Reflection on Five Months Rural District Hospital Posting of Final Year MBBS Students.

ABSTRACT: Patan Academy of Health Sciences has been sending its undergraduate medical students to rural postings aligning with the national health system of Nepal to produce competent and empathetic healthcare professionals as a part of its social accountability. One such rural posting is a 20-week long district posting where students are posted at district hospital and district health office. We were final-year students posted at Gulmi district for this purpose in the year 2021/22. We learned the functioning of a district hospital along with different clinical skills. We also learned to use the district health information system and different qualitative tools in drafting district health reports and strategic planning under the guidance of the District Health Office. Such exposure of medical students is essential to develop competent and empathetic health professionals and similar provisions should be included in the undergraduate curriculum of other universities.

Beyond The Books: Role of Extracurricular Activities In Medical Students.

ABSTRACT: Extracurricular activities (ECAs) in the field of medicine can be research related and non-research related activities that allows students to develop skills to be a good doctor in the future. Building a curriculum vitae, becoming a team player, managing stress, building good communication skills and good academics highlights the value of extracurricular activities. Challenges like time constraints, and resource limitation hinders the participation which needs to be addressed to encourage the medical students to take part in extracurricular activities.

Attitude and Perception of Preclinical Undergraduate Medical Students about Problem Based Learning in Medical College of Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Problem-based learning is a student-centered learning method. Assessing students' understanding, settled way of thinking and interpretation towards problem-based learning is essential. The objective of the study was to understand the attitude and perception of preclinicalM.B.B.S. students about problem-based learning. METHODS: A descriptive cross-sectional study was conducted from July 5, 2023 to September 4, 2023 for the duration of two months after duly approval from Institutional Review Committee (Protocol No: IRC-LMC-04/Q-23). First and second year M.B.B.S. students who had good experience of attending problem-based learning sessions in integrated basic science subjects were included in the study. Fifteen close-ended questions related to attitude and perceptions were designed in Google Form. The responses were taken on five point Likert scale ranging from strongly disagree (1), disagree (2), neutral (3), agree (4), and strongly agree (5). Data were expressed as frequency and percentage. RESULTS: Among 164 participants, 92 (56.09%) strongly agreed and 67 (40.87%) agreed that problem based learning enhances self-directed learning on the topic. Similarly, 103 (62.80%) strongly agreed and 59 (35.98%) agreed that problem based learning improves communication skills. Likewise, 78(47.57%) agreed and 53 (32.32%) strongly agreed that this learning method improves confidence in decision-making. Moreover, 89 (54.28%) agreed and 58 (35.36%) strongly agreed that tutors motivate students to learn themselves through problem based learning. CONCLUSIONS: Majority of the students have positive attitude and good perception towards problem based learning. This method helps in generating skills like communication skills, group discussion, constructive critical reasoning, decision-making.

Lived experiences of medical students of online learning: lessons for adopting virtual learning in medical education.

BACKGROUND: The COVID 19 lockdown created a shift in medical education from the traditional physical classroom to online learning. OBJECTIVES: To explore the lived experiences of students in various years of medical education attending a medical college in Chennai, India. METHODS: In this qualitative exploration of lived experiences we conducted 4 focus group discussions among students of the four years in the medical college with the help of a checklist. We recorded the interviews, transcribed them and performed a thematic content analysis. RESULTS: There was a gendered impact of the lockdown on the online learning experiences with women students finding it challenging to attend classes balancing their gender roles of performing household chores. Online learning offered some advantages in the form of increased participation and engagement due to the partial anonymity. The greatest disadvantage of online learning was lack of clinical learning experience. The students resorted to fabricating case studies for discussion, which some students found useful and some commented that it can never replace real life clinical discussions. A generational gap between adoption of technology between the senior professors and the students hampered the online learning. Online assessments were challenging, and many students resorted to cheating in these exams. CONCLUSIONS: Though online learning offers several advantages, it has serious limitations in offering the clinical learning experience. While planning adoption of online learning into routine medical education adequate time must be set aside for real life clinical exposure in addition to the online lectures and demonstrations for conceptual understanding.

An e-learning platform for clinical reasoning in cardiovascular diseases: a study reporting on learner and tutor satisfaction.

