Performance of ChatGPT on Chinese Master's Degree Entrance Examination in Clinical Medicine.

BACKGROUND: ChatGPT is a large language model designed to generate responses based on a contextual understanding of user queries and requests. This study utilised the entrance examination for the Master of Clinical Medicine in Traditional Chinese Medicine to assesses the reliability and practicality of ChatGPT within the domain of medical education. METHODS: We selected 330 single and multiple-choice questions from the 2021 and 2022 Chinese Master of Clinical Medicine comprehensive examinations, which did not include any images or tables. To ensure the test's accuracy and authenticity, we preserved the original format of the query and alternative test texts, without any modifications or explanations. RESULTS: Both ChatGPT3.5 and GPT-4 attained average scores surpassing the admission threshold. Noteworthy is that ChatGPT achieved the highest score in the Medical Humanities section, boasting a correct rate of 93.75%. However, it is worth noting that ChatGPT3.5 exhibited the lowest accuracy percentage of 37.5% in the Pathology division, while GPT-4 also displayed a relatively lower correctness percentage of 60.23% in the Biochemistry section. An analysis of sub-questions revealed that ChatGPT demonstrates superior performance in handling single-choice questions but performs poorly in multiple-choice questions. CONCLUSION: ChatGPT exhibits a degree of medical knowledge and the capacity to aid in diagnosing and treating diseases. Nevertheless, enhancements are warranted to address its accuracy and reliability limitations. Imperatively, rigorous evaluation and oversight must accompany its utilization, accompanied by proactive measures to surmount prevailing constraints.

Effectiveness of the "Hand as Foot" teaching method in human physiology: A randomized controlled trial.

BACKGROUND: The "Hand as Foot" teaching method, an innovative approach in medical education, utilizes hand gestures to simulate anatomical structures and functions. This study aimed to assess the effectiveness of the "Hand as Foot" teaching method compared to traditional method in the "Human Physiology" course. METHODS: During the 2023 spring semester, a randomized controlled trial involved 84 health management students. Participants were randomly assigned to the "Hand as Foot" teaching group or the traditional teaching group. A self-designed Likert scale was used to evaluate students' perceptions of teaching effectiveness, covering dimensions such as engagingness, intuitiveness, facilitation of understanding, enhancement of memorization, and effortlessness of learning. Additionally, a knowledge assessment test was administered to measure knowledge acquisition. RESULTS: The "Hand as Foot teaching method" group (41 students) reported significantly higher ratings for all dimensions of teaching effectiveness compared to the traditional teaching group (43 students) (p ≤ 0.01). Despite the lack of statistical significance, the experimental group's test scores were notably superior (Mean = 6.35 vs. Mean = 5.94). DISCUSSION: The "Hand as Foot" teaching method demonstrated superior effectiveness in engaging students, facilitating comprehension, and enhancing memorization. Its interactive and tangible nature provided a holistic learning experience, enabling students to visualize complex physiological mechanisms. Additionally, it fostered active student participation and a desire for deeper understanding. CONCLUSION: While the "Hand as Foot" teaching method demonstrated strengths in engaging students and aiding comprehension, further researches with larger and diverse cohorts are needed to gauge its impact on learning outcomes and broader applicability.

Predictors of Ophthalmology Resident Performance From Medical Student Application Materials.

