Medical Education Online最新文献

{"title":"Recommendations to address and research systemic bias in assessment: perspectives from directors of research in medical education.","authors":"Fei Chen, Celia Laird O'Brien, Maria A Blanco, Kathryn N Huggett, Donna B Jeffe, Martin V Pusic, Judith M Brenner","doi":"10.1080/10872981.2024.2396166","DOIUrl":"10.1080/10872981.2024.2396166","url":null,"abstract":"<p><strong>Introduction: </strong>Addressing systemic bias in medical school assessment is an urgent task for medical education. This paper outlines recommendations on topic areas for further research on systemic bias, developed from a workshop discussion at the 2023 annual meeting of the Society of Directors of Research in Medical Education.</p><p><strong>Materials and methods: </strong>During the workshop, directors engaged in small-group discussions on guidelines to address bias in assessment practices following a proposed categorization of 'Do's,' 'Don'ts,' and 'Don't knows' and listed their insights using anonymous sticky notes, which were shared and discussed with the larger group of participants. The authors performed a content analysis of the notes through deductive and inductive coding. We reviewed and discussed our analysis to reach consensus.</p><p><strong>Results: </strong>The workshop included 31 participants from 28 institutions across the US and Canada, generating 51 unique notes. Participants identified 23 research areas in need of further study. The inductive analysis of proposed research areas revealed four main topics: 1) The role of interventions, including pre-medical academic interventions, medical-education interventions, assessment approaches, and wellness interventions; 2) Professional development, including the definition and assessment of professionalism and professional identity formation; 3) Context, including patient care and systemic influences; and 4) Research approaches.</p><p><strong>Discussion: </strong>While limited to data from a single workshop, the results offered perspectives about areas for further research shared by a group of directors of medical education research units from diverse backgrounds. The workshop produced valuable insights into the need for more evidence-based interventions that promote more equitable assessment practices grounded in real-world situations and that attenuate the effects of bias.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2396166"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11382691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Games to support teaching clinical reasoning in health professions education: a scoping review.","authors":"Gilbert Koelewijn, Marije P Hennus, Helianthe S M Kort, Joost Frenkel, Thijs van Houwelingen","doi":"10.1080/10872981.2024.2316971","DOIUrl":"10.1080/10872981.2024.2316971","url":null,"abstract":"<p><strong>Introduction: </strong>Given the complexity of teaching clinical reasoning to (future) healthcare professionals, the utilization of serious games has become popular for supporting clinical reasoning education. This scoping review outlines games designed to support teaching clinical reasoning in health professions education, with a specific emphasis on their alignment with the 8-step clinical reasoning cycle and the reflective practice framework, fundamental for effective learning.</p><p><strong>Methods: </strong>A scoping review using systematic searches across seven databases (PubMed, CINAHL, ERIC, PsycINFO, Scopus, Web of Science, and Embase) was conducted. Game characteristics, technical requirements, and incorporation of clinical reasoning cycle steps were analyzed. Additional game information was obtained from the authors.</p><p><strong>Results: </strong>Nineteen unique games emerged, primarily simulation and escape room genres. Most games incorporated the following clinical reasoning steps: patient consideration (step 1), cue collection (step 2), intervention (step 6), and outcome evaluation (step 7). Processing information (step 3) and understanding the patient's problem (step 4) were less prevalent, while goal setting (step 5) and reflection (step 8) were least integrated.</p><p><strong>Conclusion: </strong>All serious games reviewed show potential for improving clinical reasoning skills, but thoughtful alignment with learning objectives and contextual factors is vital. While this study aids health professions educators in understanding how games may support teaching of clinical reasoning, further research is needed to optimize their effective use in education. Notably, most games lack explicit incorporation of all clinical reasoning cycle steps, especially reflection, limiting its role in reflective practice. Hence, we recommend prioritizing a systematic clinical reasoning model with explicit reflective steps when using serious games for teaching clinical reasoning.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2316971"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139940994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering heterogeneity in mental health changes among first-year medical students.","authors":"Sabine Polujanski, Ulrike Nett, Thomas Rotthoff, Melissa Oezsoy, Ann-Kathrin Schindler","doi":"10.1080/10872981.2024.2317493","DOIUrl":"10.1080/10872981.2024.2317493","url":null,"abstract":"<p><strong>Introduction: </strong>The initial year of medical school is linked to a decline in mental health. To assess mental health comprehensively, the dual-factor model posits the consideration of both psychopathology (e.g., depression) and positive mental health (e.g., well-being). Previous mental health research among medical students has primarily examined these two factors independently. This study uses the dual-factor approach for a deeper understanding of mental health changes during the first year of medical school.