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 teacherNicola Jones, Zilley Khan, Kirsteen Watson
BACKGROUND: Clinical teaching occurs where patient care and education coexist. Within the United Kingdom's National Health Service, workforce pressures constrain teaching and supervision. Clinical Teaching Fellow (CTF) roles have expanded in response but are often viewed as discrete posts rather than practices situated within complex clinical-educational systems. This study examined how tensions within and across these systems shaped CTF practice. METHODS: This theory-informed exploratory qualitative case study used third-generation Activity Theory. All 10 members of a hospital medical education team were invited to a semistructured group interview; eight participated. An Activity Theory-informed thematic approach was used to map the focal undergraduate clinical education activity system and examine tensions within it and at its intersections with adjacent systems. FINDINGS: Participants included three CTFs, two education facilitators and three administrators. CTF practice involved teaching, programme coordination and administrative work within a multiprofessional team. Differing understandings of the activity's purpose and outcomes shaped practice. Professional language, continuity, experience and blurred divisions of labour influenced participation and work organisation. Relationships with clinical services, the medical school, postgraduate medical education and university-based postgraduate study introduced competing demands. Participants negotiated tensions through communication, redistribution of responsibilities and closer working across professional roles. CONCLUSIONS: CTF roles are embedded within systems where educational, clinical and organisational priorities intersect. Third-generation Activity Theory makes visible how relationships within and across these systems shape practice. Supporting CTF roles requires attention to how educational work is organised, coordinated and prioritised.
The clinical teacherO Rackham, M M Maitland, P Ahluwalia, O Murray, J E McKay
BACKGROUND: The transition from pre-clinical to clinical medicine is challenging, particularly in applying anatomical knowledge to patient care. Reductions in dedicated anatomy teaching time have compounded this. Near-peer teaching may help address this gap by reducing hierarchy and enhancing psychological safety, though few programmes have explicitly targeted the pre-clinical to clinical transition through the integration of anatomy with clinical cases. APPROACH: A prospective educational evaluation examined a near-peer, case-based orthopaedic anatomy programme delivered to Year 4 medical students by Year 5 facilitators across four sessions. Knowledge acquisition was assessed using parallel pre- and post-session multiple-choice question (MCQ) sets compared using Wilcoxon signed-rank test and Cohen's dz. Student experience was evaluated using purpose-designed questionnaires. EVALUATION: Thirty-two matched pairs were available for analysis. Baseline anatomical confidence (mean 2.76/5) and ratings of placement-based anatomy teaching (mean 2.26/5) indicated clear unmet need. MCQ scores improved significantly from 5.0 to 7.0 out of 8 (mean 5.00 vs. 6.69, p < 0.001, Cohen's dz = 1.12). Post-session confidence improved to 4.03/5, facilitators were rated highly (mean 4.59/5), and 97% of students felt comfortable engaging with peer facilitators. IMPLICATIONS: This programme provides preliminary support for near-peer, case-based anatomy teaching as a promising approach to supporting the pre-clinical to clinical transition, demonstrating short-term improvements in MCQ performance, confidence and student satisfaction.
The clinical teacherLachlan Dick, Despina Kimpizi, Elena Kirwan, Maggie Kerr Livingstone, Hannah Martin, Joseph E McKay, Elizabeth Ward, Andrew G Robertson
INTRODUCTION: Operating theatre experience is central to surgical education, yet medical students often feel unprepared due to the environment's complexity. Video-based resources are increasingly used in surgical training, but their role in improving preparedness for the operating theatre is unclear. This scoping review examined how video-based interventions influence medical students' self-reported preparedness, including confidence, familiarity and anxiety. METHODS: PubMed, Web of Science and the Education Resources Information Centre were searched to 1 March 2026. Eligible studies included medical students, at least one operating room-based video intervention, and a self-reported preparedness outcome. Data were extracted using predefined criteria and synthesised thematically by intervention characteristics, delivery format and outcome domains. RESULTS: Eleven studies met the inclusion criteria, including 911 students. Interventions comprised operative footage, operating theatre environment overviews and perioperative practice demonstrations, predominantly delivered in two-dimensional format. Seven studies incorporated video into existing curricula. Preparedness was assessed through self-reported confidence, familiarity, comfort, anxiety and overall readiness. Ten studies reported improvements in at least one domain of preparedness, although only two assessed preintervention to postintervention change specific to preparation. Among comparative studies, one showed benefit over standard teaching and one found three-dimensional video superior to two-dimensional material. One study reported no effect on anxiety. CONCLUSION: Most studies indicated that operating theatre-based video can enhance medical students' perceived preparedness for theatre. Video represents a scalable approach to contextual familiarisation, but evidence remains constrained by heterogeneous designs and outcomes. Further controlled studies are needed to determine optimal formats and integration strategies.
BACKGROUND: Artificial intelligence (AI), including generative AI (GenAI), is reshaping clinical care and medical education, requiring medical education faculty to develop new competencies. As GenAI becomes integrated into clinical and teaching workflows, faculty must guide learners in AI-enabled environments. Although existing frameworks outline AI competencies for clinicians or learners, few synthesise competencies specifically for faculty roles. This review addresses that gap by synthesising AI and GenAI competency frameworks to identify GenAI domains relevant to medical education faculty. METHODS: The authors conducted a narrative review of 24 articles published between January 2020 and February 2025 on AI and GenAI competencies for clinicians, educators and learners. Structured database searches identified articles. Existing AI competency frameworks guided comparison of faculty-relevant GenAI competencies. Through iterative synthesis, the authors identified competency domains consistently represented across frameworks and aligned with educator responsibilities. FINDINGS: Using Russell et al.'s framework as an organising anchor, six competency domains were identified: (1) Foundational AI Knowledge and Literacy; (2) Ethical, Social, and Legal Policies and Implications; (3) AI-Enhanced Clinical Interactions; (4) Practice-Based Learning, Instructional Design, and Pedagogy; (5) Evidence-Based Evaluation and Assessment; and (6) Systems-Level Workflow and Integration. Existing frameworks differed in emphasis across domains, with clinical and systems-level competencies less consistently represented. IMPLICATIONS: These domains provide a foundational structure to guide faculty development, curricular decision-making and responsible integration of GenAI into medical education. Future work should translate these domains into observable indicators and assessment strategies while examining how faculty competencies support learner development and responsible GenAI use.
