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Case-based learning (CBL) is a student-centered pedagogy where medical students are given a real-world clinical problem. At St George's University of London (SGUL), anatomy academics can volunteer to facilitate CBL sessions for pre-clinical undergraduate medical students. The major benefits of facilitating CBL sessions from the perspective of a non-medically qualified early career anatomy academic (ECAA) include exposure to clinical cases that help the academic develop an understanding over key clinical cases at the context of clinical anatomy and other disciplines including physiology, pathology, and pharmacology. Furthermore, facilitating CBL sessions assists in the acquisition of basic knowledge over history taking, the conduction of clinical examinations, the investigations performed for the diagnosis of a condition as well as how it is managed. The major benefits of facilitating CBL sessions from the perspective of a medically qualified ECAA include staying in touch with the clinical aspect of medicine and becoming familiar with the country's healthcare system and its professional standards. Perceived benefits shared by both the non-medically and medically qualified ECAA include the opportunity to become familiar with the structure and key elements of the pre-clinical medical curriculum as well as gain experience in facilitating small group teaching sessions. Overall, facilitating CBL sessions can help non-medically and medically qualified ECAAs in different contexts that may help them with their individual career goals, can encourage collaborative discussions between clinical and non-clinical anatomy academics as well as help bridge the gap between the anatomy teaching approaches employed by non-medically qualified and medically qualified anatomy academics.
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Introduction: Resident physicians frequently experience bias at work, with patients and families often being the source. Women and other trainees underrepresented in medicine are disproportionately impacted by these negative experiences, and experiencing bias contributes to resident physician burnout. Unfortunately, many resident physicians feel inadequately prepared to respond to bias. Methods: We developed a 45-minute, peer-led, case-based workshop that equipped trainees with tools to respond to patient-expressed bias. Our toolkit centered on resident physicians by including an assessment of the trainee's emotional well-being, a team-based response, and an embedded debrief. The toolkit provided resident physicians with possible responses to bias directed towards themselves (bias-towards-self) or bias directed towards others (bias-towards-others). Surveys were administered pre- and postworkshop to assess change in participants' comfort in responding to patient-expressed bias. Results: Thirty-seven residents completed both surveys. The workshop significantly increased comfort in responding to bias-towards-self (p < .001; 95% CI, 1.00-1.50) and bias-towards-others (p < .001; 95% CI, 1.00-1.50). Discussion: We improved resident physicians' comfort responding to patient bias-towards-self and bias-towards-others through a toolkit and workshop designed specifically for trainees. The toolkit centers the resident physician perspective, incorporates clinical context, and embeds a debrief. Our novel approach situates the toolkit's teaching in a highly scalable, case-based workshop.
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Internato e Residência , Humanos , Internato e Residência/métodos , Inquéritos e Questionários , Feminino , Masculino , Agressão/psicologia , Médicos/psicologia , Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Educação/métodosRESUMO
Collaborative methods for learning such as team-based learning, case-based learning, and problem-based learning have become leading methods for active learning within the field of health professions education. Critical thinking and exposure to diverse perspectives within a group are highlighted as important benefits of team-based learning. However, without consideration of the potential socioemotional, behavioral, and team dynamic challenges associated with this format of learning, the tenets which support a welcoming learning community can begin to deteriorate. In this essay, authors highlight the core concepts of growth mindset, psychological safety, and culturally responsive pedagogy within a framework of 1) what learners should know and 2) what educators can do, to co-create an inclusive collaborative learning experience.
