Contribution of ethical reasoning learning sessions on medical training.

INTRODUCTION: Ethical reasoning is an important skill for all physicians who often face complex ethical dilemmas in their daily practice. Therefore, medical training should include methods for learning ethical theories and concepts, as well as how to apply them in practical situations. AIM: Assess the contribution of an Ethical Reasoning Learning session to fifth medical students' training through a comparison of results of the same objective and structured clinical examination (OSCE) in the form of simulated interview before and after sessions. METHODS: Four 45- minutes' sessions of Ethical Reasoning Learning (ERL) were implemented during a psychiatry internship for four groups of 5th-year students of the faculty of medicine of Monastir (Tunisia). Each session was divided into 7 parts: introduction, reading of a clinical vignette, brainstorming concerning the problems posed by this clinical situation, classification of the problems, identification of the principles of medical ethics, construction of the ethical matrix, and a conclusion. RESULTS: Fifty-seven students participated in the study divided into 4 groups. We found a significant difference in the means of the OSCE scores before and after the ERL session and a significant difference between the probability of respecting medical secrecy during pre and post-ethical reasoning learning sessions (p <0.001). We have found an effect of ERL sessions on the acquisition of this ethical competence by medical students. CONCLUSION: We learned that an ERL session has improved medical training in ethics applied to psychiatry. Other sessions dealing with other ethical skills are necessary to confirm these results.

Nurturing the Human Dimension in Digital and Medical Spaces Through Pedagogy of Care - a Case of Creative Enquiry.

The COVID-19 pandemic ushered in digital learning experiences to front and centre of medical education in disruptive ways. As the pandemic subsides students and educators sigh in relief, longing to move away from the loneliness and disconnection and back to the norms of face-to-face learning and consulting. In the field of medical education however, the need for digital education has exponentially increased over the decade with strong evidence for future growth. We face the pressure of increasing student numbers on clinical placement and some students now desire or even need hybrid options for the flexibility of time, place, and pace. There is persistent criticism that digital education lacks human connection. This paper argues, however, that it is possible and vital to humanise the virtual learning experience, though particular attention needs to be given to digital pedagogy and relational aspects of learning and teaching. Drawing on Noddings' pedagogies of care and her theoretical model, we unpack one case-study of a medical education elective course that transitioned online during the pandemic. The aim of this paper is to engage medical educators with the pedagogy of care and relational pedagogy literature, which are currently almost absent from the medical education literature, as applied to the digital education realm. Core themes include modelling care and connection, enabling dialogue, inviting student engagement and practice in caring for each other and supporting the deeper work of being present themselves and confirming each other. Limitations and implications for future research will also be explored.

Historical Inequities in Medical Education - Commitment to Opportunity, Diversity, and Equity at the University of Hawai'i School of Medicine.

Medical education in the US has contributed to institutionalized racism through historically exclusionary practices, which has led to health disparities and inequities in health care today. The 1910 Flexner report, which favored schools with greater resources, led to the closure of nearly half of medical schools in the Us, which were mostly small schools located in rural communities that served economically disadvantaged, ethnic minority, and female populations. Closing these schools ultimately limited the availability of physicians willing to serve disadvantaged and minority populations in impoverished and underserved communities. In order to transform medical education to be more equitable, medical schools must be proactive in opportunity, diversity, and equity efforts. This not only includes efforts in admissions and faculty hiring, but also curricula related to social and health disparities, interracial interactions between students and faculty, and service learning activities that engage and work with marginalized communities. The University of Hawai'i John A. Burns School of Medicine has a longstanding commitment to diversity, which is integral to the school's mission. Providing opportunities to underserved populations has been a priority since establishment of the school. As one of the most diverse univeristies in the US, the school of medicine continues to focus on opportunity, diversity, and equity priorities in both its strategic planning and overall mission.

The Revival of Essay-Type Questions in Medical Education: Harnessing Artificial Intelligence and Machine Learning.