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.
PloS oneNumair Belgaumi, Megan M Coe, Benjamin Oelkers, Jordan Wrigley, Samantha Hayes, Michael Bashir, Anneliese Williams, Jocelyn Rivera, Dylan Graetz, Erin Abu-Rish…
Effective communication among healthcare disciplines, professions, and patients is crucial for delivering coordinated inpatient care and achieving improved patient outcomes. The practice of daily rounds has a long history, evolving over time in structure and in the individuals involved. Rounds increasingly include diverse healthcare professionals and, in some cases, patients and families. However, inconsistent terminology-such as interprofessional, interdisciplinary, multiprofessional, and multidisciplinary-complicates research and implementation of team rounding practices. Existing reviews have explored interprofessional and patient- and family-centered rounds but less frequently addressed interdisciplinary rounds and global settings. We will conduct a systematic mapping review to describe the landscape of literature on interdisciplinary, interprofessional, and patient- and family-centered rounds in hospital settings worldwide (PROSPERO CRD420250655348). We aim to examine how daily care rounds are defined, who participates, what frameworks are utilized, and where these practices are studied. Additionally, we will identify reported strategies for implementing rounds and measures used to assess outcomes on patients, families, clinicians, healthcare teams, and institutions. Following PRISMA-P guidelines, we will include peer-reviewed quantitative, qualitative, and mixed-methods studies published since 1990, with no geographic or language restrictions. Eligible studies must focus on daily inpatient rounds involving multiple professions, disciplines, and/or patients and families, and report outcomes or implementation strategies. Data will be extracted on study characteristics, rounding practices, interventions, outcomes, and barriers or facilitators to implementation. Study quality will be assessed using the Mixed Methods Appraisal Tool (MMAT). Our review will provide a comprehensive synthesis of global rounding practices, highlight gaps in definitions and implementation strategies, and inform future interventions to enhance team communication in diverse hospital settings. By capturing a broad range of studies, this work will support efforts to standardize and expand team rounds to improve hospital care coordination worldwide.
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.
BMC medical educationGeorg Prokop, Anne-Sophie Biesalski, Mareike Krause, Pia Stine Rebmann, Johannes Heinrich Alexander Piel, Friederike Schmidt-Graf
Germany faces critical physician shortages in Neurology. This exploratory study examined factors influencing career decision-making across the Neurology training pipeline in a university setting to inform workforce development strategies. We conducted a cross-sectional two cohort study employing a mixed-methods approach surveying medical students (n = 79) and Neurology residents (n = 56) at German University hospitals via structured questionnaires and open-ended questions. The response rates were 44 % (medical students) and 32 % (residents). The important factors influencing career and medical specialization choices were the specialty itself, good teaching experiences and workplace conditions. Students showed high career motivation. Residents maintained high levels of engagement and specialty loyalty while reporting severe structural deficits in their everyday worklife and residency program. Evidence-based interventions could address these deficits.
Journal of robotic surgeryBartosz Brzoszczyk, Marcin Jarzemski, Rafał Brzóska, Bartosz Roś, Łukasz Mielczarek, Rafał Bogdan Drobot, Mateusz Władysław Jobczyk, Maciej Wojciech Przudzik, …
Robot-assisted surgery (RAS) has expanded rapidly in Poland, but its integration into resident education remains uncertain. In a nationwide anonymous 35-question survey sent to 390 Polish urology residents, 156 completed it (40.0%). Among respondents, 110 (70.5%) reported RAS availability in their training centre; 56 (35.9%) reported robotic training access, 43 (27.6%) a robotic course, 46 (29.5%) simulator availability, 76 (48.7%) assistant participation, and 16 (10.3%) a supervised robotic procedure or procedural step. All respondents with training access were in RAS centres. Among these 110 respondents, course attendance (aOR 5.38, 95% CI 2.05-14.14) and simulator availability (aOR 3.90, 95% CI 1.54-9.89) were associated with access. Training access was associated with assistant participation (aOR 6.66, 95% CI 3.06-14.50), higher current and expected self-rated skill (common aORs 12.30 and 12.15), and at least satisfactory training satisfaction (aOR 17.01, 95% CI 6.35-45.57). All 16 such reports occurred among residents with access; in an exploratory conditional Firth model, each additional residency year was associated with this outcome (aOR 2.11, 95% CI 1.30-3.97). Items were independent, not sequential stages. Institutional adoption exceeded reported training access and supervised participation. Broad survey content makes participation driven solely by robotics interest less likely, but the 40.0% completion proportion, self-report, unmeasured trainee selection, and rare supervised outcome limit inference.
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.
