Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsinyA I Pakhomova
The article analyzes current state of system of secondary vocational medical education in Russia. On the basis of data from government agencies and professional associations key issues are considered: record-breaking outflow of young professionals from industry, irregularity of practical training and low efficiency of existing mechanisms of employment. The particular attention is paid to strategies of increasing competitiveness of graduates, including implementation of tutorship, development of regional educational clusters and elaboration of system of medical training.
The clinical teacherJohn M Cunningham, Luyang Jin, Iqra Kazi, Amith Skandhan, Ronald Rodriguez
BACKGROUND: The rapid introduction of AI into clinical practice shifts how we must teach resident trainees so they may become ethical patient-facing clinicians in an AI-integrated healthcare system. Currently, few published innovations assess outcomes beyond learner attitudes. We developed a pilot curricular innovation to equip postgraduate Internal Medicine resident trainees with the attitudes and knowledge needed to responsibly integrate AI tools into patient care decisions. APPROACH: In the 2025-2026 academic year, we piloted a curricular innovation to teach resident physicians the basics of prompting strategies for AI-assisted clinical reasoning, ethical AI use and legal considerations. The innovation consisted of an initial didactic followed by a hands-on, interactive session integrating AI prompts and outputs into clinical vignettes, thereby leveraging near-peer teaching and situated learning to achieve session objectives. EVALUATION: We assessed perceived knowledge and knowledge using a pre-post intervention strategy using the Wilcoxon Rank-Sum test. Fifty-nine/96 (61.5%) and 52/96 (54.2%) of residents participated in the presession and post-session survey, respectively. Perceived knowledge increased significantly across all five learning objectives with a moderate to large effect size. Fifty-one residents participated in the pre- and post-session knowledge test. The median pre-session score was 6/8 (interquartile range [IQR] 4-8), and the median post-session score was 7/8 (IQR: 5-8); p < 0.001, with a moderate effect size = 0.33. IMPLICATIONS: A combined didactic and small-group interaction session improved residents' perceived understanding and knowledge of ethical and legal considerations related to clinical AI use. Future work developing clinical assessments of trainee skills using AI tools is needed.
The clinical teacherAaron Drovandi, Elizabeth Sheader, Margaret Kingston
BACKGROUND: There is limited published evidence supporting integrated team-based learning (TBL) as an effective method for teaching undergraduate medical students. This study describes student and staff perceptions, assessment outcomes and financial factors after integrated TBL was implemented into Year 1 of a large UK undergraduate medical programme. METHODS: Five methods of data collection were used. An online survey was distributed to students, focus groups held with academic and technical staff, observation of teaching sessions, analysis of student assessment data and calculation of expenses for TBL delivery. Quantitative data were summarised narratively; qualitative survey data were analysed using conceptual content analysis; focus group data were analysed using inductive thematic analysis; and expenses data were summarised narratively and compared with problem-based learning (PBL). RESULTS: A total of 449 participants were involved in this study. Students and staff had overall positive perceptions of TBL, highlighting the engaging and consistent teaching and learning approach, effective teamworking and real-world applicability of the weekly themes. Limitations raised were focused on logistical issues such as using new technology and session timing. Compared with previous cohorts taught through PBL, assessment analysis found mixed results by assessment type. Finally, TBL was found to be more financially viable than PBL through reduced staff time requirements despite initial cost outlays. CONCLUSION: TBL represents a potentially effective and efficient method for teaching undergraduate medical students on a large scale and should be considered by other medical programmes where increasing student numbers may affect the quality of PBL teaching.
