Re-conceptualizing medical education in the post-COVID era.

PURPOSE: The COVID-19 pandemic has forced changes in the delivery of medical education. We aimed to explore these changes and determine whether they will impact the future of medical education in any way. METHODS: We invited leaders in medical education from all accessible US-based medical schools to participate in an online individual semi-structured interview. RESULTS: Representatives of 16 medical schools participated. They commented on the adequacy of online education for knowledge transfer, and the logistical advantages it offered, but decried its negative influence on social learning, interpersonal relationships and professional development of students, and its ineffectiveness for clinical education. Most participants indicated that they would maintain online learning for didactic purposes in the context of flipped classrooms but that a return to in-person education was essential for most other educational goals. Novel content will be introduced, especially in telemedicine and social medicine, and the students' roles and responsibilities in patient care and in curricular development may evolve in the future. CONCLUSIONS: This study is the first to document the practical steps that will be adopted by US medical schools in delivering medical education, which were prompted and reinforced by their experience during the COVID-19 pandemic.

Medical Student Experiences and Perceptions of ChatGPT and Artificial Intelligence: Cross-Sectional Study.

BACKGROUND: Artificial intelligence (AI) has the potential to revolutionize the way medicine is learned, taught, and practiced, and medical education must prepare learners for these inevitable changes. Academic medicine has, however, been slow to embrace recent AI advances. Since its launch in November 2022, ChatGPT has emerged as a fast and user-friendly large language model that can assist health care professionals, medical educators, students, trainees, and patients. While many studies focus on the technology's capabilities, potential, and risks, there is a gap in studying the perspective of end users. OBJECTIVE: The aim of this study was to gauge the experiences and perspectives of graduating medical students on ChatGPT and AI in their training and future careers. METHODS: A cross-sectional web-based survey of recently graduated medical students was conducted in an international academic medical center between May 5, 2023, and June 13, 2023. Descriptive statistics were used to tabulate variable frequencies. RESULTS: Of 325 applicants to the residency programs, 265 completed the survey (an 81.5% response rate). The vast majority of respondents denied using ChatGPT in medical school, with 20.4% (n=54) using it to help complete written assessments and only 9.4% using the technology in their clinical work (n=25). More students planned to use it during residency, primarily for exploring new medical topics and research (n=168, 63.4%) and exam preparation (n=151, 57%). Male students were significantly more likely to believe that AI will improve diagnostic accuracy (n=47, 51.7% vs n=69, 39.7%; P=.001), reduce medical error (n=53, 58.2% vs n=71, 40.8%; P=.002), and improve patient care (n=60, 65.9% vs n=95, 54.6%; P=.007). Previous experience with AI was significantly associated with positive AI perception in terms of improving patient care, decreasing medical errors and misdiagnoses, and increasing the accuracy of diagnoses (P=.001, P<.001, P=.008, respectively). CONCLUSIONS: The surveyed medical students had minimal formal and informal experience with AI tools and limited perceptions of the potential uses of AI in health care but had overall positive views of ChatGPT and AI and were optimistic about the future of AI in medical education and health care. Structured curricula and formal policies and guidelines are needed to adequately prepare medical learners for the forthcoming integration of AI in medicine.

Representation in Health Professions Education: Striving for an Inclusive Health Professions Education Community.

Author representation and inclusivity in health professions education (HPE) scholarship is receiving increasing attention in academic medicine, with multiple articles calling for greater equity related to gender, geographic, and institutional affiliations. Despite journal efforts to seek diversity, authors from high-income English-speaking countries are the most highly represented in HPE scholarship. Less attention, however, has been focused on the openness of medical education scholars, themselves, to engaging in international collaborations with authors and institutions from low-and-middle income countries. This eye-opener is inspired by the authors' personal experiences in HPE scholarship from an international medical educator perspective and advocates for the creation of an open and inclusive multinational medical education community. We offer suggestions that can help create opportunities for networking, collaboration, and promoting a sense of belonging among HPE scholars worldwide. As researchers, journal editors and associate editors, and faculty in HPE programs, we can work together to create a welcoming and accommodating environment that embraces non-dominant voices and perspectives, with the ultimate goal of achieving diversity and equity in HPE scholarship.

Applications of advances in mRNA-based platforms as therapeutics and diagnostics in reproductive technologies.

The recent COVID-19 pandemic led to many drastic changes in not only society, law, economics, but also in science and medicine, marking for the first time when drug regulatory authorities cleared for use mRNA-based vaccines in the fight against this outbreak. However, while indeed representing a novel application of such technology in the context of vaccination medicine, introducing RNA into cells to produce resultant molecules (proteins, antibodies, etc.) is not a novel principle. It has been common practice to introduce/inject mRNA into oocytes and embryos to inhibit, induce, and identify several factors in a research context, while such aspects have also been proposed as potential therapeutic and diagnostic applications to combat infertility in humans. Herein, we describe key areas where mRNA-based platforms have thus far represented potential areas of clinical applications, describing the advantages and limitations of such applications. Finally, we also discuss how recent advances in mRNA-based platforms, driven by the recent pandemic, may stand to benefit the treatment of infertility in humans. We also present brief future directions as to how we could utilise recent and current advancements to enhance RNA therapeutics within reproductive biology, specifically with relation to oocyte and embryo delivery.

