medRxiv - Medical Education最新文献

{"title":"Barriers and facilitators for the implementation of wiki- and blog-based Virtual Learning Environments as tools for improving collaborative learning in the Bachelor of Nursing degree.","authors":"BEATRIZ RODRIGUEZ-MARTIN, RUBEN MIRON-GONZALEZ, MARIA DEL CARMEN ZABALA-BANOS, Montserrat Pulido-Fuentes, Esmeralda Santacruz-Salas, Carlos A Castillo-Sarmiento","doi":"10.1101/2024.09.16.24313727","DOIUrl":"https://doi.org/10.1101/2024.09.16.24313727","url":null,"abstract":"There is little research on teachers' perceptions of the use of Virtual Learning Environments (VLEs) in undergraduate nursing education. The aim of this study was to understand teachers' perceptions of the barriers and facilitators for the implementation of wiki- and blog-based VLEs as tools to improve collaborative learning.\u0000A qualitative action-research study in an intentional opinion-intensity sample of teachers on the Bachelor of Nursing degree course was used. The data were collected and analysed according to the SWOT approach, the constant comparison method, and the coding process.\u0000The analysis highlighted weaknesses (e.g., limited audio-visual communication and feedback, privacy concerns), threats (e.g., training, pre-planning, and time cost), strengths (e.g., being intuitive, friendly and accessible, creating shared knowledge) and opportunities (e.g., improving technological skills, teaching innovation, evaluation and peer learning) for the incorporation of VLEs to promote collaborative learning in nursing training.\u0000Although both our study and the existing literature on the subject show many advantages that encourage the implementation of VLEs in nursing training, the barriers described in this paper cannot be ignored in the context in which the university currently finds itself.\u0000These barriers and facilitators to implementing VLEs in nursing training will be of interest to educational authorities.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Stress Responses in Medical Students Using Virtual Reality Versus Traditional 3D-Printed Mannequins for Pericardiocentesis Training","authors":"Alberto Rubio-Lopez, Rodrigo García Carmona, Laura Zarandieta Román, Alejandro Rubio-Navas, Ángel González Pinto, Pablo Cardinal-Fernández","doi":"10.1101/2024.08.22.24312406","DOIUrl":"https://doi.org/10.1101/2024.08.22.24312406","url":null,"abstract":"Background: As medical education evolves, innovative methods like virtual reality (VR) and 3D-printed mannequins are increasingly used to simulate high-stress medical scenarios realistically. This study investigates the effectiveness of VR and 3D-printed mannequins in replicating stress levels during pericardiocentesis training, comparing their impact on the emotional and physiological responses of learners. Methods: We enrolled 108 final-year medical students who were randomized to train with both VR and 3D-printed mannequins. Heart rate variability (HRV) analysis was employed to assess stress responses. Additionally, a secondary analysis examined the influence of demographic factors, lifestyle, medication use, and academic stress on these responses. Results: Both VR and traditional mannequin-based training methods proved equally effective in simulating the stress levels encountered in real medical procedures. Our findings indicate significant interactions between stress markers and demographic factors, which highlights the complex nature of stress responses in medical education and underscores the necessity for personalized training approaches. Conclusion: The study validates the use of VR as a viable alternative to traditional mannequins, capable of simulating the technical skills and emotional pressures of medical procedures such as pericardiocentesis. Incorporating VR into medical training programs may enhance learning outcomes and accessibility, particularly in settings constrained by resources.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Artificial Intelligence in Modern Medical Education and Practice: A Systematic Literature Review","authors":"Duha Alkurdi, Shiva Rasouli, Bochen Jia","doi":"10.1101/2024.07.25.24311022","DOIUrl":"https://doi.org/10.1101/2024.07.25.24311022","url":null,"abstract":"The integration of Artificial Intelligence (AI) into medical education has emerged as a transformative element in the modern healthcare educational system. With the exponential growth of medical knowledge and the increasing complexity of healthcare systems, AI offers innovative solutions to enhance learning outcomes, facilitate personalized education pathways, and improve clinical decision-making skills among medical professionals. This literature review explores the transformative role of AI in the training of healthcare providers, focusing on advancements in medical education, medical diagnostics, and emergency care training. Additionally, it addresses the readiness of healthcare professionals to employ AI technologies, analyzing their current knowledge, attitudes, and the training provided. By synthesizing findings from multiple studies, we aim to highlight AI's potential to enhance medical education, address challenges, and propose future directions for integrating AI into healthcare training.