Australian journal of primary healthBrenden James, Robyn Ramsden, Louise Geddes, Sabrina Pit, Yann Guisard
BACKGROUND: Rural immersion programs are commonly used to expose medical students to rural practice using curriculum-embedded placements. However, evidence regarding short-term, funded, voluntary, rural immersion placements that are not part of standard curricula-based training and their association with continued rural workforce engagement remains limited. Participants of the Bush Bursary, a voluntary, scholarship-based rural immersion program delivered through innovative partnerships between local councils, community organisations and the Rural Doctors Network (Australia). The program provides 2- to 6-week immersive rural exposure experiences across New South Wales. METHODS: This was a retrospective cohort study. A post-placement survey was distributed in 2022 to 357 former participants from 1996 to 2021 to measure subsequent self-directed rural placement participation and factors associated with excellence in rural experiences. RESULTS: Participants who rated their immersion experience as 'excellent' had a significantly higher likelihood of undertaking further rural placements compared with those providing only a 'good/poor' rating (OR 6.90; 95% CI 1.70-27.99; P = 0.007). Factors independently associated with an excellent experience included rural health experience (OR 4.98; 95% CI 1.22-20.39; P = 0.026). CONCLUSIONS: Brief, voluntary, scholarship-based rural immersion placements with local council and community organisation partnerships, beyond formal curricula-based training, may influence subsequent rural engagement when experience quality is high. Although duration is an important dimension of immersion, authentic participation in rural clinical and community settings is also a defining feature of immersive educational experiences. Short-term rural placements may influence future self-directed rural placement decisions, acting as important stepping stones within the rural workforce pathway. In this context, short-term, scholarship-based rural immersion placements may complement existing policy levers to strengthen rural workforce pathways.
Journal of robotic surgeryLewis Blenkinsop, Kenneth Campbell, Neil Harrison, Ross Dolan
Explore student and surgeon perceptions of robotic theatre live-links as part of an undergraduate medical degree programme. During the surgical block, in the fourth year of a five-year medical programme at the University of Dundee, a robotic live-link session was introduced. Students undertook a pre-session case discussion and targeted anatomy revision before linking in to view the live operation. During the live-link session, the operating surgeon facilitated group discussion and answered questions via a headset. Following the session, 12 students and four participating surgeons completed a questionnaire exploring their experience of the session. The data collected was analysed descriptively to assess the acceptability of this teaching method to the staff and students as well as the students' perceived benefits of the learning environment. The session was well received, with 92% (11/12) of students describing it as relevant or very relevant to their learning. Students also reported fewer barriers to learning compared with their experiences in theatre, such as feeling unable to ask questions. Surgeons felt the quality of the teaching delivered was as good as or better than that normally delivered in theatre. They also reported that the live-link did not impact negatively on their ability to undertake the clinical case. This appears to be the first instance of a robotic theatre live-link being timetabled within an undergraduate curriculum. Student and faculty feedback is positive, and it may provide a way to introduce students to theatre without the usual barriers to learning.
BACKGROUND: Competency-based medical education increasingly uses digital workplace assessment platforms to collect longitudinal evidence of trainees' readiness for progressive responsibility. Entrustable professional activities (EPAs) translate competencies into observable clinical work, but individual workplace observations are context-dependent and may not support dependable progression decisions. Empirical guidance remains limited on how many observations, faculty raters, EPA titles, and workplace settings are needed for a dependable EPA portfolio. OBJECTIVE: This study aimed to estimate EPA portfolio dependability for competency-based progression review using nationwide data from a digital workplace assessment platform in otorhinolaryngology-head and neck surgery residency training. METHODS: We conducted a retrospective, nationwide cross-sectional generalizability and decision study using routinely collected EPA-based workplace assessment data from Taiwan's E-MyWay platform. The study included completed EPA observations from accredited otorhinolaryngology-head and neck surgery residency programs between August 2022 and May 2026. Faculty-assigned entrustment-supervision ratings were scored on a 5-level national EPA scale. The resident was the object of measurement, whereas faculty rater, EPA title, and workplace setting were measurement facets. The generalizability study partitioned rating variance into resident, facet, interaction, and residual components, which were subsequently used in decision-study projections of the generalizability coefficient, Phi coefficient, and absolute standard error of measurement under alternative portfolio configurations. RESULTS: The analytic sample included 45,526 EPA observations involving 466 residents and 448 faculty raters across 35 training programs, 11 EPA titles, and 5 workplace settings. Residents had a median of 87 (IQR 47-124) observations and were assessed by a median of 9 (IQR 6-12) faculty raters across 11 (IQR 10-11) EPA titles and 5 (IQR 4-5) workplace settings. Single EPA observations were insufficient for resident-level summative interpretation. In the primary generalizability study, residual/encounter-level variance was the largest component, accounting for 40.1% of total variance; resident variance accounted for 26.9%, faculty rater variance accounted for 10.8%, and resident × faculty rater interaction for 10.4%. A study-defined well-distributed 10-observation portfolio achieved a generalizability coefficient of 0.77 but an absolute dependability coefficient (Phi) of 0.65. A 20-observation portfolio across 5 faculty raters, 5 EPA titles, and 3 workplace settings yielded a Phi of 0.76, and a 30-observation portfolio across 6 faculty raters, 6 EPA titles, and 4 workplace settings yielded a Phi of 0.80. CONCLUSIONS: Nationwide digital workplace assessment data showed that EPA portfolio dependability reflected both observation counts and sampling breadth across faculty raters, EPA titles, and workplace settings. These study-defined portfolio configurations may help clinical competency committees, residency programs, and specialty societies monitor portfolio completeness before progression deliberation. They should complement, rather than replace, narrative feedback, case complexity, performance trajectory, and committee judgment.
Journal of Korean medical scienceJoon Sung Shin, Yeon-Ju Huh, Narae Yoon, Hyun Bae Yoon, Joo Youn Oh, Sun Jung Myung
BACKGROUND: Immersive research experiences are widely recognized as valuable for medical students. However, opportunities for extended research are often constrained by dense curricula. In 2024, the Republic of Korea experienced an inevitable nationwide suspension of medical education for about one year, allowing some students to engage in full-time research. From this unique situation, the present study aimed to explore the medical students' motivations for research participation, their self-perceived outcomes, and the types of institutional support they have identified as necessary to ensure equitable engagement. METHODS: A mixed-methods design was employed. Survey 1 collected data from the entire student body during the leave of absence to investigate research participation rates and support needs. Survey 2 examined the research experiences of students who conducted full-time research. Focus group interviews were conducted with purposively selected student representatives, and the integrated results were analyzed thematically. RESULTS: A total of 99 students responded to the survey (response rate: 16.9%), and 25 (25.3%) reported participating in research during their leave of absence. Students motivated by intrinsic interest engaged for longer periods and reported greater self-perceived competency gains, particularly in data analysis and communication, whereas non-participants most often cited barriers to access and a need for more structured information. Thematic analysis of focus group interviews underscored the pivotal role of mentorship, early curricular exposure, and faculty role modeling. CONCLUSION: Full-time, faculty-supervised research during an educational disruption provided transformative learning opportunities across motivation types. Embedding structured, early research exposure into the curriculum and ensuring transparent access to opportunities may enhance equity, strengthen professional identity formation, and support the sustainability of the clinician-scientist pipeline.
Southern medical journalPaul Park, Paul Koscumb, Nadia Ahmed, Jeremy Carter, Elizabeth Davis, T Preston Hill
OBJECTIVES: Diagnostic point-of-care ultrasound (POCUS) increasingly is recognized as a valuable bedside assessment tool; however, the most commonly cited barrier to starting a POCUS curriculum in Internal Medicine residency has been the lack of in-house experts. We propose collaborating with the emergency department because all of their faculty are POCUS trained during residency. METHODS: At the University of Texas Medical Branch, we partnered with the emergency department to create a hands-on core rotation starting in 2023 for all postgraduate year-1 residents to improve their skills, knowledge, and confidence with diagnostic POCUS. The residents watched didactic videos in addition to working with faculty and ultrasound technicians one to one for 2 weeks on live patients. RESULTS: The efficacy of the curriculum was evaluated using a pre- and postcourse knowledge quiz, a confidence survey, and a skills assessment. Out of 40 residents, 24 completed the written knowledge quiz and confidence survey, and 14 completed the skills assessment. Overall, the data showed significant improvement in all three evaluation methods. CONCLUSIONS: The success of starting a new POCUS curriculum depends heavily on the ability of the program to recruit expert educators, and that degree may vary by institution. We believe this study shows one way that success may be achieved.