Journal of epidemiology and global healthYusof Mohamed Omar, Mohamed Ashraf Elsaadany, Nour Edin Darwish, Yousuf Darwish, Lina Mohamed Omar, Mohamed Hossam Ghazy, Tasneem Deibes, Karim A Elsodany, Jam…
INTRODUCTION: The Arab region is experiencing substantial outward migration amid persistent healthcare workforce shortages. However, reported prevalence estimates and reasons vary considerably across studies. Therefore, we aimed to estimate the pooled prevalence of migration intentions among medical trainees in the Arab region and summarize the reported drivers of migration using the Push-Pull-Mooring (PPM) framework. METHODS: We searched PubMed, Scopus, Embase, and Web of Science in April 2026, supplemented by backward and forward citation searching. Studies were eligible if they reported discrete prevalence estimates of migration intentions among medical students, interns, or residents in Arab countries. The pooled prevalence was calculated using a random-effects model with a generalized linear mixed model and logit transformation. Heterogeneity was primarily assessed using Tau². Risk of bias was assessed using the Newcastle-Ottawa Scale adapted for descriptive cross-sectional studies (NOS-xs2). RESULTS: Thirty-one studies comprising 21,614 Arab medical trainees were included. The overall pooled prevalence of migration intention was 70.7% (95% CI: 63.2%-77.2%), with substantial heterogeneity (Tau² = 0.84). Subgroup analyses were not statistically significant except for region (p = 0.030), with the Nile Valley reporting the highest prevalence (74.3%; k = 14) and the Arabian Peninsula reporting the lowest (41.5%; k = 3). Prevalence was numerically highest among medical students (76.0%), followed by residents (65.4%) and interns (56.7%). By intention type, general migration intent was highest (74.1%), followed by training-related (71.5%) and work-related migration (61.9%). War and insecurity (k = 10), financial insecurity (k = 9), and poor working conditions (k = 7) were the most frequently reported push factors, while higher pay (k = 11), better training opportunities (k = 10), and career growth (k = 10) were the frequently reported pull factors. Family ties (k = 6) and patriotism (k = 5) were the frequently reported mooring influences. CONCLUSIONS: More than two-thirds of medical trainees in the Arab region report intentions to migrate abroad, highlighting a major regional health workforce challenge. While intentions do not equate to actual migration behavior, the findings nevertheless support the need for health workforce policies that strengthen physician retention through investment in competitive remuneration, safe working environments, and high-quality local postgraduate training pathways while addressing broader sociopolitical drivers of migration.
BMC medical educationWagdy Talaat, Nourhan F Wasfy, Enjy Abouzeid
BACKGROUND: The Extended Functional Practical Exam (EFPE) is an innovative postgraduate assessment model designed to overcome the limitations of traditional single-point practical examinations by adopting a longitudinal, experiential, and institution-based approach. This study aimed to critically explore the implementation of EFPE across different medical schools and examine its perceived educational value, impact on learners and institutions, and areas for improvement. METHODOLOGY: A reflective qualitative study involving different medical schools was conducted. Three samples were included in the study: a convenience sample of the postgraduate students and a purposive, convenience sample of faculty members and medical school stakeholders. Insights from the three samples were collected through semi-structured interviews. All the interviews were audio recorded and transcribed verbatim and thematically analyzed. RESULTS: The thematic analysis of data from the three samples (S1, S2, and S3) under the classified themes revealed several themes and subthemes. The main themes included the format and differences from traditional exams, the exam's impact, and challenges and areas for improvement. Participants appreciate the alignment of EFPE tasks with institutional needs and the positive role of feedback and mentorship. However, challenges such as stress, workload, resource demands, and issues with topic selection and clarity were noted. CONCLUSION: EFPE is highly valued for its practical, structured, and process-focused approach, which leads to significant skill development and confidence building among postgraduate students. Suggestions from participants include extending the duration of the EFPE, involving students in topic selection, maintaining continuous feedback and mentorship, and ensuring tasks are relevant and sustainable.
Health expectations : an international journal of public participation in health care and health policyVivien Min Er Lee, Laurie J Goldsmith, Anna Szücs, V Vien Lee, Jun Cong Goh, Jeffrey Jiang, Nicola Ngiam, José M Valderas, Victor Weng Keong Loh
INTRODUCTION: Patient interaction has long been central to medical training. In recent years, involving patients as educators and bringing their lived experiences of illness or disability to the classroom has been valued in clinical education. These "experts by experience" enrich learning by offering authentic perspectives that foster empathy, challenge assumptions, and promote person-centred care. To our knowledge, there is no existing research on the experiences of persons with disabilities (PWD) serving as patient educators. METHODS: Semi-structured in-depth interviews conducted with seven patient educators with physical disabilities (all PWD patient educators who consented to the study) about their experiences teaching in an undergraduate medical student workshop on communication with PWD. Reflexive thematic analysis was used for analysis. RESULTS: Illustrating that "engagement is not one-dimensional," participants described engaging students through three overlapping and dynamic roles: patient, educator, and advocate. Four distinct types of patient educator were identified: Type A (Patient role is more predominant than the Educator role), Type B (Patient and Educator roles are equally important with less emphasis on the Advocate role), Type C (Patient, Educator, and Advocate roles are all equally important), and Type D (Patient and Advocate roles are equally important with less emphasis on the Educator role). Patient educators who demonstrated stronger integration of the educator role (Types B and C) were more confident, pedagogically effective, and aligned with curricular aims than those in Type A, whereas those whose engagement was primarily advocacy-oriented (Type D) occasionally diverged from educational goals. CONCLUSIONS: This study highlights the multidimensional nature of patient educator roles and identifies the strengths and limitations associated with different engagement orientations. Recognising and supporting these intersecting identities can inform recruitment and facilitation practices. Structured training and guided reflection may help patient educators balance personal narratives and advocacy aims with educational objectives, thereby optimising learner outcomes and strengthening the meaningful inclusion of PWD voices in medical education. PATIENT OR PUBLIC CONTRIBUTION: This study focuses on the perspectives of PWD as educators in an undergraduate medical student workshop on communication with PWD. This workshop was co-created with patient educators with disabilities.