OBJECTIVE: To determine whether elements in ophthalmology residency applications are predictors of future resident performance. DESIGN: This multi-institutional, cross-sectional, observational study retrospectively reviewed the residency application materials of ophthalmology residents who graduated from residency from 2006 through 2018. Resident performance was scored by 2 faculty reviewers in 4 domains (clinical, surgical, academic, and global performance). Correlation between specific elements of the residency application and resident performance was assessed by Spearman correlation coefficients (univariate) and linear regression (multivariate) for continuous variables and logistic regression (multivariate) for categorical variables. SETTING: Seven ophthalmology residency programs in the US. PARTICIPANTS: Ophthalmology residents who graduated from their residency program. RESULTS: High-performing residents were a diverse group, in terms of sex, ethnicity, visa status, and educational background. Residents with United States Medical Licensing Examination Step 1 scores higher than the national average for that year had significantly higher scores in all 4 performance domains than those who scored at or below the mean (all domains P < 0.05). Residents who had honors in at least 4 core clerkships and who were members of Alpha Omega Alpha Medical Honor Society also had higher scores in all 4 performance domains (all domains P ≤ 0.04). Step 1 score (ρ=0.26, P < 0.001) and the difference between Step 1 score and the national average for that year (ρ=0.19, P = 0.009) positively correlated with total resident performance scores. Residents who passed the American Board of Ophthalmology Written Qualifying Examination or Oral Examination on their first attempt had significantly higher Step 1/2 scores (P ≤ 0.005), Ophthalmology Knowledge Assessment Program scores (P = 0.001), and resident performance scores (P ≤ 0.004). CONCLUSIONS: In this new landscape of increasing numbers of applicants to residency programs and changing of the Step 1 score to pass/fail, our findings may help guide selection committees as they holistically review applicants to select exceptional future residents in ophthalmology.

Evaluation of dental students' clinical communication skills from three perspective approaches: A cross-sectional study.

INTRODUCTION: The communication skills of clinicians are very crucial in providing better health outcomes for patients. Therefore, this study aimed to assess undergraduate dental students' communication skills in relation to their demographics and clinical setting using a three-perspective approach; the student, the patient and the clinical instructor perspective. METHODS: A cross-sectional study was conducted using validated modified-communication tools; Patient Communication Assessment Instruments (PCAI), Student Communication Assessment Instruments (SCAI) and Clinical Communication Assessment Instruments (CCAI) which included four communication domains. One hundred and seventy-six undergraduate clinical year students were recruited in this study whereby each of them was assessed by a clinical instructor and a randomly selected patient in two settings: Dental Health Education (DHE) and Comprehensive Care (CC) clinic. RESULTS: Comparing the three perspectives, PCAI yielded the highest scores across all domains, followed by SCAI and CCAI (p < .001). SCAI exhibited a better score in Year 5 compared to Year 3 and Year 4 (p = .027). The male students perceived they performed better than females in all domains (p < .05). Patients rated the students higher in the DHE clinic as compared to the CC clinic for the team interaction domain. CONCLUSION: There was an upward pattern of the communication skills score rated from the clinical instructor perspective to the student and patient perspectives. The use of PCAI, SCAI and CCAI collectively gave a complementary view of students' communication performance in all the domains assessed.

The Effects of Single Accreditation and Pass/Fail Licensing Exams on Osteopathic Medical Students Applying to Surgical Residency Programs.

OBJECTIVE: To examine the effects of single accreditation and pass/fail licensing exams on osteopathic (DO) medical students applying for surgical residency. DESIGN: Electronic surveys were distributed to 1509 program directors (PD) in 10 surgical specialties. PDs were separated into 2categories based on their program's accreditation status prior to single accreditation: formerly accredited by the American Osteopathic Association (AOA) or not accredited by the AOA. Separate chi-squared and binomial tests were used to determine statistical differences between PDs in each category and within each surgical specialty. SETTING: Voluntary, anonymous, electronic survey. PARTICIPANTS: Three hundred survey responses were received (response rate 19.8%) and 234 responses were included in statistical analyses. Sixty-six responses were excluded because the survey was incomplete, the survey was not completed by a PD, or the PD indicated disqualification of DO applicants from matching at that program. RESULTS: The majority of PDs in both categories recommend or require that DO students take both United States Medical Licensing Examination (USMLE) Step1 [Χ2 (2, N = 234) = 8.939, p = 0.011] and USMLE Step 2 CK [Χ2 (2, N = 234) = 4.161, p = 0.125] despite pass/fail outcomes only on Step 1 and Level 1. When deciding whom to interview, PDs in both categories highly ranked USMLE Step 2 CK scores and letters of recommendation (LOR). Formerly-AOA-accredited programs highly ranked COMLEX-USA Level 2 scores (p = < 0.001) and completion of an audition rotation (p = 0.001). Non-AOA-accredited programs highly ranked the Medical Student Performance Evaluation (MSPE) (p = < 0.001) and clerkship grades/evaluations (p = 0.001). CONCLUSIONS: Significant differences exist in programs despite single accreditation. DO applicants should take both USMLE Step 1 and Step 2 CK to be considered competitive for any surgical specialty. Additionally, DO students should prioritize formerly-AOA-accredited programs for audition rotations.

