Medical Education Online最新文献

{"title":"Comparison of cognitive workload between very short answer questions and multiple-choice questions: an eye-tracking experiment.","authors":"Maria Gabriela Carneiro Queiroz, Francisco Carlos Specian Junior, Pedro Tadao Hamamoto Filho, Thiago M Santos, Stefan K Schauber, Andrea M Woltman, Dario Cecilio-Fernandes","doi":"10.1080/10872981.2026.2621434","DOIUrl":"10.1080/10872981.2026.2621434","url":null,"abstract":"<p><p>Very short answer questions (VSAQs) have gained attention for their superior psychometric properties compared to multiple-choice questions (MCQs). While VSAQs require knowledge recall, MCQs primarily involve knowledge recognition. This difference in cognitive processes may lead to varying cognitive workloads, defined as the amount of mental processing in working memory. Previous studies have not demonstrated consistent differences, likely due to reliance on self-reported measures. Eye tracking provides objective, process-level indicators of cognitive workload. This study investigated whether answering VSAQs requires a higher cognitive workload than answering MCQs. In a within-subject randomized crossover experiment, sixth-year medical students answered both VSAQs and MCQs. Cognitive workload was measured using screen-based eye tracking, focusing on the number of fixations and revisitations as objective indicators of mental effort. Data were analyzed using mixed-effects models. Thirty-four medical students participated, yielding 1,326 observations, which is the multiplication of the number of students by the number of questions (39 questions). Mixed-effects models showed a significant effect of question type on both workload indicators: VSAQs elicited more fixations and revisitations than MCQs (β_std = 0.30-0.39, <i>p</i> < .001). This effect remained after controlling for accuracy. Incorrect answers were associated with higher workload (β_std = -0.15--0.16, <i>p</i> < .01). Heatmaps confirmed these findings, showing denser fixations on key diagnostic features for VSAQs and on answer options for MCQs. Answering VSAQs imposed a higher cognitive workload than MCQs. The presence of answer options in MCQs may reduce workload by providing unintentional cues, while VSAQs require active retrieval. Eye tracking proved valuable for distinguishing cognitive workload across assessment formats.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2621434"},"PeriodicalIF":3.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054637","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":"Artificial intelligence readiness in Pakistan's medical and dental education: training-phase decline, a knowledge-practice paradox, and the role of digital determinants of health.","authors":"Sadia Qazi, Izaz Ahmad Khan, Muhammad Waleed, Abdal Ahmad, Owais Qarni, Muhammad Wasif Abdullah, Anas Muiz Jehan, Afrasayab Khattak, Azmeer Aamir, Muhammad Atif Mazhar","doi":"10.1080/10872981.2026.2673253","DOIUrl":"10.1080/10872981.2026.2673253","url":null,"abstract":"<p><strong>Background: </strong>We assessed AI knowledge, attitudes, and use among medical and dental students in Pakistan, a lower-middle-income country (LMIC), and identified predictors of low AI use within Digital Determinants of Health (DDoH) and Professional Identity Formation (PIF) frameworks.</p><p><strong>Methods: </strong>A cross-sectional survey of 501 medical and dental students in Khyber Pakhtunkhwa assessed knowledge, attitudes, practices, and barriers related to AI. Analyses used ANOVA and logistic regression for low AI use (score ≤ 15; 7-35 scale, higher = greater use), with sensitivity models adjusted for age, knowledge, attitude scores, and selected barriers.</p><p><strong>Results: </strong>Mean (SD) scores were 4.23 (1.71) for knowledge (0-7), 32.72 (6.64) for attitude (10-50), and 15.85 (6.32) for practice (7-35); higher scores indicated greater knowledge, more favorable attitudes, and greater AI use. Practice differed across years [F(4,496) = 4.025, <i>p</i> = 0.003, η²p = 0.031], with Year 2 scoring higher than Year 4 and the final year. This exploratory model (AUC = 0.618) identified only associations. Fourth-year (OR = 2.02, 95% CI: 1.11-3.70; <i>p</i> = 0.022), female (OR = 1.51, 95% CI: 1.05-2.17; <i>p</i> = 0.025), and dental students (OR = 1.58, 95% CI: 1.01-2.50; <i>p</i> = 0.046) had higher odds of low AI use. The Year 4 association strengthened in sensitivity analyses (OR = 3.83, 95% CI: 1.66-8.85; <i>p</i> = 0.002), and higher knowledge paradoxically predicted lower use (OR = 1.52, 95% CI: 1.34-1.72; <i>p</i> < 0.001). The most significant barriers were a lack of training (71.7%) and limited technical access (69.7%).</p><p><strong>Conclusions: </strong>AI use was lower in later training years and differed by gender and specialty. The inverse knowledge-practice association contradicts standard adoption models and warrants longitudinal investigation; one PIF-based hypothesis is that higher-knowledge students exercise professional restraint, although cross-sectional data cannot confirm it. The clinical-phase decline implicates ward-based norms as independent barriers. Competency-based training with structured access provisions and faculty development, particularly in clinical phase education, is needed.