stanley Giddings, Reisha Rafeek, Shala Singh, Patrick Harnarayan, Niall Farnon","doi":"10.3390/ime2030021","DOIUrl":"https://doi.org/10.3390/ime2030021","url":null,"abstract":"The pandemic forced final year clinical students in six health-profession programs in a Caribbean University to suddenly transition from a clinical learning environment to an exclusively online environment for clinical instruction. The change in curriculum delivery allowed students to compare teaching of clinical skills using clinical and online learning environments. In June 2020, 278 students (78% response rate) completed a survey rating the online teaching experience. Students from each discipline also participated in a focus group discussion. Of the sample, 88% of students felt that the online environment was enthusiastic and stimulating but did not view it as satisfactory for skills transfer; 77% felt connected with their teachers but deprived of the social connectedness, peer support, and vicarious learning afforded by face-to-face instruction. Clinical students perceived the online environment as a convenient and beneficial platform to deliver didactic components of the clinical curriculum, thus providing downtime for students and ensuring equitable exposure of all students to all teachers. In the post-pandemic era, medical teachers should make the effort to maintain and refine online approaches, not just for use in times of emergency, but for integration into curriculum delivery strategies to improve the clinical learning environment and student satisfaction, while maintaining the hands-on method of clinical instruction.","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135740450","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":"Determining intra-standard-setter inconsistency in the Angoff method using the three-parameter item response theory.","authors":"Mohsen Tavakol, David O'Brien, Claire Stewart","doi":"10.5116/ijme.64ed.e296","DOIUrl":"10.5116/ijme.64ed.e296","url":null,"abstract":"<p><strong>Objectives: </strong>To measure intra-standard-setter variability and assess the variations between the pass marks obtained from Angoff ratings, guided by the latent trait theory as the theoretical model.</p><p><strong>Methods: </strong>A non-experimental cross-sectional study was conducted to achieve the purpose of the study. Two knowledge-based tests were administered to 358 final-year medical students (223 females and 135 males) as part of their normal summative programme of assessments. The results of judgmental standard-setting using the Angoff method, which is widely used in medical schools, were used to determine intra-standard-setter inconsistency using the three-parameter item response theory (IRT). Permission for this study was granted by the local Research Ethics Committee of the University of Nottingham. To ensure anonymity and confidentiality, all identifiers at the student level were removed before the data were analysed.</p><p><strong>Results: </strong>The results of this study confirm that the three-parameter IRT can be used to analyse the results of individual judgmental standard setters. Overall, standard-setters behaved fairly consistently in both tests. The mean Angoff ratings and conditional probability were strongly positively correlated, which is a matter of inter-standard-setter validity.</p><p><strong>Conclusions: </strong>We recommend that assessment providers adopt the methodology used in this study to help determine inter and intra-judgmental inconsistencies across standard setters to minimise the number of false positive and false negative decisions.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"14 ","pages":"123-130"},"PeriodicalIF":3.1,"publicationDate":"2023-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10198271","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":"Student Perception of Knowledge and Skills in Pharmacology and Pharmacotherapy in a Bachelor’s Medical Curriculum","authors":"Rahul Pandit, Merel C. S. Poleij, Mirjam A. F. M. Gerrits","doi":"10.3390/ime2030020","DOIUrl":"https://doi.org/10.3390/ime2030020","url":null,"abstract":"Background: Pharmacology and pharmacotherapy (P&PT) is a foundational subject within the medical curriculum, preparing students for safe prescribing. The characteristics of students entering medical school change with time, and novel insights on teaching and learning also become available. A periodic review of the curriculum is required to investigate whether the current P&PT teaching optimally supports learning. Methods: To investigate this, the students’ perceptions of their knowledge and competence in various P&PT topics were studied. A total of 152 third-year bachelor’s students were invited to answer a 40-point online questionnaire. Results: The response rate for completing the questionnaire was 