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BACKGROUND: Although clinical substance use disorder (SUD) care is multidisciplinary there are few opportunities to collaborate for quality improvement or systems change. In Oregon, the Project ECHO (Extension for Community Healthcare Outcomes) model was adapted to create a novel multidisciplinary SUD Leadership ECHO. The objective of this study was to understand the unique effects of the adapted ECHO model, determine if the SUD Leadership ECHO could promote systems change, and identify elements that enabled participant-leaders to make changes. METHODS: Four focus groups were conducted between August and September of 2022 with a purposive sample of participants from the second cohort of the Oregon ECHO Network's SUD Leadership ECHO that ran January to June 2022. Focus group domains addressed the benefits of the adapted ECHO model, whether and why participants were able to make systems change following participation in the ECHO, and recommendations for improvement. Thematic analysis developed emergent themes. RESULTS: 16 of the 53 ECHO participants participated in the focus groups. We found that the SUD Leadership ECHO built a multi-disciplinary community of practice among leaders and reduced isolation and burnout. Three participants reported making organizational changes following participation in the ECHO. Those who successfully made changes heard best practices and how other organizations approached problems. Barriers to initiating practice and policy changes included lack of formal leadership authority, time constraints, and higher-level systemic issues. Participants desired for future iterations of the ECHO more focused presentations on a singular topic, and asked for a greater focus on solutions, advocacy, and next steps. CONCLUSIONS: The adapted ECHO model was well received by focus group participants, with mixed reports on whether participation equipped them to initiate organizational or policy changes. Our findings suggest that the SUD Leadership ECHO model, with fine-tuning, is a promising avenue to support SUD leaders in promoting systems change and reducing isolation among SUD leaders.
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Grupos Focais , Liderança , Transtornos Relacionados ao Uso de Substâncias , Humanos , Transtornos Relacionados ao Uso de Substâncias/terapia , Oregon , Melhoria de Qualidade/organização & administração , Masculino , Feminino , Adulto , Inovação OrganizacionalRESUMO
OBJECTIVES: Research into interdisciplinary education, where concrete examples and empirical evidence of interdisciplinary teaching is explored, is limited. Furthermore, there are no standardized guidelines on best practices for designing and implementing an interdisciplinary curriculum. Recently, in healthcare settings there has been a drive to adopt interdisciplinary or transdisciplinary practices, creating a need for training individuals capable of working across discipline-specific boundaries, or to even adopt a transdisciplinary practice. This is partially attributed to recognizing that local and global complex health challenges are interlinked and share common factors and often require a new integrated approach to management. In response, a new interdisciplinary course using a modified snowflake model of interdisciplinary course design was launched at a medical school. The course aimed to provide a broad foundation for lifelong learning with a strong emphasis on the development of knowledge, skills, and professional values essential for interdisciplinary and transdisciplinary practice in applied health promotion for individuals and society. METHODS: A semi-structured focus group with students (n = 15% of the inaugural cohort) having completed at least 1 year of the course was undertaken to investigate student perspectives on best approaches for the development and delivery of interdisciplinary learning and teaching. RESULTS: Results highlighted the importance of providing training and opportunity for students to practice integration within the curriculum. Additionally, it was noted that including a module to introduce students to different disciplines and guiding students to explore their inherent interconnectedness is essential in helping them develop interdisciplinary thinking and skills. Crucially, the role of integrated assessments was also recognized as fundamental for demonstrating and practicing interdisciplinarity. CONCLUSION: Overall, this study provides valuable insights and recommendations for educators with the objective of developing interdisciplinary learning in new or existing higher education courses or those seeking to prepare learners for contemporary and emergent societal challenges more generally.
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Introduction: Global ophthalmology opportunities are becoming increasingly popular, and international partnerships are becoming more common among academic training institutions in the United States. There is need for training in the complex relational, motivational, ethical, and logistical issues that may arise in these partnerships. Methods: We developed a 3-hour case-based session featuring four characters in a fictitious international ophthalmology partnership scenario. Facilitators used structured questions for each of the four parts to foster interaction and discussion among learners. After the activity, participants completed an evaluation/questionnaire consisting of Likert-scale and open-ended questions. Results: A total of 23 ophthalmology residents and seven medical students underwent the activity over four iterations. The activity was well received, with 100% of learners either strongly agreeing (90%) or agreeing (10%) when asked if the session was worthwhile and 100% of learners either strongly agreeing (87%) or agreeing (13%) when asked if the format was conducive to achieving the learning objectives. Answers to questions on how learners would change how they practice ophthalmology in their residency and in their future careers revolved around the following topics: consideration of other perspectives, humility, self- and situational awareness, complexities of partnerships, reciprocity and exchange, importance of communication, and connection of principles between international and domestic medical practice. Discussion: While this case study explores an international ophthalmology partnership scenario, the principles and themes presented can be applicable to other fields of medicine, and can be applicable to the practice of medicine both internationally and domestically.
