Advances in Medical Education and Practice最新文献

{"title":"Associations Between Supervisory Alliance, Medical Resident Distress, Burnout, and Self-Esteem.","authors":"Danielle L Terry, Prabhdeep Bajwa","doi":"10.2147/AMEP.S472321","DOIUrl":"10.2147/AMEP.S472321","url":null,"abstract":"<p><strong>Introduction: </strong>Supervision is considered a collaboration between a supervisor and supervisee and includes perceptiveness, responsiveness of the supervisor, a state of rapport, and specific learning tasks that allow the individual to work towards a goal. The alliance in supervision has been identified as a key ingredient of effective supervision, regardless of the type of treatment, population, or supervision model being used. While it is known that the medical training environment hosts high rates of burnout, little research has examined the role of supervisory alliance in regard to burnout, distress, and self-esteem. This study aimed to apply previous models of supervisory alliance to medical education, and explore associations between educational alliance and trainee self-esteem, burnout, and distress.</p><p><strong>Methods: </strong>Participants included 108 medical trainees (response rate = 81%). Medical trainees were recruited from a rural Pennsylvanian teaching hospital and asked to complete a voluntary and anonymous electronic survey. Multiple linear regression was used to examine the association between supervisory alliance and burnout and distress, while controlling for average hours worked and slept.</p><p><strong>Results: </strong>Results suggested that supervisory alliance was associated with burnout, distress, and self-esteem among medical trainees.</p><p><strong>Conclusion: </strong>Given the high rates of depression and burnout among medical providers, it may be helpful to understand the factors that may impact medical trainee's distress and esteem. Future longitudinal research might examine the role of the supervisory alliance over time, and whether strong mentorship and guidance may serve to protect trainees from burnout throughout training and into their career.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"15 ","pages":"1019-1025"},"PeriodicalIF":1.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570011","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":"Critical Thinking Disposition and Influencing Factors Among Sophomore Pediatric Medical Students.","authors":"Hongxing Dang, Shaojun Li, Jing Li, Li Long","doi":"10.2147/AMEP.S484157","DOIUrl":"10.2147/AMEP.S484157","url":null,"abstract":"<p><strong>Objective: </strong>The second year of undergraduate medical education is a critical phase transitioning from basic medical knowledge to specialized learning, requiring strong critical thinking abilities. Pediatric diseases, with their unique characteristics, demand active critical thinking from pediatricians. This study aims to investigate and analyze the critical thinking dispositions of second-year pediatric medical students, identify influencing factors, and propose recommendations for improving teaching methods.</p><p><strong>Methods: </strong>This cross-sectional study employed the Chinese version of the California Critical Thinking Disposition Inventory (CTDI-CV) and conducted an online survey among 240 second-year pediatric medical students at Chongqing Medical University, Chongqing, China. The study described the overall CTDI-CV scores and sub-dimension scores (mean ± standard deviation) and analyzed the distribution of critical thinking dispositions using <i>t</i>-tests and trend analysis.</p><p><strong>Results: </strong>A total of 229 students (95.4%) completed the survey, with 58.95% being female. The overall mean critical thinking score was 287.96 ± 39.09, and 139 students (60.70%) exhibited positive or highly positive critical thinking dispositions. Rural students scored lower than non-rural students (t = -2.773, P = 0.0069), while only children scored higher than non-only children (t = 2.659, P = 0.0086). Higher high school academic ranking was associated with higher scores (H = 23.85, P < 0.001). Students whose parents had a bachelor's degree or higher scored significantly better (t = 2.373, P = 0.0188). Interest in pediatrics was linked to higher scores (H = 15.36, P = 0.0015). Positive correlations were found between analyticity, inquisitiveness, and self-confidence (r ≥ 0.75).</p><p><strong>Conclusion: </strong>Second-year pediatric medical students in China generally display strong critical thinking abilities. Factors such as family background, academic performance, parental education level, and interest in pediatrics significantly influence these abilities. Pediatric educators should account for these individual differences to better enhance critical thinking development in students and improve teaching strategies accordingly.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"15 ","pages":"1005-1017"},"PeriodicalIF":1.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510299","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":"The Educational Benefits of Plastic Surgery Rotations for Off-Service Residents.","authors":"Michael Diffley, Jamie M D Hall, Donna Tepper, Aamir Siddiqui","doi":"10.2147/AMEP.S482437","DOIUrl":"10.2147/AMEP.S482437","url":null,"abstract":"<p><strong>Purpose: </strong>With increasing specialization among surgical divisions, a well-rounded education during a surgical residency is often accomplished by rotating among different subspecialties. Inclusion of specific rotations in the resident curriculum can be considered as a cost-benefit calculation balancing the value of exposure to a subspecialty versus the opportunity cost of potential learning from another rotation. We find that often these decisions are based on anecdotal feedback. Our goal is to supplement these reports with a quantifiable metric of learning achieved on the plastic surgery rotation. Our hypothesis in this prospective study was that residents would demonstrate improved performance on a post-rotation test after their 1-month rotation on plastic surgery compared to the pre-rotation test.