Medical Education Online最新文献

{"title":"The evolution of character education in medicine.","authors":"Julie K Silver, Amber Brooks, Suzanne C Danhauer, Chris Gillette, Roshell Muir, Darcy Reed, Mary R Shen, Anna R Silver, Ethan Stonerook, Kenneth Townsend","doi":"10.1080/10872981.2025.2607813","DOIUrl":"10.1080/10872981.2025.2607813","url":null,"abstract":"","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2607813"},"PeriodicalIF":3.8,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12777856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835020","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":"Effects of the allopathic and osteopathic graduate medical education merger on U.S. specialty training: a review.","authors":"Sarah Ibrahim, Mohamed Abdelhady, Jacqueline Venckus, Caleb North, Forrest Bohler","doi":"10.1080/10872981.2025.2605382","DOIUrl":"10.1080/10872981.2025.2605382","url":null,"abstract":"<p><p>The Single Accreditation System (SAS) unified graduate medical education (GME) accreditation for allopathic (MD) and osteopathic (DO) programs under the Accreditation Council for Graduate Medical Education (ACGME). Implemented between 2015 and 2020, it aimed to expand access and standardize residency training across degree types. While the SAS succeeded in expanding opportunities for DO graduates in certain specialties, particularly family medicine and pathology, persistent disparities remain across competitive medical and surgical fields. Specialty-specific analyses reveal that DO applicants continue to face significant barriers in dermatology, ophthalmology, plastic surgery, neurosurgery, and orthopedic surgery, with disproportionately lower match rates and limited representation in top-tier residency programs. Structural challenges including the closure of many osteopathic-led programs, limited access to research mentorship, and degree-based bias among residency programs have exacerbated these disparities. Although Osteopathic Recognition and initiatives such as the Pathologist Pipeline have helped support osteopathic participation in select areas, broader reforms are needed to fulfill the original goals of the SAS. Enhancing academic partnerships, expanding research infrastructure, addressing implicit biases, and fostering DO leadership within academic medicine are critical steps toward ensuring equitable residency access for all graduates. Continued monitoring of match trends and specialty-specific outcomes will be essential to assessing the SAS's long-term impact on healthcare workforce diversity and equity.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2605382"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094474","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":"Mental health profiles and resilience among medical students in an active conflict zone: a cluster analysis.","authors":"Nadia El Asmar, Vanda Yazbeck Karam, Sola Aoun Bahous, Zeina Akiki","doi":"10.1080/10872981.2026.2626139","DOIUrl":"10.1080/10872981.2026.2626139","url":null,"abstract":"<p><strong>Background: </strong>Medical students globally face elevated mental health risks, yet those in conflict-affected regions experience compounded stressors. Lebanon's overlapping crises offer a unique context for examining resilience under conditions of extreme stress. This study aims to 1) evaluate depression, anxiety, resilience, and stress levels among medical students, 2) identify anxiety‒depression clusters, and 3) assess predictors such as demographics or resilience associated with each cluster.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of medical students at a Lebanese medical school between December 2024 and March 2025. Validated instruments assessed anxiety (GAD-7), depression (PHQ-9), perceived stress (PSS-10), and resilience (BRS). Clusters of anxiety and depression were identified, then bivariate and multivariable analyses were performed with the clusters being the dependent variable. An alpha of 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 187 students participated in this survey. At least mild to moderate symptoms of anxiety and depression were found at 77% and 80% of the participants, with 33% reporting high perceived stress and 26% low resilience. Three distinct clusters were identified, the 'high-risk group', the 'medium-risk group', and the 'low-risk group'. Common factors significantly associated with the 'high-risk group' or 'medium-risk group' included smoking, experiencing social isolation and high perceived stress. Being engaged in regular extracurricular activities (adjusted OR (95% CI) = 0.04 (0.004; 0.41), <i>p</i> = 0.006) was associated with lower odds of belonging to the 'high-risk group'; while having a high resilience level (0.06 (0.006; 0.61); <i>p</i> = 0.02) was associated with lower odds, and exercising irregularly (3.96 (1.24; 12.7); <i>p</i><i> </i>= 0.02) with higher odds of belonging to the 'medium-risk group'.