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Saúde Global , Oftalmologia , Humanos , Oftalmologia/educação , Saúde Global/educação , Inquéritos e Questionários , Internato e Residência/métodos , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Estados Unidos , Cooperação InternacionalRESUMO
Introduction: While many patients desire spiritual care, it is infrequently provided by physicians. When a model of cultural humility and courage is employed, resident physicians can be introduced to the spiritual care of patients. Methods: We developed this 90-minute, onetime session to speak directly to resident physicians about the relationships between medicine and spirituality and the nature of spiritual care. In the session, we facilitated residents in reflecting on their current posture toward spiritual care while addressing its evidence, obstacles, and timing. We also discussed the need for cultural humility and courage as we followed spiritual care to its root: guiding a person in finding meaning in their current circumstances. Results: We presented this interactive session to 35 internal medicine residents from all four training years. All residents responded to an embedded pre- and postsurvey question modeled after four attitudes towards spiritual care: rejecting, guarded, pragmatic, and embracing. Out of 22 residents who did not report embracing spiritual care in the presession survey, 10 (45%) reported a more positive attitude toward spiritual care on their postcourse surveys. Twenty-seven residents in attendance (77%) also provided feedback about presentation quality, with a mean rating of 4.7 out of 5 indicating overall satisfaction. Discussion: A single well-received session on spiritual care for medical residents models the integration of relevant spiritual care curricula into residency training. The resulting module can be modified for physicians of any specialty or seniority and complemented by other skill-based spiritual care curricula.
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Internato e Residência , Espiritualidade , Humanos , Internato e Residência/métodos , Inquéritos e Questionários , Coragem , Currículo , Competência Cultural/educação , Medicina Interna/educação , Médicos/psicologiaRESUMO
Background: To train highly qualified medical talent in 5-year programs and improve students' analytical and problem-solving abilities, it is necessary to change the traditional teaching method. This study introduces the combined teaching method of case-based learning (CBL) and clinical pathway and evaluates its role in practical gynecological teaching. Methods: Medical students in a 5-year program who were enrolled in the fourth year were selected as the research subjects; these students were randomized into two groups that separately received either the traditional teaching method or the combined teaching method of CBL and clinical pathway. Before the internship, a questionnaire was administered to explore students' views of internship in gynecology, and after the internship, the questionnaire was administered to assess the two teaching methods. Furthermore, theoretical and skill tests were performed both before and after the internship. Results: A total of 206 medical students in a 5-year program who were in their fourth year were enrolled in the study. Students in the experimental group performed significantly better than those in the control group. They performed significantly better in the postinternship test than in the preinternship test (P < 0.001). The questionnaire showed that more students in the experimental group thought that their learning interests, clinical skills, case analysis ability, clinical communication ability, understanding of theoretical knowledge and clinical thinking ability had improved and significantly differed between the two groups (P < 0.05). Discussion: Compared to traditional teaching methods, combined teaching method of CBL and clinical pathway can elevate students' academic performance, improve their learning enthusiasm and help promote clinical teachers' teaching quality. Additionally, this novel method is effective in facilitating the achievement of teaching objectives and improving the quality of talent training. Therefore, the combined teaching method of CBL and clinical pathway should be popularized and applied in gynecological practice.