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141778358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Education Tools for Pediatrics Trainees: A Mixed-Methods Multi-Site Usability Assessment","authors":"Alexander Fidel, Mark V. Mai, Naveen Muthu, Adam C. Dziorny","doi":"10.1101/2024.07.23.24310890","DOIUrl":"https://doi.org/10.1101/2024.07.23.24310890","url":null,"abstract":"Background\u0000Exposure to patients and clinical diagnoses drives learning in graduate medical education (GME). Measuring practice data, how trainees each experience that exposure, is critical to planned learning processes including assessment of trainee needs. We previously developed and validated an automated system to accurately identify resident provider-patient interactions (rPPIs). In this follow-up study, we employ user-centered design methods to meet two objectives: 1) understand trainees' planned learning needs; 2) design, build, and assess a usable, useful, and effective tool based on our automated rPPI system to meet these needs.\u0000Methods\u0000We collected data at two institutions new to the American Medical Association's \"Advancing Change\" initiative, using a mixed-methods approach with purposive sampling. First, interviews and formative prototype testing yielded qualitative data which we analyzed with several coding cycles. These qualitative methods illuminated the work domain, broke it into learning use cases, and identified design requirements. Two theoretical models-the Systems Engineering Initiative for Patient Safety (SEIPS) and Master-Adaptive Learner (MAL)-structured coding efforts. Feature-prioritization matrix analysis then transformed qualitative analysis outputs into actionable prototype elements that were refined through formative usability methods. Lastly, qualitative data from a summative usability test validated the final prototype with measures of usefulness, usability, and intent to use. Quantitative methods measured time on task and task completion rate. Results\u0000We represent GME work domain learnings through process-map-design artifacts which provide target opportunities for intervention. Of the identified decision-making opportunities, trainee-mentor meetings stood out as optimal for delivering reliable practice-area information. We designed a \"mid-point\" report for the use case of such meetings, integrating features from qualitative analysis and formative prototype testing into iterations of the prototype. A final version showed five essential visualizations. Usability testing resulted in high performance in subjective and objective metrics. Compared to currently available resources, our tool scored 50% higher in terms of Perceived Usability and 60% higher on Perceived Ease of Use.\u0000Conclusions\u0000We describe the multi-site development of a tool providing visualizations of log level electronic health record data, using human-centered design methods. Delivered at an identified point in graduate medical education, the tool is ideal for fostering the development of master adaptive learners. The resulting prototype is validated with high performance on a summative usability test. Additionally, the design, development, and assessment process may be applied to other tools and topics within medical education informatics.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141778361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silence in physician clinical practice: a scoping review protocol","authors":"Martina Ann Kelly, Stefanie Rivera, Caitlin McClurg, Catherine Sweeney, Stephen Mosca, Ellen McLeod, Deirdre Bennett, Megan Brown","doi":"10.1101/2024.07.10.24310250","DOIUrl":"https://doi.org/10.1101/2024.07.10.24310250","url":null,"abstract":"Objective\u0000The objective of this review is to map, describe and conceptualize how silence is discussed within literature on interactions between physicians and patients, in clinical settings. Methods\u0000We will use the methodological framework of Arksey & O’Malley, adapted by Levac et al and Joanna Briggs Institute. Empirical studies including quantitative, qualitative, mixed methods, observational studies and reviews will be included. Commentaries, editorials, and grey literature will also be examined. The databases MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus and Web of Science will be searched. A two-part study selection strategy will be applied. First, reviewers will follow inclusion and exclusion criteria based on ‘Population-Concept-Context’ framework to independently screen titles and abstracts. Next, full texts will be screened. Data will be extracted, collated, and charted to summarize methods, outcomes and key findings from the articles included. Expected results and implications\u0000This scoping review will provide an extensive description of how physicians engage with silence in clinical settings. Findings will identify how silence is perceived in physician patient interactions, the roles it plays, what factors influence use of silence and guide development of educational initiatives on use of silence in clinical settings.