Medical Teacher最新文献

{"title":"Using large language models (LLMs) to apply analytic rubrics to score post-encounter notes.","authors":"Christopher Runyon","doi":"10.1080/0142159X.2025.2504106","DOIUrl":"https://doi.org/10.1080/0142159X.2025.2504106","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) show promise in medical education. This study examines LLMs' ability to score post-encounter notes (PNs) from Objective Structured Clinical Examinations (OSCEs) using an analytic rubric. The goal was to evaluate and refine methods for accurate, consistent scoring.</p><p><strong>Methods: </strong>Seven LLMs scored five PNs representing varying levels of performance, including an intentionally incorrect PN. An iterative experimental design tested different prompting strategies and temperature settings, a parameter controlling LLM response creativity. Scores were compared to expected rubric-based results.</p><p><strong>Results: </strong>Consistently accurate scoring required multiple rounds of prompt refinement. Simple prompting led to high variability, which improved with structured approaches and low-temperature settings. LLMs occasionally made errors calculating total scores, necessitating external calculation. The final approach yielded consistently accurate scores across all models.</p><p><strong>Conclusions: </strong>LLMs can reliably apply analytic rubrics to PNs with careful prompt engineering and process refinement. This study illustrates their potential as scalable, automated scoring tools in medical education, though further research is needed to explore their use with holistic rubrics. These findings demonstrate the utility of LLMs in assessment practices.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-9"},"PeriodicalIF":3.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specialty disrespect in the medical learning environment: What is known and how can we intervene? A scoping review: BEME review no. 93.","authors":"Jeffrey M Weinfeld, Kathryn M Hart, Andrea P Cammack, Charles S Dorris, Tyrel Powell, Susan M Cheng, Brendan Egan, Yadana Khin, Xerxeser Kayode, Jordan Bui","doi":"10.1080/0142159X.2025.2503377","DOIUrl":"https://doi.org/10.1080/0142159X.2025.2503377","url":null,"abstract":"<p><strong>Background: </strong>Specialty disrespect or badmouthing is an aspect of the hidden curriculum that can inappropriately affect medical student specialty choice. The authors sought to map the breadth and depth of knowledge on this topic and identify existing interventions.</p><p><strong>Methods: </strong>A scoping review was conducted by systematically searching several databases, grey literature, and hand-searching reference lists. English-language reports were included from any country through September 2024. Two authors screened each record for eligibility, coded and extracted data.</p><p><strong>Results: </strong>Eighty-three reports were included in further analysis. Many terms were used to describe specialty disrespect, with badmouthing being the most common. Clinical faculty and non-primary care specialties were common sources of badmouthing and medical students were the most frequent recipients. Learners often encountered specialty shaming and perceived specialty hierarchies. Causes of disrespect included bias and stereotyping. Specialty disrespect was one of many factors impacting specialty choice. Few reports included implemented interventions.</p><p><strong>Conclusions: </strong>Specialty disrespect is a worldwide phenomenon negatively impacting the learning environment and specialty choice. It is experienced by trainees in many fields, though it disproportionately impacts primary care specialties. Given the dearth of published interventions, future work should identify and assess responses to this issue.[Box: see text].</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-10"},"PeriodicalIF":3.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fellows and medical students as tutors: Facilitating beginning medical students' clinical reasoning abilities.","authors":"Binbin Zheng, Joseph M Maciuba, Ting Dong, Steven J Durning","doi":"10.1080/0142159X.2025.2503379","DOIUrl":"https://doi.org/10.1080/0142159X.2025.2503379","url":null,"abstract":"<p><strong>Backgrounds: </strong>Clinical reasoning (CR) is a foundational ability for medical students, requiring the integration of analytical and non-analytical (intuitive) approaches. While expert performing clinicians often struggle to articulate their CR, near-peer teaching (NPT) offers a promising approach to facilitate CR development. This study explores how NPT supports beginning medical students in learning CR through small group discussions.</p><p><strong>Methods: </strong>This study was conducted in a U.S. medical school and included four small group discussions led by senior medical students with faculty support or fellows. Video recordings of the discussions were transcribed and analyzed at both entire conversation and episode levels. A combination of thematic analysis and lag-sequential analysis (LSA) was used to identify tutors' discourse moves, sequential patterns, and unique facilitation strategies.