The clinical teacherJohn Wenham, Megan C Best, David W Kissane Ac
BACKGROUND: Spiritual care has been shown to be an important component of holistic patient care. However, students have reported it missing from current Australian medical school curricula. The aim of this study was to evaluate the impact of a three-hour spiritual care workshop designed to enable final year medical students to take a spiritual history from their patients. METHODS: We used a prospective pilot study design to evaluate a novel half-day workshop designed to equip final year medical students to assess the spiritual wellbeing of their patients. The impact of the spiritual care workshop was evaluated using video analysis of a formative objective structured clinical examination (OSCE) of a spiritual consultation using a standardised patient prior to and after the teaching episode. Students self-assessed confidence scales pre- and post-workshop. Student characteristics that might facilitate learning in this domain were assessed. RESULTS: Thirty-two final year medical students from four universities participated at two training sites. Video analysis by four independent assessors showed satisfactory inter-rater reliability and demonstrated a statistically significant increase (p < 0.001) in the use of spirituality questions. The students' self-assessed confidence scales pre- and post-workshop demonstrated statistically significant increases in assessing all domains except empathic responsiveness; the greatest improvement was in the spiritual domain. CONCLUSION: Whilst this study was confined to medical students, we believe that the objective and subjective effectiveness demonstrated in this spiritual care workshop will be readily translatable into multidisciplinary holistic communication skills training.
The clinical teacherCarol Boutrous, Shweta Rao, Anna Harvey Bluemel, Megan E L Brown, Heidi Stelling
BACKGROUND: Pelvic examination is a core clinical skill in undergraduate medical education, requiring integration of technical competence with communication, consent and patient-centred care. Despite its importance, opportunities to learn pelvic examination are variable, and educational approaches differ widely. Existing reviews have largely focused on short-term learner outcomes rather than broader questions of implementation, cultural context and patient impact. This review aimed to map teaching methods used to teach pelvic examination, examine how effectiveness is defined and evaluated, and identify reported barriers and enablers to implementation. METHOD: A scoping review was conducted in accordance with Arksey and O'Malley's framework and prospectively registered with Open Science Framework. Database searches were undertaken in June 2024 and repeated in May 2026. Studies describing pelvic examination teaching for undergraduate medical students were included. Data were extracted and analysed using inductive qualitative content analysis. Outcomes were mapped to the Kirkpatrick model to enable comparison. FINDINGS: Fifty-five studies were included. Teaching approaches were grouped into received knowledge (e.g., lectures, videos and e-learning) and experiential approaches (e.g., models, professional patients and clinical encounters). Most studies combined multiple modalities. Evaluation predominantly focused on learner-centred outcomes at Kirkpatrick levels 1 and 2, particularly confidence and perceived competence. No studies assessed behavioural change or patient-level outcomes. Implementation was influenced by resource availability, workforce pressures, organisational culture and equity considerations. IMPLICATIONS: Pelvic examination education requires balanced, feasible and culturally sensitive approaches that extend beyond short-term learner outcomes. Future research should prioritise patient perspectives, long-term behavioural change, inclusivity and cost-effective implementation within real-world clinical contexts.
The clinical teacherAkhil Bansal, Kirsten I Black, Jane Bleasel, Annette W Burgess
BACKGROUND: Medical student electives play an important role in both personal and professional development. The need for medical students to have early exposure to teacher training skills has also been recognised. The Sydney Medical School elective in medical education was designed and implemented in 2021 in response to growing student interest in acquiring professional skills in teaching, as well as the global mobility restrictions at the time. We sought to explore students' perception of their experience. APPROACH: The 4-week elective was designed based on the successful 'Peer Teacher Training' programme for health professional students. Delivered online to 49/250 (20%) final year medical students, the programme consisted of 13 e-learning modules with required asynchronous and synchronous activities and formative assessment. EVALUATION: We collected qualitative data from 34 participants (69%) using a postcourse questionnaire. Students valued learning about educational theory with opportunities to practice teaching and feedback with their peers. The elective was found to enhance participants' confidence in teaching. Although students valued the flexibility afforded by online delivery, some expressed a preference for the inclusion of in-person learning activities. IMPLICATIONS: The medical education elective provided students with dedicated time to develop knowledge and skills in clinical teaching and fostered engagement and interest in teaching activities. Such electives present a valuable alternative for students and may offer an initial entry point into the clinician educator pipeline.