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Ginecologia , Aprendizagem Baseada em Problemas , Estudantes de Medicina , Ensino , Humanos , Ginecologia/educação , Aprendizagem Baseada em Problemas/métodos , Feminino , Procedimentos Clínicos , Inquéritos e Questionários , Masculino , Educação de Graduação em Medicina/métodos , Competência Clínica , Avaliação Educacional , Internato e Residência , AdultoRESUMO
Introduction and objective Interstitial lung disease (ILD) is a subject with which preclinical medical students often struggle. Because case-based learning (CBL) engages students in discussions centered around complex clinical scenarios, it may be effective for teaching ILD to preclinical medical students by fostering the development of critical thinking and clinical reasoning skills. Methods Lecture-based learning on ILD in the second-year Respiratory System course was replaced with a large group CBL session. Students worked in a large group team-based CBL (TB-CBL) to answer questions about the etiology, presentation, diagnostic radiology images, pathophysiology, and management of various ILDs. Performance on ILD-related final exam questions from Cohort A (Class of 2023, lecture) was compared with Cohort B (Class of 2025, TB-CBL). Student satisfaction was assessed through an anonymous end-of-course survey (5-point Likert). Results Mean performance on ILD-related final exam questions was 85.4 (SD: 16.5) for Cohort B (TB-CBL) vs. 80.0 (SD: 17.6) for Cohort A (lecture). Mean overall satisfaction was 3.31 (SD: 1.37), with 87.6%, 88.4%, and 87.6% agreeing or strongly agreeing with the statements "The session was well organized," "The session contributed to my learning," and "The session was a valuable use of my time," respectively. Conclusion Students participating in TB-CBL scored higher on ILD-related final exam questions compared with those who received lecture-based learning of the same material. Student satisfaction was acceptable but lower than expected. This TB-CBL session may be adapted at other institutions aiming to utilize active learning methods to teach the principles of diagnosis and management of ILD to preclinical medical students.
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BACKGROUND: International student education has become an important part of higher education and an important symbol to measure the level of higher education. To change the traditional teaching model, here we introduced a combination of Case-Based Learning (CBL)and Flipped Classroom (FC) into the pathophysiology course for international students. This study aimed to explore whether the active learning ability and critical thinking ability of international students can be improved, based on this new teaching model, improving the innovation ability of teachers' team and students' attitude to the reform. METHODS: The two chapters of Cardiac Insufficiency and Apoptosis in Pathophysiology are designed as a CBL + FC teaching method. Distribute the Self-assessment Scale on Active Learning and Critical Thinking (SSACT) and satisfaction questionnaire to international students to evaluate teaching reform based on CBL + FC. RESULTS: Compared with the traditional classroom, the online flipped classroom based on CBL has significantly improved the learning enthusiasm, as these students are required to independently complete literature review, actively participate in classroom teaching, learn to use multiple learning strategies, and collaborate with other students to complete PowerPoint (PPT)production. At the same time, the students' ability to raise problems and solve problems has been greatly improved by analyzing clinical cases; By consulting the literature, the theoretical knowledge learned can be better applied to clinical analysis. The results of the satisfaction survey also show that international students are more likely to accept the flipped classroom teaching mode. CONCLUSIONS: This teaching mode will stimulate the learning motivation of international students, enhance teaching attraction and increase teaching interaction; At the same time, the CBL + FC teaching method can strengthen the evaluation of international students' in and out of class and online learning, enhance students' active learning ability and critical thinking ability, promote the development of personalized learning, and integrate with international medical education.