</p><p><strong>Results: </strong>Near-peer tutors employed four key strategies: modeling reasoning processes, preparing students for real-world clinical interactions, sharing test-taking strategies, and creating a conducive learning environment through humility. Sequential patterns revealed that tutors used strategic questioning to scaffold students' diagnostic reasoning, guiding them from basic orientation to complex evaluation. Tutors' relatability, rooted in recent learning experiences, enhanced student engagement and understanding.</p><p><strong>Conclusion: </strong>To maximize NPT's potential, medical schools should provide targeted professional development and consider co-facilitation with faculty to balance relatability and content expertise.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-11"},"PeriodicalIF":3.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve tips: Using generative AI to create and optimize content for virtual patient simulations.","authors":"Michael Moser, Nancy Posel, Olivia Ganescu, David Fleiszer","doi":"10.1080/0142159X.2025.2501252","DOIUrl":"https://doi.org/10.1080/0142159X.2025.2501252","url":null,"abstract":"<p><p>Generative Artificial Intelligence (GenAI) is increasingly being used in medical education, including the creation of content for clinical virtual patient simulation (VPS). We share practical insights drawn from our experience as medical educators, designed to help other educators integrate GenAI tools such as ChatGPT, Gemini, or Claude. We provide 12 practical tips that illustrate how GenAI can be used for the creation of content for VPS to streamline case development and increase realism for our learners. GenAI saves resources of time and expense by streamlining case creation, including creating patient images, clinical reports, and assessment questions. Clinical content experts can now concentrate on defining the case focus and on final-stage review, improving efficiency. It simplifies the development of effective scoring rubrics and meaningful formative feedback, enhancing learner engagement and clinical reasoning. By reducing the time needed to create VPS content, GenAI can allow educators to focus more on educational objectives and feedback to programs and learners. While GenAI is new and has limitations, these are likely to be addressed in the near future. As GenAI evolves, it will continue to transform VPS through improved realism, streamlined case creation, and more informative feedback, further supporting its role in medical education.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-7"},"PeriodicalIF":3.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge circulation and the politics of citation: Referencing is not a neutral act.","authors":"Jennifer Cleland","doi":"10.1080/0142159X.2025.2504313","DOIUrl":"https://doi.org/10.1080/0142159X.2025.2504313","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-2"},"PeriodicalIF":3.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of virtual pathology teaching in health professions education: A systematic review: BEME Systematic Review No. 95.","authors":"Justin Hau, See Chai Carol Chan, Ishrat Hussain, James Kelly, Mohammed Ahmed Rashid","doi":"10.1080/0142159X.2025.2497890","DOIUrl":"https://doi.org/10.1080/0142159X.2025.2497890","url":null,"abstract":"<p><strong>Purpose: </strong>Rapid changes to learning technologies, accelerated by the COVID-19 pandemic, have led to the widespread adoption of virtual education. Pathology is an important medical science that is central to many curricula in health professions education (HPE). It has been impacted by the broader transition to virtual education. This systematic review and meta-ethnography evaluated the experiences of virtual pathology education within HPE.</p><p><strong>Methods: </strong>MEDLINE and EMBASE were systematically searched for peer-reviewed qualitative journal articles describing the experiences of virtual pathology in HPE. Of 1119 articles identified, 17 were synthesised using a meta-ethnographic approach.</p><p><strong>Results: </strong>The final synthesis represented a total of 2126 participants, including 1256 undergraduate medical students, 297 resident doctors, 473 senior clinicians, and 100 teaching faculty. We identified the following third-order constructs: 'Adaptability to learner's needs', 'negative human consequences', and 'uncertainty about trajectory'.</p><p><strong>Conclusion: </strong>This review highlights both positive and negative impacts of transitioning pathology education to virtual delivery. The need to enhance current educational practice according to these findings is particularly pressing since the shift to virtual education in pathology looks set to accelerate in years to come.