The clinical teacherOrlando Carlos Conceição-Neto, Frederico Medeiros Rosas da Silva, Erika Verissimo Villela, Paula Borges de Andrade Lemes, João Pedro Gotti Ferreira, Chiara Gur…
BACKGROUND: Medical biochemistry and molecular genetics stand out as some of the most demanding courses for first-year medical students, who often require repeated exposure to complex pathways and molecular processes. To provide additional support in this early stage of training, we created PodBases, a peer-led educational podcast integrated into an academic mentoring program and made available through a widely accessible global audio-streaming platform. The goal was to offer brief, clinically oriented episodes that reinforced key concepts and complemented traditional teaching. APPROACH: The initiative followed a defined workflow involving close collaboration between student tutors and faculty. Tutors prepared scripts aligned with the weekly course content, which were subsequently reviewed for accuracy. Recordings were made using smartphones and edited with freely accessible audio-editing tools and published on a podcast-hosting service. We documented the entire process to create a practical tutorial that facilitates replication in similar educational settings. EVALUATION: Between May 2023 and January 2026, 30 episodes were published, reaching 13,050 streams across 16 countries. Student feedback highlighted the usefulness of the podcast during commutes and study sessions. Mentors reported skill development in communication, simplification of content and teamwork. IMPLICATIONS: PodBases demonstrates that student-generated podcasts can effectively complement traditional teaching by reinforcing core topics, supporting learner autonomy, enhancing comprehension and developing tutors' pedagogical skills. The experience suggests that peer-led digital resources can enhance comprehension while promoting engagement and professional growth in the foundational years of training. TRIAL REGISTRATION: Not applicable.
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.
The clinical teacherTina Huang, Anita Laidlaw, Rachel Falconer, Rona Patey
INTRODUCTION: The prevalence of remote consultations and the use of electronic health records necessitate their meaningful integration into medical education. Remote consultations may offer medical students valuable opportunities for longitudinal patient interactions that complement traditional clinical learning. In this regard, the University of Aberdeen piloted the Digital Consultation Clinical Placement (DCCP), which aimed to equip early-year medical students with essential skills in carrying out remote consultations, conducting follow-up consultations and practising medical documentation. This study aimed to evaluate the DCCP's acceptability and explore its associated challenges and opportunities. METHODS: Acceptability of this novel placement was evaluated using questionnaires grounded in the theoretical framework of acceptability (TFA). Questionnaire data from 15 students, 4 tutors and 14 patient volunteers were analysed using descriptive statistics. Qualitative focus groups underwent thematic analysis to generate understanding of the challenges and opportunities of this innovative placement. RESULTS: At least 50% of stakeholders selected agree or strongly agree in the questionnaire responses across all TFA categories. Qualitative findings suggest that remote consultations could help achieve the benefits of longitudinal patient contact, and exposure to authentic digital healthcare technology could impact students' professional identity. CONCLUSION: The DCCP was acceptable across all stakeholder groups, with a shared belief that it successfully achieved its intended purpose but with challenges and perceived opportunities for stakeholders, which should be considered in future placements. With further refinement, early exposure to this placement may support the development of patient-centred care skills and better prepare students for technology-enabled healthcare practice.
The clinical teacherW Baraza, Georgina Staples, Cameron Wells, Louise Barbier, Isi Tonga, Parry Singh, Mike Puttick, Craig Webster
INTRODUCTION: Self-directed learning (SDL) and reflection are critically important for clinicians. There is limited evidence describing the utilization of artificial intelligence (AI) to support medical SDL. AI simulated patients (AISP) may allow for high-fidelity, reflective educational interactions. We aimed to determine how SDL with AISP interaction compared to standard SDL in the development of clinical reasoning skills. METHODS: This was a single-institution randomized controlled study in early clinical years' undergraduate students, learning about gallstone disease. For 90% power and a 20% noninferiority margin, 36 participants were randomized either to an intervention group using an AISP or to a control group using current educational resources. Both groups underwent a standardized clinical skills assessment. Quantitative and qualitative data were collected. RESULTS: Twenty-seven participants completed the study. The intervention group demonstrated statistical noninferiority compared with the control group (assessment scores of 13.1 vs. 12.1, respectively, p = 0.11). In addition, there were fewer borderline grades, and significantly more distinction grades in the intervention group than control (6 vs. 1, respectively, p = 0.037), suggesting the AISP may have improved performance in clinical management. The qualitative data suggested widespread satisfaction and enthusiasm for AISPs. CONCLUSION: Our results suggest that AISPs are comparable to traditional resources in developing undergraduate clinical skills, and may contribute to improved academic performance in undergraduate surgery. Globally, there is an appetite for their introduction into the clinical curriculum. Real patient interaction is the standard. However, AISPs may have a supplementary role and are likely to become increasingly prominent in medical curricula.
The clinical teacherKareena Nanda, Jaslyn Rasmuson, Julian T Lau, Pamela Mathura, Winnie W Sia
BACKGROUND: Active Mind Active Body (AMAB) is a novel student-led program designed to lessen cognitive and physical isolation in hospitalized patients by facilitating social and physical activities. It offers preclinical undergraduate medical students (UMS), who often have limited clinical exposure, structured encounters while engaging patients socially, cognitively and physically. The aim of this study was to evaluate AMAB patient encounters and assess the experience of participating UMS. METHODS: Using convergent mixed methods, data were collected from the following sources: anonymized patient encounter records quantifying participating patients and types of activities, a postshift volunteer feedback form and a program evaluation survey. Data were analyzed using descriptive statistics and thematic analysis. RESULTS: A total of 424 encounters with 220 patients were completed from July 2021 to August 2023. Nearly all (98%) encounters included socialization, and many included cognitive activities (27%) or physical activity (22%). Thirty-four UMS (56%, 34/61) completed the study survey. Most UMS perceived AMAB as valuable for patients (94%) and meaningful for UMS (88%). UMS (67%) reported exposure to different medical specialties and (74%) felt their involvement would impact how they engage with patients. UMS indicated improvement in communication skills, interprofessional collaboration and relationship building. Opportunities for program improvement included diversifying activities and implementing peer-to-peer mentoring. CONCLUSION: The AMAB program provides impactful clinical education for UMS in communication and interprofessional collaboration. UMS also reported perceived benefit on patient mobility and social connectedness. This offers a replicable and low-cost model that can be adapted to other medical education programs.