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Aprendizagem Baseada em Problemas , Pensamento , Humanos , Aprendizagem Baseada em Problemas/métodos , Estudantes de Medicina , Currículo , Modelos Educacionais , Inquéritos e Questionários , Avaliação Educacional , Educação de Graduação em Medicina/métodos , MasculinoRESUMO
OBJECTIVE: This study aimed to compare the impact of case-based learning (CBL) versus lecture-based learning (LBL) on dental students' clinical decision-making regarding DF severity using Visual Analog Scale (VAS) scoring. METHODS: Eighty first-year graduate dental students were randomly assigned to either the CBL (n = 38) or LBL (n = 42) groups. Both groups received instruction on DF diagnosis, with CBL involving small group sessions analyzing real cases and LBL involving traditional lectures. Effectiveness was assessed by presenting 32 dental fluorosis cases with Thylstrup-Fejerskov Index (TSIF) scores ranging from 0 to 7 through slide presentations to both groups for VAS assessment. Five evaluators of each group randomly selected were asked to repeat the rating 2 weeks later. Statistical analysis included two-way ANOVA for group and gender differences, intra-class correlation coefficient (ICC) for reliability, and Spearman correlation coefficients for validity. RESULTS: Variations in VAS scores were observed between CBL and LBL groups, with no significant gender impact. Excellent inter- and intra-evaluator agreement was found for VAS scoring in both groups, indicating its reliability. Validation against established indices (such as DI and TSIF) demonstrated strong correlations, with CBL students exhibiting higher correlations. CONCLUSIONS: CBL enhances students' clinical decision-making and proficiency in DF diagnosis, as evidenced by more consistent and accurate VAS scoring compared to LBL. These findings highlight the importance of innovative educational strategies in dental curricula, with implications for improving training quality and clinical outcomes. TRIAL REGISTRATION: The study was registered at the Clinical Research Center, Hospital of Stomatology, Wuhan University (Registration code: HGGC-036).
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Educação em Odontologia , Fluorose Dentária , Escala Visual Analógica , Humanos , Fluorose Dentária/diagnóstico , Feminino , Masculino , Educação em Odontologia/métodos , Estudantes de Odontologia , Aprendizagem Baseada em Problemas , Avaliação Educacional , Competência Clínica , Reprodutibilidade dos Testes , Tomada de Decisão ClínicaRESUMO
Introduction: Human trafficking (HT) is a public health issue that adversely affects patients' well-being. Despite the prevalence of trafficked persons in health care settings, a lack of educational modules exists for use in clinical contexts. We developed a 50-minute train-the-trainer module on HT. Methods: After piloting the workshop for faculty, fellows, and residents (n = 19) at the Society for Academic Emergency Medicine (SAEM) national conference, we implemented it in medical students' curricula during their emergency medicine clerkship at the University of Iowa (n = 162). We evaluated the worskhop by (a) a retrospective pre-post survey of self-reported ability to (1) define HT, (2) recognize high-risk signs, (3) manage situations with trafficked persons, and (4) teach others about HT, and (b) a 3-month follow-up survey to assess longitudinal behavior change. Results: In both contexts, results demonstrated improvement across all learning outcomes (pre-post differences of 1.5, 1.3, 1.9, and 1.7 on a 4-point Likert-type scale for each learning objective above, respectively, at the SAEM conference and 1.2, 1.0, 1.3, and 1.3 at the University of Iowa; p < .001 for all). In the 3-month follow-up, we observed statistically significant changes in self-reported consideration of and teaching about HT during clinical encounters among learners who had previously never done either (p < .001 and p = .006, respectively). Discussion: This train-the-trainer module is a brief and effective clinical tool for bedside teaching about HT, especially among people who have never previously considered HT in a clinical context.
