International Journal of Medical Education最新文献

{"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}

{"title":"Beyond travel restrictions: exploring alternative infection control measures for Japanese medical students.","authors":"Yudai Kaneda, Miyuka Kushibe","doi":"10.5116/ijme.64b8.db07","DOIUrl":"10.5116/ijme.64b8.db07","url":null,"abstract":"","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"14 ","pages":"106-107"},"PeriodicalIF":3.1,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9925449","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":"Effect of shift-based scheduling on student learning, satisfaction and capacity in obstetrics and gynecology rotations.","authors":"Erin Nelson","doi":"10.5116/ijme.64b4.f880","DOIUrl":"10.5116/ijme.64b4.f880","url":null,"abstract":"<p><strong>Objectives: </strong>Determine how a shift- based schedule to accommodate more students affects learning, performance, and satisfaction with the Obstetrics and Gynecology (OBG) rotation.</p><p><strong>Methods: </strong>The study was conducted among third year OBG medical students with a triangular convergent cross-sectional approach. A new shift-based schedule was implemented. After each rotation, an online survey was conducted using a convenience sampling. Student scores on the National Board of Medical Examiner (NBME) OBG subject exam were analyzed using paired t test. Survey data was analyzed using two sample t test. The relationship between survey responses and exam score findings were described. Data from shift-schedule students was compared to traditional schedule students from the prior academic year.</p><p><strong>Results: </strong>A statistically significant improvement was seen for average NBME score for shift-schedule students during the beginning portion (groups 1-3) of the academic year (M=80, SD=6.9) compared to traditional (M=75.7, SD=7.3) [t ₍₁₄₅₎ =3.69, p =.001]. A similar pattern was not seen in subsequent groups (groups 4-6). Shift-schedule students also showed a statistically significant improvement in their perception of learning (t ₍₁₈₃₎ =-2.54, p =.012). Parallel results were seen for belonging, manageable workload, time to study, and engaging meaningfully. Using this model, we increased rotation capacity from 24 to 30 students per group (20%).</p><p><strong>Conclusions: </strong>Shift based scheduling allows 20% increase in capacity. Exam scores and student learning outcomes were similar or better than traditional schedule controls.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"14 ","pages":"100-105"},"PeriodicalIF":3.1,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10300830","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":"How Can Curricular Elements Affect the Motivation to Study?","authors":"Catherine Bopp, Aline Salzmann, Silke Ohlmeier, Melanie Caspar, E. Schmok, Sara Volz-Willems, Johannes Jäger, Fabian Dupont","doi":"10.3390/ime2030015","DOIUrl":"https://doi.org/10.3390/ime2030015","url":null,"abstract":"(1) Background: This qualitative study aimed to identify and describe course components which affect a student’s motivation to learn within a blended-learning competency-based curriculum. (2) Methods: The data were gathered via two consecutive semi-structured group interviews. The participants were purposefully sampled from medical students attending the Family Medicine (FM) class at Saarland University (UdS) in Winter 2020. The two interviews were transcribed verbatim and inductively analysed using content analysis. (3) Results: Three categories of curricular components that affected motivation were inductively formed: (a) the provision of structure (curriculum design), where providing external learning milestones to self-regulated learning positively influenced an interviewee’s learning motivation; (b) the provision of interpersonal interactions and emotional relatedness by staff, where constructive feedback and enthusiasm from a teacher facilitated intrinsic motivation and real-life examples helped the students to remember content more easily; and (c) perceived gain in self-efficacy, where a participant’s motivation to learn a particular subject area was especially high if it appeared to be highly relevant to practice or exams and the applicability of the knowledge gained was readily apparent. (4) Conclusions: It is important for educators to be aware of how they influence a student’s motivation. This study may help to provide an orientation on what to avoid and what to include in a curriculum design project to purposefully foster motivation in students.","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"135 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73786409","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":"Examining factors that drive health-related students to seek help for psychological challenges.","authors":"Nidwaree Sojindamanee, Sirichai Hongsanguansri, Somboon Hataiyusuk, Nareemarn Neelapaichit, Karn Suttapanit, Ponjit Jithavech, Komsan Kiatrungrit","doi":"10.5116/ijme.64a7.bffb","DOIUrl":"10.5116/ijme.64a7.bffb","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to find the prevalence of mental health problems and the rates of seeking mental health care among health-related students, as well as identifying factors associated with seeking mental health care.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among students from the Faculty of Medicine at a university in the 2021 academic year. A total of 832 students voluntarily completed an online survey measuring mental health problems and factors influencing mental health care seeking. Descriptive and analytic statistics including t-test, Pearson's chi-square test, and binary logistic regression analysis, were used to analyze the data.</p><p><strong>Results: </strong>Among the participants, 46.80% (n = 389) reported experiencing mental health problems, but only 16.97% (n = 66) of them sought mental health care. Binary logistic regression analysis revealed that female (OR = 2.63 (1.08 - 6.43)) and LGBTQ (OR = 4.26 (1.36 - 13.37)) students, and those with a positive attitude toward professionals (OR = 1.10 (1.02 - 0.19)), were more likely to seek formal mental health care than those who did not.</p><p><strong>Conclusions: </strong>The study findings indicate that mental health problems are prevalent among health-related students, yet formal mental health care uptake is low. To address this issue, mental health screening programs, improved knowledge and attitudes about mental health care, and mental health training for academic staffs who work with health-related students are necessary. Future studies should explore interventions to increase the uptake of mental health services among health-related students.</p>","PeriodicalId":14029,"journal":{"name":"International Journal of Medical Education","volume":"14 ","pages":"88-99"},"PeriodicalIF":3.1,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9856055","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}