Mymensingh medical journal : MMJA A Jewel, S Gazi, M M Masum, S Fardous, S M A Haque, N Akter, N S Siddiquee, M Akter, A Jesmin, T Enam
Traditional teaching materials in Anatomy, like cadavers, prosected specimens, models and illustrations have their respective issues of strengths and weaknesses, especially in dealing with complex three-dimensional spatial relationships. This quasi-experimental study was performed in the department of Anatomy, Bangladesh Medical University, Bangladesh from March 2025 to February 2026 to compared 3D Anatomy software (Complete Anatomy) against selected traditional materials (3D illustrations and 3D plastic models) for teaching Neuroanatomy and Head-Neck Anatomy. In the quasi-experimental study, 60 undergraduates from each of two medical colleges not yet exposed to Neuroanatomy or Head-Neck Anatomy were invited and divided into 'Experimental' and 'Control' groups by selecting alternate students. The 'Experimental group' was taught 10 micro-modules of Neuroanatomy or Head-Neck Anatomy using a 3D Anatomy software. The 'Control group' was taught the same using selected traditional materials- 3D illustrations or 3D plastic models. The experimental group using 3D Anatomy software obtained significantly higher overall score and scores across the 10 micro-modules compared to the group taught using 3D illustrations or 3D plastic models. The experimental group achieved significantly higher median scores (30.00 vs. 24.00, p=0.001) across 10 micro-modules, suggesting interactive 3D Anatomy software is superior for short-term knowledge acquisition in complex regions in Neuroanatomy and Head-Neck Anatomy.
BACKGROUND: Cooperative learning methodologies are progressively used in medical education to promote engagement and understanding. This research compared the jigsaw cooperative learning strategy with the conventional tutorial method among second-year MBBS students, with a focus on short-term learning outcomes and learner perceptions. METHODS: A quasiexperimental educational study with random allocation was conducted among 160 students assigned to tutorial (n = 80) and jigsaw (n = 80) groups. Pretest and posttest assessments were used to evaluate learning gain. Student perceptions were collected using a 5-point Likert scale, and faculty feedback was obtained. Statistical analysis included paired and independent t tests, along with effect size (Cohen's d) and relative improvement measures. RESULTS: Both groups demonstrated substantial improvement in posttest scores (p < 0.05). The mean learning gain differed between groups (jigsaw: 5.50 ± 3.76; tutorial: 3.78 ± 3.55; p = 0.003). Effect size estimates were 2.17 for the jigsaw method and 1.22 for the tutorial method, with a between-group effect size of 0.47. Relative improvement was 64.8% in the jigsaw group and 38.3% in the tutorial group. Student perception data indicated generally higher engagement and satisfaction with the jigsaw approach, and faculty feedback was positive. CONCLUSION: The findings suggest that the jigsaw method may offer improved short-term learning outcomes and engagement compared to conventional tutorials. However, as the assessment was limited to immediate outcomes, further studies are needed to evaluate long-term retention and broader educational impact.
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.
Journal of genetic counselingMarin Kalista, Lisa Jay Kessler, Deborah Requesens, Kathleen D Valverde, Rebecca Mueller
Patient advocacy organizations (PAOs) and genetic counseling have expanded in tandem with the growth of precision medicine. Genetic counseling and PAOs share important goals related to advancing genomic medicine, creating novel possibilities for synergistic collaboration, especially as the sheer number of PAOs focused on genetic conditions presents new options for genetic counselor education. While patient advocacy has long been part of genetic counseling education, there are few published reports or studies focused on how advocacy is incorporated into genetic counseling graduate training. Accordingly, the University of Pennsylvania Master of Science in Genetic Counseling Program and the University of Pennsylvania Orphan Disease Center's JumpStart Program collaborated to launch an experiential service-learning opportunity wherein genetic counseling trainees partner with a disease-specific advocacy group over the course of a 10-week advocacy internship. Here, we describe our evolving efforts to incorporate an advocacy internship in our graduate curriculum, culminating in the development of The Genetic Counseling Student Exchange (GCSX) program. We share the curricular format, planning and staff workflow, as well as examples of internship project deliverables. We also reflect on the internship from varying perspectives, highlighting our experiences and feedback from different stakeholders. In closing, we consider how the GCSX may be a key step towards incorporating more disability education into our genetic counseling training program while calling for future research on GCSX to measure its impact and to determine how best to tailor disability education around the internship experience. Overall, we hope that detailing the GCSX inspires other GC programs to consider adapting aspects of the educational framework that we have developed to expand advocacy training across genetic counseling programs.