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Currículo , Tráfico de Pessoas , Humanos , Iowa , Tráfico de Pessoas/prevenção & controle , Inquéritos e Questionários , Medicina de Emergência/educação , Ensino , Estudantes de Medicina/estatística & dados numéricos , Estudos Retrospectivos , Educação de Graduação em Medicina/métodosRESUMO
AIM: To develop a patient, assessment, situation, safety concerns, background, action, recommendation (PASS-BAR) handoff training program and compare the educational effects of the program between simulation-based (experimental group) and case-based (control group) groups using repeated measures among new nurses. BACKGROUND: New nurses are not well prepared to provide clear handoff reports because nursing schools and healthcare institutions rarely offer structured programs or training for handoff communication practices. DESIGN: This study used a pretest-posttest quasi-experimental design with repeated measures with two non-randomized groups. METHODS: This study targeted new nurses with less than 12 months of experience and was conducted at a university hospital's clinical nursing education center in Seoul, South Korea, between September 2022 and April 2023. Seventeen participants were allocated to the experimental group and 17 participants to the control group. Both groups were given lectures and exercises for both scenarios. Participants were asked to complete a questionnaire on nursing handoff competency, handover performance competency and perceived self-efficacy of handoff at pre- and posttest and two weeks after training. Satisfaction with learning was measured after the intervention. RESULTS: We developed a simulation-based learning handoff program that includes a simulated handoff performance and debriefing and a case-based learning handoff program that includes discussion, handoff performance and feedback. This study found no immediate difference in the educational effect of PASS-BAR handoff training between simulation-based learning and case-based learning; however, over time, simulation-based learning was more effective than case-based learning in improving nursing handoff competency and handover performance competency. CONCLUSIONS: Based on the results of this study, a simulation-based handoff training program using PASS-BAR can enhance handoff competencies and help new nurses strengthen their communication skills to understand patients and convey important information. TWEETABLE ABSTRACT: Developing a simulation-based handoff training program using PASS-BAR helps nurses strengthen their communication skills with colleagues.
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INTRODUCTION AND AIMS: As an experimental teaching method, emerging learning methods including problem-based learning (PBL), case-based learning, team-based learning and flipped classroom (FC) have been widely applied in dental education. This study aims to evaluate the effect of these teaching methods on dental education performance compared to traditional lecture-based learning (LBL). METHODS: The search was carried out in April 2024 in PubMed, EMBASE, Web of Science, and Cochrane Library. All randomized controlled trials were included and the methodological quality assessment was based on the guidelines described in the Cochrane Handbook for Systematic Reviews, followed by a meta-analysis using Stata 14.0 software. Using standard mean deviation (SMD) and 95% confidence interval (95% CI) to determine the effectiveness of emerging teaching methods and LBL in all dental disciplines. Meta-regression was used to analyse sources of heterogeneity. Sensitivity analysis was performed to determine the stability, and Begg's analysis was used to determine whether there is publication bias. RESULTS: A total of 29 randomized controlled trials including 3502 students were included. The results indicate that emerging educational methods have a significantly positive effect on achieving higher scores (SMD = 0.48, 95% CI = 0.34-0.62, P < .001), whether it was theoretical scores (SMD = 0.52, 95% CI = 0.32-0.72, P < .001) or skill scores (SMD = 0.45, 95% CI = 0.15-0.76, P < .001). Compared to LBL, PBL (SMD = 0.33, 95% CI = 0.01-0.65, P = .045) and FC (SMD = 0.50, 95% CI = 0.31-0.69, P < .001) can both significantly improve students' academic performance. CONCLUSION: Compared to LBL, emerging educational methods (PBL, case-based learning, and FC) have significantly improved the learning effectiveness of dental students. These emerging educational methods can be advocated and popularized as routine teaching methods. CLINICAL RELEVANCE: This study is the first meta-analysis of the effects of emerging teaching methods in dental education which shows great impact of emerging teaching methods on students' development.
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Introduction: Medical curricula implicitly teach that race has a biological basis. Clinical rotations reinforce this misconception as race-based algorithms are used to guide clinical decision-making. This module aims to expose the fallacy of race in clinical algorithms, using the estimated glomerular filtration rate (eGFR) equation as an example. Methods: We created a 60-minute module in consultation with nephrologists. The format was an interactive, case-based presentation with a didactic section. A third-year medical student facilitated the workshops to medical students. Evaluation included pre/post surveys using 5-point Likert scales to assess awareness regarding use of race as a biological construct. Higher scores indicated increased awareness. Results: Fifty-five students participated in the module. Pre/post results indicated that students significantly improved in self-perceived knowledge of the history of racism in medicine (2.6 vs. 3.2, p < .001), awareness of race in clinical algorithms (2.7 vs. 3.7, p < .001), impact of race-based eGFR on quality of life/treatment outcomes (4.5 vs. 4.8, p = .01), differences between race and ancestry (3.7 vs. 4.3, p < .001), and implications of not removing race from the eGFR equation (2.7 vs. 4.2, p < .001). Students rated the workshops highly for quality and clarity. Discussion: Our module expands on others' work to expose the fallacy of race-based algorithms and define its impact on health equity. Limitations include a lack of objective assessment of knowledge acquisition. We recommend integrating this module into preclinical and clinical curricula to discuss the use of race in medical literature and clinical practice.