Comparison of video-assisted education and traditional classroom education in pediatric cardiopulmonary resuscitation education of nursing students.

AIM: This research aimed to compare the effectiveness of traditional classroom education and video-assisted education methods used in Pediatric (CPR) education and determine students' level of satisfaction with the education methods used. METHOD: This research had a randomized, experimental, pretest-posttest design. The research was completed with 98 students (54 in the video-assisted education group and 44 in the traditional classroom education group). The traditional classroom education group received pediatric CPR education through traditional classroom education. On the other hand, the video-assisted education group watched the pediatric CPR education video prepared by the researchers. The level of knowledge of pediatric CPR, the level of pediatric CPR practice skills, and the satisfaction score of each student were evaluated. RESULTS: When the skills levels of the groups were compared, it was determined that there was no statistical difference between the test results. In both groups, the students' mean knowledge and skill scores in the first and second posttests were significantly higher than their pretest knowledge scores. The satisfaction scores of the students in both groups were similar. CONCLUSION: Both methods effectively improve students' pediatric CPR-related knowledge, skills, and satisfaction. IMPLICATIONS FOR PRACTICE: As support for traditional education, using video-assisted visual education materials that nursing students can constantly access when needed is important.

Designing and implementing an OMMID midwifery professional competence mixed test: A multimethod, multiphasic study.

The assessment of professional competence is essential to ensure the achievement of competence standards. The goal of this study is to design and implement a professional competence test model to make the test unified, comprehensive, and fair. This research was a multimethod, multiphasic study. The first qualitative phase of the nominal group technique was conducted to design the test model with specific guidelines. The second phase was a mixed-method parallel field trial conducted on 161 senior midwifery bachelor students in universities of Iran. The test was conducted following the traditional method in the control group and OMMID model in the intervention group. This model consists of three parts: the MCQs (multiple choice questions), OSCE (objective structured clinical examination), and clinically-oriented tests, which included Mini-CEX (mini-clinical evaluation exercise) and DOPS (direct observation of procedural skills). Data were collected using questionnaires and interviews, and the results were assessed qualitatively and quantitatively. The OMMID model and the associated guideline were designed. Qualitative data analysis resulted in six main themes, including organizing, structure, tension due to change, fairness, unification, and outcome. The OMMID model did not increase students' anxiety and stress and did not decrease their satisfaction. The merits of this model include having a centralized guideline, using multiple evaluation methods, comprehensive evaluation of necessary skills, promotion of fairness, and increased student satisfaction.

Impact of the USMLE Step 1 and COMLEX Level 1 transition to Pass/Fail on osteopathic medical student stress levels and board preparation.