Journal of robotic surgeryShayan Hosseinzadeh, Maria Carolina Jimenez, Michel Cordies, Tarini Mudunuri, Mahsa Shariat, Gary Girma Gamme, Jose Manuel Martinez, Robert Frank Cubas
Robotic surgery is increasingly integrated into general surgical practice, creating a need for standardized training methods that objectively assess technical skill acquisition. Current robotic simulation curricula often rely on psychomotor tasks that may not reflect clinically relevant reconstructive procedures. Enterotomy repair requires precise tissue handling and suturing and may serve as a practical benchmark for robotic training. This study evaluated whether a standardized robotic enterotomy repair task could demonstrate reproducible skill acquisition among junior residents. A prospective longitudinal study was conducted involving PGY-1 and PGY-2 general surgery residents performing a standardized two-layer robotic enterotomy repair on a porcine small bowel model using the da Vinci Xi platform. Participants completed three sessions spaced 1-2 weeks apart. The primary outcome was time to task completion. Secondary outcomes included leak testing, technical errors, and exploratory comparisons by postgraduate year and prior robotic training. Changes in performance across sessions were analyzed using a linear mixed-effects model accounting for repeated measures. Thirty-eight residents participated, with 30 completing all three sessions. Mean completion time decreased from 18.47 ± 4.87 min in session 1 to 14.90 ± 6.00 min in session 2 and 13.20 ± 5.60 min in session 3 (p < 0.001). Leak rates declined from 26.3% in session 1 to 20.0% in session 3. Logistic regression analysis accounting for repeated observations demonstrated no significant association between completion time and leak occurrence (OR 1.0003, 95% CI 0.9988-1.0019; p = 0.671). PGY-1 residents demonstrated greater improvement, with convergence between PGY levels by the final session. Residents with prior robotic training demonstrated numerically faster repair times, though differences were not statistically significant. A short, standardized robotic suturing curriculum using a procedure-based enterotomy repair task produces reproducible improvements in technical efficiency among junior surgical residents without compromising repair integrity. This model provides an objective and practical framework for assessing robotic skill acquisition early in surgical training.
Medical education onlineJ C Malsawmzuali, Fadi W Adel, Wojciech Pawlina, Punnose Kattil
BACKGROUND: The heart is commonly introduced in early medical education through its structural, mechanical, and electrophysiological roles. Although this framing remains foundational, it may underemphasize the heart's endocrine functions. Cardiac endocrine signaling, particularly natriuretic peptide physiology, offers a concise structure-function example linking anatomy, histology, cardiovascular physiology, and clinical biomarker interpretation. OBJECTIVE: To synthesize scientific and educational principles of cardiac endocrine function and propose an anatomy-anchored framework for integration into pre-clerkship medical education. METHODS: A librarian-assisted narrative review was conducted in May 2025 using representative literature from PubMed, Google Scholar, and Scopus, supplemented by historical, molecular, physiological, anatomical, and medical education sources. The search focused on cardiac endocrine function, natriuretic peptides, and medical education and yielded 23 abstracts. The aim was conceptual synthesis rather than systematic or exhaustive retrieval. RESULTS: The discovery of atrial natriuretic peptide (ANP), B-type natriuretic peptide (BNP) and C-type natriuretic peptide (CNP) established the heart as an endocrine organ influencing renal, and cardiovascular homeostasis. The available medical education literature provides limited explicit guidance on how this topic should be introduced, and reinforced in early curricula. Integration of cardiac endocrine biology aligns with principles of cognitive integration, spiral curriculum design, and authentic learning. ANP and BNP/NT-proBNP are proposed as high-yield teaching examples: ANP links atrial structure and stretch to volume regulation, whereas BNP/NT-proBNP links ventricular wall stress to heart failure evaluation. CONCLUSIONS: Early integration of the heart's endocrine function into medical curricula may fortify structure-function reasoning, enhance systems thinking, and support mechanistic clinical reasoning. Rather than adding a separate curricular block, cardiac endocrine signaling can be incorporated through anatomy and histology, then reinforced in cardiovascular physiology, renal physiology, biochemistry, pharmacology, and clinical reasoning. Aligning foundational instruction with modern cardiovascular science can improve learners' conceptual frameworks and better prepare them for clinical decision making.