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-9"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing medical student participation in scholarly publications at a primary care-focused medical school.","authors":"Em Long-Mills, Dmitry Tumin, Kori L Brewer, David L Eldridge, Jason D Higginson","doi":"10.1080/0142159X.2025.2504112","DOIUrl":"https://doi.org/10.1080/0142159X.2025.2504112","url":null,"abstract":"<p><strong>Introduction: </strong>Research and scholarly activity during medical education can support medical students' ability to apply skills learned in the curriculum, develop professional networks, explore new interests, and strengthen their application for residency programs. Existing programs developed to facilitate medical student scholarly activity have typically resulted in poster or oral presentations of student work, but have encountered barriers to guiding student projects towards peer-reviewed publication. We sought to evaluate how a novel approach of offering both mentorship and logistical support for student scholarly activity within a school-level office contributed to medical students' output of peer-reviewed publications.</p><p><strong>Methods: </strong>The Office of Clinical and Educational Scholarship (OCES) was established in 2021. Students graduating between 2015 and 2024 were included in the evaluation, and student publications during medical school were tracked using PubMed. Mixed-effects regression models quantified the association between OCES establishment and student publication outcomes in each calendar year.</p><p><strong>Results: </strong>The proportion of students with a publication increased from 14% to 51% between the Classes of 2015-2024. Among the Class of 2024, the OCES team coauthored or consulted on 34 of 81 unique publications. On multivariable analysis, OCES establishment doubled students' odds of having any publication in a given calendar year (odds ratio: 2.3; 95% confidence interval [CI]: 1.3,4.0; <i>p</i> = 0.003) and the number of publications per year (incidence rate ratio: 2.2; 95% CI: 1.4,3.4; <i>p</i> = 0.001).</p><p><strong>Discussion: </strong>By offering both mentorship and logistical support for scholarly projects in a centralized, flexible model, our office supported student engagement in scholarly work at students' own pace, and facilitated an increase in the proportion of students graduating with a publication to over half of the graduating class. This strategy can help other institutions meet students' demand for research opportunities progressing to publication, while helping students balance scholarly efforts with their medical school curriculum and other extracurricular activities.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-10"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translating faculty development into practice and professional identity: The lived experience of clinical educators.","authors":"Emma Bartle, Kiah Evans, Annette Burgess, Tyler Clark, Akhil Bansal, Wendy Hu, Elie Matar, Sandra E Carr","doi":"10.1080/0142159X.2025.2503380","DOIUrl":"https://doi.org/10.1080/0142159X.2025.2503380","url":null,"abstract":"<p><strong>Introduction: </strong>There is limited evidence about whether and how faculty development programs influence clinical educators' practice and professional identity formation, and the factors which make faculty development outcomes sustained and impactful.</p><p><strong>Methods: </strong>This multi-institution interpretive phenomenological study reports on the findings from in-depth interviews of 21 clinical educators who had participated in university-based longitudinal faculty development programs.</p><p><strong>Results: </strong>Participants perceived completing these programs had influenced their growth as clinical educators. There was evidence that participants experienced growth differently based on the program duration: all participants described growth in teaching practices but those who had completed a program of one year or longer in duration also articulated their experiences around growing in their educator identity and perspective. According to participants, the program elements that most influenced growth were embedded reflective learning activities, opportunities to learn and apply at the same time, and connections they made with other clinical educators in the program.</p><p><strong>Conclusions: </strong>Our findings contribute to an ongoing discussion around how clinical educators' translate learning outcomes from university-based faculty development programs into their clinical and education workplaces. Importantly, they provide insights into how longer longitudinal faculty development programs can support professional identity development and provide a viable and visible career path as a future clinician educator.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-10"},"PeriodicalIF":3.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical education in Brazil: More schools, but what for?","authors":"Ugo Caramori","doi":"10.1080/0142159X.2025.2503378","DOIUrl":"https://doi.org/10.1080/0142159X.2025.2503378","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1"},"PeriodicalIF":3.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical students with disabilities: Pushing for research and reconceptualization of inclusion.","authors":"Sarah Ross, Samantha Smith, Jennifer Cleland","doi":"10.1080/0142159X.2025.2501260","DOIUrl":"https://doi.org/10.1080/0142159X.2025.2501260","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-3"},"PeriodicalIF":3.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}