BACKGROUND: Medical students gain essential skills through hospital training and internships, which complement their theoretical education. However, virtual patient platforms have been shown to effectively promote clinical reasoning and enhance learning outcomes. This study evaluates a web-based platform designed for learning clinical reasoning in cardiovascular diseases, detailing its functionalities and user satisfaction. METHODS: The Virtual Patient platform presents medical students with clinically valid scenarios, encompassing stages such as patient description, anamnesis, objective examination, presumptive diagnosis, health investigations, treatment planning, complications, differential and final diagnoses, and prognosis. Scenarios are generated either automatically or manually by professors, based on labeled and annotated clinical data. The Virtual Patient contains two types of medical cases: simple scenarios describing patients with one pathology, and complex scenarios describing patients with several related pathologies. The platform was evaluated by a total of 210 users: 178 medical students, 7 professors, and 25 engineering students, using questionnaires adjusted for each evaluation round to assess satisfaction and gather feedback. The evaluation by medical students was performed in four rounds, each round corresponding to successive enhancements of the platform functionalities and addition of new cases, with a total number of 1,098 evaluation sessions. RESULTS: The platform was evaluated at different implementation stages, involving simple and complex scenarios for various heart diseases. The majority of students found the platform very useful (82.58%), with significant appreciation for its features and functionalities, for example the dialogue module supporting natural language interactions in Romanian and English or the feed-back obtained during interaction. Professors highly valued the platform's flexibility in scenario generation, real-time feedback provision, and data management capabilities. They appreciated the possibility to provide feedback and score student performance in real-time or after the session, though some professors suggested improving the explainability of the scores. CONCLUSIONS: The Virtual Patient platform enables medical students to virtually replicate hospital interactions, diagnose patients, and plan treatments in clinically valid scenarios for cardiovascular diseases. User evaluations demonstrated high satisfaction and appreciation for the platform's features. Future work will focus on expanding medical cases, enhancing the dialogue module, improving scenario generation for complex cases, and extending the synthetic data generation component to produce additional types of medical investigations.

Does lecture playback speed not affect memory and concentration in medical students?

Merhavy et al.'s study on the impact of lecture playback speeds on concentration and memory is valuable as it is one of the few studies on how different playback speeds may affect medical students' learning. However, despite the novelty of this study, some limitations concerning its methodological rigor, including statistical analyses, lack of evaluation of confounders, unclear characteristics of participants, and lack of a true control group, need to be considered in the interpretation of findings.

Immersive medical training: a comprehensive longitudinal study of extended reality in emergency scenarios for large student groups.

Young healthcare professionals and medical graduates often fall short in the practical experience necessary for handling medical emergencies. This can not only lead to strained feelings of inadequacy and insecurity among future physicians and less experienced healthcare providers in general, but also to detrimental outcomes for patients as emergency medicine demands rapid decision-making with low tolerance for errors. New didactic modalities and approaches may be needed to effectively address this shortcoming. Immersive technologies are powerful novel educational tools with untapped potential in medical training, and may be particularly suitable for simulation trainings in the high-stakes field of emergency medicine.Herein, we systematically explored the educational potential of extended reality (XR) technology, particularly virtual reality (VR), in the management of patients presenting as medical emergencies, combining the use of the STEP-VR application with an untethered hardware setup.Importantly, we aimed at studying multiple, large cohorts of senior medical students involving a total of 529 participants and collecting data over a period of two years. We assessed students' acceptance of the training through a modified questionnaire measuring device handling, content complexity, degree of immersion, learning success, and seminar design.Our results show high, sustained acceptance and ease of use across different student cohorts and subgroups, with most students finding XR/VR engaging and beneficial for acquiring emergency medicine skills. Importantly, the prevalence of simulation sickness was minimal. Moreover, no major effect of the head-mounted displays (HMDs) price range was noted with regard to the learning experience. The results underscore the potential of XR/VR capabilities in effectively enhancing medical education, particularly in areas of high-stakes clinical scenarios and emergency care, by providing realistic and reproducible immersive training environments.In summary, our findings suggest that XR/VR-based training approaches could significantly contribute to preparing future physicians for the complexities of emergency medical care, encouraging the integration of such technologies into medical curricula. However, careful consideration must be given to its suitability for all students and the practical challenges of its implementation, highlighting the need for further research to harness its full potential for medical education.

Unfolding the empathic insights and tendencies among medical students of two gulf institutions using interpersonal reactivity index.