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2673253"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13228174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139341","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":"Pre-qualifications, learning strategies, and study satisfaction among medical students: insights from a multicenter German study.","authors":"Carla Schröpel, Anne Herrmann-Werner, Teresa Festl-Wietek, Tim Wittenberg, Sabine C Herpertz, Katrin Schüttpelz-Brauns, Andrea Heinzmann, Tobias Böckers, Stephan Zipfel, Rebecca Erschens","doi":"10.1080/10872981.2026.2694212","DOIUrl":"10.1080/10872981.2026.2694212","url":null,"abstract":"<p><strong>Introduction: </strong>Although medical students with pre-medical qualifications (e.g., paramedic training) may enhance diversity within the student body, they have received little attention in international research. Their prior experience may influence study satisfaction through different learning strategies or working alongside their studies. This study investigates how pre-qualifications relate to three dimensions of study satisfaction (content, conditions, and coping with study load) and examines whether deep-processing learning strategies (elaboration and critical thinking) and part-time employment help explain these associations.</p><p><strong>Method: </strong>The authors conducted a cross-sectional survey at five German medical schools across different stages of study (3rd, 6th and 10th semester, final year). A structural equation model tested (a) whether pre-qualifications (i.e., academic degree, vocational training in the medical field) moderated the relationship between deep-processing strategies and study satisfaction and (b) whether part-time employment mediated the relationship between pre-qualifications and study satisfaction, controlling for age, gender, undergraduate GPA, semester, and medical school.</p><p><strong>Results: </strong>Associations between deep-processing strategies and satisfaction did not differ by pre-qualifications. Regardless of students' pre-qualifications, elaboration was positively (ß = .51) and critical thinking negatively (ß = -.31) associated with satisfaction with study contents. Students with vocational training or prior academic degree more often worked part-time to finance studies; part-time employment was associated with lower satisfaction with study conditions (ß = -.07) but higher satisfaction with coping with study load (ß = .08). Indirect effects via part-time employment were significant but small.</p><p><strong>Discussion: </strong>The findings suggest that elaboration may be a particularly relevant learning strategy for satisfaction with study contents, regardless of students' prior professional or academic qualifications. The negative association between critical thinking and satisfaction highlights the complexity of students' perceptions of study contents. Although associations involving part-time employment were small, the findings contribute to a better understanding of students with professional and academic pre-qualifications and may inform efforts to support increasingly diverse medical student populations.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2694212"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333520","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":"Inaugural year of preference signaling in im subspecialty fellowships: multi-institutional survey about program director perceptions, benefits, and challenges.","authors":"Radhika Narla, Robin Stiller, Laura A Huppert","doi":"10.1080/10872981.2026.2688662","DOIUrl":"10.1080/10872981.2026.2688662","url":null,"abstract":"<p><strong>Background: </strong>Preference signalling was introduced into internal medicine subspecialty fellowship recruitment in the 2025-2026 cycle, adding a new consideration for applicants, mentors, and fellowship programs. We sought to characterize program director (PD) perceptions of signalling during this inaugural cycle and identify implications for advising.</p><p><strong>Methods: </strong>We conducted a cross-sectional anonymous survey of PDs in five internal medicine subspecialties at three West Coast academic institutions (University of Washington, Oregon Health & Science University, and University of California, San Francisco) from December 2025 to January 2026. Quantitative responses were summarized descriptively, and free-text responses were analyzed using inductive content analysis.</p><p><strong>Results: </strong>Eleven of 15 PDs responded (73%). Ten of 11 respondents (91%) agreed that signalling helped identify applicants with genuine interest, and 10 of 11 (91%) agreed that it streamlined interview selection. However, signalling was not perceived to reduce overall review burden. Common challenges included interpreting a 'no signal' (7/11, 64%), uncertainty about how much weight to assign signals (5/11, 45%), ambiguity regarding whether home-institution applicants should signal, and inconsistent interpretation of tiered signals across programs. PDs emphasized the importance of transparency and consistency in signalling practices.</p><p><strong>Conclusions: </strong>In this early multi-institutional experience, preference signalling was valued as a practical screen-in tool, but its interpretation remained variable across programs. For educators, the main challenge is not deciding whether signalling matters but helping applicants navigate how it is used in different subspecialty contexts. More consistent communication about non-signals, home-institution expectations, and tiered signals may improve advising, transparency, and trust in the fellowship recruitment process.