BACKGROUND: Outpatient procedures are an important part of primary care practice; however, few trainees or attendings feel they have adequate skills to perform them. This curricular intervention aimed to improve internal medicine (IM) Post-Graduate Year 1 (PGY1) outpatient procedure training through a 2-h skills session and procedure rotation. APPROACH: Thirty-seven PGY1 residents attended a 2-h skills session covering the utility and evidence behind common outpatient procedures with an opportunity to practice procedures on models. Residents already assigned to one continuity clinic rotated through a specific procedure clinic while the other continuity clinics received the standard curriculum. The skills session and procedure clinic were started in 2023 and evaluated during 2024-2025 academic year. EVALUATION: Residents were surveyed prior to the skills session and at the end of their PGY1 year. The primary outcomes measured were self-reported procedure volume and confidence. The two-tailed Mann-Whitney U test was used to compare differences between groups. Residents completing the procedure clinic rotation demonstrated higher confidence scores for performing procedures (median 4 [IQR 0] vs. 2 [IQR 2.5] on 5-point Likert scale, p = 0.009) and discussing procedures with patients (median 4 [IQR 1] vs. 3 [IQR 2], p = 0.027). Residents completing the rotation also reported performing significantly more procedures during their PGY1 year (median 5 [IQR 2] vs. 1 [IQR 2], p = 0.001). IMPLICATIONS: A hands-on skills session followed by procedure clinic rotation was associated with higher PGY1 confidence in discussing and performing outpatient procedures. The curriculum was integrated into existing residency program infrastructure and continuity clinic rotation.
BACKGROUND: There is ongoing debate about how best to deliver anatomy teaching in a modern medical curriculum. Some studies suggest that the separation of basic sciences and clinical teaching can impact students' confidence in anatomy, which has potential long-term implications on their medical career. This suggests new pedagogic approaches to improve anatomy teaching may be beneficial. This study aimed to establish if integrating a clinical case into anatomy practical classes would improve students' anatomy recall compared to anatomy teaching alone. APPROACH: A ten minute clinical scenario was developed, which focused on the typical history, examination, investigations and management of a hip fracture patient. Medical students (n = 220) currently studying lower limb anatomy were randomised by pre-assigned anatomy groups to become intervention or control. In the intervention group, students received the clinical case teaching, followed by their anatomy session. In the control group, students attended the anatomy session. Students in both groups were then assessed on hip anatomy. The intervention group also gave their perception of the clinical case. EVALUATION: This study showed that participants who received integrated teaching performed significantly better in the anatomy recall test (3.64 SD ± 0.574) than whose who had anatomy teaching only (1.95 SD ± 0.994) (chi2 = 185.51, p < 0.00001). Most participants (93.5%; 101/108) strongly agreed/agreed that integrating clinical cases into anatomy teaching benefited their learning. IMPLICATIONS: These results suggest that students' anatomy recall may be improved by integrating clinical cases and anatomy teaching. It also suggests that students found this approach beneficial for their learning.
The clinical teacherSusan Harris, Aaron Drovandi, Shireen Tahir, Sarah Merrifield
BACKGROUND: Explicit teaching of clinical reasoning to medical students can be difficult to achieve, though may be facilitated through structured clinical debrief sessions supporting student discussions of case studies and placement experiences. This study aimed to understand student perceptions of the value of clinical debrief throughout their curriculum. APPROACH: A scaffolded series of clinical debrief sessions were incorporated into Years 1, 3 and 5 of a 5-year UK undergraduate medical programme. Sessions are increasingly complex across year-levels and continuously improved across academic years according to student feedback. Each session receives student feedback through Likert-scale and open-ended questions on the session and their facilitating tutor, which were consolidated and analysed using descriptive statistics and AI-assisted conceptual content analysis. EVALUATION: From over 8000 responses across the three year-levels and nine academic years, clinical debrief was positively viewed across all cohorts, with increasing perceived value for Year 3 students, though some decrease in perceptions for Year 5 students. Earlier year students emphasised the value for their communication and clinical reasoning skills, while later year students valued the ethical and medico-legal skill development and preparing for practice as a doctor. Tutors across all year levels were perceived highly for their contributions to an inclusive and effective learning environment and reducing professional isolation. IMPLICATIONS: Scaffolded clinical debrief is positively viewed by undergraduate medical students across year levels, with perceived contributions to skill development influenced by year level. Development and implementation of clinical debrief require design aligning to student experiences and expectations, with effective tutor training.
JMIR medical educationShiv Patil, Mert Karabacak, Sotirios Bisdas, Konstantinos Margetis
Early discussions of generative language models in medical education emphasized their promise for simulation, digital patients, individualized feedback, learner assessment, health information dissemination, research support, and translation, while also warning about bias, privacy, academic integrity, misinformation, legal ambiguity, and unequal access. Since that first wave, generative AI has moved from novelty to routine exposure for learners, educators, researchers, and institutions. Medical education therefore needs a more mature framework than a catalog of opportunities and risks. This viewpoint argues that the next phase should be organized around educational entrustment: determining which functions can be delegated to AI systems, under what conditions, with what human supervision, and with what evidence of benefit. Building on recent proposals to apply entrustment to AI in health professions education, we operationalize the concept into a graduated, function-level model that specifies which educational functions may be delegated; at what stakes; and with what oversight, assessment, and governance. We classify use cases by educational stakes and AI autonomy and outline implications for assessment redesign, curriculum development, faculty capability, cognitive autonomy, equity, and institutional governance. The central challenge is whether medical schools can integrate these tools in ways that preserve clinical reasoning, professional identity, accountability, and fairness. The next generation of research should move beyond model performance on examinations and evaluate how AI changes learning, judgment, behavior, and patient care.
Perspectives on medical educationHaang Jeung-Maarse, Rosa L Ecos, Luisa F Jimenez-Soto, Philipp Linde, Mara Müssigmann, Sandra Schuh, Sarah Wahlster, Changryul Claud Yi
Concerns about reproducibility, transparency, and research waste have intensified debates about trust in medical research and health-related sciences. Although Open science initiatives aim to address these challenges, their role in undergraduate medical education remains underexplored. Undergraduate medical education typically emphasizes appraisal of published evidence but pays less attention to how research is conducted, governed, and disseminated. This article proposes an international conceptual framework that positions Open science as part of professional formation in undergraduate medical education. The framework comprises three domains: epistemic transparency, ethical responsibility, and professional identity formation. Together, they describe how learners engage with knowledge production, uncertainty, and responsibility. Rather than prescribing curricular models, the framework offers adaptable principles that can be mapped onto existing structures such as competency-based programs in diverse contexts. By framing Open science as a formative orientation rather than a technical skill set, it links medical education to professional responsibility and the public role of medicine.
Primary health care research & developmentMehmet Kibar, Erhan Şimşek
AIM: To characterise baseline levels and contextual triggers of public speaking anxiety (PSA) among family medicine residents and to examine whether a theory-driven educational intervention was associated with short-term changes in PSA across cognitive, behavioural, and psychological dimensions. BACKGROUND: Effective communication is a core competency in primary healthcare. However, while clinical consultation skills are prioritised, academic presentation skills are systematically absent from most family medicine residency curricula. This 'null curriculum' leaves primary care trainees unprepared for professional advocacy, academic leadership, and teaching roles. METHODS: A quasi-experimental one-group pre-test-post-test study was conducted involving 199 family medicine residents at a tertiary hospital in Türkiye. A theory-based single-session educational intervention was delivered. PSA was measured using the validated Turkish Public Speaking Anxiety Scale (PSAS). The study was reported in accordance with TREND and CRISP guidelines for primary care research. FINDINGS: Before the intervention, 87.4% of residents had never received formal PSA training. Academic instructors were the most frequently reported source of anxiety (82.9%) compared with patient encounters (4.0%). Following the intervention, total PSAS scores were associated with a statistically significant short-term decrease (p < 0.001). Significant short-term reductions were observed across cognitive (p = 0.005), behavioural (p < 0.001), and psychological (p < 0.001) dimensions. In exploratory subgroup analyses, married residents (p = 0.026) and senior residents (p = 0.002) appeared to experience larger short-term improvements, although these findings should be interpreted cautiously. These findings suggest that structured educational support may be beneficial for a subset of family medicine residents and that academic presentation skills warrant consideration as part of residency training; however, given the mixed individual-level responses and absence of a control group, this recommendation should be treated as preliminary pending controlled longitudinal evidence.