CONTEXT: The United States Medical Licensing Examination (USMLE) Step 1 and Comprehensive Osteopathic Medical Licensing Exam (COMLEX) Level 1 transitioned from a numeric scoring system to a Pass/Fail designation in 2022. This transition intended to decrease stress, improve medical student well-being, and encourage residency program directors to emphasize other aspects of residency applications. Pass/Fail score transitions in the undergraduate medical education curriculum have improved medical student psychological well-being and satisfaction; whether these same benefits translate to the board examination period is unknown. OBJECTIVES: The objectives of this study are to assess the impact of USMLE Step 1 and COMLEX Level 1 grade scale transition on medical student stress, wellness, board preparation decisions, and future residency selection processes. Investigators hypothesized that students under the Pass/Fail designation would experience less stress during the intensive study period leading up to USMLE Step 1 and COMLEX Level 1 and devote more time to other aspects of their residency applications. METHODS: To examine the impact on osteopathic medical student (OMS) stress and approach to board preparation, two surveys were administered to Rocky Vista University College of Osteopathic Medicine (RVU-COM) students before (Class of 2023) and after (Class of 2024) the transition to a Pass/Fail designation. All students within the RVU-COM Classes of 2023 and 2024 were invited to participate. The Cohen Perceived Stress Scale (PSS-10) was administered at the beginning of the focused board study period in May 2021 and 2022 to the Class of 2023 and 2024, respectively. The investigator-designed Licensing Exam Questionnaire (LEQ), meant to capture board preparation patterns, residency application perspectives, and wellness during examination preparation, was administered immediately after the board examination deadline in July 2021 and 2022 to the Class of 2023 and 2024, respectively. Statistical analysis included the use of independent t tests (numeric variables) and chi-square tests (categorical data). This project was considered exempt from full Institutional Review Board review. RESULTS: Approximately one-third of the Class of 2023 (PSS-10: n=86; LEQ: n=93) and 2024 (PSS-10=89; LEQ: n=92) responded. No difference was detected in mean PSS-10 score, 20.14 (SD=7.3) compared to 19.92 (SD=6.56) for the Class of 2023 and 2024 (p=0.84), respectively. The Class of 2023 reported more weeks studying (mean 6.27 weeks, SD=0.79) vs. the Class of 2024 (mean 5.44 weeks, SD=0.007), p<0.001, more practice examinations taken X 2 (1, n=182)=13.75, p<0.001, and a greater proportion scheduled examinations after June 20 X 2 (1, n=182)=29.01, p<0.001. No difference existed in hours studying per day, sequence of Step 1/Level 1, time between examinations, money spent, or type of study resources utilized. CONCLUSIONS: The transition of USMLE Step 1 and COMLEX Level 1 to a Pass/Fail designation did not reduce stress for OMSs at a single, multicampus COM. Respondents, however, altered board preparation practices in meaningful ways. As student behaviors and board-study patterns emerge, these insights must be connected to outcomes in the future.

Cumulative Sum Chart as Complement to Objective Assessment of Graduating Surgical Resident Competency: An Exploratory Study.

BACKGROUND: Rater-based assessment and objective assessment play an important role in evaluating residents' clinical competencies. We hypothesize that a cumulative sum (CUSUM) chart of operative time is a complement to the assessment of chief general surgery residents' competencies with ACGME Milestones, aiding residency programs' determination of graduating residents' practice readiness. STUDY DESIGN: We extracted ACGME Milestone evaluations of performance of operations and procedures (POP) and 3 objective metrics (operative time, case type, and case complexity) from 3 procedures (cholecystectomy, colectomy, and inguinal hernia) performed by 3 cohorts of residents (N = 15) during their PGY4-5. CUSUM charts were computed for each resident on each procedure type. A learning plateau was defined as at least 4 cases consistently locating around the centerline (target performance) at the end of a CUSUM chart with minimal deviations (range 0 to 1). RESULTS: All residents reached the ACGME graduation targets for the overall POP by the end of chief year. A total of 2,446 cases were included (cholecystectomy N = 1234, colectomy N = 507, and inguinal hernia N = 705), and 3 CUSUM chart patterns emerged: skewed distribution, bimodal distribution, and peaks and valleys distribution. Analysis of CUSUM charts revealed surgery residents' development processes in the operating room towards a learning plateau vary, and only 46.7% residents reach a learning plateau in all 3 procedures upon graduation. CONCLUSIONS: CUSUM charts of operative time complement the ACGME Milestones evaluations. The use of both may enable residency programs to holistically determine graduating residents' practice readiness and provide recommendations for their upcoming career/practice transition.

USMLE step 1 and step 2 CK as indicators of resident performance.