BACKGROUND: Empathy is an essential core competency for future doctors. Unfortunately, the medical curriculum is infamously known to burn out aspiring doctors, which may potentially lead to a decline in empathy among medical students. This research was planned to understand the evolution of empathic approaches among students across the curriculum using the Interpersonal reactivity index (IRI) as a benchmark at the Royal College of Surgeons in Ireland - Medical University of Bahrain (RCSI-MUB) and University of Sharjah (UoS). METHODS: We adopted a cross-sectional design and administered an online survey to the medical students of RCSI-MUB and UoS using a modified version of the IRI along with its three subscales of empathic concern (EC), perspective taking (PT), and personal distress (PD). To identify intra- and inter-institutional variations in empathy scores, the Analysis of Variance (ANOVA) was performed separately for each institution and with both institutions combined. A two-way ANOVA was conducted for the comparison between years and institutions. For the subscale analysis of EC, PT, and PD, we used one-way ANOVA for significant differences between years at both institutions. For the gender-effect analysis, t-test was performed to examine the differences in total IRI scores at both institutions combined and at each institution separately. Additionally, an Analysis of Covariance (ANCOVA) was done to identify the influence of gender on empathy scores. RESULTS: A total of 140 students from both institutions participated in this study. We found a fluctuating pattern of empathy scores without a clear trend across the years. The sub-scales of EC, PD, and PT across academic years at both institutions showed significant differences within the EC at RCSI-MUB (p = 0.003). No significant differences were identified across other years from both institutions. There were significant differences between empathy scores from RCSI-MUB and UoS for EC (p = 0.011). Additionally, a pronounced interaction effect between year and institution was observed for PT (p = 0.032). The gender-wise analysis showed that female students had higher empathy scores than males (p = 0.004). The ANCOVA for IRI score results revealed a p-value of 0.023, indicating that gender plays a crucial role in empathy levels among medical students. The ANCOVA results revealed a p-value of 0.022 in the EC subscale. CONCLUSION: Our study unveiled intricate patterns in empathy development among medical students across years and genders at RCSI-MUB and UoS. These congruences and dissimilarities in empathy scores signal a subjective understanding of empathy by medical students. The disparities in understanding may encourage medical educators to embed empathy in standard medical curricula for better healthcare outcomes.

Impact of Teaching Methods on Clinical Reasoning in Forensic Medicine: A Quasi-Experimental Study.

OBJECTIVE: To compare the effectiveness of flipped classroom and video-assisted learning techniques with didactic lectures in promoting clinical reasoning skills in Forensic Medicine. STUDY DESIGN: Quasi-experimental study. Place and Duration of the Study: Department of Forensic Medicine, Dow International Medical College and Dow University of Health Sciences, Karachi, Pakistan, from May to October 2023. METHODOLOGY: The study included 114 third-year medical students divided into three predefined tutorial groups. Over four weeks, within the Forensic Medicine respiratory module, each group was taught one topic per week using a distinct teaching strategy: Traditional lectures (TL) for the first group, flipped classroom (FC) method for the second group, and video-assisted teaching (VAT) for the third group. Students' learning achievements and clinical reasoning skills were assessed through a pre-test, post-test, and revision post-test. RESULTS: Pre-test scores showed no significant differences among the groups (p = 0.655). However, post-test scores differed significantly (F2:111 = 11.93, p <0.001). Tukiye's test indicated that the mean score for the FC group was significantly different from the TL group (p = 0.003) and the VAT group (p <0.001), but there was no significant difference between the TL and VAT groups (p = 0.422). The revision post-test indicated a significant decrease in mean scores across all groups, regardless of the instructional approach (p <0.001). CONCLUSION: The FC approach for teaching clinical reasoning in Forensic Medicine shows promising results, effectively improving student performance and learning experience. KEY WORDS: Flipped classroom, Video-assisted teaching, Clinical reasoning, Forensic Medicine teaching.

Knowledge and Skill Retention in First-Year MBBS Students After Basic Life Support Training: A One-Year Longitudinal Study.

BACKGROUND: The Indian National Medical Council has incorporated the Basic Life Support (BLS) course in the foundation course of the undergraduate (MBBS) medical curriculum. However, medical teachers raise concerns about how training would affect the retention of Basic Life Support (BLS) abilities in the longer run. So, the current study assesses the knowledge and retention of BLS skills among first-year MBBS students over one year. METHODS: We included one hundred first-year MBBS students in our study who were trained for BLS, including theory, demonstrations and hands-on training using mannequins. Theoretical knowledge was assessed using pre-test and post-test questionnaires. At the same time, the skills were evaluated using Directly Observed Procedural Skills (DOPS) scores before, just after the training session, and again after one month, six months, and one year. Course feedback was also taken from the students after completing the sessions. RESULTS: There was a statistically significant difference between pre-and post-test knowledge scores, indicating that training improved their knowledge. (p < 0.001) There was also a statistically significant difference between pre-and post-test skills using DOPS (p < 0.001). There was no significant difference in the score when DOPS was conducted at one month, but a significant decrease in their skills was seen at six months and one year when compared with the Post Skill Score. (P < 0.001) CONCLUSIONS: The first-year medical students' knowledge and skills were enhanced by BLS training coupled with practical sessions. Such waning skills necessitate repeating the training at periodic intervals to reinform retention of skills acquired during BLS training.