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Algoritmos , Currículo , Taxa de Filtração Glomerular , Estudantes de Medicina , Humanos , Estudantes de Medicina/estatística & dados numéricos , Estudantes de Medicina/psicologia , Taxa de Filtração Glomerular/fisiologia , Inquéritos e Questionários , Grupos Raciais/estatística & dados numéricos , Educação de Graduação em Medicina/métodos , Masculino , Racismo , FemininoRESUMO
INTRODUCTION: Dental schools have a primary responsibility to devise a curriculum that enhances students' confidence and knowledge in orthodontic case analysis. This study aims to compare the confidence levels and performance of undergraduate students in orthodontic case screening, moderated by faculty in a lecture-based format against their self-analysis of the same cases 1 year later, using a case-based and flipped learning approach. MATERIALS AND METHODS: This study involved 100 fifth-year students. The same group received predoctoral orthodontics training through an instructor-centered, didactic approach in their fifth year and a case-based, student-centered, flipped classroom approach in their sixth year. At the end of each semester, the students completed an orthodontic case analysis and a self-reflection survey. RESULTS: This study found no significant differences in diagnostic capabilities for orthodontic findings between the two methods studied. However, the self-evaluation survey data revealed an increase in students' confidence levels. This was specifically in terms of carrying out independent orthodontic case diagnosis, effectively communicating with orthodontic specialists, and their comfort in approaching orthodontic cases following the flipped classroom approach. Despite increased confidence in case diagnosis, the results showed that final-year students are uncertain about creating initial treatment plans and referring cases at an early stage. CONCLUSION: Despite no observed improvement in students' orthodontic diagnostic abilities after another semester of student-centered learning, their confidence in diagnosing orthodontic cases was notably enhanced.
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Introduction: Patient encounters perceived to be challenging are common and contribute to both suboptimal patient health outcomes and provider burnout. A trauma-informed care (TIC) approach to these encounters is critical, as many of the characteristics associated with challenging patient encounters can be linked to a history of trauma exposure. Methods: Our team created and delivered a 1-hour synchronous virtual session intended to bolster provider knowledge of TIC principles and their application to challenging adolescent encounters. Participants were all faculty and staff engaged in pediatric primary care at an urban academic center, including physicians, nurse practitioners, psychologists, and social workers. The content was rooted in adult learning principles and included didactic components anchored to case-based learning with facilitated group discussions and opportunities for reflection. We used paired pre- and postsession self-assessments of provider knowledge, confidence, and practice related to TIC using Likert-scale and free-text questions. Descriptive statistics and a paired t test were used to determine the impact of the session on these metrics. Results: In 24 paired surveys, there were statistically significant increases (p ≤ .001) in participant perceived knowledge, confidence, and practice, with 100% of participants having a statistically significant improvement in one or more of these domains. There were also strongly positive Likert-scale and free-text responses regarding content relevance and delivery. Discussion: We demonstrate that a brief session can create improvement in pediatric providers' perceived knowledge about the application of TIC principles to challenging adolescent encounters as well as confidence in their ability to put these into practice.