BACKGROUND: The purpose of this systematic review was to (1) determine the scope of literature measuring USMLE Step 1 and Step 2 CK as predictors or indicators of quality resident performance across all medical specialties and (2) summarize the ability of Step 1 and Step 2 CK to predict quality resident performance, stratified by ACGME specialties, based on available literature. METHODS: This systematic review was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [16]. The original search strategy surveyed MEDLINE and was adapted to survey Cochrane Library and Embase. A study was deemed eligible if it provided all three of the following relevant information: (a) Step 1 or Step 2 CK as indicators for (b) resident outcomes in (c) any ACGME accredited specialty training program. RESULTS: A total of 1803 articles were screened from three separate databases. The 92 included studies were stratified by specialty, with Surgery (21.7% [20/92]), Emergency Medicine (13.0% [12/92]), Internal Medicine (10.9% [10/92]), and Orthopedic Surgery (8.7% [8/92]) being the most common. Common resident performance measures included ITE scores, board certification, ACGME milestone ratings, and program director evaluations. CONCLUSIONS: Further studies are imperative to discern the utility of Step 1 and Step 2 CK as predictors of resident performance and as tools for resident recruitment and selection. The results of this systematic review suggest that a scored Step 1 dated prior to January 2022 can be useful as a tool in a holistic review of future resident performance, and that Step 2 CK score performance may be an effective tool in the holistic review process. Given its inherent complexity, multiple tools across many assessment modalities are necessary to assess resident performance comprehensively and effectively.

Misperceptions and Missed Opportunities: A Qualitative Analysis of Barriers to Evaluating Surgical Teachers.

OBJECTIVE: Teaching skills can be improved with written evaluations from learners. In addition to this primary purpose, teaching assessments are used in other aspects of faculty development including appointments, advancement and in some cases, compensation. Surgical trainees' willingness to provide meaningful assessments of their teachers is variable but the reasons for this are ill-defined. This study aims to elucidate surgical residents' perceptions regarding barriers to providing useful feedback to their teachers. DESIGN: A qualitative, semi-structured confidential interview approach was used. A demographically diverse cohort of surgical residents in an urban university-based program was invited to participate. Interviews explored experiences and perceptions of teaching assessments. Specific attention was paid to understand perceptions of barriers; topics including utility, anonymity, time burden, and others were explored. Interviews were transcribed verbatim with identifiers removed from transcripts before analysis. All data was double coded to ensure accuracy with the development of a codebook until thematic exhaustion was reached. SETTING: Yale New Haven Hospital is an academic, university-based medical center with approximately 70 residents in the general surgery program and approximately 170 surgical faculty. PARTICIPANTS: A total of 21 residents completed individual or small group interviews. A theoretically driven sampling technique was used to recruit participants and maximize diversity. Individuals with varying backgrounds including PGY year, gender, age, IMG status, race, academic rank, research background and surgical division were asked to participate. RESULTS: A total of 21 residents completed individual or small group interviews. Coding and analysis revealed 4 principal motifs: (1). Process- The process to complete assessment instruments is time-consuming and cumbersome to complete during the busy and acute surgical workday while failing to accurately address important aspects of surgical teaching. (2). Utility- Respondents reported uncertainty as to the downstream utility of the assessments, and a lack of confidence that the assessments would be used for faculty growth and improvement. (3). Resident Standing- Respondents described a lack of training, knowledge, skills, and empowerment to assess their teachers. (4). Perceived Consequences- Residents noted concern for identification, future autonomy, and other potential negative career consequences due to small resident sample sizes, recognizable experiences with attendings, and perceived power dynamics. CONCLUSIONS: This study elucidates the perceptions of surgical trainees regarding barriers to providing feedback and assessments of their faculty. Although limited to a single-institution study, residents observed the current system does not allow for honest and accurate evaluations of surgical teachers. The extensive overlap between motifs highlights the need for a holistic approach to address these interconnected themes before teaching evaluations can be honest and productive. Importantly, it is also the first to identify residents' perceived lack of skill and sense of disempowerment to provide constructive faculty assessment. Due to the limited scope of the single-institution study, further verification and studies are needed to improve the quality of faculty feedback and assessment of surgical teachers.