32% (N = 49). Students valued P&PT teaching, did not skip P&PT topics and desired more P&PT classes. Interestingly, students were hesitant to use recommended literature and textbooks to prepare themselves for classes. Concerning perceptions of knowledge and competence, students rated lower confidence in prescription writing skills and knowledge of drugs acting on the central nervous system. Conclusions: Although there are many positive elements within the current curriculum, the incorporation of teaching methodologies to ensure active student engagement is warranted. These modifications are essential to properly training the current generation of medical students for their role as future prescribers. A relatively low response rate and overestimation of one’s competencies remain potential biases in the study.","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"29 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78144690","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":"The development of clinical reasoning throughout the training and career of psychiatrists in Singapore.","authors":"Daniel Poremski, Kay Wee Kwang, Felix Rene Zhi Yuan Lim, Yiqing Yan, Giles Ming-Yee Tan, Kang Sim","doi":"10.5116/ijme.64d9.e64b","DOIUrl":"10.5116/ijme.64d9.e64b","url":null,"abstract":"<p><strong>Objectives: </strong>The current study sought to explain how different professional experiences led Singaporean psychiatrists to alter their clinical reasoning processes as their careers evolved from psychiatry residents to senior consultant psychiatrists.</p><p><strong>Methods: </strong>The current qualitative study interviewed 26 clinicians at various stages of their psychiatric career, spanning residents to senior psychiatrists.  The authors used a constructivist grounded theory approach to structure the collection and analysis of data. Analyses produced a dense theoretical explanation rooted in the experiences of participants.</p><p><strong>Results: </strong>Several differences emerged between the way psychiatry residents and senior psychiatrists explained their reasoning process and the experiences on which they based their preference. Residents preferred using deductive logic-driven frameworks that were diagnosis-centric, because of the pressures they experienced during their training and assessments. Senior psychiatrists emphasized a more holistic and problem-centric approach. Participants attributed the changes that occurred over time to practical experiences, such as their greater clinical responsibility and independence, and individual experiences, such as growing sensitivity to the clinical reasoning process or their growing propensity for professional reflectiveness. These changes manifest as an increase in repertoire and flexibility in deployment of different clinical reasoning strategies.</p><p><strong>Conclusions: </strong>It is important for trainees to be aware of the deductive and inductive modes of clinical reasoning during supervision and to be comfortable with shifting clinical focus from diagnoses to specific individual problems. Training programs should provide and plan adequate longitudinal clinical exposure to develop clinical reasoning abilities in a way that allows consequences of decisions to be explored. Continued faculty development to ease the diversification of clinical reasoning skills should be encouraged, as should reflectivity in the learners during clinical supervision.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"14 ","pages":"108-116"},"PeriodicalIF":3.1,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10144424","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":"Prompt Engineering in Medical Education","authors":"Thomas F. Heston, Charya Khun","doi":"10.3390/ime2030019","DOIUrl":"https://doi.org/10.3390/ime2030019","url":null,"abstract":"Artificial intelligence-powered generative language models (GLMs), such as ChatGPT, Perplexity AI, and Google Bard, have the potential to provide personalized learning, unlimited practice opportunities, and interactive engagement 24/7, with immediate feedback. However, to fully utilize GLMs, properly formulated instructions are essential. Prompt engineering is a systematic approach to effectively communicating with GLMs to achieve the desired results. Well-crafted prompts yield good responses from the GLM, while poorly constructed prompts will lead to unsatisfactory responses. Besides the challenges of prompt engineering, significant concerns are associated with using GLMs in medical education, including ensuring accuracy, mitigating bias, maintaining privacy, and avoiding excessive reliance on technology. Future directions involve developing more sophisticated prompt engineering techniques, integrating GLMs with other technologies, creating personalized learning pathways, and researching the effectiveness