Primary health care research & developmentElizabeth Louise Field, Jo-Anne Johnson, Sanjiv Ahluwalia, Colin Melville, Margaret Greenfields
BACKGROUND: Inclusion health focuses on populations systematically excluded from healthcare including people experiencing homelessness, vulnerable migrants, and those with justice system involvement. Despite political commitments to National Health Service (NHS) equity, inclusion health remains inconsistently embedded in undergraduate medical curricula. This curriculum development report describes an educator workshop undertaken to identify priorities and practical strategies for embedding inclusion health within a medical school curriculum. METHODS: A structured workshop was conducted during Anglia Ruskin University School of Medicine's 2025 Annual Educator Day. Multidisciplinary educators from a range of organisations participated. Small-group discussions explored four areas: populations affected by healthcare exclusion, barriers to access and engagement, challenges to student involvement in inclusion health settings, and opportunities for curriculum development. Emerging priorities were shared during a plenary session to confirm resonance with discussions. Subsequent structured thematic synthesis of facilitator notes identified curriculum priorities and implementation strategies. CURRICULUM DEVELOPMENT OUTCOMES: Educators described current inclusion health exposure as incidental, fragmented, and insufficiently supported. Key challenges included stigma, mistrust, digital exclusion, limited placement capacity, and a lack of structured student preparation and debriefing. Priorities for curriculum development included longitudinal community-based primary care placements, stronger partnerships with third-sector organizations and people with lived experience, integration of inclusion health across professionalism, leadership and wellbeing teaching, and incorporation of inclusion health competencies into assessment. IMPLICATIONS FOR PRIMARY HEALTH CARE EDUCATION: Embedding inclusion health within undergraduate medical education requires intentional curriculum design aligned with primary care realities, national policy, and assessment frameworks. Development-focused approaches offer practical routes to strengthening equity-focused competencies across both newly established and long-standing medical schools.
Perspectives on medical educationHolly A Caretta-Weyer, Ming-Ka Chan, Mary Ellen J Goldhamer, Alan Schwartz, Teresa M Chan, Lalena M Yarris, Ian W Incoll, Arvin Damodaran, H Carrie Chen, As me…
INTRODUCTION: Graduate medical education (GME) selection processes may pose significant barriers to implementing competency-based health professions education (CBHPE). Current selection metrics are largely nonpredictive of future success, and the removal of clerkship grades has given rise to a shadow economy of effort focused on publications, research hours, and other activities that detract from clinical training. This misalignment between selection practices and CBHPE principles constitutes a wicked problem that requires innovative approaches to develop new solutions. METHODS: We conducted a TRIZ (Theory of Inventive Problem Solving) exercise, a Liberating Structure that challenges assumptions by asking what would make a process fail spectacularly. Eight participants representing three countries, two continents, and four medical specialties convened via video conference in October 2025. Participants served as proxies for key stakeholder groups (students, program directors, medical school leadership, and patients/society), identified elements of the worst-possible selection system, compared them to current practices, and proposed solutions. RESULTS: Participants identified numerous elements characterizing suboptimal selection systems, including inequitable and biased processes, arbitrary decision-making, gaming of metrics, resource-intensive processes that fail to differentiate candidates, misinformation from training sites, and prioritization of self-interest over patient needs. Many of these elements were recognized as present in current GME selection systems worldwide. DISCUSSION: Recommendations to align selection with CBHPE included embedding social accountability throughout selection, leveraging coproduced competency frameworks, prioritizing workforce diversity, ensuring equity in assessment and selection, incentivizing a growth mindset through a transparent learner handover, and implementing structural innovations, including preference signaling or potentially lottery systems, to better align CBHPE and selection.
MedEdPORTAL : the journal of teaching and learning resourcesAnna Maria Gramelspacher, Bernice Man, Brandon Bedell, Michael Blackie
INTRODUCTION: Engaging in reflective practice is a critical component of training resident physicians toward competency in clinic practice, yet opportunities to engage in it are rare. To be effective practicing clinicians, residents must be able to reflect on and learn from their clinical work. METHODS: One 60-minute 55-word story reflective writing workshop was delivered to 3 groups of second- and third-year internal medicine residents as part of a mandatory curriculum. RESULTS: Each session was led by 2 facilitators with varying levels of training in health humanities. Sixty-one residents completed the workshop, and 54 of them completed a postworkshop survey (89% response rate). All respondents enjoyed the session, and 87% found that the session improved their connection to colleagues. Eighty-two percent of respondents agreed or strongly agreed that the workshop improved their well-being. Ninety-four percent found the session valuable. Ninety-eight percent agreed or strongly agreed that the workshop offers a safe space to process emotionally distressing and/or difficult experiences related to patient care. Seventy-five percent agreed or strongly agreed that the session improved their understanding of their role within a health care team. DISCUSSION: This workshop is an accessible way to incorporate reflective practice into a busy resident curriculum. The facilitated close reading and writing of 55-word stories offered a safe and effective way for residents to process emotionally distressing experiences, form greater connections with colleagues, deepen their understanding of their role as health care providers, and improve well-being.
Journal of robotic surgeryAbdullah Al-Lawati, Azzan Al-Wahshi, Lubna Al-Hashmi, Ali Abduwani, Ibrahim Al-Sibayi, Ahmed Al-Rawahi, Said Al-Busafi, Hani Al-Qadhi
Robotic surgery is an advanced form of minimally invasive surgery, and its use has continued to grow worldwide. Despite this, undergraduate medical education has not expanded at the same rate, and formal exposure to robotic surgery remains limited in many settings, including Oman. A structured educational needs assessment is an important first step in curriculum development. Understanding medical students' perceived knowledge, attitudes, and preferred learning approaches can help guide the introduction of robotic surgery into undergraduate and postgraduate training. This study therefore aimed to assess medical students' perceived knowledge, attitudes, and curriculum preferences regarding robotic surgery in medical training in Oman. This cross-sectional observational study used a validated questionnaire adapted from a published robotic-surgery study and distributed electronically to medical students at Sultan Qaboos University (SQU). It was used as a local educational needs-assessment tool to examine students' perceived knowledge, attitudes, and preferred learning approaches regarding robotic surgery. Convenience sampling was used. Data were analyzed using IBM SPSS Statistics version 26.0, and P ≤ 0.05 was considered statistically significant. A total of 519 medical students were included in the study. Although 71.5% had heard of robotic surgery, 87.3% felt that their knowledge of the field was insufficient. Greater precision was identified most often as an advantage (67.2%), whereas higher cost was the most frequently reported disadvantage (82.3%). Some students remained hesitant about undergoing robotic surgery themselves. Despite this, support for incorporating robotic surgery into training was high, with 81.3% favouring its inclusion in the MD curriculum and 88.2% supporting its inclusion in residency training. Simulation-based teaching was the preferred learning method (73.5%), followed by attending robotic procedures during surgical rotations (66.5%). Most respondents also believed that Oman should invest in robotic surgery. Medical students in Oman generally had a positive view of robotic surgery, but self-perceived knowledge gaps and cost concerns remain. Robotic surgery education could therefore be introduced gradually, beginning with basic concepts, patient counselling, simulation-based learning, and supervised clinical exposure. These findings may help guide the curricular integration of this subject into undergraduate and postgraduate medical training in Oman.