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141612476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress from Cadaver Dissection Linked to Learning Conditions: Evidence from Sub-Saharan Africa","authors":"Jude Amechi Nnaka, Victor Udochukwu Ezeike, Kristjan Thompson, Izuchukwu Azuka Okafor","doi":"10.1101/2024.07.09.24310166","DOIUrl":"https://doi.org/10.1101/2024.07.09.24310166","url":null,"abstract":"Objective\u0000This study examined the relationship between students′ perceptions of cadaver dissection (CD) and some learning conditions during CD. Methods\u0000This is a cross–sectional study involving 2968 medical students and graduates exposed to CD at nine countries systematically and proportionally selected from Sub–Saharan African countries based on their ranking on the four World Bank indices of development and education: population, literacy, human capital index (HCI), and human development index (HDI). A self–administered questionnaire was used to collect relevant data on learning conditions during CD experience of the participants, using online channels, including email, Whatsapp, Facebook, Instagram, and Twitter. Results\u0000About half (48.76%) of the participants perceived CD as stressful, while 51.24% thought otherwise. However, 57% of participants from institutions where a CD session lasts three hours described their experience as stressful, whereas 69.67% of participants whose institution spent one hour in a single CD session agreed that CD is not stressful. Similarly, 60.63% of participants from institutions with a student-donor ratio between 5 to 10 students per cadaver described their experience as ′not stressful′. In comparison, 57.51% of participants from institutions with a student-donor ratio of 10–20 students per donor and 53.80% of participants from institutions with over 20 students per donor described their experience as stressful. Conclusions\u0000Students from institutions with CD instructors, shorter CD sessions, and a smaller student-donor ratio are more likely to perceive CD as stress–free. Providing more support for students during CD and reducing time for CD may be an antidote to CD-related stress.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141586768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Sexual Harassment of Medical Students: Victims, Experiences, Impact, and Barriers to Reporting","authors":"Rahma Menshawey, Esraa Menshawey","doi":"10.1101/2024.07.09.24310170","DOIUrl":"https://doi.org/10.1101/2024.07.09.24310170","url":null,"abstract":"Abstract\u0000Background: Sexual harassment of medical students is a growing concern. Sexual harassment is an unethical and illegal conduct. Yet, medical students are at a unique disadvantage to be victimized to due organizational failures, fear of retaliation, and unique power dynamics. As more women, minorities, and vulnerable groups enter the medical field, the time is ripe for proactive measures to ensure their empowerment and protect in light of such heinous and harmful acts. Main body of the abstract: Original research studies, which examined the sexual harassment of medical students were identified on the PubMed database using the key terms, sexual harassment, and medical students. A total of 36 studies were identified. The purpose of this review is to highlight the key findings in the original research literature on the sexual harassment of medical students, and to identify themes in hopes to inspire progressive solutions to embolden student safety. Short conclusion: There is a growing global body of literature that has examined the sexual harassment experiences of medical students. Themes across the studies reveal a wide array of experiences. Medical students, especially females, are faced with harassment from professors, colleagues, and patients. The impact of harassment is far reaching, and includes depression, post-traumatic stress disorder, loss of concentration and academic interests, changing specialty of interest and relocation. There is a number of barriers to reporting these events, notably including a lack of institutional response, lack of time to go forward with a complaint, fear of retaliation and career impact. Proactive measures are needed to protect the students and embolden them and provide them with safe and accessible means to reporting these events, as well as ensuring adequate responses to reports on the institutional level, and continued emotional and career support are needed.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141588454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Advanced Large Language Models (GPT-4o, GPT-4, Gemini 1.5 Pro, Claude 3 Opus) on Japanese Medical Licensing Examination: A Comparative Study","authors":"Mingxin Liu, Tsuyoshi Okuhara, Zhehao Dai, Wenbo Huang, Hiroko Okada, Furukawa Emi, Takahiro Kiuchi","doi":"10.1101/2024.07.09.24310129","DOIUrl":"https://doi.org/10.1101/2024.07.09.24310129","url":null,"abstract":"Study aims and objectives\u0000This study aims to evaluate the accuracy of medical knowledge in the most advanced LLMs (GPT-4o, GPT-4, Gemini 1.5 Pro, and Claude 3 Opus) as of 2024. It is the first to evaluate these LLMs using a non-English medical licensing exam. The insights from this study will guide educators, policymakers, and technical experts in the effective use of AI in medical education and clinical diagnosis.