Anesthesia and analgesiaJed Wolpaw, Aditee Ambardekar, Edward C Nemergut, Tekuila Carter, Larry Chu, Shelby Labe, Beth Duggan, Lara Zisblatt, Susan M Martinelli, Larry Roper, Sanjay D…
BACKGROUND: Without strategic intervention to support medical education research in anesthesiology, the training of future anesthesiologists may be compromised. Currently no comprehensive strategy exists for developing education research into a robust and self-sustaining discipline within anesthesiology. Few anesthesiologists are qualified to mentor the next generation of rigorous researchers in education who will advance both the theory and practice of medical education in our specialty and throughout medicine. METHODS: The Anesthesia Research Council convened a working group of education leaders and charged them with mapping the future of education research in anesthesiology. This working group sought to understand the current state of anesthesiology education research funding and to identify key initiatives to consider in generating research excellence in this field. This article explores three key aspects of developing a path forward for medical education research: understanding the current state of anesthesiology education research funding and publications as markers of impact; integrating educational frameworks that support diversity, equity, and inclusion to ensure that anesthesiology training reflects the diverse needs of learners and patients; and making recommendations for improving medical education research in anesthesiology to help democratize the resources necessary for research, cultivate collaboration, and advance faculty development. A qualitative thematic analysis of relevant literature was completed. RESULTS: Recommendations for expanding the current education frameworks, measures, and methods include addressing (1) diversification of the physician workforce, (2) teaching styles and learning environments, (3) quality and accountability of graduate medical education, (4) cultural competency and intersectionality, and (5) advocacy. Identifying high-priority immediate and future actions that key stakeholders should undertake to generate centers of excellence and establish early career development programs in medical education research will likely have a national impact in anesthesiology and in medicine. CONCLUSIONS: This article provides a specialty-specific analysis of anesthesiology education research grant funding, publication efficiency, and the integration of diversity, equity, and inclusion frameworks. It sets forth a road map for building robust education research capacity through strategic recommendations, including fostering collaborations, incorporating artificial intelligence competencies, democratizing resources, and transforming funding and review processes.
AnesthesiologyJed Wolpaw, Aditee Ambardekar, Edward C Nemergut, Tekuila Carter, Larry Chu, Shelby Labe, Beth Duggan, Lara Zisblatt, Susan M Martinelli, Larry Roper, Sanjay D…
BACKGROUND: Without strategic intervention to support medical education research in anesthesiology, the training of future anesthesiologists may be compromised. Currently no comprehensive strategy exists for developing education research into a robust and self-sustaining discipline within anesthesiology. Few anesthesiologists are qualified to mentor the next generation of rigorous researchers in education who will advance both the theory and practice of medical education in our specialty and throughout medicine. METHODS: The Anesthesia Research Council (Walnut Creek, California) convened a working group of education leaders and charged them with mapping the future of education research in anesthesiology. This working group sought to understand the current state of anesthesiology education research funding and to identify key initiatives to consider in generating research excellence in this field. This article explores three key aspects of developing a path forward for medical education research: understanding the current state of anesthesiology education research funding and publications as markers of impact; integrating educational frameworks that support diversity, equity, and inclusion to ensure that anesthesiology training reflects the diverse needs of learners and patients; and making recommendations for improving medical education research in anesthesiology to help democratize the resources necessary for research, cultivate collaboration, and advance faculty development. A qualitative thematic analysis of relevant literature was completed. RESULTS: Recommendations for expanding the current education frameworks, measures, and methods include addressing (1) diversification of the physician workforce, (2) teaching styles and learning environments, (3) quality and accountability of graduate medical education, (4) cultural competency and intersectionality, and (5) advocacy. Identifying high-priority immediate and future actions that key stakeholders should undertake to generate centers of excellence and establish early career development programs in medical education research will likely have a national impact in anesthesiology and in medicine. CONCLUSIONS: This article provides a specialty-specific analysis of anesthesiology education research grant funding, publication efficiency, and the integration of diversity, equity, and inclusion frameworks. It sets forth a road map for building robust education research capacity through strategic recommendations, including fostering collaborations, incorporating artificial intelligence competencies, democratizing resources, and transforming funding and review processes.