OBJECTIVE: To analyse and compare the assessment and grading of human-written and machine-written formative essays. STUDY DESIGN: Quasi-experimental, qualitative cross-sectional study. Place and Duration of the Study: Department of Science of Dental Materials, Hamdard College of Medicine & Dentistry, Hamdard University, Karachi, from February to April 2023. METHODOLOGY: Ten short formative essays of final-year dental students were manually assessed and graded. These essays were then graded using ChatGPT version 3.5. The chatbot responses and prompts were recorded and matched with manually graded essays. Qualitative analysis of the chatbot responses was then performed. RESULTS: Four different prompts were given to the artificial intelligence (AI) driven platform of ChatGPT to grade the summative essays. These were the chatbot's initial responses without grading, the chatbot's response to grading against criteria, the chatbot's response to criteria-wise grading, and the chatbot's response to questions for the difference in grading. Based on the results, four innovative ways of using AI and machine learning (ML) have been proposed for medical educators: Automated grading, content analysis, plagiarism detection, and formative assessment. ChatGPT provided a comprehensive report with feedback on writing skills, as opposed to manual grading of essays. CONCLUSION: The chatbot's responses were fascinating and thought-provoking. AI and ML technologies can potentially supplement human grading in the assessment of essays. Medical educators need to embrace AI and ML technology to enhance the standards and quality of medical education, particularly when assessing long and short essay-type questions. Further empirical research and evaluation are needed to confirm their effectiveness. KEY WORDS: Machine learning, Artificial intelligence, Essays, ChatGPT, Formative assessment.

Optimizing Family Presence through Medical Education.

AbstractMany family members are wary of asking whether they can be present in the intensive care unit (ICU) while patients are receiving care. However, the opportunity to be present can be profoundly beneficial, especially to family members as they approach the grieving process. In the long run, this may decrease emotional complications such as post-traumatic stress disorder (PTSD) and complex grief. Family presence may also be profoundly important to patients, who may find comfort in the presence of their loved ones. Optimizing the needs of distressed families remains a controversial topic because it may distract physicians from providing needed medical care. Both parties may benefit maximally, however, through proactive training and early education during medical school, as this article will outline. Family members who may want to visit but are unable to be present in person may also benefit through virtual telehealth visits. Finally, we acknowledge specific cases that may pose ethically difficult dilemmas for ICU providers. Solutions that may be optimal in these situations will be suggested.

[ChatGPT for use in technology-enhanced learning in anesthesiology and emergency medicine and potential clinical application of AI language models : Between hype and reality around artificial intelligence in medical use]. / ChatGPT im Einsatz für "technology-enhanced learning" in Anästhesiologie und Notfallmedizin und potenzielle klinische Anwendung von KI­Sprachmodellen : Zwischen Hype und Wirklichkeit um künstliche Intelligenz im medizinischen Einsatz.

BACKGROUND: The utilization of AI language models in education and academia is currently a subject of research, and applications in clinical settings are also being tested. Studies conducted by various research groups have demonstrated that language models can answer questions related to medical board examinations, and there are potential applications of these models in medical education as well. RESEARCH QUESTION: This study aims to investigate the extent to which current version language models prove effective for addressing medical inquiries, their potential utility in medical education, and the challenges that still exist in the functioning of AI language models. METHOD: The program ChatGPT, based on GPT 3.5, had to answer 1025 questions from the second part (M2) of the medical board examination. The study examined whether any errors and what types of errors occurred. Additionally, the language model was asked to generate essays on the learning objectives outlined in the standard curriculum for specialist training in anesthesiology and the supplementary qualification in emergency medicine. These essays were analyzed afterwards and checked for errors and anomalies. RESULTS: The findings indicated that ChatGPT was able to correctly answer the questions with an accuracy rate exceeding 69%, even when the questions included references to visual aids. This represented an improvement in the accuracy of answering board examination questions compared to a study conducted in March; however, when it came to generating essays a high error rate was observed. DISCUSSION: Considering the current pace of ongoing improvements in AI language models, widespread clinical implementation, especially in emergency departments as well as emergency and intensive care medicine with the assistance of medical trainees, is a plausible scenario. These models can provide insights to support medical professionals in their work, without relying solely on the language model. Although the use of these models in education holds promise, it currently requires a significant amount of supervision. Due to hallucinations caused by inadequate training environments for the language model, the generated texts might deviate from the current state of scientific knowledge. Direct deployment in patient care settings without permanent physician supervision does not yet appear to be achievable at present.

Trainee advocacy for medical education on the care of people with intellectual and/or developmental disabilities: a sequential mixed methods analysis.

BACKGROUND: Medical trainees (medical students, residents, and fellows) are playing an active role in the development of new curricular initiatives; however, examinations of their advocacy efforts are rarely reported. The purpose of this study was to understand the experiences of trainees advocating for improved medical education on the care of people with intellectual and/or developmental disabilities. METHODS: In 2022-23, the authors conducted an explanatory, sequential, mixed methods study using a constructivist paradigm to analyze the experiences of trainee advocates. They used descriptive statistics to analyze quantitative data collected through surveys. Participant interviews then yielded qualitative data that they examined using team-based deductive and inductive thematic analysis. The authors applied Kern's six-step approach to curriculum development as a framework for analyzing and reporting results. RESULTS: A total of 24 participants completed the surveys, of whom 12 volunteered to be interviewed. Most survey participants were medical students who reported successful advocacy efforts despite administrative challenges. Several themes were identified that mapped to Steps 2, 4, and 5 of the Kern framework: "Utilizing Trainee Feedback" related to Needs Assessment of Targeted Learners (Kern Step 2); "Inclusion" related to Educational Strategies (Kern Step 4); and "Obstacles", "Catalysts", and "Sustainability" related to Curriculum Implementation (Kern Step 5). CONCLUSIONS: Trainee advocates are influencing the development and implementation of medical education related to the care of people with intellectual and/or developmental disabilities. Their successes are influenced by engaged mentors, patient partners, and receptive institutions and their experiences provide a novel insight into the process of trainee-driven curriculum advocacy.