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2688662"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13270860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253871","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":"Cross-cultural adaptation and psychometric evaluation of the artificial intelligence learning intention scale (AILIS) among medical sciences students: a methodological study.","authors":"Amir Hossein Taghiparast, Amaneh Mahmoudian, Maryam Ghaemi-Amiri, Fatemeh Ghaffari","doi":"10.1080/10872981.2026.2690326","DOIUrl":"10.1080/10872981.2026.2690326","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to adapt and psychometrically evaluate the Artificial Intelligence Learning Intention Scale (AILIS) among Iranian medical sciences students.</p><p><strong>Methods: </strong>This methodological psychometric study was conducted among 800 medical sciences students at Babol University of Medical Sciences, Iran. The AILIS was translated and culturally adapted into Persian using a standardized cross-cultural adaptation process. Construct validity was examined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was assessed using Cronbach's alpha, McDonald's omega, and the intraclass correlation coefficient (ICC). Convergent and discriminant validity were evaluated using composite reliability (CR) and average variance extracted (AVE). Measurement invariance across gender and structural stability were assessed using multi-group confirmatory factor analysis and exploratory graph analysis (EGA).</p><p><strong>Results: </strong>EFA supported a four-factor structure consisting of Epistemic Capacity, Psychological Attitudes, Facilitating Environments, and Psychological and Behavioral Outcomes, explaining 44.55% of the total variance, with factor loadings greater than 0.40. Confirmatory factor analysis indicated an acceptable model fit, supporting the proposed factor structure (χ²/df = 3.42, RMSEA = 0.078, CFI = 0.932). Internal consistency and test-retest reliability were satisfactory, with Cronbach's alpha ranging from 0.854 to 0.904, McDonald's omega from 0.854 to 0.899, and ICC from 0.750 to 0.860. Composite reliability values were adequate, while AVE values indicated acceptable but partially limited evidence of convergent validity. Discriminant validity was generally supported. In addition, multi-group analysis demonstrated measurement invariance across gender, and exploratory graph analysis confirmed the structural stability of the four-factor model.</p><p><strong>Conclusion: </strong>The Persian AILIS is a valid and reliable instrument for assessing AI learning intention among medical sciences students. Beyond its psychometric robustness, the instrument may support curriculum planning, evaluation of AI-related educational interventions, and evidence-based decision-making in medical sciences education by providing a standardized measure of students' intentions to engage with AI learning.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2690326"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13288542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279290","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":"Assessing digital health curriculum needs: a mixed-methods study of student and faculty perspectives in a Singapore medical school.","authors":"Saumya Bajaj, Eng Chun David Goh, Yih Yng Ng, Zheng-Wei Lee","doi":"10.1080/10872981.2026.2726067","DOIUrl":"10.1080/10872981.2026.2726067","url":null,"abstract":"<p><strong>Background: </strong>The rapid advancement of digital technologies has transformed healthcare delivery, creating an imperative for medical education to integrate digital health (DH) competencies into undergraduate training. Despite growing recognition of its importance, progress in embedding DH literacy within formal medical curricula has been uneven and slow.</p><p><strong>Objective: </strong>This study examined DH education within an undergraduate medical programme by integrating faculty and student perspectives to identify curriculum development needs and inform evidence-based educational strategies.</p><p><strong>Design: </strong>A mixed-methods study was conducted at a Singapore medical school offering a 5-year undergraduate curriculum. Semi-structured interviews were conducted with four faculty members as DH content experts, exploring curriculum design, pedagogical strategies, and competency expectations. A 24-item survey assessing knowledge, attitudes, and usage of DH tools was administered to students across pre-clinical and clinical training, with 131 responses from 848 eligible participants. Qualitative data were analysed using grounded theory-based thematic analysis, whilst survey data were analysed using descriptive statistics.</p><p><strong>Results: </strong>Faculty interviews identified three key themes: curriculum gaps requiring more practical and clinically-oriented DH teaching, structural barriers including time constraints and rapid technological change, and complex stakeholder ecosystem influencing curriculum development. Student survey results revealed a persistent theory-practice gap across DH domains. Students reported high self-perceived knowledge in DH applications and artificial intelligence (AI) but consistently lower confidence in practical application, particularly in electronic health records (EHR) and telemedicine. Clinical students paradoxically rated their EHR knowledge lowest despite greater clinical exposure. Students expressed strong interest in programming, data analytics, and hands-on AI, favouring applied DH skills with direct clinical relevance.