Medical education onlineYvette Martin McGrew, Darrell R Schroeder, Steven H Rose, Bhargavi Gali
BACKGROUND: Anesthesia-specific milestone evaluations are intended to objectively assess performance in ACGME core competencies for anesthesiology residents. Recent reports in several medical specialties have documented differences in resident evaluations based on gender. OBJECTIVE: We studied the impact of faculty and resident gender on milestone evaluations during Anesthesiology residency. DESIGN: This was a retrospective analysis of 20,570 anesthesiology resident milestone evaluations from a single institution over a 7-year period during the ACGME milestones 1.0 time frame. Standardized scores were analyzed using a linear mixed model. RESULTS: 170 anesthesiology residents were evaluated by 194 faculty. For CA1 evaluations, mean standardized milestone scores for the core competencies of professionalism (p = 0.002) and interpersonal/communication (p < 0.001) and for overall assessment (p = 0.009) were dependent on faculty gender. For CA2 evaluations, regardless of the evaluator gender, the mean standardized milestone scores for many individual core competencies were significantly higher for female residents compared to male residents. For CA3 evaluations, mean standardized milestone scores did not differ significantly between male residents and female residents for any core competency, however overall assessment scores were dependent on faculty gender with male faculty scoring male residents more highly and female faculty scoring female residents more highly (p < 0.001). CONCLUSIONS: We observed an association between faculty gender and milestone evaluation scores of residents that was most evident for CA1 residents. We also observed the overall assessment scores for male and female residents were significantly influenced by the gender of the faculty evaluator. Further work is required to better understand and mitigate gender bias to promote equity in resident assessment.
Medical education onlineShahid Akhtar Akhund, Sadia Qazi, Muhammad Atif Mazhar, Aftab Ahmed Shaikh, Eshal Atif, Adeen Shaikh, Hassan Shaibah, Mohammed Alged Elsheikh Musa, Sabiya N Qa…
BACKGROUND: Medical education faces increasing demand for scalable grading solutions. Large language models have been proposed as automated graders for high-stakes assessments, but evidence for their reliability in multimodal practical examinations remains limited. METHODS: This retrospective inter-rater reliability study compared three LLMs: ChatGPT-4o, Gemini 2.5 Flash, and Claude 3.5 Haiku with original human reference scores on 19 integrated anatomy, histology, and physiology objective structured practical examination items completed by 309 pre-medical students. Human reference scores were assigned during live summative grading by two content experts who divided items, with each item marked by one expert across all students; no human inter-rater reliability estimate was available. Items required simultaneous image interpretation and short-answer responses. Models were evaluated using zero-shot prompting reflecting deployment-realistic conditions. Agreement was assessed using Spearman's ρ, Cohen's κ, intraclass correlation coefficients, and Bland-Altman analysis. Item-level gap analysis compared student success rates with LLM performance across items. RESULTS: Rank-order correlations were strong across all models (ρ = 0.784-0.921), but categorical agreement diverged substantially. Pass/fail agreement ranged from 52.1% (ChatGPT; κ = 0.067, slight) to 84.1% (Claude; κ = 0.680, substantial). Bland-Altman analysis showed inconsistent systematic bias: Claude over-scored by +2.5 points, Gemini under-scored by -5.0 points, and ChatGPT by -10.0 points. Item-level gap analysis highlighted three recurring divergence patterns: non-standard histological staining, three-dimensional spatial reasoning from two-dimensional images, and semantic inflexibility in short-answer evaluation. The most extreme case was a pelvic three-dimensional model item on which 93.3% of students succeeded by human grading but all three LLMs assigned a mean score of zero. CONCLUSIONS: Strong rank-order correlation alone does not support LLM grading for categorical decisions in high-stakes assessment contexts. LLMs may serve as assessment assistants for first-pass ranking and discrepancy flagging, but item-level human review of flagged discordances, error-profile monitoring, and preserved human authority over pass/fail decisions are required before high-stakes deployment.