of GLMs in medical education.","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"18 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82663675","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":"Cross-border contextualisation of family medicine curriculum: an examination of the process.","authors":"Brian McEllistrem, Molly Owens, David L Whitford","doi":"10.5116/ijme.64e3.740e","DOIUrl":"10.5116/ijme.64e3.740e","url":null,"abstract":"<p><strong>Objectives: </strong>This study explores a method of transferring a post graduate medical education curriculum internationally and contextualising it to the local environment. This paper also explores the experiences of those local medical educationalists involved in the process.</p><p><strong>Methods: </strong>Several methods were implemented. Firstly, a modified Delphi process for the contextualisation of learning outcomes was implemented with a purposefully sampled expert group of Malaysian Family Medicine Specialists. Secondly a small group review for supporting materials was undertaken. Finally, qualitative data in relation to the family medicine specialists' experiences of the processes was collected via online questionnaire and analysed via template analysis. Descriptive statistics were used.</p><p><strong>Results: </strong>Learning outcomes were reviewed over three rounds; 95.9% (1691/1763) of the learning outcomes were accepted without modification, with the remainder requiring additions, modifications, or deletions. Supporting materials were extensively altered by the expert group. Template analysis showed that Family Medicine Specialists related positively to their involvement in the process, commenting on the amount of similarity in the medical curriculum whilst recognising differences in disease profiles and cultural approaches.</p><p><strong>Conclusions: </strong>Learning outcomes and associated material were transferable between \"home\" and \"host\" institution. Where differences were discovered this novel approach places \"host\" practitioners' experiences and knowledge central to the adaptation process, thereby rendering a fit for purpose curriculum. Host satisfaction with the outcome of the processes, as well as ancillary benefits were clearly identified.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"14 ","pages":"117-122"},"PeriodicalIF":3.1,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10148843","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":"Efficacy of the Continuous Resuscitation Training with the Gap Period Due to the COVID-19 Pandemic","authors":"Que N. N. Tran, T. Moriguchi, N. Harii, J. Goto, D. Harada, H. Sugawara, J. Takamino, Masateru Ueno, Hirobumi Ise, A. Watanabe, Hiroki Sakata, Kengo Kondo, Natsuhiko Myose, Fuki Sakurabayashi","doi":"10.3390/ime2030018","DOIUrl":"https://doi.org/10.3390/ime2030018","url":null,"abstract":"(1) Objective: This study evaluates the effects of simulation education at our institute on cardiac arrest resuscitation regarding knowledge, attitude, and practice (KAP) over a five-year period (2016–2020). (2) Subjects: Staff responded to the annual survey questionnaires followed by monthly training in Basic Life Support/Advanced Cardiovascular Life Support (BLS/ACLS) and Immediate Cardiac Life Support (ICLS) of the Japanese Association for Acute Medicine (JAAM) in 2016, 2017, and 2018. Additionally, in-house training was implemented in 2019 without post-assessment followed by training suspension in 2020 due to the COVID-19 pandemic. The last delivery of the survey questionnaires was in late 2020 for KAP retention measurement. (3) Measurements and Results: The self-efficacy level of BLS/ACLS/ICLS KAP of the survey respondents was analyzed using a five-point Likert scale. The mean self-efficacy level of BLS/ACLS/ICLS KAP increased over time, and that of the trained people was three-fold that of the untrained people. Trainees that had no cardiopulmonary resuscitation (CPR) experience gained the BLS/ACLS/ICLS key-point self-efficacy level, which we call the “Grip 14” in this study, as high as their untrained counterparts who had three-time CPR experience. Training suspension lessened the BLS/ACLS/ICLS KAP in both groups. (4) Conclusions: Continuous training enhances not only the BLS/ACLS/ICLS KAP of trainees but also of their untrained colleagues. The training likely had the same efficacy as the CPR experience.","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"9 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81903387","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":"Integrating Language Instruction into Pharmacy Education: Spanish and Arabic Languages as Examples","authors":"M. N. Valcarcel-Ares, S. Abdulrhim, Karli Anders, R. Ali, B. Mukhalalati, F. Mraiche","doi":"10.3390/ime2030017","DOIUrl":"https://doi.org/10.3390/ime2030017","url":null,"abstract":"Effective