International journal of medical educationTakami Maeno, Ryohei Goto, Junji Haruta, Ayumi Takayashiki, Sachiko Ozone, Masatsune Suzuki, Tetsuhiro Maeno
OBJECTIVES: This study aimed to examine changes in medical students' readiness for interprofessional learning before and after community-based medical education (CBME), and whether these changes are sustained until graduation. METHODS: This longitudinal observational study included medical students at T University who participated in CBME during the 2018-2019 and 2019-2020 academic years. Data were collected as part of routine curriculum evaluation, with written informed consent obtained for research use. Participants were followed prospectively until graduation, with earlier data obtained from interprofessional education (IPE) programs. Readiness for interprofessional learning was assessed using the Japanese version of the Readiness for Interprofessional Learning Scale (RIPLS). The primary analysis focused on changes before CBME (T5), after CBME (T6), and at graduation (T7). A one-way repeated-measures analysis of variance (ANOVA) with Greenhouse-Geisser correction was conducted, followed by Bonferroni-adjusted post hoc comparisons. RESULTS: Analyses were conducted among participants with complete data at T5-T7 (n = 192). RIPLS scores increased after CBME, peaked at T6, and decreased at graduation. Repeated-measures ANOVA showed a significant effect of time (F(1.60, 305.28) = 31.50, p < .001, ηp² = 0.14). Post hoc analyses showed higher scores at T6 than T5 (p < .001) and lower scores at T7 than T6 (p < .001), with no difference between T5 and T7 (p = .062). CONCLUSIONS: Readiness for interprofessional learning increased after CBME but was not sustained until graduation. Strengthening continuity between undergraduate IPE and postgraduate training may help sustain readiness and support transition to clinical practice.
MedicineAram Jeong, Sunju Im, Sang-Won Shin, Hye-Yoon Lee
Health systems science (HSS) is increasingly recognized as a core component of contemporary medical education. Although early clinical exposure (ECE) has been shown to enhance students' understanding of clinical practice, evidence regarding its role in shaping HSS-related perspectives in Korean medicine (KM) education remains limited. This study explored how participation in an HSS-based ECE program influenced KM students' perceptions and learning experiences. Between 2023 and 2025, a qualitative study was conducted with 65 third-year students enrolled in a KM college. Following HSS-oriented lectures and case-based discussions, the students participated in a 4-week observational ECE program in community-based KM clinics. Data were collected from reflective journals and analyzed using conventional qualitative content analysis with inductive coding. The derived codes were organized into themes and subsequently interpreted in relation to the core functional and foundational domains of HSS. Four overarching themes were identified: clinical practice competency, patient-centered care, health care systems, and professional competency. A total of 35 codes across 11 subcategories were derived. Students demonstrated an increased awareness of clinical processes, patient-centered approaches, and the broader health care system, including the influence of policies, organizational structures, and social determinants of health. Ethical considerations and professional responsibility were also prominently reflected in students' experiences. Participation in the HSS-based ECE program was associated with an expanded understanding of clinical practice within broader health care contexts among KM students. These findings suggest that early experiential learning facilitates the development of systems-oriented perspectives and professional awareness. These results provide preliminary evidence that supports the integration of HSS-informed educational approaches into KM curricula.
Journal of visualized experiments : JoVEPingping Hou
This systematic review aims to synthesize empirical evidence on the impact of ideological and political education (IPE) on the formation of professional values in medical students, assessing the efficacy of different curricular models and pedagogical approaches. Conducted in accordance with PRISMA 2020 guidelines, the review analyzed 14 eligible studies identified through a systematic search of four major databases (PubMed, Web of Science, EMBASE, Scopus). A narrative synthesis was performed to integrate findings from diverse geographical and methodological contexts. IPE interventions reliably improve students' cognitive knowledge of ethical principles. However, their effect on affective (attitudinal) and behavioral domains is more variable and contingent. Effectiveness is strongly moderated by pedagogical design, with active, experiential, and reflective methods showing greater promise than didactic instruction. The influence of formal IPE is heavily mediated by its alignment with the informal "hidden curriculum" of the clinical environment and by broader socio-cultural contexts, which define the prioritized values. Medical educators should move beyond standalone ethics lectures towards integrated, longitudinal, and experiential curricula. Success requires aligning the formal and hidden curriculum through faculty development and fostering a supportive institutional culture. While IPE is a valuable tool for values formation, its impact is not guaranteed. Its success depends on strategic instructional design, cultural relevance, and systemic reinforcement throughout the medical education continuum.
BMC medical educationPhilip Vogt, Nadine Wolf, Sandra Jordan, Sara Volz-Willems, Johannes Jäger, Fabian Dupont
BACKGROUND: Beyond technical feasibility of Artificial Intelligence (AI)-generated multiple-choice questions (MCQs), their educational value in assessment remains unclear. This study aims to evaluate whether students can distinguish between AI-MCQs and National Licensing Exam (NLE) questions in an exam setting and if they align with the curriculum. METHODS: In this cross-sectional study 119 year five medical students completed a Family Medicine MCQ tablet-based exam. Participants answered 30 AI-generated and 30 NLE MCQs. AI questions were generated from digital learning materials using ChatGPT-4o and Gemini 1.5 Pro. Experts accepted 82% of the questions, with minor edits to retained items and removing those needing major changes. During the exam, students were asked about the question source and whether each item aligned with the course curriculum. Statistical analyses were obtained using Jamovi 2.3.28.0. RESULTS: No significant difference in correct attribution of AI or NLE MCQs (t(29.6) = -1.24, p = .225; t(29.6) = 1.18, p = .246) was observed. No significant correlation was found between item difficulty and recognition (τ_b: p = .534). Distractor distributions did not differ across ChatGPT, Google Gemini and NLE (χ2(2) = 2.61, p = .271, U p > .05 for all comparisons). Item difficulty did not differ significantly between AI and NLE items; however, exploratory source-specific analysis showed an overall difference among ChatGPT, Google Gemini, and NLE items (χ²(2) = 6.71, p = .035), with a difference between Google Gemini and NLE items (p = .028). Student-perceived curricular alignment did not differ significantly between AI and NLE or among ChatGPT, Google Gemini, and NLE. CONCLUSIONS: Students' recognition did not differ between AI-generated MCQs and NLE MCQs. Easier MCQs are generally perceived as more aligned with the curriculum. AI-MCQs may provide a feasible approach to item drafting within a structured human-review process.
INTRODUCTION: This study investigated the perceptions and preferences of medical students at Abubakar Tafawa Balewa University (ATBU) regarding various teaching methods, including lectures, problem-based learning (PBL), team-based learning (TBL), practical demonstrations, and digital learning tools. METHODS: A cross-sectional survey of 171 medical students was conducted, using a semi-structured questionnaire. Students were selected using stratified random sampling techniques. Quantitative data were analyzed using descriptive statistics (frequencies, percentages) and inferential statistics (Chi-square test) and qualitative data were analysed using thematic content analysis. The thematic content analysis was based on 171 responses. RESULTS: Practical demonstrations (32.2%) and small group activities (24.0%) were the preferred teaching methods. Key challenges identified include difficulty retaining information (48.0%) and inadequate preparation for clinical practice (15.8%). The students demanded practical, clinically relevant learning, and lecturers who are well-grounded in their subjects and had good teaching skills. Specifically, they preferred lecturers who are medical consultants and could also mentor them. CONCLUSION: The teaching curriculum in the school should incorporate more clinically relevant, practical demonstrations with adequate clinical exposure, more group-based learning, and improved digital infrastructure. Retention techniques should be routinely taught to improve learning retention. Finally, more doctors should be employed for training and mentoring the students. Lecturers should be trained in positive teaching and mentoring skills and to avoid student intimidation.
Medical education systems vary widely across countries, yet the structure of medical and postgraduate training in China remains relatively unfamiliar to international readers. China has developed a relatively comprehensive pathway spanning undergraduate education, postgraduate programs, standardized residency training, and standardized specialty training, thereby shaping an evolving framework that aims to integrate clinical practice with scientific research. Within this framework, postgraduate nephrology education highlights both clinical training and research development. In recent years, Critical Care Nephrology has demonstrated notable strengths in the management of critical illness, blood purification, and multidisciplinary collaboration. This review provides an overview of the development, current status, and future trends in medical and postgraduate nephrology education in China, with a particular focus on the emerging role of Critical Care Nephrology.