Medical education onlineHillary Anderson, Amara Heard Stittum, Lisa Grefe, Molly Rideout
OBJECTIVE: To explore aspects of professional identity formation in participants of a longitudinal pediatric program for final-year medical students in the US. INTRODUCTION: Many institutions have specialty-specific courses focused on the transition to residency, typically at the end of medical school. This study examines professional identity formation among participants of a longitudinal fourth-year Pediatric Concentration. METHODS: Authors used a case study design for this qualitative research study using semi-structured interview questions based on a conceptual model of professional identity formation. Authors used purposeful sampling to identify study participants who were randomly selected from former students who completed the program between 2019 and 2021. Three interviewers independently conducted interviews with individual program participants. Thematic analysis with coder reliability was utilized for data analysis; two investigators independently coded and performed inter-rater reliability (IRR) on three sets of questions from transcriptions. After ensuring acceptable IRR, investigators coded the remaining questions and subsequently identified themes and sub-themes. FINDINGS: Eleven former students completed interviews. Following initial independent coding, IRR for three questions was 80%. After coding the 11 interviews, investigators determined that code saturation was achieved. They subsequently identified six main themes: career development, interpersonal connection, personal growth, positive role models, skill-building, and supportive learning environment. Two cross-cutting themes were recognized throughout the data: sense of belonging and gaining confidence toward starting residency. CONCLUSIONS: Participants in a longitudinal specialty-specific program in the final year of medical school experienced professional identity formation through a supportive learning environment fostering connection and personal growth while building skills, surrounded by positive role models. This community of practice cultivated a sense of belonging and helped participants gain confidence toward their residency and career. This longitudinal, specialty-specific approach to the final year of medical school may enhance professional identity formation for students entering all specialties and could facilitate transition to internship.
Medical education onlineMichaela Wagner-Menghin, Stefan Heber, Ivo Volf, Richard Marz, Michael J M Fischer
BACKGROUND: In team-based learning, students are typically placed in fixed teams based on the idea that stable group membership fosters collaboration: as teammates get to know each other, they share more information, resolve differences and feel motivated to contribute. This rationale had not been tested in a randomized controlled trial. OBJECTIVE: The study compares team-based learning in temporary teams with the default permanent teams regarding individual and team readiness assurance test performance (iRAT, tRAT), reaching team consensus, the learning climate, and intrinsic motivation. DESIGN: In a randomized controlled trial, first-year medical students were assigned either to permanent TBL teams or to teams that were re-assigned for each problem. The team readiness assurance test (tRAT) votes, submitted individually and covertly, served as an indirect indicator for team consensus (concordant versus discordant tRAT vote). RESULTS: Discordant tRATs (n = 268, 11.8% of all votes) were submitted more frequently in temporary than in permanent teams, both for correct and incorrect majority decisions. The self-rated learning climate was more cooperative in permanent than in temporary teams, while intrinsic motivation and tRAT scores were similar for both types of teams. A poorer learning climate was associated with a higher proportion of discordant tRATs. CONCLUSION: Working in temporary teams does not lead to inferior intrinsic motivation; this was previously also shown for knowledge gain. However, the poorer learning climate, together with reaching a consensus less often, might indicate that at least some members of temporary teams feel not adequately appreciated in the discussion and do not accept the majority decision. With instructional strategies promoting a cooperative learning climate in temporary teams, preclinical TBL courses might serve as an early promoter of the relational team competencies required for subsequent clinical workplace learning in temporary teams.