Study preferences and exam outcomes in medical education: insights from renal physiology.

BACKGROUND: Efficient learning strategies and resource utilization are critical in medical education, especially for complex subjects like renal physiology. This is increasingly important given the rise in chronic renal diseases and the decline in nephrology fellowships. However, the correlations between study time, perceived utility of learning resources, and academic performance are not well-explored, which led to this study. METHODS: A cross-sectional survey was conducted with second-year medical students at the University of Bergen, Norway, to assess their preferred learning resources and study time dedicated to renal physiology. Responses were correlated with end-of-term exam scores. RESULTS: The study revealed no significant correlation between time spent studying and overall academic performance, highlighting the importance of study quality over quantity. Preferences for active learning resources, such as Team-Based Learning, interactive lessons and formative assignments, were positively correlated with better academic performance. A notable correlation was found between students' valuation of teachers' professional competence and their total academic scores. Conversely, perceived difficulty across the curriculum and reliance on self-found online resources in renal physiology correlated negatively with academic performance. 'The Renal Pod', a locally produced renal physiology podcast, was popular across grades. Interestingly, students who listened to all episodes once achieved higher exam scores compared to those who listened to only some episodes, reflecting a strategic approach to podcast use. Textbooks, while less popular, did not correlate with higher exam scores. Despite the specific focus on renal physiology, learning preferences are systematically correlated with broader academic outcomes, reflecting the interconnected nature of medical education. CONCLUSION: The study suggests that the quality and strategic approaches to learning significantly impact academic performance. Successful learners tend to be proactive, engaged, and strategic, valuing expert instruction and active participation. These findings support the integration of student-activating teaching methods and assignments that reward deep learning.

A combination of case-based learning with flipped classroom improved performance of medical students in nephrology bedside teaching.

BACKGROUND: Bedside teaching remains a challenging endeavor for clinical doctors and medical students, as the students often encounter difficulties in applying their knowledge to clinical situations. This study aims to evaluate the efficacy of combining case-based learning (CBL) with a flipped classroom (FC) approach in nephrology bedside teaching. METHODS: A total of 92 medical students were enrolled in this study, including clerks and interns. The students were assigned into two groups. The CBL/FC group students received the combined teaching approach of CBL and FC (CBL/FC). Students who received the traditional lecture-based teaching (LBT) approach were treated as the control group. General knowledge tests, clinical case scenarios, and questionnaires were used to evaluate the teaching efficacy. RESULTS: Ninety-two students were included in this study. Overall, 46 students were assigned to the CBL/FC group, while the other 46 students were assigned to the LBT group. The students in both groups showed comparable performance in the knowledge test. However, in clinical case scenarios, students in the CBL/FC group demonstrated superior performance compared to those in the LBT group. Additionally, the analysis of questionnaires revealed that the CBL/FC group students expressed more positive attitudes toward their proficiency in medical history taking, physical examination, medical record documentation, clinical reasoning, and consideration for patients' welfare. Moreover, the students from the CBL/FC group regarded the CBL/FC teaching approach as an effective and satisfying method without increasing the learning burden. CONCLUSION: This study reveals that the CBL/FC combined teaching approach shows promise in nephrology education and provides an effective and alternative format for medical teaching.

Breaking bad news: an active learning method for medical students.