</p><p><strong>Methods: </strong>Students from eight German medical schools (<i>N</i> = 450) were surveyed three times (T0 = entering medical school, T1 = end of the first semester, T2 = end of the second semester) regarding depression (PHQ-9), well-being (subscale of FAHW-12), and general life satisfaction (German Single-Item Scale L1). Latent profile analysis was used to identify distinct mental health groups based on their combinations of psychopathology and positive mental health. We then analysed trajectories descriptively by examining the longitudinal stability and dynamics of mental health group membership during the first year of medical school.</p><p><strong>Results: </strong>We identified five mental health groups: (1) complete mental health, (2) moderately mentally healthy, (3) symptomatic but content, (4) vulnerable, and (5) troubled. The examination of change trajectories unveiled diverse paths pointing towards both recovery and deterioration. In comparison to the other groups, students belonging to the complete mental health group exhibited greater stability and a higher potential to recover after initial deteriorations in the first semester.</p><p><strong>Conclusions: </strong>Our study uncovers distinct mental health trajectories in the first year of medical school, emphasizing the crucial role of initial mental health status. Our findings stress the diverse nature of mental health changes in medical students, underscoring the need for tailored prevention strategies. The implications for research and practice are discussed.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2317493"},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139940995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tailoring a specific medical leadership development program for faculty members: the Lyon-Ottawa experience.","authors":"Claire Falandry, Justine Bacchetta, Muriel Doret-Dion, Carole Ferraro-Peyret, Cyrille B Confavreux, Marion Douplat, Patrick Feugier, Arnaud Friggeri, Pierre-Adrien Bolze, Yesim Dargaud, Alexandre Messager, Martine Wallon, Loïc Geffroy, Yves Matillon, Jacques Bradwejn","doi":"10.1080/10872981.2024.2308955","DOIUrl":"10.1080/10872981.2024.2308955","url":null,"abstract":"<p><p>The development of leadership skills has been the topic of several position statements over recent decades, and the need of medical leaders for a specific training was emphasized during the COVID-19 crisis, to enable them to adequately collaborate with governments, populations, civic society, organizations, and universities. However, differences persist as to the way such skills are taught, at which step of training, and to whom. From these observations and building on previous experience at the University of Ottawa, a team of medical professors from Lyon (France), Ottawa, and Montreal (Canada) universities decided to develop a specific medical leadership training program dedicated to faculty members taking on leadership responsibilities. This pilot training program was based on a holistic vision of a transformation model for leadership development, the underlying principle of which is that leaders are trained by leaders. All contributors were eminent French and Canadian stakeholders. The model was adapted to French faculty members, following an inner and outer analysis of their specific needs, both contextual and related to their time constraints. This pilot program, which included 10 faculty members from Lyon, was selected to favor interactivity and confidence in older to favor long-term collaborations between them and contribute to institutional changes from the inner; it combined several educational methods mixing interactive plenary sessions and simulation exercises during onescholar year. All the participants completed the program and expressed global satisfaction with it, validating its acceptability by the target. Future work will aim to develop the program, integrate evaluation criteria, and transform it into a graduating training.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2308955"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10829808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physicians have feelings: illuminating the relationship between emotional valence, clinical reasoning and context specificity.","authors":"Thomas Bertagnoli, Steven Durning, Michael Soh, Jerusalem Merkebu","doi":"10.1080/10872981.2024.2404299","DOIUrl":"10.1080/10872981.2024.2404299","url":null,"abstract":"<p><strong>Introduction: </strong>Research demonstrates that emotions play an important role in clinical reasoning (CR); however, the relationship between emotional valence, CR, and the context in which reasoning takes place, remains to be empirically explored. While situated cognition has been used to investigate CR and context specificity (e.g. the presence of contextual factors, things other than the information directly related to establishing a diagnosis), it has not explicitly examined the role of emotional valence during CR encounters. Our research question was how do emotional valence and arousal emerge in CR, particularly in the presence or absence of contextual factors?</p><p><strong>Methods: </strong>Physicians (<i>n</i> = 45) reviewed two video cases, one with contextual factors and one without. Immediately afterwards, participants completed a 'think-aloud' while reviewing cases. Thematic analysis was used to code transcribed think-alouds for CR activities, emotional valence (positive, neutral or negative) and arousal by three researchers. Frequencies and relationships between codes were compared, both in the presence or absence of contextual factors.