JMIR formative researchWilliam Gatenby, Sumeet R Gopwani, Glenn E Woodworth, McKenzie Hollon, Stacey Kaltman
BACKGROUND: Precision medical education (PME) is an emerging concept that aims to improve physician education by tailoring curricula specifically to each learner. The basic framework behind PME requires collecting data on each individual learner, identifying gaps in knowledge, and then applying direct educational interventions. However, logistical difficulties in the delivery of such interventions hinder the implementation of PME in existing academic programs. OBJECTIVE: We developed the Personalized Automated Reading Delivery System (PARDS) software application to support a potential PME intervention, aiming to increase the volume of relevant scientific literature read by resident physicians. The PARDS analyzes surgical case lists for the following day, selects relevant scientific articles according to predetermined keywords, and delivers each article via email to an anesthesiology resident physician. This technology may assist in the application of personalized educational interventions, and we evaluated the feasibility of implementing the PARDS in a population of medical learners. METHODS: From July 2018 to December 2018, a pilot prospective crossover study was performed with N=10 postgraduate year 2 (PGY2) anesthesiology residents in an academic medical center (response rate 10/10, 100%). Residents were randomly assigned to the PARDS intervention group for 2 of the 4 months of the study period. The primary outcomes were organizational viability (evaluated by successful delivery of selected articles by the PARDS, required faculty hours, and total expenses) and acceptability in the study population (assessed by the number of reported weekly reading hours). An analysis using a linear mixed model for repeating measures was performed to compare weekly reading hours between intervention and nonintervention conditions. RESULTS: Total reported faculty time involvement for the study period was 24 hours. The cost estimate for implementation ranged from US $2360 to US $8360. The mean difference of recorded reading hours by residents while using the PARDS vs not using the PARDS for months 1, 2, 3, and 4 of the study was 2.56 (95% CI -0.03 to 5.15; P=.053), 0.44 (95% CI -2.15 to 3.03; P=.74), 0.99 (95% CI -1.38 to 3.36; P=.41), and 3.7 (95% CI 1.34 to 6.08; P=.002), respectively. CONCLUSIONS: The PARDS was successfully implemented in an academic medical center. Calculated costs indicate that the PARDS is an inexpensive intervention compared to contemporary alternatives. The effect on resident reading requires further research.
Annals of family medicineLauren E Harriett, Katherine M Wright, Lauren Anderson, Santina Wheat, Lauren Harrison, Kathleen Rowland, Lauren Oshman, Emma Worringer, Jacob Prunuske
BACKGROUND: Quality improvement (QI) is a core component of family medicine residency training, preparing physicians to lead system-level changes and deliver value-based care. However, there is no standardized curriculum or metric for evaluating success of residency QI projects and a lack of consensus on best practices for QI education and assessment in graduate medical education. We sought to characterize the current landscape of QI curricula in US family medicine residencies, including pedagogic methods, project requirements, faculty roles, and perceived markers of success and barriers. METHODS: This study was part of the 2025 Council of Academic Family Medicine Educational Research Alliance cross-sectional survey of family medicine residency program directors. Survey question topics included QI training, project logistics, characteristics, and outcomes. We analyzed data by descriptive statistics and χ2 analyses. RESULTS: The response rate was 44.2% (321/726). Programs reported using a residency-developed (38.8%) or hybrid (46.8%) QI curriculum, and most oversight was provided by core faculty (54.2%). Residents' access to QI data was typically limited (44.6%) or full (27.6%), and QI projects were often structured in resident teams (45.2%). Graduate QI proficiency was mostly rated as intermediate (63.5%). Greater graduate proficiency was significantly associated with programs reporting hybrid curricula, fewer barriers to data access, continuity of projects, and greater dissemination and implementation of project outcomes (all P < .05). CONCLUSIONS: Training and project characteristics linked to outcome measures, including resident proficiency and clinical practice change, highlight the need for more standardized and longitudinal approaches to QI training in family medicine residencies.Abstract available in: يبرع (Arabic); (Chinese); Francais (French); Deutsch (German); हिन्दी (Hindi); Indonesian (Indonesian); (Japanese); Portugues (Portuguese); Español (Spanish).
BMC medical educationM Wegmann, M Lemos, D Fink, A Scherg, F Elsner
BACKGROUND: In Germany, assisted suicide is legal, placing ethical and communicative demands on physicians. Medical students (MS), however, often feel inadequately prepared for such conversations. This study explores how MS perceive two teaching formats designed to support communication skills in such a context. METHODS: As part of the Erasmus+-funded ELPIS project (E-Learning on Palliative Care for International Students), in 2023 a drama seminar (DS) and an online tool (OT) were offered to MS of the RWTH Aachen University on a voluntary basis to support communication skills training. For evaluation, qualitative interviews were conducted with 15 MS from RWTH Aachen University. Semi-structured interviews were transcribed and analysed through qualitative content analysis, applying both inductive and deductive approaches. RESULTS: All 15 MS viewed the DS as emotionally intense and immersive, with empathic engagement, self-reflection, and opportunities to practise communication skills emerging as central aspects of the experience. Several MS, however, reported emotional overload when performing in front of peers. The OT was appreciated for its flexibility, structured design, and emotionally safe environment, particularly by those with limited prior experience. Its limitations included reduced realism, lack of non-verbal interaction, and a diminished sense of authenticity. MS suggested a hybrid learning approach, using the OT as a preparatory phase before the DS. The interviews revealed a lack of knowledge regarding the legal framework of assisted suicide, reinforcing the need to integrate legal and ethical education into the medical curriculum. CONCLUSION: The findings suggest that the two formats offer different strengths in preparing MS for challenging end-of-life conversations, with the interview findings further indicating that a blended learning format may reduce emotional barriers and support a stepwise approach to communication training. Integrating communication training alongside ethical and legal education represents an important step towards strengthening palliative care curricula.
Frontiers in public healthDili Xie, Xuechun Sun, Jianshu Guo, Peng Liu, Junling Yang, Ping Zhong
OBJECTIVE: To evaluate the association between an Intelligent Hypertension Excellence Centers (iHEC)-integrated teaching model and multidimensional educational outcomes in standardized residency training, and to explore whether self-directed learning (SDL) mediates the association between digital health-enhanced training and educational performance. METHODS: A retrospective sequential cohort study was conducted among 245 resident physicians who completed a standardized 4-week hypertension rotation in the Department of Geriatric Cardiology between September 2022 and August 2024. Residents were assigned to a conventional ward-based teaching cohort (n = 118) or an iHEC-integrated teaching cohort (n = 127) according to rotation period. Both cohorts received identical curriculum requirements, faculty supervision, and assessment procedures. Educational outcomes included objective structured clinical examination (OSCE) performance, knowledge acquisition, SDL readiness, critical thinking disposition, and educational satisfaction. Structural equation modeling (SEM) with bias-corrected bootstrapping was performed to evaluate direct and indirect associations. RESULTS: Baseline characteristics and educational assessments were comparable between cohorts. After adjustment for baseline performance, specialty, and calendar time, the iHEC cohort demonstrated higher post-rotation OSCE scores [adjusted mean difference (AMD) 6.85, 95% CI 5.12-8.58, p < 0.001], knowledge scores (AMD 5.42, 95% CI 3.84-7.00, p < 0.001), SDL scores (AMD 9.86, 95% CI 7.21-12.51, p < 0.001), and critical thinking scores (AMD 12.45, 95% CI 9.15-15.75, p < 0.001). The respecified SEM demonstrated good model fit (CFI = 0.962, TLI = 0.951, RMSEA = 0.052, SRMR = 0.038). The iHEC teaching model was positively associated with SDL (β = 0.68, p < 0.001) and educational performance (direct effect β = 0.36, p < 0.001). SDL showed a significant indirect association with educational performance (β = 0.38, 95% bootstrap CI 0.21-0.55), accounting for 51.4% of the total association. CONCLUSION: The iHEC hypertension teaching model was associated with improved resident educational outcomes, with enhanced self-directed learning representing a potential explanatory pathway underlying these observed associations; prospective multicenter studies are needed to further evaluate causal relationships, long-term retention, and implementation feasibility.
BMC medical educationChristoph Noll, Marie Mikuteit, Sina Golon, Christian Louzek, Kambiz Afshar, Ingo Just, Sandra Steffens
BACKGROUND: Practical clinical skills cannot be adequately assessed through written examinations. This article describes the development and implementation of a summative Objective Structured Clinical Examination (OSCE) prior to the Practical Year (PJ) at Hannover Medical School. METHODS: An interdisciplinary team, medical experts and students developed 34 OSCE stations based on Entrustable Professional Activities. Stations were piloted in 2022 with voluntary student participants and focus group feedback. The PJ-OSCE was curricularly integrated in 2023/24 and linked to five core clinical clerkships/modules. Pass-fail cut scores were established using the modified Angoff method. RESULTS: The pilot OSCEs proved high staffing demands but overall feasible and favorable for student learning. In June 2024, 278 students completed the mandatory PJ-OSCE across 15 circuits of eight stations (8 min each). Mean score was 603.08 (SD 67.57)/800 points (75.2%); pass rate was 97.1%. Examination reliability averaged 0.84 (Cronbach's alpha, SD 0.06). Students rated the examination 10.90/15 points, with 41.0% reporting substantial learning gains. Examiners rated the format as appropriate (86.3%). CONCLUSIONS: This feasibility and implementation study demonstrates that a large-scale summative PJ-OSCE can be successfully developed and delivered within a German model curriculum context. The structured development process may serve as a model for other medical faculties implementing similar examination formats.