Increasing Diversity in the Physician Workforce: Pathway Programs and Predictive Analytics.

PROBLEM: Lack of diversity in the physician workforce has well-documented negative impacts on health outcomes. Evidence supports the use of pathway or pipeline programs to recruit underrepresented in medicine students. However, data on how a pathway program should deliver instruction are lacking. This report describes a multiyear project to build such a system with the goal of increasing diversity within medical school cohorts and ultimately the physician workforce. APPROACH: In the 2015-2016 academic year, the Ponce Health Sciences University started a 3-phase project to create a data-driven medical school feeder system by coupling a pathway program with predictive analytics. Phase 1 launched the pathway program. Phase 2 developed and validated a predictive model that estimates United States Medical Licensing Examination (USMLE) Step 1 performance. Phase 3 is underway and focuses on adoption, implementation, and support. OUTCOMES: Data analysis compared 2 groups of students (pathway vs direct) across specific factors, including Medical College Admission Test (MCAT) score, undergraduate grade point average (GPA), first-generation status, and Step 1 exam performance. Statistically significant differences were found between the 2 groups on the MCAT exam and undergraduate GPA; however, no significant differences were found between groups for first-generation status and performance on the Step 1 exam. This finding supports the authors' hypothesis that although pathway students have significantly lower mean MCAT exam scores compared with direct students, pathway students perform just as well on the USMLE Step 1 exam. NEXT STEPS: Next steps include expanding the project to another campus, adding more socioeconomic status and first-generation data, and identifying best curricular predictors. The authors recommend that medical school programs use pathway programs and predictive analytics to create a more data-centered approach to accepting students with the goal of increasing physician workforce diversity.

Canales dominantes de percepción del conocimiento. Influencia en la evaluación del aprendizaje de la inmunología / Knowledge Perception Dominant Channels. Influence of the Evaluation of Immunology Learning

Introducción: Los estilos de aprendizaje según canales de percepción dominante del conocimiento de los estudiantes influyen en su aprendizaje. Su uso por los docentes puede favorecer o no a estudiantes con un canal específico. Objetivo: Describir la ubicación según los canales de percepción dominante del conocimiento de los estudiantes de medicina y la relación de estos con el resultado de las evaluaciones frecuentes en la asignatura Sangre y Sistema Inmune. Métodos: Se realizó una investigación en 234 estudiantes y 30 profesores de la carrera de medicina en los cursos 2020-2021 y 2022. Los estudiantes se clasificaron según los resultados de un cuestionario para identificar el predominio del canal de percepción (visuales-auditivos-kinestésicos) y a los profesores se les realizó una encuesta para determinar su percepción sobre el uso de estrategias de enseñanza diferenciales para cada canal. El procesamiento se realizó en programa SPSS 25, a través de números, porcentaje y prueba de ji al cuadrado. Resultados: Predominó el canal visual con el 48 por ciento. Existió asociación con el sexo con p = 0,0016; en varones prevaleció el canal auditivo y en hembras el visual. La relación entre los canales de percepción dominante y el rendimiento académico fue significativa con p = 0,000. Conclusiones: Prevaleció el canal de percepción dominante visual. La distribución de cada canal se asoció con el sexo y el rendimiento académico; así se lograron mejores resultados por los estudiantes con percepción dominante visual. Esto último estuvo relacionado con el predominio de acciones por parte de los docentes que potencian este canal de percepción(AU)

Introduction: Learning styles according to dominant perception channels of students' knowledge influence their learning. Their use by professors may or may not favor students with a specific channel. Objective: To describe the location according to the dominant knowledge perception channels of medical students and their relationship with the results of frequent evaluations in the subject Blood and Immune System. Methods: A research was conducted with 234 students and 30 professors of the Medicine major during the academic years 2020-2021 and 2022. The students were classified according to the results of a questionnaire to identify the perception channel predominance (visual-auditory-kinesthetic), while the professors were surveyed to determine their perception on the use of differential teaching strategies for each channel. Processing was performed in SPSS 25, using numbers, percentages and the chi-squared test. Results: The visual channel predominated, accounting for 48 percent. There was an association with sex (p=0.0016); the auditory channel prevailed among males, while the visual channel prevailed among females. The relationship between dominant perception channels and academic performance was significant (p=0.000). Conclusions: The visual dominant perception channel prevailed. The distribution of each channel was associated with sex and academic performance; thus, better results were achieved by students with visual dominant perception. The latter was related to the predominance of actions by professors that enhance this perception channel(AU)