\u0000Method\u0000Authors inputted 790 questions from Japanese National Medical Examination into the chat windows of the LLMs to obtain responses. Two authors independently assessed the correctness. Authors analyzed the overall accuracy rates of the LLMs and compared their performance on image and non-image questions, questions of varying difficulty levels, general and clinical questions, and questions from different medical specialties. Additionally, authors examined the correlation between the number of publications and LLMs' performance in different medical specialties.\u0000Results\u0000GPT-4o achieved highest accuracy rate of 89.2% and outperformed the other LLMs in overall performance and each specific category. All four LLMs performed better on non-image questions than image questions, with a 10% accuracy gap. They also performed better on easy questions compared to normal and difficult ones. GPT-4o achieved a 95.0% accuracy rate on easy questions, marking it as an effective knowledge source for medical education. Four LLMs performed worst on \"Gastroenterology and Hepatology\" specialty. There was a positive correlation between the number of publications and LLM performance in different specialties.\u0000Conclusions\u0000GPT-4o achieved an overall accuracy rate close to 90%, with 95.0% on easy questions, significantly outperforming the other LLMs. This indicates GPT-4o's potential as a knowledge source for easy questions. Image-based questions and question difficulty significantly impact LLM accuracy. \"Gastroenterology and Hepatology\" is the specialty with the lowest performance. The LLMs' performance across medical specialties correlates positively with the number of related publications.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141577421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can ChatGPT-4o really pass medical science exams? A pragmatic analysis using novel questions.","authors":"Phil Newton, Chris J Summers, Uzman Zaheer, Maira Xiromeriti, Jemima R Stokes, Jaskaran Singh Bhangu, Elis G Roome, Alanna Roberts-Phillips, Darius Mazaheri-Asadi, Cameron D Jones, Stuart Hughes, Dominic Gilbert, Ewan Jones, Keioni Essex, Emily C Rees, Ross Davey, Adrienne A Cox, Jessica A Bassett","doi":"10.1101/2024.06.29.24309595","DOIUrl":"https://doi.org/10.1101/2024.06.29.24309595","url":null,"abstract":"ChatGPT apparently shows excellent performance on high level professional exams such as those involved in medical assessment and licensing. This has raised concerns that ChatGPT could be used for academic misconduct, especially in unproctored online exams. However, ChatGPT has also shown weaker performance on questions with pictures, and there have been concerns that ChatGPTs performance may be artificially inflated by the public nature of the sample questions tested, meaning they likely formed part of the training materials for ChatGPT. This led to suggestions that cheating could be mitigated by using novel questions for every sitting of an exam and making extensive use of picture-based questions. These approaches remain untested. Here we tested the performance of ChatGPT-4o on existing medical licensing exams in the UK and USA, and on novel questions based on those exams. ChatGPT-4o scored 94% on the United Kingdom Medical Licensing Exam Applied Knowledge Test, and 89.9% on the United States Medical Licensing Exam Step 1. Performance was not diminished when the questions were rewritten into novel versions, or on completely novel questions which were not based on any existing questions. ChatGPT did show a slightly reduced performance on questions containing images, particularly when the answer options were added to an image as text labels.\u0000These data demonstrate that the performance of ChatGPT continues to improve and that online unproctored exams are an invalid form of assessment of the foundational knowledge needed for higher order learning.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141508484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Team-based Learning in a Blended Curriculum","authors":"Natalie Smith","doi":"10.1101/2024.06.25.24309485","DOIUrl":"https://doi.org/10.1101/2024.06.25.24309485","url":null,"abstract":"This article explores the redesign of a Physician Associate (PA) programs didactic coursework from traditional lecture-based methods to a student-centered blended learning platform incorporating Team-Based Learning (TBL). The initiative, supported by a course innovation grant, aimed to address the limitations of passive learning by integrating active learning experiences that enhance student engagement and comprehension. The redesigned Diagnostic Methods I course leverages blended learning to combine online materials with face-to-face interactions, fostering critical thinking and practical application of knowledge. TBL, a structured approach to collaborative learning, facilitates deeper understanding through readiness assurance tests and team-based problem-solving. Early findings indicate improved student outcomes and positive perceptions of the blended TBL approach, suggesting its potential as a valuable educational strategy in PA programs. The article provides practical insights and lessons learned for educators seeking to implement TBL and blended learning in similar educational settings.","PeriodicalId":501387,"journal":{"name":"medRxiv - Medical Education","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141532375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}