communication is key for healthcare providers to provide optimal care for patients. Pharmacists’ fluency in a patient’s native language is important for effective communication. Additionally, language concordance improves patients’ trust and ensures health equity. In the United States (US), Hispanics are the largest minority group, but only 36% of the pharmacy schools in the US offer Spanish courses in their curriculum. Conversely, Middle Eastern countries have implemented English as the language of instruction in pharmacy schools, though the native language of the patient population is Arabic. The discrepancy between the language of education and the language used by patients might lead to communication problems, thus limiting a pharmacist’s role in practice. This review aims to describe the efforts of pharmacy schools both in the US and Middle Eastern countries to incorporate a second language (Spanish and Arabic, respectively) in their curriculum. Spanish language content has scarcely been introduced into the pharmacy curriculum in the US, either as didactic elements (elective courses, lab sessions, modules within a course, or co-curricular programs) or as language immersion experiences (rotations and internships, nationally or abroad). In Arabic-speaking countries, an Arabic course was introduced to the pharmacy curriculum to enhance students’ communication skills. This review provides an overview of the steps taken in various pharmacy programs to prepare students for adequate multilingual speaking. The findings reveal the need for additional strategies to assess the impact of language courses on student performance and patient experience, as well as language competence in pharmacists and pharmacy students.","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"7 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89954907","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":"A Pilot Study on Burnout in Medical Students (BuMS) over an Academic Year","authors":"Frederick J. Ashby, W. Dodd, Emily W. Helm, Daniel Stribling, L. Spiryda, C. Heldermon, Yuxing Xia","doi":"10.3390/ime2030016","DOIUrl":"https://doi.org/10.3390/ime2030016","url":null,"abstract":"Background: Physician burnout is increasingly recognized as a problem in physician well-being and may negatively affect patient care outcomes. Burnout can begin at any point of training or practice, potentially as early as the first year of medical school. Thus, there is a need to characterize possible burnout in medical students as the first step to optimizing strategies for mitigation. Traditionally, burnout has been studied using survey-based variables; however, identifying novel physiological and molecular biomarkers could allow for the expansion of screening and intervention strategies. Methods: In this pilot prospective cohort study, we followed a group of preclinical 1st and 2nd year medical students (n = 9) at the University of Florida over one academic year of medical school. We collected survey responses (Maslach Burnout Inventory [MBI], Patient Health Questionnaire-9 [PHQ-9], and Perceived Stress Scale [PSS]) and measured a panel of candidate physiological biomarkers of burnout (Inflammatory Cytokine Panel, Heart Rate Variability [HRV], and Leukocyte Telomere Length). Results: In the study participants, MBI composite scores and PHQ-9 scores showed a statistically significant increase over the course of an academic year, indicating higher levels of medical student burnout. Additionally, respondents reported a statistically significant decrease in time devoted to exercise, and we measured a significant increase in body mass index (BMI) during the academic year. PSS scores showed an upward trend which was not statistically significant. Likewise, average leukocyte telomere length trended downward, but the change was not statistically significant. There were no measured changes in the serum concentration of pro-inflammatory cytokines, and time-domain heart rate variability metrics did not differ significantly between timepoints. Conclusions: This pilot study supports the notion that burnout can begin early in medical school and is detectable via survey instruments in first-year and second-year medical students even with a small sample size. Additionally, leukocyte telomere length could potentially be a useful biomarker of burnout with supporting data, but we did not observe any statistically significant changes in inflammatory cytokines or heart rate variability. Further investigation into these potential biomarkers with larger cohort sizes is required to fully characterize their clinical utility.","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"15 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78691929","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}