Self-Reported Disadvantage in Medical School Admissions: A Call to Review, Revise, and Further Advance Holistic Review.

PURPOSE: This study examined how applicants interpret the self-reported disadvantaged (SRD) question in the American Medical College Application Service (AMCAS) application. METHOD: Data from 129,262 applicants who applied through AMCAS from 2017 through 2019 were used, including financial and family history, demographic characteristics, and work status and residence. Fifteen applicants from the 2020 and 2021 AMCAS cycles were interviewed about their experiences with the SRD question. RESULTS: Large effects were found for SRD applicants with fee assistance waivers ( h = 0.89), Pell grants ( h = 1.21), state or federal aid ( h = 1.10), and parents with less education ( h = 0.98) and non-SRD applicants with a large proportion of their education paid by family ( d = 1.03). Another large difference was found for reported family income distribution (73% of SRD applicants reporting family income < $50,000 vs 15% of non-SRD applicants). More SRD applicants were Black or Hispanic (26% vs 16% and 5% vs 5%), Deferred Action for Childhood Arrivals recipients (11% vs 2%), born outside the United States (32% vs 16%), and raised in a medically underserved area (60% vs 14%). There was a moderate effect for first-generation to college SRD applicants ( h = 0.61). SRD applicants had lower Medical College Admission Test scores ( d = 0.62) and overall and science grade point averages ( d = 0.50 and 0.49, respectively) but no meaningful differences in acceptance or matriculation rates. The interviews identified 5 themes: (1) unclear disadvantage definition; (2) different perceptions of disadvantage and overcoming challenges or obstacles ; (3) identification as disadvantaged or not; (4) SRD essay content; and (5) concerns about lack of transparency in how the SRD question is used in admissions. CONCLUSIONS: Revising the SRD question by including context, phrasing, and instructions for broader experience categories might be beneficial because of lack of transparency and understanding.

The USMLE® STEP 1 Pass or Fail Era of the Vascular Surgery Residency Application Process: Implications for Structural Bias and Recommendations.

United States Medical Licensing Examination® (USMLE®) STEP 1 score reporting has been changed to a binary pass/fail format since January 26, 2022. The motives behind this change were (1) the questionable validity of using USMLE STEP 1 as a screening tool during the candidate selection process and (2) the negative impact of using standardized examination scores as an initial gatekeeping threshold for the underrepresented in medicine (URiM) candidates applying to graduate medical education programs, given their generally lower mean standardized exams scores compared to non-URiM students. The USMLE administrators justified this change as a tactic to enhance the overall educational experience for all students and to increase the representation of URiM groups. Moreover, they advised the program directors (PDs) to give more attention to other important qualities and components such as the applicant's personality traits, leadership roles and other extracurricular accomplishments, as part of a holistic evaluation strategy. At this early stage, it is unclear how this change will impact Vascular Surgery Integrated residency (VSIR) programs. Several questions are outstanding, most importantly, how VSIR PDs will evaluate applicants absent the variable which heretofore was the primary screening tool. Our previously published survey showed that VSIR PDs will move their attention to other measures such as USMLE STEP 2 Clinical Knowledge (CK) and letters of recommendation during the VSIR selection process. Furthermore, more emphasis on subjective measures such as the applicant's medical school rank and extracurricular student activities is expected. Given the expected higher weight of USMLE STEP 2CK in the selection process than ever, many anticipate that medical students will dedicate more of their limited time to its preparation at the expense of both clinical and nonclinical activities. Potentially leaving less time to explore specialty pathways and to determine whether Vascular Surgeons  is the appropriate career for them. The critical juncture in the VSIR candidate evaluation paradigm presents an opportunity to thoughtfully transform the process via current (Standardized Letter of Recommendation, USMLE STEP 2CK, and clinical research) and future (Emotional Intelligence, Structure Interview and Personality Assessment) measures which constitute a framework to follow in the USMLE STEP 1 pass/fail era.