Clinical photography can convey phenotypic, anatomical, and diagnostic information that may be difficult to replace with text. This also applies to highly sensitive pediatric clinical photographs when the scope of patient exposure is necessary to achieve a specific educational objective. This viewpoint addresses a more specific problem: "How should the educational function of a highly sensitive pediatric clinical photograph be evaluated when the condition identified with the photograph is substantively described elsewhere in the educational material?" The analysis is grounded in a documented longitudinal observation of 28 editions and reprints of a single academic textbook lineage published between 2005 and 2019, across which the same image-condition configuration persisted. At the point of image presentation, the depicted clinical conditions were explicitly identified, while the accompanying text stated that they were described elsewhere in the textbook, where their substantive clinical descriptions were located in accordance with the textbook's declared curricular structure. On this basis, I propose educational disconnection to describe a situation in which the image-specific educational contribution at the point of presentation is difficult to reconstruct from the observable relationship among image location, the clinical condition identified with the image, the condition's declared curricular location, the location of its substantive clinical description, and the destination indicated in the text accompanying the photograph. The central distinction is that identification of a clinical condition, identification of where that condition is substantively described, and identification of the educational contribution of its photograph are not the same. A separate question therefore remains: "What additional educational information does the image contribute here?" The longitudinal dimension extends this analysis through the concept of educational value decay, referring to the possibility that the relationship between an image and the context-specific justification for its presence may weaken over time, without assuming that educational value automatically declines with the age or repeated reproduction of the image. In response, I propose an Educational Reassessment Framework-a practical, event-triggered process that proceeds from identifying the image's educational function and its relationship to the curricular structure, through assessment of its image-specific educational contribution and exposure-function proportionality, to the consideration of equivalent alternatives, the continuing validity of its justification, and the conditions of responsible continued use. Reassessment is not intended to automatically remove historical, repeatedly used, or highly sensitive photographs. Responsible reuse of an educationally valuable image may remain justified and may reduce the need to photograph additional patients, but educational value does not substitute for appropriate authorization or other conditions of responsible use. Its purpose is to determine whether continued use is supported by an identifiable, current, and context-specific educational contribution, whether the scope of patient information disclosed is necessary and proportionate to that contribution, and whether the conditions supporting use remain appropriate.
Perspectives on medical educationSandra Monteiro, Matthew Sibbald, Matthew Lineberry, Teresa M Chan
INTRODUCTION: Values (value judgments, beliefs, etc.) have implications for clinician educators' conceptualization of postgraduate education, as well as their interpretation and application of assessment data. Seeking clarity around individual, program, and systems values within a competency based medical education (CBME) program, the authors sought evidence of distinct values reflected in the CBME assessment literature. METHODS: The authors conducted an exploratory critical review study in two phases aligned with Kahlke's method. In phase one (from September 2020 to December 2022) the authors worked towards five interconnected goals: focus, generate data, appraise, sample, and analyze. In phase two (October 2022), the authors invited peer review of the process and findings. RESULTS: Three values and related assessment goals were distilled from the literature on competency-based assessment: 1) Safety: Assessment protects patient safety, ensuring that only clinicians who demonstrate safe practice are advanced; 2) Development: Assessment supports the development of learners' competence, rather than ranking or differentiating between individuals; and 3) Agility: Assessment evolves in response to context and should be adapted to better support learners and faculty. The authors linked the values within assessment programs to practical consequences for measuring clinical competence. DISCUSSION: The authors articulated how values within academic medicine directly shape the interpretation and judgement of competence. Deliberately balancing the values of patient safety, learner development, and systems agility can prevent harm when any single value dominates. Preparing faculty to recognize and navigate these value tensions is essential for fair, transparent, and defensible assessment decisions in CBME.
JMIR medical educationKatharina Sternecker, Christoph Schmitz, Markus Berndt
BACKGROUND: Since 2021, the histology of organs in the microscopic anatomy course at the Department of Anatomy II of the Ludwig-Maximilians-Universität Munich has been held as a hybrid course using a 3D virtual microscopy system. Evidence comparing synchronous online versus face-to-face instruction using an advanced 3D virtual slide system remains limited. In particular, it is unclear whether learning outcomes are equivalent across instructional modes, and whether individual student characteristics influence learning outcomes under these conditions. OBJECTIVE: This study systematically (1) compares the learning outcomes of preclinic students attending a microscopic anatomy course either face-to-face or synchronously online using a 3D virtual microscopy slide box generated from fully scanned histological glass slides previously used in a traditional course, and (2) investigates whether selected demographic characteristics and personal skills predict learning outcomes in either instructional mode. We hypothesized that learning outcomes would not differ between online and face-to-face participation when instructional conditions are identical. METHODS: The students attended 2 consecutive course days on 2 topics (kidney and liver) in a crossover design. Half of the students attended the first day face-to-face, and the second day online, while the other half attended in the reverse order. Demographic characteristics (eg, self-organization and affinity for technology interaction) and learning outcomes were collected via survey and simulated examination on the day after the second course day. To minimize potential confounding factors (eg, learning by means of external resources) and to ensure that the results reflected the learning outcomes within the scope of this study, 2 particularly challenging course days were intentionally selected, and the time interval before the simulated examination was kept short. Learning outcomes were analyzed using a linear mixed-effects model, and potential predictors were explored using stepwise linear regression. RESULTS: Overall, 740 student questionnaires and examinations (740/864, 86% of the total student cohort) were used to assess the items' quality of the simulated examination. Inferential analyses included data from 415 students who completed the crossover design as intended. No significant main effect of participation mode on learning outcomes was found (F1, 413=0.16; P=.69). Although a significant effect of examination topic was observed (F1, 413=25.56; P<.001), there was no significant interaction between participation mode and examination topic (F1, 413=0.13; P=.72). Regression analyses showed low predictive power overall (R2≥0.12), with self-organization emerging as a weak but consistent predictor across both instructional modes. CONCLUSIONS: The results of this study suggest that the microscopic anatomy learning outcomes of students under controlled short-term conditions are comparable in synchronous online and face-to-face teaching. However, it should be noted that the study was limited to 2 topics and 2 consecutive course days. Further research should address additional topics, long-term learning outcomes, and broader student populations.
GMS journal for medical educationAndrea Punz, Thomas Breakell, Thomas Kühlein, Sigrid Harendza, Raphael Kunisch, Bettina Engel
BACKGROUND: Clinical electives in German medical education provide valuable insights into healthcare practice but often lack structured learning guidance. The FamuPlus project was developed to support medical students in defining and pursuing self-created learning outcomes to foster self-oriented learning (SOL), which is recognized as a key competence for lifelong learning and professional development in medical practice. In this study, self-created learning outcomes describe a guided process. PROJECT DESCRIPTION: Within FamuPlus, seven students completed a brief online training introducing the SMART (specific, measurable, achievable, relevant, and time-bound) framework and the learning domains of Bloom's taxonomy. Thereafter, participants formulated individual learning outcomes prior to their clinical elective and reviewed them with their clinical teachers (e.g. general practitioner or ward physician, etc.) at the beginning of their independently chosen, monthlong, clinical elective on site. Throughout the elective, students reflected on their progress using an online self-evaluation tool and engaged in guided follow-up discussions about their experiences. To evaluate the intervention, a control group was additionally surveyed at the end of the clinical elective. RESULTS AND EXPERIENCES: Students reported that defining their own learning outcomes improved focus, motivation, and perceived learning success it also seemed to promote self-efficacy during their electives. However, designing measurable learning outcomes was challenging. DISCUSSION AND CONCLUSION: FamuPlus appears to be a feasible approach to support medical students in strengthening SOL during clinical electives. Despite the small, potentially highly motivated cohort the findings suggest beneficial effects of FamuPlus on perceived learning success, motivation and focus. Refinement and broader implementation are warranted to strengthen learner-centred education in clinical electives. The low-threshold online format and minimal faculty workload make the approach transferable to other faculties. For widespread implementation, careful consideration should be given to the involvement of faculty staff, depending on the available resources as adequate infrastructure is essential for sustainable implementation.