</p><p><strong>Methods: </strong>A question bank was developed to reflect institutional curriculum objectives and clinical scenarios commonly seen on the service. The questions were developed, validated and vetted in collaboration with medical educators and attending plastic surgeons yielding 20 questions available for use. Postgraduate year 1 residents were given a 10-question test before and after their plastic surgery rotation. A one-tailed paired <i>t</i>-test was used to assess improvement between the pre-rotation test and the post-rotation test.</p><p><strong>Results: </strong>A total of 378 tests were administered with 228 (60%) pre- and post-rotation tests completed meeting inclusion criteria. Average percentage of correct answers for the pre-rotation test was 29% and 88% for the post-rotation test showing a differential improvement of 58% (p < 0.001).</p><p><strong>Conclusion: </strong>Surgical trainee time is a limited commodity. Each clinical rotation needs proven consistent benefit for the trainees. We developed a questionnaire that documents the improvement in clinical knowledge after a one-month rotation on plastic surgery relative to before. The test results were consistent even when comparing trainees who did the rotation early versus late in the PGY-1 year. Clinical exposure reinforces and solidifies specialty learning.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"15 ","pages":"999-1004"},"PeriodicalIF":1.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510300","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":"Students' Perception of Peer-Students Mentoring Program \"Big Sibling Mentoring Program\" to Complement Faculty Mentoring of First-Year Medical Students in Saudi Arabia [Letter].","authors":"Deanna Yiu, Prince Okong'o, Humza Hossain","doi":"10.2147/AMEP.S499690","DOIUrl":"10.2147/AMEP.S499690","url":null,"abstract":"","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"15 ","pages":"997-998"},"PeriodicalIF":1.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477603","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":"The Value of Peer Mentoring: Transforming the First-Year Medical Student Experience [Letter].","authors":"Vinesh Sivaneswaran","doi":"10.2147/AMEP.S498964","DOIUrl":"10.2147/AMEP.S498964","url":null,"abstract":"","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"15 ","pages":"995-996"},"PeriodicalIF":1.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477604","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":"Regarding the Article Students' Perception of Peer-Students Mentoring Program \"Big Sibling Mentoring Program\" to Complement Faculty Mentoring of First-Year Medical Students in Saudi Arabia [Letter].","authors":"Naireen Asim, Ianna Alberto","doi":"10.2147/AMEP.S499333","DOIUrl":"10.2147/AMEP.S499333","url":null,"abstract":"","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"15 ","pages":"993-994"},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477602","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":"First Aid Training for Non-Medical Professionals: The Need for Comprehensive Assessments [Response to Letter].","authors":"Diana Ygiyeva, Lyudmila Pivina, Assylzhan Messova, Nazarbek Omarov, Gulnara Batenova, Ulzhan Jamedinova, Almas Dyussupov","doi":"10.2147/AMEP.S498991","DOIUrl":"https://doi.org/10.2147/AMEP.S498991","url":null,"abstract":"","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"15 ","pages":"991-992"},"PeriodicalIF":1.8,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477598","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":"Impact of a Nutrition and Diabetes Continuing Education Program on Primary Care Provider's Knowledge, Attitude, and Clinical Practice.","authors":"Daniel J Kahn, Jane L Hubbard, Stephen Dunn, Alex Hoyt","doi":"10.2147/AMEP.S459304","DOIUrl":"https://doi.org/10.2147/AMEP.S459304","url":null,"abstract":"<p><strong>Purpose: </strong>Diet/nutrition is the first-line non-pharmacological therapy in the treatment of diabetes. Diet/nutrition counseling is infrequently provided by primary care providers (PCPs), who have limited nutrition education in both medical and advanced practice provider curricula. This quality improvement project aimed to improve knowledge and attitude, and frequency of diet/nutrition counseling by PCPs among patients with uncontrolled diabetes (glycosylated hemoglobin A1c ≥8%), by providing an online continuing medical education (CME) program on diabetes diet/nutrition.</p><p><strong>Methods: </strong>At a community health center in New England, PCPs attended a live 50-minute online CME program that was developed internally, which taught PCPs current diet/nutrition guidelines and recommendations related to diabetes. Knowledge was assessed prior to and two weeks following the program, utilizing a 10-question tool, the Nutrition Management of Diabetes Assessment (NMDA). Similarly, attitude was evaluated using two subscales of the Nutrition in Patient Care Survey (NIPS): Nutrition in routine care and Physician efficacy. Chart audits of patients with uncontrolled diabetes were evaluated to assess PCPs documentation of diet/nutrition counseling four weeks prior to and six weeks following the CME program.