Crafting medical MCQs with generative AI: A how-to guide on leveraging ChatGPT.

As medical educators grapple with the consistent demand for high-quality assessments, the integration of artificial intelligence presents a novel solution. This how-to article delves into the mechanics of employing ChatGPT for generating Multiple Choice Questions (MCQs) within the medical curriculum. Focusing on the intricacies of prompt engineering, we elucidate the steps and considerations imperative for achieving targeted, high-fidelity results. The article presents varying outcomes based on different prompt structures, highlighting the AI's adaptability in producing questions of distinct complexities. While emphasizing the transformative potential of ChatGPT, we also spotlight challenges, including the AI's occasional "hallucination", underscoring the importance of rigorous review. This guide aims to furnish educators with the know-how to integrate AI into their assessment creation process, heralding a new era in medical education tools.

Teaching prudent antibiotic use on the go: a descriptive report on development, utilization and listener satisfaction of an educational podcast format for medical students and young professionals.

BACKGROUND: An important component in fostering the responsible use of antibiotics is training of new and future prescribers in this interdisciplinary topic. Because podcasts are playing an increasing role in medical education, we aimed to develop and evaluate a podcast format with practice and guideline-oriented learning content on antibiotic therapy for medical students and young medical professionals. METHODS: We developed the concept for the podcast with the direct involvement of medical students and medical experts with teaching experience. We used video conferencing when recording the episodes in order to have quick, easy, and nationwide access to the experts involved. We released an episode every 2 to 4 weeks on the popular podcast platforms. The podcast was promoted through mailing lists, social and print media, and at conferences. The evaluation of episodes was based on user data provided by the platforms and an anonymous feedback questionnaire linked to each episode in the podcast notes. RESULTS: Between December 2021 and December 2022 19 episodes of InfectEd: der Antibiotika-Podcast were released. The mean duration of an episode was 91 min. By March 9, 2023, a total of 38,829 downloads and streams had been recorded. The majority of users listened to the podcast on a mobile device. The average playing time per episode was 65%. The feedback questionnaire was completed 135 times. 60.7% of respondents were female, 38.5% male. The majority of respondents were in their twenties and thirties (66.7%). 31.1% were medical students, 25.9% were residents, and 25.2% were specialists. Listeners were asked to rate episodes on a scale from 1 to 6, where 1 was "very good" and 6 was "insufficient." Ratings did not differ significantly between female and male respondents or between medical students and others. 118 respondents (87.4%) reported an increase in knowledge. Free-text feedback frequently emphasized clinical and also exam relevance. CONCLUSION: Our podcast format, developed with a user-centered approach, was broadly distributed and has been well accepted by both medical students and physicians alike. It provides a large number of learners with low-threshold access to current, guideline-orientated content and could be a useful supplement to conventional teaching formats.

Using Qualitative Questionnaires in Medical Education Research.

Most students in Health Profession Education courses are new to the world of qualitative research. Faced with the challenge of designing a research project, they are often drawn towards using the questionnaire as a data collection method, commonly assuming that utilising open-ended questions alone constitutes qualitative research design. Designing questionnaires that meet the standards of rigour is challenging, and this common assumption reflects inexperience with and misunderstandings of qualitative ontology, as well as the lack of methodological literature on designing and developing qualitative questionnaires. This paper is written with research supervisors as well as students in mind, as it is aimed to help elucidate the decision-making process and the justification for using a qualitative questionnaire. Drawing upon examples of research conducted by our students, and the wider literature, we demonstrate how qualitative questionnaires can produce rich and meaningful findings when they (1) prioritise qualitative research values, and (2) follow a rigorous design process when the questionnaire is developed. We conclude by offering a simple framework for developing rigorous qualitative questionnaires to those who may consider using this approach.

Launching an International Community of Practice in Hematology/Oncology Medical Education.