</p><p><strong>Conclusion: </strong>Medical students in this conflict-affected region experience alarming levels of anxiety, depression, and stress, yet resilience provides a degree of protection. Tailored, risk-based interventions combined with stress-management, resilience training, and healthy lifestyle habits are essential. Further longitudinal research is needed to assess long-term impacts.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2626139"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12884995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133304","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":"Impact of longitudinal integrated clerkships on national medical licensing examination (Japan) performance.","authors":"Toshiki Kido, Satoshi Kondo, Kento Takeshima, Akiteru Takamura","doi":"10.1080/10872981.2026.2673246","DOIUrl":"10.1080/10872981.2026.2673246","url":null,"abstract":"<p><strong>Introduction: </strong>Longitudinal integrated clerkship (LIC) represents an innovative clinical education model emphasizing continuity of patient care, supervision, and interdisciplinary learning. Previous studies have demonstrated educational advantages of LIC and its stable performance in institutional assessments; however, its impact on high-stakes national licensing examinations remains to be elucidated. In Japan, where the National Medical Examination is a critical summative assessment, evidence regarding the influence of clerkship type on examination outcomes is lacking. This study aimed to evaluate the effect of LIC participation on academic performance, compared with the traditional block rotation (TBR) model.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted at the University of Toyama. Medical students completed a mandatory 50-week TBR followed by a 24-week optional clerkship, during which up to 12 weeks could be taken as LIC across seven affiliated community hospitals. Students with missing examination data or who withdrew consent were excluded. Data collected included Computer-Based Test Item Response Theory (CBT-IRT) scores and results from the 118th and 119th National Medical Licensing Examinations. Analysis of covariance (ANCOVA) was used to assess the association between LIC participation and total, essential, and specific examination scores, adjusting for age, sex, and CBT-IRT performance.</p><p><strong>Results: </strong>A total of 119 students were included. In the 118th cohort, LIC students had significantly higher CBT scores, while in the 119th cohort, a greater proportion had repeated a year (both <i>p</i> < 0.05). After adjustment, no significant differences were observed between LIC and TBR students in total or component National Examination scores in either cohort.</p><p><strong>Discussion: </strong>The findings indicated that LIC participation was not associated with inferior outcomes on the National Examination after adjusting for baseline academic performance. These results suggest that LIC may be implemented without apparent detriment to academic outcomes in the context of Japanese medical education.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2673246"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934571","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":"Training climate matters: programmatic openness, individual belonging, and trainee mistreatment in graduate medical education.","authors":"TingLan Ma, Binbin Zheng, Michael Soh, Jerri Curtis, Steven J Durning, Ting Dong","doi":"10.1080/10872981.2026.2687300","DOIUrl":"10.1080/10872981.2026.2687300","url":null,"abstract":"<p><strong>Background: </strong>Medical trainee mistreatment remains a widespread challenge in graduate medical education, contributing to burnout, depression, and workforce attrition. Graduate medical education programs have sought to create safer learning environments by fostering programmatic openness-climates perceived as transparent, welcoming, and supportive. Yet it remains unclear how such programmatic conditions interact with individual experiences of belonging to shape wellbeing. Drawing on ecological systems theory, we examine how programmatic openness and trainee belonging interact to mitigate trainee mistreatment during residency.</p><p><strong>Methods: </strong>We conducted an anonymous online survey (Dec 2023-Jan 2024) at three large US teaching sites with 62 GME programs. Scales with robust validity evidence measured perceived programmatic openness, individual belonging, perceived mistreatment, burnout, and social support. We built a latent moderation model, encompassing both confirmatory factor analysis and latent interaction effects. We examined how programmatic openness moderated trainee perceived mistreatment while controlling for social support and trainee demographics.