Medical education onlineCarla Schröpel, Anne Herrmann-Werner, Teresa Festl-Wietek, Tim Wittenberg, Sabine C Herpertz, Katrin Schüttpelz-Brauns, Andrea Heinzmann, Tobias Böckers, Steph…
INTRODUCTION: Although medical students with pre-medical qualifications (e.g., paramedic training) may enhance diversity within the student body, they have received little attention in international research. Their prior experience may influence study satisfaction through different learning strategies or working alongside their studies. This study investigates how pre-qualifications relate to three dimensions of study satisfaction (content, conditions, and coping with study load) and examines whether deep-processing learning strategies (elaboration and critical thinking) and part-time employment help explain these associations. METHOD: The authors conducted a cross-sectional survey at five German medical schools across different stages of study (3rd, 6th and 10th semester, final year). A structural equation model tested (a) whether pre-qualifications (i.e., academic degree, vocational training in the medical field) moderated the relationship between deep-processing strategies and study satisfaction and (b) whether part-time employment mediated the relationship between pre-qualifications and study satisfaction, controlling for age, gender, undergraduate GPA, semester, and medical school. RESULTS: Associations between deep-processing strategies and satisfaction did not differ by pre-qualifications. Regardless of students' pre-qualifications, elaboration was positively (ß = .51) and critical thinking negatively (ß = -.31) associated with satisfaction with study contents. Students with vocational training or prior academic degree more often worked part-time to finance studies; part-time employment was associated with lower satisfaction with study conditions (ß = -.07) but higher satisfaction with coping with study load (ß = .08). Indirect effects via part-time employment were significant but small. DISCUSSION: The findings suggest that elaboration may be a particularly relevant learning strategy for satisfaction with study contents, regardless of students' prior professional or academic qualifications. The negative association between critical thinking and satisfaction highlights the complexity of students' perceptions of study contents. Although associations involving part-time employment were small, the findings contribute to a better understanding of students with professional and academic pre-qualifications and may inform efforts to support increasingly diverse medical student populations.
Advances in physiology educationVisula Abeysuriya, Sachintha N Alwis, Vasitha Abeysuriya
Problem-based learning (PBL) is an effective strategy for developing higher-order cognitive skills in biomedical education; however, structured exposure is often introduced late in postgraduate immunology curricula, leaving students insufficiently prepared for complex, independent learning tasks. Teaching immunity to COVID-19 presents additional challenges due to the need to integrate innate, adaptive, and cytokine-mediated immune pathways. The objective of this study was to quantitatively evaluate the effect of a pyramidal PBL intervention using structured mind mapping on academic performance, conceptual organization, and learner engagement among postgraduate immunology students. The intervention group (n = 18) replaced a scheduled didactic lecture with an intergroup pyramidal PBL activity involving domain-specific mind mapping, iterative peer and facilitator feedback, and whole class synthesis, while a comparable control cohort (n = 20) received conventional lecture-based instruction. Knowledge retention was assessed using a delayed summative examination administered 2 wk postintervention, and student perceptions were measured using a structured Likert-scale questionnaire. The intervention group achieved significantly higher examination scores than controls (means ± SD: 73.5 ± 4.4 vs. 66.2 ± 6.5), with a mean difference of 7.3 percentage points [95% confidence interval (CI): 3.8-10.7; P < 0.001] and a large effect size (Cohen's d = 1.30). Questionnaire findings demonstrated high acceptability and perceived effectiveness, with most participants reporting improved conceptual understanding, communication skills, and engagement with complex immunological content. These findings indicate that pyramidal mind-mapping-based PBL produces educationally meaningful improvements in learning outcomes and supports earlier scaffolding of problem-based learning within postgraduate immunology curricula.NEW & NOTEWORTHY This study introduces a pyramidal problem-based learning (PBL) model combined with structured mind mapping for postgraduate immunology, applied for the first time to teaching complex COVID-19 immunity. Early scaffolding of PBL significantly enhanced students' conceptual organization, engagement, and examination performance, with a large measurable effect. These findings provide the first evidence that this interactive, structured approach can accelerate mastery of challenging biomedical content in postgraduate curricula.