Clinical teaching in dentistry: Evaluating a clinical oral pathology rotation while looking to the future of dental education.

PURPOSE/OBJECTIVES: Clinical teaching in dentistry has cycled through specialty-based "departmental" teaching to group practice scenarios. The aims of this study were to ascertain third-year dental students' perceptions of a specialty-based rotation supplemented by online educational tools and to compare their Objective Structured Clinical Exam (OSCE) scores to those of the students in the previous year. METHODS: This retrospective research design included the analysis of OSCE scores, and student responses to survey questions regarding their perceptions of the clinical oral pathology (COP) rotation. This study was completed in 2022. It included data from 2020 to 2021 and 2021 to 2022 corresponding to input from the Classes of 2022 and 2023, respectively. The response rate was 100%. RESULTS: The students evaluated the focused COP rotation and the online teaching modules as a positive experience. The results of the OSCE were similar to those of the previous class and showed a high average score. CONCLUSIONS: This study shows that students had a positive perception to specialty-based learning with online educational tools and that it enhanced the education they received in the comprehensive care clinic. The OSCE scores were similar to those of the previous class. These findings suggest a method of maintaining high-quality dental education through challenges as it continues evolving.

Oral 'Board Style' Examination for Surgery Clerkship.

Evaluating medical students during surgical clerkships relies on multifactorial methods of evaluation. Clinical evaluations, combined with standardized multiple-choice exams, are often the foundation of evaluation highlighting the challenge of combining subjective and objective measurements. Oral board exams are standard amongst medical certification and employ an additional element to evaluate students more holistically. Course evaluations from years that incorporated an oral board exam were compared to a year that omitted the exam. We found course satisfaction was higher in the years that included the oral exam (3.25 /5) than years without the oral board exam (3/ 5). The oral exam adds a novel element to the evaluation of a medical student that allows for a comprehensive understanding of a student's fund of knowledge and helps prepare them for future board certifications. Because students have an opportunity to demonstrate knowledge in a standard, more comprehensive format, they have higher satisfaction with the course.

Transforming musculoskeletal anatomy learning with haptic surface painting.

Anatomical body painting has traditionally been utilized to support learner engagement and understanding of surface anatomy. Learners apply two-dimensional representations of surface markings directly on to the skin, based on the identification of key landmarks. Esthetically satisfying representations of musculature and viscera can also be created. However, established body painting approaches do not typically address three-dimensional spatial anatomical concepts. Haptic Surface Painting (HSP) is a novel activity, distinct from traditional body painting, and aims to develop learner spatial awareness. The HSP process is underpinned by previous work describing how a Haptico-visual observation and drawing method can support spatial, holistic, and collaborative anatomy learning. In HSP, superficial and underlying musculoskeletal and vascular structures are located haptically by palpation. Transparent colors are then immediately applied to the skin using purposive and cross-contour drawing techniques to produce corresponding visual representations of learner observation and cognition. Undergraduate students at a United Kingdom medical school (n = 7) participated in remote HSP workshops and focus groups. A phenomenological study of learner perspectives identified four themes from semantic qualitative analysis of transcripts: Three-dimensional haptico-visual exploration relating to learner spatial awareness of their own anatomy; cognitive freedom and accessibility provided by a flexible and empowering learning process; altered perspectives of anatomical detail, relationships, and clinical relevance; and delivery and context, relating to curricular integration, session format, and educator guidance. This work expands the pedagogic repertoire of anatomical body painting and has implications for anatomy educators seeking to integrate innovative, engaging, and effective learning approaches for transforming student learning.