A community of practice (CoP) is a group of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly. While the field of hematology/oncology has historically prioritized clinical care and biomedical research, medical education has received increasing attention within hematology/oncology in recent years. In 2018, ASCO launched the Education Scholars Program to train hematology/oncology clinicians in the science of teaching and learning. However, the number of hematology/oncology educators nationally and internationally far exceeds the capacity of the Education Scholars Program to train them. In addition, hematology/oncology educators often lack sufficient mentorship and guidance at their own institutions to pursue their chosen career path effectively. To ensure high-quality clinical care and research for generations to come, attention must be paid to improving support for hematology/oncology educators. Therefore, supported by ASCO, we developed an international medical education (Med Ed) CoP for hematology/oncology educators with the purpose of providing them with support, community, mentorship, resources, and scholarly opportunities in medical education. In this article, we describe the development of the Med Ed CoP using a three-stage framework (Establish-Grow-Sustain) including successes, challenges, and reflections. By supporting the needs of hematology/oncology educators, the Med Ed CoP will serve as a home for all who contribute to the field of hematology/oncology.

Beyond the surface: unveiling gaps in medical education through eyes of diverse learners.

Inadequate education regarding disease manifestations in diverse skin colors hinders diagnosis and exacerbates health disparities. All levels of medical trainees report low confidence in accurately identifying disease in skin of color (SOC). To help further elucidate these concerns, our research aims to assess medical student confidence in recognizing cutaneous diseases in SOC and their viewpoints regarding SOC education within their institution. An eight-question, open-ended survey was provided to medical students before and after a SOC presentation. The survey assessed participants' confidence in their diagnostic ability and perspectives on educational material. Among the 70 attendees, 58 (82.8%) and 64 (91.4%) completed the pre- and post-seminar surveys, respectively. There was a significant discrepancy in confidence levels when assessing cutaneous manifestations of internal pathology in light (Monk Skin Colors 1-5) versus dark (Monk Skin Colors 6-10) skin (p < 0.009). Notably, 78.7% (37/47) perceived the institutional learning materials as insufficient for SOC. Post-seminar reflections indicated that 87.2% (40/46) of students lacked confidence in diagnosing SOC, with 78.7% (32/46) citing inadequate curriculum coverage as the cause. An additional 8.5% (6/46) identified the predominance of white-centric medical descriptions as a hindrance. Students collectively called for improved educational approaches, including better visual representation of diseases in darker skin. Medical education must continue to strive for increased SOC representation to train competent physicians in treating a diverse patient population and reduce disparities in SOC patients.

Evaluating the Integration of Patient Safety in Medical Training in Spain.

Objectives: The aim of this study was to determine the degree of integration of patient safety in the training of medical faculties at universities in Spain. Methods: A descriptive, cross-sectional study was conducted. An assessment was made of the curse syllabi of Spanish medical schools, summarizing the proportion of faculties that present each of the topics recommended in the WHO's curriculum guide. Results: Of the 49 faculties, access to the curse syllabus of the subjects for the academic year 2023-2024 was obtained from 38 (78%). Although 82% of the faculties integrated some patient safety topic, only 56% included between 1 and 3 of the 11 topics recommended by WHO. The maximum number of integrated topics was 7, and this was only achieved by 1 faculty. Conclusion: There is progress in the incorporation of fundamental concepts in patient safety, but the comprehensive implementation of all topics recommended by the WHO in Spanish medical schools is insufficient.

Physicians' emotion awareness and emotion regulation training during medical education: a systematic scoping review protocol.

INTRODUCTION: The objective of this systematic scoping review is to identify what approaches have been implemented in medical education programmes to teach medical students the skills to identify and manage emotions that may be elicited in them during physician-patient interactions and in the clinical environment. Emotions of all involved in the clinical encounter are central to the process of clinical care. However, a gap remains addressing and teaching medical students about recognising and dealing with their own emotions. METHODS AND ANALYSIS: This scoping review will follow the updated JBI (The Johanna Briggs Institute) methodology guidance for the conduct and reporting of systematic scoping reviews, and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. A search strategy was developed and applied to five databases. Terms used included medical education, medical curriculum, medical students, emotion (regulation), psychological well-being and mental health. Additionally, a grey literature and reference list search will be conducted. Two independent reviewers will first screen titles and abstracts followed by a second, full-text screening phase. Publications to be included will contain information and data about teaching approaches such as lectures, and other teaching material on physicians' emotion awareness and emotion regulation training in medical education. ETHICS AND DISSEMINATION: This study will review existing literature on emotion awareness and emotion regulation training in medical education, and a systematic scoping review does not require ethical approval. The results of this scoping review will be submitted for publication to relevant peer-reviewed journals and will be used to inform the development and implementation of training programmes and research studies aimed at preparing medical students to identify and manage their own emotions in the clinical environment.