BACKGROUND: Breaking bad news is one of the most difficult aspects of communication in medicine. The objective of this study was to assess the relevance of a novel active learning course on breaking bad news for fifth-year students. METHODS: Students were divided into two groups: Group 1, the intervention group, participated in a multidisciplinary formative discussion workshop on breaking bad news with videos, discussions with a pluri-professional team, and concluding with the development of a guide on good practice in breaking bad news through collective intelligence; Group 2, the control group, received no additional training besides conventional university course. The relevance of discussion-group-based active training was assessed in a summative objective structured clinical examination (OSCE) station particularly through the students' communication skills. RESULTS: Thirty-one students were included: 17 in Group 1 and 14 in Group 2. The mean (range) score in the OSCE was significantly higher in Group 1 than in Group 2 (10.49 out of 15 (7; 13) vs. 7.80 (4.75; 12.5), respectively; p = 0.0007). The proportion of students assessed by the evaluator to have received additional training in breaking bad news was 88.2% (15 of the 17) in Group 1 and 21.4% (3 of the 14) in Group 2 (p = 0.001). The intergroup differences in the Rosenberg Self-Esteem Scale and Jefferson Scale of Empathy scores were not significant, and both scores were not correlated with the students' self-assessed score for success in the OSCE. CONCLUSION: Compared to the conventional course, this new active learning method for breaking bad news was associated with a significantly higher score in a summative OSCE. A longer-term validation study is needed to confirm these exploratory data.

When medical students are autonomously motivated to mentor: a pilot study on confidence in clinical teaching and psychological well-being.

Introduction: Near peer mentorship (NPM) programs can help support medical students' well-being. Most studies, however, have not accounted for students' underlying motives to mentor, nor focused on clinical skills development and teaching. These limitations represent opportunities to better understand what motivates medical student mentors, and how to support their autonomous motivation, clinical development, and well-being. Methods: Informed by self-determination theory (SDT), we collected data from a group of medical student mentors involved in a NPM program at the University of Saskatchewan called PULSE. We then used correlation and regression to assess the relationship between students' autonomous motivation towards mentoring, perceived competence in teaching the clinical material, and psychological well-being. Results: In line with our hypotheses, autonomous motivation towards mentoring (identified motivation in particular) was associated with higher perceived competence in clinical teaching, which in turn was associated with greater psychological well-being. Conclusions: Why medical students choose to mentor in NPM programs appears to have important implications for their clinical confidence and overall well-being. Findings are discussed in terms of designing NPM programs that support student growth and wellness in Canadian medical education.

Introduction: Les programmes de mentorat par les pairs peuvent contribuer au bien-être des étudiants en médecine. Cependant, la plupart des études n'ont pas pris en compte les motivations sous-jacentes des étudiants à devenir mentor, ni ne se sont concentrées sur le développement des compétences cliniques et l'enseignement. Ces limites ouvrent des perspectives pour mieux comprendre ce qui motive les étudiants en médecine mentors, et comment soutenir leur motivation autonome, leur développement clinique et leur bien-être. Méthodes: En nous appuyant sur la théorie de l'autodétermination, nous avons recueilli des données auprès d'un groupe d'étudiants en médecine mentors participant à un programme de mentorat par les pairs à l'Université de la Saskatchewan appelé PULSE. Nous avons ensuite eu recours à la corrélation et la régression pour évaluer la relation entre la motivation autonome des étudiants envers le mentorat, leur perception de leur compétence dans l'enseignement clinique et leur bien-être psychologique. Résultats: Conformément à nos hypothèses, la motivation autonome envers le mentorat (la motivation identifiée en particulier) a été associée à une plus grande compétence perçue dans l'enseignement clinique, qui à son tour a été associée à un plus grand bien-être psychologique. Conclusions: Les raisons pour lesquelles les étudiants en médecine choisissent d'être mentors dans les programmes de mentorat par les pairs semblent avoir des implications importantes pour leur confiance en clinique et leur bien-être général. Les résultats sont discutés en termes de conception de programmes de mentorat par les pairs qui soutiennent la progression et le bien-être des étudiants dans le secteur de l'enseignement de la médecine au Canada.

Thriving Together: a novel workshop to improve cohesion and class culture in medical school cohorts.

Thriving Together, a workshop for first year medical students, addresses crucial aspects of class culture early into medical school. Through small group discussions, this student-led event creates a safe space for open dialogue and self-reflection. Participants gain valuable insights into classmates' perspectives and how to foster communication, empathy, and improved class cultures. These lessons are likely to transfer into future practice through enhanced conflict-resolution and relationship-building skills, contributing to higher-quality patient care. Because Thriving Together can readily be adopted elsewhere, we encourage other medical schools to conduct similar workshops to help in addressing an otherwise neglected aspect of medical education.