The clinical teacherJuliana Sá, Ana L Da Silva, Pia Strand, Simon Kitto
BACKGROUND: The transition from undergraduate to postgraduate medical education is a crucial phase of professional development, requiring trainees to assume greater clinical responsibility and adapt to new social norms. This transition influences professional identity formation (PIF), which is important for safe practice, well-being and resilience. We conducted a scoping review to map studies of PIF during this transition and synthesise the key findings of this body of literature. METHODS: We searched five databases for studies published between January 2000 and December 2023. Eligibility criteria guided inclusion. We extracted relevant information and PRISMA-ScR reporting elements and used inductive thematic analysis to synthesise findings. RESULTS: Twenty-one studies met the inclusion criteria, representing mixed-methods, qualitative and quantitative designs and diverse theoretical approaches to PIF. Only one study explicitly defined 'transition'. Most studies (n = 14) were descriptive; two were justification studies, and five aimed to clarify mechanisms, contextual influences and theoretical underpinnings. Four themes described factors influencing PIF in the transition from undergraduate to postgraduate education: navigating the self, the system, clinical practice and collaboration. CONCLUSIONS: Supporting early-career doctors requires more than fostering resilience. Training environments must reduce systemic barriers, model professional values and create relational spaces where emerging doctors can belong, reflect and grow. Future research should move beyond description towards theoretically informed, multi-context studies that examine mechanisms underlying these influences and generate transferable, actionable knowledge for those supporting trainees during this transition.
The clinical teacherMatthew Bowker, Leah Williams, Michael Atkinson, Chris Tiplady
BACKGROUND: Postgraduate qualifications for clinical educators have proliferated internationally, raising questions about whether this reflects professionalisation or a credentialist response to competitive specialty selection. Postgraduate Certificates in Medical Education (PGCMEs) are established in the United Kingdom (UK), yet no published data describe enrolment over time. This research determined PGCME enrolment trends in the UK universities from 2010 to 2024 and interpreted them against this framing. METHODS: Freedom of Information requests were sent to all the UK public universities offering PGCMEs (n = 40), requesting annual enrolment figures. We obtained contextual data on the National Health Service (NHS) workforce size, specialty training competition ratios and application scoring from the NHS England and archived recruitment websites. FINDINGS: A total of 36 universities (90%) responded. Courses more than doubled (13 in 2010-2011 to 29 in 2024-2025); student numbers rose 41% (1180-1667). Enrolments were stable through the 2010s, jumped in 2020-2021 (1082-1894), then settled at 1600-1700. Against the NHS England workforce, the proportion of doctors enrolled held at about 1%. Training competition rose: general practice ratios from 1.70 to 3.67 and internal medicine training (IMT) from 2.55 to 3.69. The PGCME's IMT scoring weight doubled from 4.7% to 10%. CONCLUSION: PGCME provision has grown, but enrolment has not outpaced the expanding medical workforce. The 2020 spike likely reflects pandemic-era online access and scoring reforms. Aggregate data cannot tell us whether holders teach afterwards or move straight into specialty training, how they funded their studies, whether they completed or what proportion are doctors.
The clinical teacherRocco Sheldon, Andrew Gan, Thomas Fleck, Richard Phillips, Elizabeth Peterknecht
INTRODUCTION: Clinical teaching fellows (CTFs) are an increasingly important part of undergraduate medical education in the United Kingdom. Despite their valuable and uniquely multifaceted role, research investigating the qualities that make an effective CTF is limited. This study aimed to identify and compare the views of stakeholder groups regarding the most important qualities of CTFs. METHODS: We conducted a single-centre mixed-methods study at a large UK teaching hospital. An online questionnaire was distributed to clinical medical students (years 3-5), CTFs, administrative staff and faculty. Data were collected via Likert scales, asking respondents to rank qualities and teaching experiences and free-text responses. RESULTS: Quantitative analysis (n = 43) identified friendliness, being knowledgeable and an engaging teaching style as the most valued qualities. Prior experience of conducting bedside teaching and small-group tutorials was prioritised, with postgraduate teaching qualifications and specialist knowledge ranked as least important. Medical students valued professionalism and teamwork significantly less than other groups (p < 0.05). Qualitative thematic analysis revealed students prioritised a supporting learning environment and practical clinical tips. Conversely, administrative staff, faculty and CTFs valued collaborative teamwork and organisational reliability. Reflecting these differences, 29 (67.4%) respondents agreed with our hypothesis that disparities exist between stakeholder groups in the qualities/experiences they value most. CONCLUSIONS: This study highlights commonalities and differences regarding the interpersonal skills and teaching experiences that are central to effective CTFs. These findings have important implications for recruitment, training and professional development of CTFs, ensuring alignment with the needs of stakeholders and addressing perceived disparities between groups.
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTESAbdul Samet Sahin, Aynur Sahin, Vildan Ozer, Ozgen Gonenc Cekic, Selçuk Akturan, Bilge Delibalta, Emily Kiernan, Ebru Turhal, Sinan Pasli, Yunus Karaca, Melih …
BACKGROUND: Toxic terrorism is a rare but potentially catastrophic threat that can result in mass casualties and overwhelm healthcare systems. Effective management of such incidents requires specialized clinical competencies and preparedness that may be underemphasized in standard emergency medicine training. This study aimed to assess emergency medicine residents' competencies in toxic terrorism preparedness and emergency medical management using a structured simulation-based examination. METHODS: Emergency medicine residents working in the emergency departments of two tertiary university hospitals in Trabzon participated in a simulation-based clinical assessment. The examination comprised five realistic, fully immersive objective structured clinical examination (OSCE) stations designed to evaluate diagnostic decision-making and treatment planning in toxic terrorism scenarios. Each station was scored using standardized checklists developed by medical toxicologists. Factors associated with improved performance were also examined. RESULTS: Although 33.3% of participants successfully passed the botulism scenario (Station 3), no participant successfully completed all five stations. The radiation exposure scenario (Station 2) was the most challenging. Higher performance was significantly associated with having more than 24 months of residency training, prior chemical, biological, radiological, and nuclear (CBRN) training, and previous exposure to simulation-based education. CONCLUSION: These findings suggest that current training may not adequately prepare emergency medicine residents to manage toxic terrorism incidents. Incorporating standardized simulation-based assessments, such as OSCEs, into residency curricula may help identify training gaps and improve preparedness for low-frequency, high-impact events.