GMS journal for medical educationKathrin Gerstacker, Jonas Engert, Luke Lükewille, Adrian von Witzleben, Lisa Budelmann
BACKGROUND: In an effort to improve the structured training during the practical year in Germany, the German Medical Licensing Regulations have made it mandatory for final-year students to keep a logbook in 2013. This strategy aims to ensure the relevance and review of learning content and to improve the transparency and quality of teaching in the final year. The logbook recommended by the German Society of Otorhinolaryngology is to be used nationwide. METHODS: Our study investigated the acceptance and use of logbooks through voluntary, anonymous online surveys of supervisors and students in Germany. The questionnaires contained eight and twelve questions, respectively. A total of 50 supervisors and 28 students participated in the survey. RESULTS: The results showed that 26% of supervisors and 21% of students do not use a logbook. 64% of the supervisors preferred a digital version of the logbook, while 60.7% of the students also mostly agree with a digital version. It is particularly noteworthy that 79% of the students, who currently rarely use the logbook (as an analog version), stated that they would use it more often if it were available digitally. CONCLUSION: Our study confirms the highly heterogeneous use of logbooks during the practical year in otorhinolaryngology. Faculty-owned logbooks can be customized to specific curricula and needs more easily, which explains their popularity. Although most supervisors consider digitization useful, there are concerns about the effort involved and the potential lack of added value. Therefore, a digitized logbook should be designed not only as a control tool, but also as an interactive learning companion with clear learning objectives, in order to promote internal learning motivation.
GMS journal for medical educationDorothee Schüle, Benedikt Sonnek, Judith Lübbert, Sonia Kurczyk, Katharina Glassen, Svetla Loukanova
OBJECTIVES: This study aims to show the process of developing a competency-based medical education (CBME) General Practice (GP) block clerkship at the University of Heidelberg, aligned with frameworks such as CanMEDS, Entrustable Professional Activities (EPAs), and the National Competency-based Learning Objectives Catalogue (NKLM 2.0). Objectives are to identify competencies addressed in the current two-week clerkship, determine additional content needed to cover all required competencies, and assess student perspectives. METHODS: A questionnaire completed by 165 students in 2023 evaluated perceived competence in various areas and their interest in GP before and after the clerkship. Data were analysed using a 5-point Likert scale ((1=fully agree to 5=completely disagree), and the curriculum was mapped to NKLM 2.0, CanMEDS, and EPAs to identify represented and missing competencies. Focus group meetings with lecturers and students were held to develop a new concept. RESULTS: The current clerkship received an overall rating of 1.8 (SD: 1.06) but did not significantly increase interest in GP careers. Some competencies were well-covered, but areas like interprofessional skills or leadership and management were lacking. A six-week longitudinal clerkship was proposed to address these gaps, focusing on interprofessional collaboration, leadership, and patient-centred care, and including digital teaching, reflection and simulation training, and shadowing experiences. CONCLUSION: The proposed CBME curriculum addresses evolving needs in medical education. Successful implementation will require longitudinal integration, interdisciplinary cooperation, trained preceptors, and centralised coordination. This study provides a roadmap for emphasising key competencies, promoting GP career choice, and contributing to high-quality patient care.
GMS journal for medical educationJudith Lübbert, Dorothee Schüle, Cornelia Wachter, Sonia Kurczyk, Attila Altiner, Svetla Loukanova, Rüdiger Leutgeb
BACKGROUND: To educate high-quality medical graduates who can contribute to a resilient, primary care-based health system, medical education must shift its focus towards decentralized and curricular competency-based medical education (CBME). However, undergraduate general practice education in Germany remains fragmented: theoretical content is delivered at universities, while practical experience is confined to clerkships in community practices, which often lack sufficient didactic infrastructure. This persistent separation of theory and practice hinders the genuine transformation towards CBME. New models that embed structured teaching directly within real care environments are required to bridge this gap. APPROACH: VISIOn Network of Academic Reference Practices in General Medicine (VISIONARA) introduces a novel model for decentralized competency-oriented education in general practice. By establishing academic teaching clusters within community practices, the program creates structured, contextually anchored learning environments that enable experiential learning and professional development. While the initiative aligns with the Medical Research Council (MRC) framework for complex interventions, its primary innovation lies in its design as a scalable model for competency-based learning integrated directly into real-world practice. METHODS: Following the Medical Research Council (MRC) framework, this paper reports on the first two phases: (1) concept development and (2) pilot planning. The development phase comprised a synthesis of evidence on competency-based and decentralized medical education, design of a didactic model based on Kolb's Experiential Learning Cycle, and process/outcome modelling to guide feasibility testing. The pilot phase will assess the model's feasibility, acceptability, and integration into routine general practice. DISCUSSION: VISIONARA seeks to bridge the gap between theoretical academic instruction and real-world healthcare in general practice education by embedding structured, competency-based learning within authentic clinical settings. The feasibility study will examine financial and personnel resource requirements, acceptance among practice staff, students, and patients. It will further assess organizational integration into routine practice workflows, and the identification of structural and logistical barriers. These findings will inform further refinement and the potential progression to a subsequent evaluation phase.
Pediatric blood & cancerAnshul Vagrecha, Adit L Tal, Kayleen A Bailey, Andrea D Orsey, Danielle Cohen, Jessica E Briggs, Jeremy Rosenblum, Farzana Pashankar, Katharine Offer, Alexande…
BACKGROUND: Starting a pediatric subspecialty fellowship presents numerous challenges to trainees. Virtual Symposium of Pediatric Hematology/Oncology of New York (v-SYMPHONY), an educational collaborative organized by 18 pediatric hematology-oncology (PHO) programs, initiated an annual bootcamp in 2022 aimed at easing the transition from pediatric residency to PHO fellowship. METHODS: The bootcamp consisted of virtual clinical lectures and fellow-led panels, which were created with input from diverse program leadership, educators, and past fellows using Kern's six-step module of curriculum development. It was offered to incoming fellows, first in the NY/NJ/CT region, and subsequently expanded nationally. RESULTS: Over 4 years (2022-2025), 147 pediatric residents completed this virtual bootcamp. The number of residents attending the live sessions increased from 19 in 2022 to 62 in 2025. Forty-four participants completed pre- and post-bootcamp surveys over this period, which showed significant improvement in both self-reported medical knowledge and preparedness and reported a decrease in transition to fellowship anxiety scores. CONCLUSION: These results highlight the need and benefits of a standardized orientation program that can be delivered virtually to ease the transition of PHO trainees from residency to fellowship. Such a standardized curriculum is feasible, adaptable, and potentially scalable to a national level.
Perspectives on medical educationDavid Rekhtman, Jessica Campanile, Alex F Nisbet, Abigail Kohler, Jennifer Hong, Ish Sethi, Suzanne Rose, C Jessica Dine
PURPOSE: Medical student curricular evaluation is both beneficial and required. Most medical schools rely on online questionnaires for evaluations, but these are often overlooked or completed haphazardly. We describe the implementation of focus groups as a supplemental form of curricular assessment and evaluate students' and faculty members' attitudes towards this novel approach. METHOD: Ten randomly selected students were assigned to eight focus groups regarding three different preclerkship courses. Following the completion of focus groups, interviews were conducted with students who participated in them, course directors who received the focus group reports, and administrators who oversaw the preclerkship curriculum and the implementation of the focus group program. The semi-structured interviews were then analyzed using inductive thematic analysis, with initial codes generated from the data and subsequent interpretation informed by prior literature on feedback relationships and curricular program evaluation. RESULTS: Interviews were conducted with 17 students, 5 faculty members, and 3 administrators. Participants highlighted key themes related to trust, engagement, collaboration, and the learning environment. Students described the focus groups as a safe space and said they enjoyed thinking critically about improvements. Faculty perceived the thematic content of focus group reports to be comparable to course evaluation summaries from established online forms despite concerns for a smaller sample size. CONCLUSIONS: Focus groups are a novel supplemental tool that can complement existing evaluation mechanisms. Engaging students through focus groups can improve feedback and advance medical school curricula, resulting in a more responsive and adaptive approach to education.