</p><p><strong>Results: </strong>Of 675 eligible trainees, 266 responded (39.4%). Measurement models demonstrated good fit, supporting construct validity. Both programmatic openness and belonging were protective against perceived mistreatment, which was strongly associated with burnout. Residents' belonging to the training program was significantly associated with low burnout, even after accounting for social support. Moderation analyses revealed that programmatic openness most strongly buffered mistreatment among trainees who experienced low belonging, with diminished effects at higher belonging levels.</p><p><strong>Conclusion: </strong>Findings revealed a compensatory effect, suggesting the beneficial effects of programmatic openness were especially crucial among trainees who experienced low individual belonging. This finding aligns with the ecological system theory, which posits that supportive environments may mitigate individual-level vulnerabilities. Both burnout and perceived mistreatment were at its lowest when programmatic openness and individual belonging were both present. This underscores the need for residency programs to foster both openness and belonging as core strategies to support trainee wellbeing.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2687300"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240286","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":"AI-assisted case-based learning and flipped classroom to improve clinical decision-making: a randomized controlled trial in reproductive medicine.","authors":"Qi Wang, Cong Hu, Yiyang Li, Ting Zhang, Songling Zhang","doi":"10.1080/10872981.2026.2670047","DOIUrl":"10.1080/10872981.2026.2670047","url":null,"abstract":"<p><strong>Background: </strong>Efficient training of reproductive medicine clinicians is critical in the context of declining global fertility and increasing infertility. Traditional lecture‑based instruction often fails to sufficiently develop clinical decision‑making skills within limited residency rotations. Innovative strategies that integrate artificial intelligence (AI) with case‑based learning (CBL) and flipped classroom (FC) formats may enhance clinical reasoning, however rigorous evidence in reproductive medicine education remains limited.</p><p><strong>Methods: </strong>We conducted a randomized controlled trial involving 50 obstetrics and gynecology residents at the First Hospital of Jilin University. Participants were randomly assigned to an AI‑assisted CBL+FC group or a traditional lecture control group. The AI‑assisted CBL+FC group completed pre‑class interactive case work with virtual standardized patients on the DoctorU platform and case analyses on the Superstar Learning platform, followed by interactive in‑class discussions. Primary outcomes included post‑course theoretical knowledge tests, Mini‑Clinical Evaluation Exercise (Mini‑CEX), and Objective Structured Clinical Examination (OSCE) scores. Secondary outcomes assessed learner motivation, clinical thinking, self‑directed learning, and perceived course effectiveness using a 5‑point Likert scale.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. After the intervention, the AI‑assisted CBL+FC group achieved significantly higher theoretical test scores than the control group. The AI‑assisted CBL+FC group also demonstrated superior overall clinical competence in Mini‑CEX assessments and higher OSCE total scores. Participants in the AI‑assisted CBL+FC group reported greater improvements in learning motivation, clinical reasoning, self‑directed learning, and perceived course effectiveness.</p><p><strong>Conclusions: </strong>The AI‑assisted CBL+FC instructional model significantly enhances theoretical knowledge, clinical decision‑making skills, and learner engagement among reproductive medicine residents. This blended learning model offers an efficacious and generalizable methodology for training practitioners to address the evolving clinical requirements within contemporary fertility care.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2670047"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13218306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148036327","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 impact of supervisor support on academic adaptation of medical research postgraduates: a serial mediation model of research self-efficacy and psychological resilience.","authors":"Yuanyuan Liu, Wenjun Guan, Li Zhang, Jiatong Han, Jingjing Liu","doi":"10.1080/10872981.2026.2668765","DOIUrl":"10.1080/10872981.2026.2668765","url":null,"abstract":"<p><p>Supervisor support (SS) constitutes a core element in cultivating academic Master of Medical Science (MMS) students, yet the psychological mechanisms associated