</p><p><strong>Results: </strong>The majority of emotional valence codes were neutral (85.2%), with negative valence more frequent (11.2%) than positive valence (3.5%). Five CR themes were consistently demonstrated: knowledge organization (with two sub-themes of linking and differential diagnosis formation), proceeding with caution, curiosity, assumption, and reflection. In the presence of contextual factors, there was an increase in negative valence with a decrease in positive valence, as well as a shift in CR from knowledge organization to curiosity and proceeding with caution.</p><p><strong>Discussion: </strong>The complex interaction between clinical reasoning themes, emotional valence, and changes with contextual factors have important implications for clinical practice, education, and future research on CR.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2404299"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The positive impact of introducing public engagement as a self-directed learning strategy in undergraduate nervous system education.","authors":"Chen Zhao, Xiaolu Liu, Jingchao Wang, Yan Zhang, Yingshuang Zhang, Yan Ma, Aping Sun, Hongsong Song, Liping Wang, Yuanjin Zhang, Xiaoxuan Liu, Wenqing Yuan, Shixian Gu, Dongsheng Fan, Shan Ye","doi":"10.1080/10872981.2024.2383017","DOIUrl":"10.1080/10872981.2024.2383017","url":null,"abstract":"<p><p>Undergraduate medical education in China has shifted from educator-centered learning to self-directed learning (SDL) over the past few decades. Careful design of public engagement activities can enable SDL and empower medical students to pioneer public health and patient safety education. In this study, we aimed to innovate nervous system education by implementing a public engagement model that empowers students to learn about the nervous system by teaching the public. Our goal was to generate greater interest in the nervous system at the undergraduate stage, inspire students' enthusiasm to pursue a career in neurology, and ultimately, contribute to health promotion. During the nervous system module of the second year of the undergraduate curriculum, students were given the option to participate in the public engagement model. Participants were tasked with the creation of educational videos focusing on knowledge, attitudes, and behaviors associated with the prevention and management of neurological diseases and their complications. The videos were made accessible to the general public through the university's official channel at the end of the semester. A total of 117 students (67.24% of all students) chose to participate in the public engagement model. Female students and those with higher Grade Point Averages in the present semester were more likely to participate. The model received strong positive feedback from participants, as students found the public engagement task helpful in learning about the nervous system module as well as in enhancing their public engagement skills. Despite the time and effort consumption, participating in the public engagement task did not affect students' exam scores. The public engagement task is an innovative model in the nervous system curriculum and has the potential to be integrated into a broader range of undergraduate courses. It empowers medical students to pioneer public health and patient safety education.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2383017"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11288200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minding the gap: towards a shared clinical reasoning lexicon across the pre-clerkship/clerkship transition.","authors":"Robin K Ovitsh, Shanu Gupta, Anita Kusnoor, Jennifer M Jackson, Danielle Roussel, Christopher J Mooney, Roshini Pinto-Powell, Joel L Appel, Rahul Mhaskar, Jonathan Gold","doi":"10.1080/10872981.2024.2307715","DOIUrl":"10.1080/10872981.2024.2307715","url":null,"abstract":"<p><p>Teaching and learning of clinical reasoning are core principles of medical education. However, little guidance exists for faculty leaders to navigate curricular transitions between pre-clerkship and clerkship curricular phases. This study compares how educational leaders in these two phases understand clinical reasoning instruction. Previously reported cross-sectional surveys of pre-clerkship clinical skills course directors, and clerkship leaders were compared. Comparisons focused on perceived importance of a number of core clinical reasoning concepts, barriers to clinical reasoning instruction, level of familiarity across the undergraduate medical curriculum, and inclusion of clinical reasoning instruction in each area of the curriculum. Analyses were performed using the Mann Whitney U test. Both sets of leaders rated lack of curricular time as the largest barrier to teaching clinical reasoning. Clerkship leaders also noted a lack of faculty with skills to teach clinical reasoning concepts as a significant barrier (<i>p</i> < 0.02), while pre-clerkship leaders were more likely to perceive that these concepts were too advanced for their students (<i>p</i> < 0.001). Pre-clerkship leaders reported a higher level of familiarity with the clerkship curriculum than clerkship leaders reported of the pre-clerkship curriculum (<i>p</i> < 0.001). As faculty transition students from the pre-clerkship to the clerkship phase, a shared understanding of what is taught and when, accompanied by successful faculty development, may aid the development of longitudinal, milestone-based clinical reasoning instruction.