</p><p><strong>Results: </strong>In September 2023, PCPs (n = 29) completed the CME program. There was an improvement in knowledge in the NMDA amongst PCPs (36% difference, p < 0.001). Attitude scores from two subscales of the NIPS were evaluated and both showed improvement, however only <i>physician efficacy</i> was significant (15% difference, p < 0.01). There was a positive difference in the trend of diet/nutrition counseling after the education program (p < 0.05).</p><p><strong>Conclusion: </strong>An online CME program improved diabetes diet/nutrition knowledge and attitude of PCPs and improved counseling practices for patients living with uncontrolled diabetes. The education program provided PCPs current standards of care guidelines/recommendations, which they can utilize when counseling patients with diabetes. PCPs would benefit from dedicated continuing education programs regarding diet/nutrition therapy for chronic illnesses.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"15 ","pages":"981-990"},"PeriodicalIF":1.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477600","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":"Academic Health System Framework for Health Services Transformation: A Perspective View from West Java, Indonesia.","authors":"Dwi Agustian, Insi Farisa Desy Arya, Qorinah Estiningtyas Sakilah Adnani, Guswan Wiwaha, Muhammad Hasan Bashari, Windi Nurdiawan, Ria Bandiara, Wijana Hasansulama, Afiat Berbudi, Gaga Irawan Nugraha, Wiryawan Permadi, Ruswana Anwar, Irvan Afriandi, Arief Kartasasmita, Yudi Mulyana Hidayat, Tri Hanggono Achmad, John Norcini","doi":"10.2147/AMEP.S474314","DOIUrl":"https://doi.org/10.2147/AMEP.S474314","url":null,"abstract":"<p><p>Although the field of medicine has made significant progress in recent decades, low and middle-income countries continue to face significant difficulties in addressing the unprecedented obstacles to improving health. Medical schools should play a critical role in driving health services reform and take on a new leadership role in strengthening the health system. This paper discusses a conceptual framework and outlines the Academic Health Systems (AHS) agenda in Indonesia. A comprehensive analysis was conducted on the existing literature and frameworks regarding AHS, applying the system thinking method, which engages stakeholders actively. The findings and interpretations from interviews, focus groups, and collaborative workshops were consolidated and a set of proposed frameworks, fundamental principles, and a route for enhancing the health system in Indonesia were put forward. Our recommendations include transformative learning, community engagement, and translational research as pillar principles of AHS program. These recommendations have the potential to be modified and implemented in other low- and middle-income countries.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"15 ","pages":"957-969"},"PeriodicalIF":1.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477596","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":"Benefits and Drawbacks of International Medical Elective Databases in Abroad Elective Research: A Narrative Review.","authors":"Maximilian Andreas Storz, Rintaro Imafuku","doi":"10.2147/AMEP.S487142","DOIUrl":"https://doi.org/10.2147/AMEP.S487142","url":null,"abstract":"<p><strong>Background: </strong>International medical electives (IMEs) are considered high-impact practice in global health education. Nevertheless, international medical elective (IME) research remains scarce, with only a few new publications appearing each year. The discrepancy between the many unanswered questions regarding IMEs and the lack of opportunities to perform research in this field has been further aggravated by the COVID-19 pandemic. Elective databases cataloguing structured IME reports/testimonies could offer a viable solution here. This narrative review provides a balanced and objective evaluation of the strengths and weaknesses of elective databases, summarizing their potential usefulness in IME research.</p><p><strong>Methods: </strong>The methodology employed was a multidisciplinary narrative review of the published and grey literature on databases cataloguing IME testimonies.</p><p><strong>Results: </strong>Elective databases offer numerous benefits to the IME researcher. Their size allows for large analyses, built on hundreds of equally structured elective testimonies. Pre-defined outcomes, such as the elective destination, elective discipline or duration, are queried in a standardized way, allowing for a broad set of research questions. Elective databases are usually open-access, not confined to a single university, and free to use. Most databases also offer user-friendly filter functions, permitting targeted analyses centered around a particular outcome. A major drawback is that reports are rarely verified. Subject to several forms of bias (eg, recall and reporting bias), elective databases may not be suitable for all types of research questions, and the report quality is often inhomogeneous. Above all, they rarely allow for an informational depth that may result from qualitative face-to-face interviews.</p><p><strong>Conclusion: </strong>Elective databases could be a valuable supplement to interview-based elective research, potentially allowing for larger and broader analyses not confined to single institutions.</p>","PeriodicalId":47404,"journal":{"name":"Advances in Medical Education and Practice","volume":"15 ","pages":"971-979"},"PeriodicalIF":1.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477597","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}