with academic adaptation (AA) remain insufficiently elucidated. This study investigates the pathways through which supervisor support influences academic adaptation via research self-efficacy (RSE) and psychological resilience (PsyRes). Employing a cross-sectional design, 1,486 academic MMS students from two medical universities in Xinjiang were surveyed through cluster sampling. Canonical correlation analysis (CCA) validated variable associations, while Structural Equation Modeling (SEM) tested chain mediation effects. Results indicated significant positive correlations between supervisor support and research self-efficacy (<i>r</i> = 0.411, <i>P <</i> 0.001), psychological resilience (<i>r</i> = 0.379, <i>P</i> < 0.001), and academic adaptation (<i>r</i> = 0.623, <i>P</i> < 0.001). Research self-efficacy strongly correlated with psychological resilience (<i>r</i> = 0.760, <i>P</i> < 0.001) and academic adaptation (<i>r</i> = 0.619, <i>P</i> < 0.001), while psychological resilience positively was positively associated with academic adaptation (<i>r</i> = 0.634, <i>P</i> < 0.001). Redundancy analysis revealed the first canonical variable (U₁ = -0.643X₁ - 0.374X₂) explained 96.3% of supervisor support variance, with the second (U₂ = -2.654X₁ + 2.705X₂) explaining 3.7%. Further mediation analysis revealed a significant direct effect of supervisor support on academic adaptation was 0.377 (95% CI:0.346,0.408), accounting for 67.20% of the total effect. The total indirect effect through research self-efficacy and psychological resilience was 0.184 (95% CI:0.159,0.210), representing 32.80% of the total effect, confirming significant chain mediation (<i>P</i> < 0.001). The findings suggest that to enhance academic adaptation, we recommend strategically leveraging supervisor support, cultivating positive research mindsets, proactively tracking motivation and efficacy, and facilitating deep scientific engagement.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2668765"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844526","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":"A study on the Dilemmas faced by Chinese clinical medicine interns preparing for postgraduate entrance examinations: a grounded theory approach.","authors":"Hai Xu, Huayuan Zhu, Junjie Du, Xiaozhi Wang, Huanhuan Chen, Surong Jiang, Binlin Luo, Wei Sun, Qiao Ke, Liling Chen","doi":"10.1080/10872981.2026.2667657","DOIUrl":"10.1080/10872981.2026.2667657","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical internship is a critical stage for cultivating clinical competence among medical undergraduates. However, Chinese clinical medicine interns (CMI) often face intense conflicts between completing internships and preparing for the postgraduate entrance examination (PEE), which severely affects the quality of clinical internship and professional development.</p><p><strong>Methods: </strong>Adopting a grounded theory approach, this study conducted in‑depth interviews with CMI who had experienced an internship and PEE preparation. Data were analyzed using open coding, axial coding, and selective coding to explore the dilemmas and corresponding solutions.</p><p><strong>Results: </strong>Three levels of dilemmas were identified: (1) Student‑level dilemmas: limited learning outcomes from internships, pressure for postgraduate advancement, and aspiration‑reality gaps. (2) Teaching‑level dilemmas: low sense of teaching accomplishment and low teaching efficacy. (3) Institutional‑level dilemmas: weak regulation enforcement and misalignment of institutional orientation.</p><p><strong>Conclusion: </strong>To alleviate these conflicts, this study proposes optimizing the internship model, strengthening teaching incentives, redesigning the clinical skill evaluation system, and tightening regulation enforcement. These strategies are expected to foster a supportive clinical learning environment and strengthen the development of competent medical professionals.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2667657"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844533","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":"Evaluating a targeted educational intervention to promote high-value, cost-conscious care among medical students.","authors":"Poojita Chinmay, Mohammed Khan, Zhidong Wang, Nivan Lakshman, Nicole Rockich-Winston","doi":"10.1080/10872981.2026.2673290","DOIUrl":"10.1080/10872981.2026.2673290","url":null,"abstract":"<p><p>Rising healthcare costs in the United States, with estimates suggesting up to 25% of spending is wasteful, have created an urgent need for cost-conscious, value-based care (VBC). VBC aims to improve patient outcomes relative to costs, yet its integration into medical education remains inconsistent, leaving future physicians underprepared for cost-sensitive