S'épanouir ensemble, un atelier destiné aux étudiants en première année de médecine, aborde les aspects cruciaux de la culture de classe dès le début des études de médecine. Grâce à des discussions en petits groupes, cet événement organisé par les étudiants crée un espace sûr pour un dialogue ouvert et une auto-réflexion. Les participants acquièrent des connaissances précieuses sur les perspectives de leurs camarades de classe et sur la manière de favoriser la communication, l'empathie et l'amélioration de la culture de classe. Ces leçons sont susceptibles d'être transférées dans la pratique future grâce à l'amélioration des compétences en matière de résolution des conflits et d'établissement de relations, contribuant ainsi à des soins de meilleure qualité pour les patients. Comme S'épanouir ensemble peut facilement être adopté ailleurs, nous encourageons d'autres facultés de médecine à organiser des ateliers similaires pour aider à aborder un aspect autrement négligé de l'enseignement médical.

Practice makes perfect: the development of a medical student-led crowdsourced question bank for self-study in undergraduate medical education.

The development of multiple-choice questions (MCQs) for undergraduate medical education study purposes is resource intensive. Commercially available question banks are typically expensive, only available in English, and may not be aligned with medical school learning objectives. Here, we introduce The Ottawa Question Bank: a student-led, bilingual study resource curated to a Canadian undergraduate medicine curriculum (www.theottawaquestionbank.ca). In total, 205 medical students wrote and edited 4438 original MCQs linked to objectives from the University of Ottawa undergraduate medical education curriculum. The project has received positive feedback from both developers and users. Our experience suggests that involving medical students in MCQ development is feasible and can result in the rapid creation of a low-cost, high-quality study resource curated to a program's learning objectives. The platform outlined here can be used as a model for other medical schools and professional degree programs to develop their own question banks, including pharmacy, dentistry, nursing, and physiotherapy. Interested programs are encouraged to contact our team for collaborative opportunities.

L'élaboration de questions à choix multiples (QCM) dans le cadre de l'enseignement médical de premier cycle exige beaucoup de ressources. Les banques de questions disponibles dans le commerce sont généralement coûteuses, disponibles uniquement en anglais et ne correspondre pas forcément aux objectifs d'apprentissage des facultés de médecine. Nous présentons ici la Banque de questions d'Ottawa : une ressource d'étude bilingue dirigée par des étudiants et adaptée à un programme d'études de médecine de premier cycle au Canada (www.theottawaquestionbank.ca). Au total, 205 étudiants en médecine ont rédigé et édité 4438 QCM originaux liés aux objectifs du programme d'enseignement médical de premier cycle de l'Université d'Ottawa. Le projet a reçu des commentaires positifs de la part des développeurs et des utilisateurs. Notre expérience suggère qu'il est possible d'impliquer des étudiants en médecine dans le développement de QCM et de créer rapidement une ressource d'étude peu coûteuse et de haute qualité, adaptée aux objectifs d'apprentissage d'un programme. La plateforme décrite ici peut servir de modèle à d'autres facultés de médecine et programmes professionnels pour développer leurs propres banques de questions, y compris la pharmacie, l'odontologie, les soins infirmiers et la physiothérapie. Les programmes intéressés sont encouragés à contacter notre équipe pour des opportunités de collaboration.

The state of wellbeing education across North American medical schools: a scoping review.

Background/Objective: Medical students experience increased rates of burnout and mental illness compared to the general population. Yet, it is unclear to what extent North American medical schools have adopted formal wellbeing curricula. We sought to establish prevailing themes of existing wellbeing educational interventions to identify opportunities for further curricular development. Methods: We conducted a scoping review of the literature to identify wellbeing education programs implemented for undergraduate medical students across North America. We searched four comprehensive databases and grey literature and only included published original research. Two independent researchers screened all papers, with a third resolving disagreements. Two researchers conducted the data extraction using a continuously refined template, with a third researcher resolving any discrepancies. Results: We identified 3996 articles in the initial search of which 30 met inclusion criteria and were included for further analysis. The most common types of interventions were mindfulness and meditation practices. 27 studies found that their wellbeing sessions contributed to positive wellbeing outcomes of learners. Conclusions: Our review identified that there are few wellbeing curricular initiatives that have been evaluated and published in the literature. Additionally, the methodology and rigour of wellbeing curriculum evaluation to date leaves significant room for improvement. The existing literature does suggest that the adoption of a wellbeing curriculum has the potential to improve outcomes for medical students. These findings can be used to assist the development of a validated wellbeing curricular framework for wellbeing initiatives. However, while such a curriculum may represent an effective tool in enhancing medical trainee wellbeing, it cannot effect change in isolation; lasting and meaningful change will require concurrent shifts within the broader systemic framework and cultural fabric of the medical education system.