The clinical teacherIsabel Dutra da Cruz, Marlon Natan Baracho de Oliveira, Alessandra Mazzo, Raphael Raniere de Oliveira Costa
OBJECTIVE: This study aimed to identify the teaching methodologies used in point-of-care ultrasound (POCUS) education for undergraduate medical students and to synthesise the educational outcomes associated with these approaches. METHODS: A scoping review followed Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The research question was developed using the Population-Concept-Context framework. Systematic searches were performed in PubMed/MEDLINE, Web of Science, Scopus, Embase, CINAHL and ERIC. The review protocol was prospectively registered in the Open Science Framework. RESULTS: Fifty-nine studies were included. Teaching methodologies comprised supervised practice with real patients, simulation using high-fidelity and low-cost models, didactic lectures, active learning strategies (including flipped classroom and peer-assisted learning), short and longitudinal courses and educational technologies such as e-learning platforms, portable ultrasound devices and virtual reality. Assessment strategies included objective structured clinical examinations, structured questionnaires and theoretical and practical tests. The most frequently reported educational outcomes were improved diagnostic accuracy and clinical performance, technology-supported theoretical learning, increased confidence and practical autonomy and the educational benefits of integrated active learning approaches. Educational interventions combining supervised practice, simulation and active learning were consistently associated with more favourable educational outcomes than isolated teaching strategies. CONCLUSIONS: The structured and longitudinal integration of POCUS into undergraduate medical curricula appears to be a promising strategy for strengthening clinical reasoning, diagnostic accuracy and bedside decision-making. These findings support implementing competency-based curricula that integrate supervised practice, simulation and active learning methodologies, while highlighting the importance of longitudinal curricular integration for sustainable competency development.
PloS oneJoshua Vo, Tina Mai, Nhi Yen Bui, Dang Ngoc Khoi, Minh Phan Ngoc Nguyen, Quang Thanh Nguyen
Telemedicine has become an increasingly important component of contemporary health care delivery, yet its integration into undergraduate and graduate medical education remains variable and insufficiently standardized. Although individual studies have described telemedicine training initiatives, the literature remains fragmented across disciplines, learner groups, and geographic settings, limiting understanding of how telemedicine is taught, learned, assessed, and implemented for medical trainees worldwide. This scoping review aims to map the characteristics of telemedicine education for medical students enrolled in undergraduate or graduate entry physician training programs and for resident physicians, examine variation across learner groups, specialties, and geographic contexts, and identify reported implementation factors, barriers, facilitators, and evidence gaps. The review will follow Joanna Briggs Institute methodology for scoping reviews. A comprehensive search will be conducted in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Education Resources Information Center, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature, with additional studies identified through reference list screening of included articles. Two reviewers will independently screen titles, abstracts, and full-texts against predefined eligibility criteria and will extract data using a structured, piloted form. Findings will be synthesized descriptively in tabular and narrative formats to characterize curricular content, teaching methods, assessment strategies, and contextual influences on implementation. By providing a comprehensive map of the existing literature, this review will inform future curriculum development, educational research, and policy related to telemedicine training in medical education. Review registration: Open Science Framework (OSF) (https://osf.io/jxudv).
Open heartJeremy Chan, Maria Comanici, Pradeep Narayan, Tim Dong, Gianni D Angelini
OBJECTIVE: To evaluate trends, early clinical outcomes and surgeon-variation and hospital-variation in trainees performing isolated aortic valve replacement (AVR) and mitral valve (MV) surgery, including replacement (MVR) and MV repair (MVr) in the UK. METHODS: All adults undergoing elective or urgent isolated AVR or isolated MVr/MVR in the National Adult Cardiac Surgery Audit between 1996 and 2019 were included. Temporal trends and early clinical outcomes were compared between consultants and trainees as primary operators. Three-level multilevel logistic regression was used to quantify hospital-level and consultant-level variation in the proportion of cases performed by trainees. RESULTS: Among 71 710 isolated AVR and 25 197 isolated MV surgery cases, 13 432 (18.7%) and 2472 (9.8%) were performed by trainees, respectively. MV surgery included 9893 MVR and 15 292 MVr, of which 1226 (12.4%) and 1246 (8.1%) were performed by trainees, respectively.Propensity matching generated balanced cohorts of 13 432 AVR, 1223 MVR and 1243 MVr pairs. Trainee-led procedures were not associated with higher in-hospital morbidity or mortality.Multilevel modelling demonstrated substantial variation in trainees being the primary operator, with 59.6%, 57.1% and 44.8% of variation at hospital-level and surgeon-level for AVR, MVr and MVR, respectively. CONCLUSIONS: In this national UK cohort, trainees performed approximately one in five isolated AVR operations and one in ten isolated MV operations. Trainee exposure was the lowest in MVr. Trainee-led procedures were not associated with an increase in in-hospital mortality or early morbidity. There was a marked hospital-level and consultant-level variation in trainees' operating opportunities. These findings support continued structured exposure to isolated aortic and MV surgery, with particular attention to a specific MVr training pathway.