Effect of Targeted Curricular Reform on the Learning Environment, Student Empathy, and Hidden Curriculum in a Medical School: A 7-Year Longitudinal Study.

OBJECTIVE: The American University of Beirut Faculty of Medicine follows the American model of medical education. In 2013-2014, a carefully designed new curriculum replaced the previous, largely traditional curriculum, and aimed to improve student wellbeing, upgrade the learning environment, enhance student empathy, and counter the negative influences of the hidden curriculum. This longitudinal study assessed the effectiveness of the new curriculum in those domains over a period of 7 years. METHODS: Three cohorts of medical students anonymously filled a paper-based survey at the end of years 1, 2, 3, and 4 of the 4-year curriculum. These included the Class of 2016, the last batch of students who followed the old curriculum, and 2 cohorts that followed the new curriculum (Class of 2017 and Class of 2019). The perceived learning environment was assessed by the Dundee Ready Education Environment Measurement survey; the student's empathy was assessed by the Jefferson Scale of Physician Empathy-Student version; and the hidden curriculum was examined using a locally developed survey. RESULTS: The scores on the learning environment survey were significantly higher among the cohorts following the new curriculum relative to those following the old curriculum. Similar significant results appeared when looking at each of the subscales for the learning environment. The students' empathy scores were also significantly higher in both cohorts of the new curriculum when compared with the old curriculum. Nevertheless, there was a significant decrease in empathy in both third and fourth years relative to second year. The new curriculum also improved aspects of the students' perceptions and responses to the hidden curriculum. CONCLUSION: In conclusion, a well-planned and well-researched curricular intervention, based on sound educational theories, practices, and standards can indeed transform the learning environment, as well as the attitudes, values, and experiences of medical students.

Peroneal neuropathy and bariatric surgery: untying the knot.

Purpose: Peroneal neuropathy is a neurological complication of bariatric surgery (BS) that can impair the functional capacity of the presenting patient and reduce quality of life. The aim of this paper is to explore and offer medical insight into the presentation, etiologies, and therapeutic modalities of peroneal neuropathy following BS.Methods: We explored PubMed/Medline for cases involving peroneal neuropathy as a complication of BS. The search included all articles published from database inception until April 25, 2019. Only articles published in English were included. Clinical information and demographics extracted from the reported studies were analyzed and assessed.Results: Only 9 studies met our criteria, with a total of 21 cases (n = 21). Females dominated in 14 cases (67%). Ages ranged from 12 to 53 years with mean age being 36. All cases reported pain, numbness and weakness in their lower limb. Gastric bypass was the most common procedure with 9 cases (43%). All cases witnessed loss of a large amount of weight following BS. Amount of weight lost per month ranged from 2.7 kg/month to 19 kg/month. Electrodiagnostic studies were used in 18 cases (86%). Of all the cases presented, 12 (57%) underwent surgical treatment, 7 (33%) underwent conservative treatment, and 2 (10%) resolved spontaneously. All patients reported improvement of symptoms.Conclusion: Better knowledge of the demographics and clinical characteristics of peroneal neuropathy following BS will help in achieving earlier diagnosis and avoiding invasive therapeutic modalities. Guidance with respect to weight reduction is pivotal in deterring similar neurological complications.

Slipping Rib Syndrome: Solving the Mystery of the Shooting Pain.

Slipping rib syndrome is an often unrecognized and underdiagnosed condition caused by the increased mobility of the anterior ends of the costal cartilages of the false ribs. Patients usually present with severe intermittent abdominal pain that is exacerbated by various physical movements. Diagnosis of slipping rib syndrome is mainly clinical and can be confirmed by a physical examination technique termed the "Hooking Maneuver." Treatment includes conservative therapy, intercostal nerve block and surgical operation. Hence, the management and care plan of each patient must be individualized as per the presenting symptoms and medical history. Early recognition and prompt intervention necessitate that physicians be more aware of the symptomatology and prognosis of this condition. This study presents a rare case of a patient with slipping rib syndrome and offers medical insight to the clinical diagnosis and therapeutic modalities of this condition, in light of the current existing literature.

The long-term impact of team-based learning on medical students' team performance scores and on their peer evaluation scores.

BACKGROUND: The Faculty of Medicine at the American University of Beirut implemented a new medical curriculum, which included 90 team-based learning (TBL) sessions in years 1 and 2 of medical school. METHODS: A validated team performance scale (TPS) and peer evaluation of communication skills, professionalism and personal development were collected at different time points during the two years. Grades on the individual and group readiness assurance tests and an evaluation form were collected after every TBL session. RESULTS: Students generally positively evaluated most TBL sessions as promoters of critical thinking and appreciated the self-learning experience, though they preferred and had better individual grades on those that entailed preparation of didactic lectures. There was a sustained and cumulative improvement in teamwork skills over time. Similar improvement was noted with peer evaluations of communication skills, professionalism, and personal development over time. CONCLUSIONS: This is the first report about such a longitudinal follow-up of medical students who were exposed to a large number of TBL sessions over two years. The results support the suggestion that TBL improves medical students' team dynamics and their perceived self-learning, problem solving and communication skills, as well as their professionalism and personal development.