Contexte/Objectif: Les étudiants en médecine connaissent des taux plus élevés d'épuisement professionnel et de maladie mentale que la population générale. Pourtant, on ne sait pas exactement dans quelle mesure les facultés de médecine nord-américaines ont adopté un curriculum formel sur le bien-être. Nous avons cherché à établir les thèmes dominants des interventions éducatives existantes en matière de bien-être afin d'identifier les possibilités de développement curriculaire. Méthodes: Nous avons procédé à un examen approfondi de la littérature à la recherche de programmes de formation en matière de bien-être mis en œuvre pour les étudiants en médecine de niveau prédoctoral en Amérique du Nord. Nous avons interrogé quatre bases de données exhaustives et la littérature grise et n'avons retenu que les recherches originales publiées. Deux chercheurs indépendants ont examiné tous les articles, un troisième étant chargé de résoudre les éventuels désaccords. Deux chercheurs ont procédé à l'extraction des données en suivant un modèle prédéterminé qui a été affiné de façon itérative, un troisième chercheur étant chargé de résoudre les éventuelles divergences. Résultats: Nous avons identifié 3996 articles lors de la recherche initiale, dont 30 répondaient aux critères d'inclusion et ont été retenus pour une analyse plus approfondie. Les types d'interventions les plus courants étaient les pratiques de pleine conscience et de méditation. Au total, 27 études ont montré que leurs sessions de bien-être contribuaient à des résultats positifs quant au bien-être des apprenants. Conclusions: Notre revue de la littérature actuelle a révélé que peu d'initiatives curriculaires en matière de bien-être ont été évaluées et publiées dans la littérature. En outre, la méthodologie et la rigueur de l'évaluation des curriculum sur le bien-être à ce jour laissent une grande place à l'amélioration. La littérature existante suggère que l'adoption d'un curriculum sur le bien-être peut améliorer les résultats des étudiants en médecine. Ces résultats peuvent être utilisés pour aider au développement d'un cadre validé de curriculum sur le bien-être pour les initiatives dans ce domaine.

Sexual and gender minority health: a roadmap for developing evidence-based medical school curricula.

Background: Educating future physicians about sexual and gender minority (SGM) patients and their health care needs is an important way to mitigate discrimination and health disparities faced by this community. Canada, across its 17 medical schools, lacks a national standard for teaching this essential topic. This paper aims to review the best practices for teaching an SGM curriculum in undergraduate medical education and synthesize this information into actionable propositions for curriculum development. Methods: A scoping literature review was conducted to identify best practices for SGM teaching. The review elicited peer-reviewed and grey literature on best practices for SGM teaching, policy documents, and opinion pieces from medical education authorities and SGM advocacy groups. Through an iterative process with all authors, the Canadian Queer Medical Students Association (CQMSA), and the Association of Faculties of Medicine of Canada (AFMC), a set of propositions was developed. Results: The search yielded 1347 papers, of which 89 were kept for data extraction. The main outcomes of these papers were sorted along five repeating themes, which formed the basis for six propositions; two more propositions were then added after discussion with all authors. Conclusion: We present eight propositions for the development of a national standard for SGM education at the undergraduate medical level. These include standardizing learning objectives across all schools, using established curricular models to guide curriculum development, interweaving concepts across all levels of training, diversifying teaching modalities, providing faculty training, ensuring a safe space for SGM students and faculty, using OSCEs as a teaching tool, and involving the local SGM community in curriculum development and delivery.