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2307715"},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10848998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who needs education on LGBTQIA+ healthcare inclusion?","authors":"Lia Ginaldi, Massimo De Martinis","doi":"10.1080/10872981.2024.2329403","DOIUrl":"10.1080/10872981.2024.2329403","url":null,"abstract":"<p><p>The topic of education on healthcare needs and equity of care for LGBTQIA+ populations is an extremely current issue. There is a demand for education on these topics not only from medical and other health sciences students but also from established healthcare professionals. Given this widespread educational deficiency, it is natural to ask whether the teaching class is prepared to satisfy these requests or in turn needs training on these issues and above all whether it is capable of transmitting attention and sensitivity on the issues of inclusion and equality in needs of healthcare.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2329403"},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10946259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examiner workload comparison: three structured oral examination formats for the European diploma in anaesthesiology and intensive care.","authors":"Mikhail Dziadzko, Andrey Varvinskiy, Rodolphe Di Loreto, Hugues Scipioni, Bazil Ateleanu, Markus Klimek, Joana Berger-Estilita","doi":"10.1080/10872981.2024.2364990","DOIUrl":"10.1080/10872981.2024.2364990","url":null,"abstract":"<p><p>The COVID-19 pandemic triggered transformations in academic medicine, rapidly adopting remote teaching and online assessments. Whilst virtual environments show promise in evaluating medical knowledge, their impact on examiner workload is unclear. This study explores examiner's workload during different European Diploma in Anaesthesiology and Intensive Care Part 2 Structured Oral Examinations formats. We hypothesise that online exams result in lower examiner's workload than traditional face-to-face methods. We also investigate workload structure and its correlation with examiner characteristics and marking performance. In 2023, examiner's workload for three examination formats (face-to-face, hybrid, online) using the NASA TLX instrument was prospectively evaluated. The impact of examiner demographics, candidate scoring agreement, and examination scores on workload was analysed. The overall NASA TLX score from 215 workload measurements in 142 examiners was high at 59.61 ± 14.13. The online examination had a statistically higher workload (61.65 ± 12.84) than hybrid but not face-to-face. Primary contributors to workload were mental and temporal demands, and effort. Online exams were associated with elevated frustration. Male examiners and those spending more time on exam preparation experienced a higher workload. Multiple diploma specialties and familiarity with European Diploma in Anaesthesiology and Intensive Care exams were protective against high workload. Perceived workload did not impact marking agreement or examination scores across all formats. Examiners experience high workload. Online exams are not systematically associated with decreased workload, likely due to frustration. Despite workload differences, no impact on examiner's performance or examination scores was found. The hybrid examination mode, combining face-to-face and online, was associated with a minor but statistically significant workload reduction. This hybrid approach may offer a more balanced and efficient examination process while maintaining integrity, cost savings, and increased accessibility for candidates.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2364990"},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing an interactive reproductive health equity session for pre-clerkship medical students.","authors":"Max Jordan Nguemeni Tiako, Gabriela Aguilar, Oluwatosin Adeyemo, Heather Reynolds, Katherine H Campbell, Nancy Stanwood, France Galerneau","doi":"10.1080/10872981.2024.2364984","DOIUrl":"10.1080/10872981.2024.2364984","url":null,"abstract":"<p><p>In the United States, sexual, reproductive, and perinatal health inequities are well documented and known to be caused by a history of systemic oppression along many axes, including but not limited to race, ethnicity, gender, socioeconomic position, sexual orientation, and disability. Medical schools are responsible for educating students on systems of oppression and their impact on health. Reproductive justice advocates, including lay persons, medical students, and teaching faculty, have urged for integrating the reproductive justice framework into medical education and clinical practice. In response to medical student advocacy, we developed introductory didactic sessions on social and reproductive justice for preclinical medical students. These were created in a team-based learning format and include pre-course primer materials on reproductive justice. During the sessions, students engaged with hypothetical clinical vignettes in small groups to identify oppressive structures that may have contributed to the health outcomes described and potential avenues for contextually relevant and level-appropriate advocacy. The sessions took place in November 2019 (in-person) and 2020 (virtually) and were well attended by students. We highlight our experience, student feedback, and next steps, including further integration of reproductive health equity into medical school curricula in concert with department-wide education for faculty, residents, nursing, and allied health professionals. This introduction to social and reproductive justice can be adapted and scaled across different medical school curricula, enhancing the training of a new generation of physicians to become critically aware of how oppressive structures create health inequities and able to mitigate their impact through their roles as clinicians, researchers, and advocates.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2364984"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}