</p><p><strong>Conclusions: </strong>Medical curricula struggle to translate DH conceptual knowledge into practice, reconcile divergent competency expectations between students and faculty, and remain current amid rapid technological change. Tiered competency models, coupled with experiential learning approaches and continuous faculty development, represent a promising strategy for preparing future physicians for digitally enhanced healthcare delivery.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2726067"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867210","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":"Disability, mental health symptom recognition, and treatment-seeking in resident physicians with depressive symptoms.","authors":"Karina Pereira-Lima, Katherine E T Ross, Elena Frank, Erene Stergiopoulos, Zoie C Sheets, Srijan Sen, Lisa M Meeks","doi":"10.1080/10872981.2026.2740874","DOIUrl":"10.1080/10872981.2026.2740874","url":null,"abstract":"<p><strong>Introduction: </strong>Resident physicians are at high-risk for depressive symptoms, yet most of those meeting depression criteria do not seek care. Resident physicians with disabilities are at higher risk for depressive symptoms. However, their mental health treatment-seeking behaviours remain poorly understood. This study investigates associations between self-identified disability-status, mental health symptom recognition, and treatment-seeking among first-year residents with depressive symptoms.</p><p><strong>Methods: </strong>We analysed data from the 2020-2022 cohorts of the Intern Health Study, a longitudinal study of first-year resident physicians. Depressive symptoms were assessed quarterly with the Patient Health Questionnaire (PHQ-9); scores ≥10 indicated a positive depression screen. Residents who screened positive at least once during internship and identified their disability-status were included. Mental health symptom recognition and treatment-seeking were assessed via quarterly surveys throughout the first residency year. Associations between disability-status, symptom recognition, and treatment-seeking were examined using weighted logistic regression adjusting for sex and specialty-type. Post-stratification and attrition weights addressed nonrepresentative sampling and loss to follow-up. Sensitivity analyses excluded interns reporting psychological disabilities.</p><p><strong>Results: </strong>Of 5,062 interns, 1,386 (27.4%) screened positive for depression during internship; 940 identified their disability-status and were included (127 [13.5%] with disabilities). Compared to nondisabled interns, those with disabilities were significantly more likely to recognise mental health symptoms (adjusted weighted-OR = 4.5, 95% CI: 1.8-14.7) and seek treatment (adjusted weighted-OR = 3.2, 95% CI: 2.1-5.0). Results remained significant in sensitivity analyses excluding psychological disabilities.</p><p><strong>Conclusion: </strong>Among depressed first-year residents, self-identified disability-status was associated with significantly greater symptom recognition and treatment-seeking. These findings suggest disability-related experiences may be associated with reduced normalisation of depressive symptoms in residency, offering insights for reducing stigma and treatment barriers in medical training.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2740874"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082461","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":"From prediction to advising: a multi model approach using NBME subject examinations to inform step 2 CK performance.","authors":"Beatrice Boateng, Karina Clemmons, Lindsey Sward, Rebecca Latch, Charles Graham, John Spollen","doi":"10.1080/10872981.2026.2741461","DOIUrl":"https://doi.org/10.1080/10872981.2026.2741461","url":null,"abstract":"<p><strong>Background: </strong>Following the transition of the USMLE Step 1 to pass/fail scoring, Step 2 Clinical Knowledge (CK) has become a primary metric in residency screening. This study evaluates multiple approaches to identify performance patterns that may support individualised longitudinal advising and targeted preparation aligned with students' educational and specialty goals.</p><p><strong>Methods: </strong>De-identified first-attempt scores from 819 medical students who completed Step 2 CK between May 2021 and April 2026 were analysed. Three models were applied: linear regression, a conditional inference tree, and weighted logistic regression to predict at-risk status. Outcomes included continuous Step 2 CK scores and an at-risk classification defined as scoring at least 1 standard deviation below the national mean for the corresponding passing standard. Model outputs were synthesised to identify performance patterns relevant to advising.</p><p><strong>Results: </strong>First-attempt pass rates ranged from 95% to 98% across testing years. 184 students (22.4%) met the at-risk criteria. Paediatrics, Internal Medicine, and Neurology showed relatively strong associations with Step 2CK performance. Linear regression explained 71.8% of the variance in Step 2 CK scores. The conditional inference tree produced 17 terminal nodes and yielded a mean root mean squared error of 10.63. Weighted logistic regression demonstrated good discrimination for at-risk classification (AUC = 0.915).