Introduction: La formation des futurs médecins sur les patients issus des minorités sexuelles et de genre (MSG) et sur leurs besoins en matière de soins de santé est un moyen important d'atténuer la discrimination et les disparités en matière de santé auxquelles est confrontée cette communauté. Le Canada, avec ses 17 écoles de médecine, ne dispose pas d'une norme nationale pour l'enseignement de ce sujet essentiel dans l'ensemble de ses 17 écoles de médecine. Cet article vise à passer en revue les meilleures pratiques pour l'enseignement d'un programme SGM dans la formation médicale de premier cycle et à synthétiser ces informations sous forme de propositions concrètes pour le développement d'un programme d'études. Méthodes: Un examen de la portée de la littérature a été mené pour identifier les meilleures pratiques en matière d'enseignement en SCMSG. L'étude a permis d'obtenir de la documentation évaluée par des pairs et de la documentation grise, des documents de politique et des articles d'opinion provenant des autorités en matière d'éducation médicale et des groupes de défense de la SCMSG. Un ensemble de lignes directrices a été élaboré dans le cadre d'un processus itératif auquel ont participé tous les auteurs, l'Association des étudiant•es 2ELGBTQ+ en médecine (ACÉQM) et l'Association des facultés de médecine du Canada (AFMC). Résultats: La recherche a trouvé 1 347 articles, dont 89 ont été retenus pour l'extraction des données. Les principaux résultats des articles ont été classés selon cinq thèmes récurrents, qui ont servi de base à six recommandations ; deux autres recommandations ont ensuite été ajoutées après discussion entre les auteurs. Conclusion: Nous présentons huit propositions pour le développement d'une norme nationale pour l'enseignement de la SCMSG au sein des programmes de premier cycle de médecine. Il s'agit notamment de normaliser les objectifs d'apprentissage dans toutes les facultés, d'utiliser des modèles établis pour guider l'élaboration des programmes, d'imbriquer les concepts à tous les niveaux de la formation, de diversifier les modalités d'enseignement, d'assurer la formation du corps enseignant, de garantir un espace sûr pour les étudiants et le corps enseignant, d'utiliser les ECOS comme outil d'enseignement et d'impliquer la communauté 2ELGBTQ+ locale dans l'élaboration et la mise en œuvre des programmes d'enseignement.

Changing the Approach in Supporting and Advancing Underrepresented in Medicine (UIM) Medical Students.

Introduction: Research has shown the importance of diversity in improving patient care. Medical students from backgrounds underrepresented in medicine (UIM) face unique challenges, including minority tax, stereotype threat, and expectations to be the sole representative of their identity group. Mentors must be aware of these challenges and develop skills to address them. Methods: We designed a 90-minute workshop about the challenges UIM students encounter in medical school and best practices in mentorship. Target audience and facilitators were undergraduate medical educators. Three videos and questions for case-based facilitated small-group discussion with medical school faculty and administrators were included. Using a retrospective pre-post design, we elicited participants' confidence level in recognizing and addressing issues UIM students may experience and plans to apply skills gained in the workshop. Results: Workshop participants (N = 57) reported a mean increase in confidence rating of 20-26 points out of 100 for recognizing, identifying, and applying skills related to optimal UIM mentorship (mean confidence: 53-60 preworkshop, 79-81 postworkshop). Participants also reported a mean of 82 in readiness to apply skills learned. Participants rated the workshop a 4.6 in overall helpfulness on a 5-point Likert scale (1 = not helpful, 5 = extremely helpful). Discussion: Health care professionals working with UIM medical students have an essential role in mentorship and support. This workshop provides a structured forum to discuss challenges and build awareness, comfort, and skills regarding engaging in meaningful discussions about race and the experiences of medical students, even when identities are incongruent.

Enhancing Medical Interview Skills Through AI-Simulated Patient Interactions: Nonrandomized Controlled Trial.

BACKGROUND: Medical interviewing is a critical skill in clinical practice, yet opportunities for practical training are limited in Japanese medical schools, necessitating urgent measures. Given advancements in artificial intelligence (AI) technology, its application in the medical field is expanding. However, reports on its application in medical interviews in medical education are scarce. OBJECTIVE: This study aimed to investigate whether medical students' interview skills could be improved by engaging with AI-simulated patients using large language models, including the provision of feedback. METHODS: This nonrandomized controlled trial was conducted with fourth-year medical students in Japan. A simulation program using large language models was provided to 35 students in the intervention group in 2023, while 110 students from 2022 who did not participate in the intervention were selected as the control group. The primary outcome was the score on the Pre-Clinical Clerkship Objective Structured Clinical Examination (pre-CC OSCE), a national standardized clinical skills examination, in medical interviewing. Secondary outcomes included surveys such as the Simulation-Based Training Quality Assurance Tool (SBT-QA10), administered at the start and end of the study. RESULTS: The AI intervention group showed significantly higher scores on medical interviews than the control group (AI group vs control group: mean 28.1, SD 1.6 vs 27.1, SD 2.2; P=.01). There was a trend of inverse correlation between the SBT-QA10 and pre-CC OSCE scores (regression coefficient -2.0 to -2.1). No significant safety concerns were observed. CONCLUSIONS: Education through medical interviews using AI-simulated patients has demonstrated safety and a certain level of educational effectiveness. However, at present, the educational effects of this platform on nonverbal communication skills are limited, suggesting that it should be used as a supplementary tool to traditional simulation education.