The clinical teacherShazia Sarela, Malvi Shah, Emma Kelley, Nidhi Rege, Harish Bava, Rama Aubeeluck, Elena Boby, Anusha Prabhu
BACKGROUND: Mnemonics, both self-created and well established, are commonly used by medical students to boost their recall of knowledge. Previous studies have evaluated mnemonics' utility in medical education, but few have demonstrated positive effects on students' knowledge and confidence. Mnemonics are also more commonly shared directly between peers, as opposed to being formally taught. This study explores the impact of mnemonic-based, near-peer-led teaching on medical students' knowledge and confidence. It aimed to determine whether mnemonics enhance students' ability to answer questions and boost self-perceived confidence and future mnemonic use. METHODS: Over 8 months, 23 peer-led teaching sessions on commonly tested clinical medical topics were held for third-year medical students, with mnemonics incorporated into all sessions. Presession and postsession SBA questions and five-point Likert scales were used to assess change in students' knowledge and confidence, respectively. Postsession, Likert scales were used to assess students' self-rated utility of the mnemonics taught and their likely future use of mnemonics. RESULTS: Students demonstrated a significant improvement in SBA scores, particularly for mnemonic-linked questions (p < 0.05). Confidence levels significantly increased postteaching (p < 0.01). Students reported a higher likelihood of future mnemonic use, and a strong correlation was found between improved confidence and increased mnemonic use (p < 0.001). CONCLUSION: Peer-led teaching with mnemonic integration significantly improved both knowledge, student confidence and likelihood of future mnemonic use. This study highlights the potential of both mnemonic-based and peer-led learning strategies in medical education.
BACKGROUND AND PURPOSE: Numerous studies in the international literature address workplace traumatic experiences affecting psychiatry residents and their impacts. No such survey has been conducted in Hungary so far, so I set as my goal to assess the occurrence of stressful situations affecting Hungarian psychiatry residents and their psychological consequences. Emphasizing the mental health of psychiatry residents and improving prevention in specialist training is an essential condition for training stable, well-prepared specialists. METHODS: A total of 80 psychiatry residents from the specialist training programs of the 4 Hungarian universities were included in the survey. The questionnaire consisted of 5 parts: occurrence of stressful situations; psychological reactions; Mini-Oldenburg Burnout Inventory (MOLBI); coping mechanisms; needs for specialist training development. RESULTS: Among stressful situations, verbal abuse and discriminatory remarks were the most common. Physical assault affected 34.6% of respondents, and patient suicide occurred in 34.5% of cases. Burnout criteria were met in 62.5% of residents. High scores were achieved on the MOLBI Disengagement subscale by 65% and on the Exhaustion subscale by 90%. Although burnout and disengagement levels were similar, the proportion of those with significant exhaustion was significantly higher in the Budapest sample compared to the national average (94.2% vs. 84.6%). For processing cases, young residents most commonly chose discussion with fellow residents. 100% of respondents supported the development of specialist training programs that would aid the professional processing of difficult situations. CONCLUSION: The occurrence of stressful situations shows similar trends to international literature data. However, burnout and exhaustion levels are significantly higher, which may have several explanations. The two most important factors to build future development strategies around are more thorough preparation for difficult situations and the programmatic implementation of professional and regular case processing.
Continuing medical education (CME) and continuing professional development (CPD) systems have traditionally relied on time-based credit allocation, using participation duration as a proxy for professional learning. Although administratively simple and scalable, this model does not reliably demonstrate whether physicians have engaged in meaningful learning, improved clinical reasoning, or critically appraised evidence. The emergence of generative AI creates an opportunity to rethink how physician learning is documented, assessed, and credited. This viewpoint proposes the Case-based Learning Intelligence Credit System (CLICS), a conceptual framework for translating AI-mediated clinical learning interactions into auditable evidence of reasoning-related engagement that could support CME/CPD credit. CLICS introduces the professional learning episode (PLE) as the basic unit of creditable learning: a coherent AI-mediated interaction demonstrating a clinically meaningful problem, reasoning development through iterative inquiry, contextual or evidentiary integration, and reflective synthesis. PLEs are evaluated using the proposed Practice Intelligence Score-7 (PIS-7) rubric, subject to human calibration and oversight; the rubric assesses observable reasoning behavior within the episode rather than the AI's answer, and qualifying PLEs may be translated into CME/CPD credit through threshold-based, human-auditable conversion rules. CLICS is not intended to replace traditional CME but to extend it as an optional, evidence-generating pathway for personalized, practice-embedded professional development. Its implementation requires iterative validation, stratified human audit, privacy-by-design architecture, antigaming controls, bias monitoring, and professional oversight. If validated, CLICS may enable identification of domain-specific areas for improvement and support personalized, adaptive learning pathways.
Medical education onlineBeatrice Boateng, Karina Clemmons, Lindsey Sward, Rebecca Latch, Charles Graham, John Spollen
BACKGROUND: Following the transition of the USMLE Step 1 to pass/fail scoring, Step 2 Clinical Knowledge (CK) has become a primary metric in residency screening. This study evaluates multiple approaches to identify performance patterns that may support individualised longitudinal advising and targeted preparation aligned with students' educational and specialty goals. METHODS: De-identified first-attempt scores from 819 medical students who completed Step 2 CK between May 2021 and April 2026 were analysed. Three models were applied: linear regression, a conditional inference tree, and weighted logistic regression to predict at-risk status. Outcomes included continuous Step 2 CK scores and an at-risk classification defined as scoring at least 1 standard deviation below the national mean for the corresponding passing standard. Model outputs were synthesised to identify performance patterns relevant to advising. RESULTS: First-attempt pass rates ranged from 95% to 98% across testing years. 184 students (22.4%) met the at-risk criteria. Paediatrics, Internal Medicine, and Neurology showed relatively strong associations with Step 2CK performance. Linear regression explained 71.8% of the variance in Step 2 CK scores. The conditional inference tree produced 17 terminal nodes and yielded a mean root mean squared error of 10.63. Weighted logistic regression demonstrated good discrimination for at-risk classification (AUC = 0.915). CONCLUSIONS: Combining these modelling approaches offers a multidimensional view of student performance that may support targeted preparation for Step 2 CK. By integrating prediction, risk stratification, and performance interpretation, we developed the TRACE Framework to translate institutional assessment data into actionable insights for individualised residency advising.
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.