Ultrasound quarterlyFahad F Almutairi, Rawan Abdeen, Fatimah Jambi, Afnan M Darwesh
Cardiovascular ultrasound is an operator-dependent modality that requires careful sequencing of the theoretical and practical training to optimize skills acquisition. This study compares lecture-first (LF) versus practical-first (PF) teaching strategies in undergraduate radiologic sciences students to evaluate the impact of 2 different teaching strategies on students' scores. In a randomized controlled trial, 54 students were allocated to LF (n=25) or PF (n=29) groups. The LF group received didactic lectures followed by hands-on practice, while the PF group reversed this sequence. Outcomes were measured using a multiple-choice question (MCQ) exam for theoretical knowledge and an objective structured clinical examination (OSCE) for practical skills. Evaluation was performed by blinded faculty using standardized rubrics. An exploratory analysis of the impact of supplemental practice sessions was also performed. LF students demonstrated superior overall performance (median score: 0.9 vs. 0.82, P=0.009, effect size: d=0.72) and practical skills (0.95 vs. 0.82, P=0.002, effect size: d=0.85). Theoretical knowledge scores were comparable between groups, with median scores of 0.86 for LF and 0.85 for PF (P=0.9). Students attending extra practice sessions achieved significantly higher scores across all domains (overall: 0.9 vs. 0.83, P=0.004; skills: 0.93 vs. 0.87, P=0.01). Teaching strategy in which a lecture is delivered first, followed by a practical session, was associated with improved scores compared with the design starting with a practical session. Attending additional hands-on sessions can significantly enhance students' knowledge and skills for performing ultrasound examinations. This study suggests that sequencing can influence student academic achievement and indicates that arranging practical sessions after lectures and providing extra practical sessions can enhance learning in the cardiovascular ultrasound curriculum.
Rheumatic diseases clinics of North AmericaShannon Amerilda Scielzo, Salahuddin Dino Kazi
Artificial intelligence (AI) is revolutionizing our approach to medical care in Rheumatology. From significant forthcoming changes in clinical care approaches, to changes in patient perspectives and the way they approach care, to our training approaches, changes in educational needs will be extensive. Similarly, AI will greatly support many components of training physicians but also comes with many potential concerns. Ethical expertise around utilization of AI, along with guidelines to guide practice are needed. Moreover, extensive research will be needed to help achieve these goals and support the successful integration of AI into rheumatology practice.
Pediatric clinics of North AmericaMollie Oudenhoven, Jennifer Fernandez, Nicole Harter
This article addresses the critical shortage in the pediatric dermatology workforce despite growing demand. It explores barriers including limited early exposure, mentorship, and lengthy, costly training pathways. The authors propose new models to streamline training, including alternative residency tracks and combined programs, while emphasizing the importance of mentorship, educational resources, and institutional support. They recommend actionable strategies like requiring pediatric dermatology exposure during training and increasing preliminary pediatric positions. The article calls for collaboration and innovation to expand access, improve training pathways, and ultimately increase the number of practicing pediatric dermatologists.
SurgeryChen Lew, Samuel J A Robinson, Sarah Goh, Md Nazmul Karim, Dragan Ilic
BACKGROUND: Five billion individuals worldwide lack access to safe and affordable surgical care, a deficit disproportionately skewed toward low- and middle-income countries. Global surgery may be defined as "an area of study, research, practice, and advocacy" aiming to improve health outcomes for surgical patients. Universities play an important role in global surgical work in high-income countries. We aimed to determine the relevant knowledge, attitudes, and perspectives of medical students in Australia and Aotearoa New Zealand (ANZ). METHODOLOGY: We surveyed senior medical students in ANZ medical schools (n = 24) from August to October 2022. Participants were recruited through university channels, social media, and snowball sampling. Participants completed questionnaires examining attitudes, exposures, and content knowledge relating to global surgery. RESULTS: A total of 851 eligible responses were analyzed. This included 189 of 851 (22.2%) participants with prior global surgery exposure, most commonly through student organizations (10.9%), and 686 of 851 (80.6%) participants believed global surgery to be relevant to medical students. Few participants (72 of 851; 8.5%) reported timetabled teaching of global surgery content, despite 494 of 741 (66.7%) supporting mandatory inclusion in medical school curricula. Preferred methods of global surgery exposure did not align with the methods received, and global surgery was infrequently reported in university curricula. Global surgery knowledge was limited and lower than that of students overseas. Despite this, participants indicated significant interest in global surgery teaching. CONCLUSION: ANZ medical students lack global surgery education and knowledge. Most global surgery education is delivered through nonacademic methods, including student societies and social media. Educators should consider these findings when planning medical school curricula.