BMC medical educationSomaya Hosny, Hany Atwa, Mona S Ghaly, Ahmed M Makhlouf, Sanaa Radi, Zeinab N A Said, Hala Salah, Abdelrahim Shoulah, Asmaa Abdelnasser
BACKGROUND: The global emphasis on medical education reform highlights the need for essential competencies to meet evolving healthcare demands. In Egypt, significant reforms in 2018 introduced a competency-based, integrated undergraduate medical curriculum-a five-year program followed by a two-year internship aligned with the National Academic Reference Standards for Medicine. This study assesses graduates' perceptions and experiences with the newly implemented reformed national medical program. METHODS: This descriptive, cross-sectional study was conducted between December 2023 and December 2024. Using a convenience sampling, it included 7,264 recent graduates from 27 Egyptian medical schools. Data was collected via an online survey comprising 45 Likert-scale items assessing various aspects of the program. Additionally, three open-ended questions explored graduates' most and least favorable aspects of the program and improvement suggestions. The survey underwent validity testing through exploratory factor analysis and expert review, as well as reliability testing through Cronbach's test. Data analysis included descriptive and inferential statistics, such as independent samples t-tests and one-way ANOVA, with significance set at p < 0.05. Effect sizes (Cohen's d and η²) were calculated for all significant group comparisons to assess practical significance. Responses to open-ended questions were categorized and analyzed using quantitative content analysis (thematic categorization with frequency counts). Ethical approval, informed consent, and participant anonymity were ensured. RESULTS: The study received responses from 7,264 graduates (40.7%). Validity and reliability tests confirmed the survey's robustness, with Cronbach's alpha of 0.98 and exploratory factor analysis identifying four factors, accounting for 64.53% of total variance. Survey responses indicated moderate overall satisfaction across program dimensions, with mean scores ranging from 2.71 to 3.41. Key strengths included integration of basic and clinical sciences, diverse learning opportunities, early clinical exposure, emphasis on critical thinking, self-directed learning, and faculty support. Male students, high achievers, and those with strong English proficiency or university housing reported slightly higher satisfaction, though effect sizes were small. Challenges such as heavy workload, difficulty adapting to the new curriculum, and frequent assessments were noted. Quantitative content analysis of open-ended responses reinforced the quantitative findings, offering additional descriptive insights into students' experiences. CONCLUSION: The shift to Competency-Based Medical Education in Egypt marks a significant reform to better prepare graduates for modern medical practice. Key strengths include subject integration, diverse learning opportunities, early clinical exposure, emphasis on critical thinking and self-directed learning. However, challenges like increased workload, frequent assessments, and difficulties adapting to the new curriculum were noted.
MedEdPORTAL : the journal of teaching and learning resourcesAlexandra López Vera, Jessica Lin, Jocelyn Sagahon-Ramirez, Daniel Ninan
INTRODUCTION: Spanish-speaking patients with non-English language preferences experience communication inequities, particularly in encounters that are sensitive and require nuanced language. Prior medical Spanish curricula have improved general communication skills but have largely focused on other organ systems, with limited attention to reproductive health. To address this gap, we developed a 3-week reproductive medical Spanish module focused on reproductive health communication in Spanish. METHODS: We implemented a 3-week module for second-year medical students that included faculty-led sessions, small-group activities, and standardized patient encounters. Assessment consisted of a 12-minute OSCE using a standardized patient case of a 30-year-old with lower abdominal pain requiring a focused reproductive history and patient-centered communication in Spanish. Performance was evaluated using an observational rubric with published validity evidence for assessing medical Spanish oral proficiency in standardized patient encounters. RESULTS: A total of 128 students completed the final assessment. The mean score was 77.42% (SD = 2.28), with a median of 78% (range 68%-92%). More than half (53.9%) scored 80% or higher, and 87.5% scored at least 70%, demonstrating the ability to obtain a focused reproductive health history and communicate effectively in Spanish during a standardized patient encounter. DISCUSSION: Learners completed core reproductive health communication tasks in Spanish during a standardized patient encounter. The module addressed an underrepresented area in medical Spanish education and demonstrated the feasibility of integrating reproductive health communication training within a systems-based curriculum.
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine]Y Q Chen, L Y Guan, C J Sun, C X Fu
Vaccinology education, as a fundamental strategy that supports vaccine research and practice while integrating the needs of public health and clinical services, constitutes an important component of medical education in China. This paper reviews the recent development of vaccinology education in China, covering disciplinary organization, textbook development, curriculum systems, and the levels of talent cultivation, and identifies existing problems such as outdated textbook content, insufficient faculty resources, and inadequate instructional time allocation. On this basis, this article proposes development pathways, including fully integrating vaccinology education into higher education and promoting integrated dynamic updates that combine print textbooks with digital resources, with the aim of improving the quality of vaccinology teaching and student learning outcomes. These efforts may serve as a reference for strengthening the cultivation of vaccinology professionals and refining the vaccine-related education system in China.
Annals of medicineJessica R Newman, Danny Hernandez, Selina Gierer, Dorothy Hughes
INTRODUCTION: The curriculum of the Doctor of Medicine program at The University of Kansas School of Medicine includes a substantial portion of content delivered via small-group, case-based collaborative learning (CBCL) activities. As critical stakeholders in continuous quality improvement in their education, medical students are poised to make contributions to curriculum enhancement, though they are often underutilized resources. METHODS: Without a faculty-led curriculum revision committee, we piloted a student-led Case-Based Collaborative Learning Review Committee (SCRC) to systematically incorporate student feedback into curriculum revision efforts by reviewing three CBCL activities. The SCRC provided structured anonymous edits and feedback to faculty authors. Qualitative (thematic) data analysis used mixed methods to assess the intervention's impact and develop guidance for future iterations. RESULTS: Sessions were well-received by participating students and receiving faculty based on satisfaction surveys. Thematic analysis of student-generated suggested edits revealed five primary categories of revisions: simple edits, pre-work recommendations, relevancy of social constructs, clarification, and 'need more'. CONCLUSION: Overall, the intervention demonstrated that student-led review was feasible and yielded valuable multi-level feedback on small-group learning activities, such as CBCL. Further research could help determine if similar work could be feasible and effective for lectures and flipped classroom material and whether such continuous quality improvement should be required in our medical education curriculum processes.
Culture, medicine and psychiatryBushra Juhi Jani, Luma K Mohammed, Nawal Juhi Jani
Iraq has endured decades of political instability, war, and social fragmentation that have profoundly affected the nation's psychological and cultural landscape. The erosion of health infrastructures and the normalization of trauma have produced a population in need not only of medical intervention but also of moral and social repair. While biomedical psychiatry remains indispensable for diagnosis and treatment, it does not by itself fully address the relational, cultural, and ethical dimensions of suffering shaped by prolonged violence. This paper examines how Iraqi medical educators and clinicians perceive the introduction of "Medical and Health Humanities" (MHH) within Iraqi medical education as a culturally grounded complement to scientific training and a possible contribution to professional development and psychosocial repair. Drawing upon a three-round Delphi consensus study (2024-2025) involving twenty-two Iraqi medical educators, clinicians, and humanities scholars, the analysis is informed by a pilot pedagogical implementation of an "English through Medical and Health Humanities" course delivered to first-year medical students at the College of Medicine, Al-Nahrain University (2023-2024), providing an initial applied model of culturally grounded MHH in practice, with illustrative student feedback drawn on as perceptions rather than as outcome measures. Together, these strands investigate perceptions, barriers, and strategies for implementing MHH as part of national post-conflict recovery. Findings reveal an 85% consensus among participants that MHH should be embedded across medical curricula, emphasizing narrative medicine, reflective writing, and ethical reasoning as central to rebuilding empathy and restoring moral balance in healthcare. The study argues that such integration supplements scientific rigor rather than replacing it, cultivating narrative competence, cultural sensitivity, and moral resilience. By situating education as a site of healing, participants positioned MHH as a potential pedagogical and psychosocial intervention rather than a proven one. The Iraqi case suggests the potential cultural and geographic adaptability of Medical and Health Humanities approaches, which future intervention studies would need to test directly. When adapted to local ethical and literary traditions, MHH functions not as a Western import but as an applied form of cultural pedagogy capable of filling relational and interpretive gaps within technically oriented medical training. In this sense, the participating Iraqi experts contribute a locally grounded perspective for integrating humanities and biomedicine in contexts of recovery and reconstruction.