practice. Early exposure to VBC principles can promote resource stewardship and reduce unnecessary interventions, yet few studies have rigorously evaluated structured educational interventions for medical students. This study examined the effectiveness of a single one-hour educational intervention on high-value, cost-conscious care (HVCCC) in improving pre-clerkship students' attitudes, confidence, and preparedness to apply VBC concepts in clinical practice. Pre-clerkship students (Class of 2027, Medical College of Georgia) completed pre- and post-lecture surveys using the validated Maastricht HVCCC Attitude Questionnaire (MHAQ), which measures three domains: Provision of High-Value Care, Integration of Costs, and Perceived Drawbacks. Additional items assessed self-efficacy and communication confidence regarding cost-related discussions. Paired <i>t</i>-tests compared pre- and post-intervention responses. Of the 85 students who participated, 78 provided paired responses for MHAQ items, while all 85 completed the additional non-MHAQ survey items. Following the lecture, total MHAQ scores increased significantly (mean 70.48 to 72.31; <i>p</i> < 0.001), indicating a more favorable overall attitude toward HVCCC. Both the Provision of High-Value Care and Integration of Costs domains improved significantly (<i>p</i> < 0.001 for each), while Perceived Drawbacks decreased (<i>p</i> = 0.019), suggesting reduced concerns about the negative consequences of HVCCC. Students also demonstrated gains in self-efficacy: confidence discussing cost-conscious care increased by 28-30 percentage points across communication settings, and 90.6% agreed they felt better equipped to initiate VBC conversations. A brief, structured HVCCC lecture improved medical students' attitudes, confidence, and preparedness for value-based practice. Integrating targeted VBC education early in training may foster sustainable, cost-conscious, and patient-centered care.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2673290"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934598","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":"Using academic admissions data to predict PA training attrition and academic difficulties: a survival analysis approach.","authors":"Joshua Waynick, Sobia Shariff Hussaini, Ethan Stonerook, Tiffany Hiatt, Caroline Sisson, Brian Peacock, Sarah O'Neal, Andrea McKinnond, Laiton Steele, Chris Gillette","doi":"10.1080/10872981.2026.2745370","DOIUrl":"10.1080/10872981.2026.2745370","url":null,"abstract":"<p><strong>Background: </strong>Research studying health professions' student attrition and academic difficulties generally treat these outcomes as dichotomous variables that obscure important time-varying aspects. Scant attention has been paid to incorporating time-varying methods, such as survival analysis, to model attrition and academic difficulties in health professions trainees.</p><p><strong>Objective: </strong>The objectives of this study are to (1) identify when students were most likely to attrit from the program and/or experience academic probation and (2) identify predictors of time to attrition and academic probation using undergraduate student performance metrics.</p><p><strong>Design: </strong>Using a database of physician associate (PA) student admissions variables and academic performance, we examined the relationship between time-to-attrition and time-to-first-probation using semi-parametric multivariable Cox Proportional Hazards models. Results are presented in adjusted Hazards Ratios (HR) with 95% Confidence Intervals (CI).</p><p><strong>Results: </strong>The rate at which students experienced at least one probation event was 131 per 19,563.5 person-weeks. The rate of students who experienced an attrition event was 32 per 22,210 person-weeks. Overall GPA (aHR = 0.16, 95% CI = 0.08-0.33), verbal GRE scores (aHR = 0.91, 95% CI = 0.87-0.94), having a science major in undergraduate studies (aHR = 0.43, 95% CI = 0.26-0.69) and number of undergraduate course withdrawals (aHR = 1.14, 95% CI = 1.05-1.24) were associated with time to first probation. Verbal GRE scores (aHR = 0.87, 95% CI = 0.80-0.94) and number of undergraduate course withdrawals (aHR = 1.24, 95% CI = 1.08-1.43) were associated with time to attrition.</p><p><strong>Conclusions: </strong>We employed a novel application of survival analysis to predict PA school attrition and academic probation using an entire cohort of students. Our work informs admissions policies by identifying students at-risk of academic probation and attrition who may need more academic support prior to program matriculation.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"31 1","pages":"2745370"},"PeriodicalIF":4.4,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208095","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}