</p><p><strong>Conclusions: </strong>Combining these modelling approaches offers a multidimensional view of student performance that may support targeted preparation for Step 2 CK. By integrating prediction, risk stratification, and performance interpretation, we developed the TRACE Framework to translate institutional assessment data into actionable insights for individualised residency advising.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2741461"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116632","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":"Entrustable professional activities in medical education: strategies and results - a systematic review.","authors":"Nuno Fernandes, Clarinda Neves, Helena Donato, José Miguel Pêgo, João Carlos Ribeiro","doi":"10.1080/10872981.2026.2740871","DOIUrl":"10.1080/10872981.2026.2740871","url":null,"abstract":"<p><strong>Background: </strong>Medical education has been marked in the last decades by the introduction of Competence-Based Medical Education (CBME). Despite its clear objectives, CBME has faced significant challenges and Entrustable Professional Activities (EPAs) have been conceptualised as an answer to some of those challenges.</p><p><strong>Aims/purposes: </strong>This systematic review aimed primarily to summarise the evidence published on the strategies used for the development, implementation, and assessment of EPAs and their results. Secondarily this review also aimed to characterise the body of evidence produced on EPAs, assess its quality, and explore its limitations and future research paths.</p><p><strong>Methods: </strong>Systematic searches were conducted in six electronic databases in July 2021 and updated in March 2025. The data extracted included the quality assessment of the studies considered using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD).</p><p><strong>Results: </strong>Four hundred and seventy-eight studies were included for data extraction and posterior analysis, most of which referred to Postgraduate programmes (59.6%, <i>n</i> = 285) and took place in the USA (51.5%, <i>n</i> = 246). A relevant diversity of methodologies and stakeholders involved was detected in the development, implementation, and assessment of EPAs. References to factors influencing the implementation of EPAs (50.8%, <i>n</i> = 243) and the potential of implementing EPAs for the improvement of learning and assessment practices (46.4%, <i>n</i> = 222) were found in a significant number of studies, but only a small number focused on the cost-effectiveness of the use of EPAs. The quality analysis of the included studies revealed modest results.</p><p><strong>Conclusions: </strong>This broad systematic review highlights the increasing adoption of EPAs, showcasing the diversity of contexts and strategies for the development, implementation, and assessment of EPAs. Nevertheless, significant challenges persist, namely concerning study quality, warranting further research.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2740871"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170991","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":"Integrating disability and language access education in undergraduate medical training: a curriculum mapping study at a rural medical school.","authors":"Lesley Cottrell, Scott Cottrell, Isabela Negrin, Anna Schuster, Megann Boone, Norman Ferrari","doi":"10.1080/10872981.2026.2627020","DOIUrl":"10.1080/10872981.2026.2627020","url":null,"abstract":"<p><p>This study offers a detailed analysis of how disability and English as a Second Language (ESL) competencies are incorporated into undergraduate medical curricula. Using systematic curriculum mapping at a rural LCME-accredited medical school, the research quantifies the hours dedicated to these areas-approximately 202 hours for disability-related topics and 177 hours for ESL-distributed across all four years. The curriculum emphasizes foundational knowledge in social determinants of health, cultural humility, communication strategies, and health disparities, with increasing clinical application throughout training. Early stages focus on core concepts, such as understanding disability definitions and culturally sensitive communication, which are reinforced during clinical rotations involving rural health, pediatrics, and internal medicine. The curriculum aims to develop skills gradually, culminating in leadership and advocacy roles by the final year. The analysis highlights the importance of longitudinal reinforcement and integration to ensure sustained competency development and effective application in clinical settings. Despite the comprehensive overview, the study's limitations include its focus on a single institution and reliance on quantitative data, without assessing actual student competency or exploring extracurricular learning experiences. The findings underscore that a developmental, interconnected approach-combining knowledge, skills, and application-is essential to prepare physicians to deliver equitable, culturally competent care to diverse populations. Such curriculum design can help address health disparities, improve patient outcomes, and promote health equity. The study advocates for ongoing curriculum refinement that emphasizes continuous reinforcement and integration of disability and ESL-related competencies throughout medical training, ensuring future clinicians are equipped to meet the needs of increasingly diverse patient populations.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2627020"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167266","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}