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Pediatras , Humanos , Adolescente , Inquéritos e Questionários , Pediatras/psicologia , Desenvolvimento de Pessoal/métodos , Feminino , Masculino , Pediatria/métodos , Ferimentos e Lesões/terapiaRESUMO
Introduction: Without explicit education and training on how social determinants of health (SDoH) impact patient care and health outcomes, medical schools are failing to effectively equip future physicians to serve their patients. We created this workshop on health equity with a focus on SDoH to help students more effectively communicate with diverse populations. Methods: Third-year medical students and faculty were provided with class guides, learning objectives, role-play vignettes containing clerkship-specific history and physical exams, schedules, and discussion questions during a 2-hour session centered on SDoH. The workshop's impact was measured through mixed-methods analysis of surveys. Results: Based on pre- and postsurvey results from 87 participants, medical students strongly agreed that (1) SDoH factor more into a patient's health outcomes than the clinical encounter (pre: 67%, post: 87%), (2) it is their duty to gather information about SDoH (pre: 86%, post: 97%), (3) neighborhood safety is one of the key SDoH (pre: 88%, post: 97%), (4) they understood the impact of upstream interventions (pre: 35%, post: 93%), (5) they could efficiently screen all patients for SDoH at every medical encounter (pre: 27%, post: 86%), and (6) they could find preliminary resources to quickly assist patients in need of help regarding particular SDoH (pre: 26%, post: 85%). Discussion: This was the first iteration of this workshop; challenges involved piloting the content, time restraints, and organizational structure of the workshop design. Future directions include making SDoH curricula an integral part of undergraduate medical education and diverse clinical environments.
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Educação de Graduação em Medicina , Determinantes Sociais da Saúde , Estudantes de Medicina , Humanos , Estudantes de Medicina/estatística & dados numéricos , Estudantes de Medicina/psicologia , Inquéritos e Questionários , Educação de Graduação em Medicina/métodos , Currículo , Educação/métodos , Masculino , FemininoRESUMO
Introduction: Pelvic fistulas affect a significant number of patients globally, with a relatively low prevalence in the United States. Virtual education offers an effective, scalable solution to bridge this educational gap and lead to a deeper understanding of more common conditions, such as urinary and fecal incontinence. Methods: We developed two virtual cases on rectovaginal and vesicovaginal/ureterovaginal fistulas to enhance medical students' exposure, knowledge, and confidence regarding assessment of pelvic fistulas. The cases could be completed in approximately 30 minutes, asynchronously, and at students' own pace. The cases were integrated into an OB/GYN clerkship. We conducted a survey among students receiving the cases to gather feedback on usability, acceptability, and educational value, which guided subsequent improvements. Results: Forty medical students, ranging from first to third year, participated in the urogynecology elective; 21 (53%) completed the survey. Ninety-one percent agreed or strongly agreed they were satisfied with the cases. All respondents found the format easy to use and appropriate for their level of learning. Most reported the cases improved their confidence in nonsurgical and surgical management options for pelvic fistulas. Discussion: Offering virtual and interactive patient cases on e-learning platforms represents an innovative approach to increasing clinical exposure to urogynecologic disorders. By providing medical students with the opportunity to interact with pelvic fistulas virtually, these cases can help bridge a gap in clinical education. Future exploration is valuable for examining knowledge deficiencies and developing cost-effective, self-paced, easily accessible educational resources to advance medical training and optimize patient care.
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Ginecologia , Humanos , Feminino , Inquéritos e Questionários , Ginecologia/educação , Estudantes de Medicina/estatística & dados numéricos , Educação de Graduação em Medicina/métodos , Educação a Distância/métodos , Fístula Vesicovaginal/cirurgia , Adulto , Estados Unidos , Estágio Clínico/métodos , Urologia/educação , Competência ClínicaRESUMO
Introduction: This module teaches core knowledge and skills for undergraduate medical education in reproductive health, providing instruction in the management of normal and abnormal pregnancy and labor utilizing interactive small-group flipped classroom methods and case-based instruction. Methods: Advance preparation materials were provided before the education session. The 2-hour session was facilitated by clinical educators using a faculty guide. Using voluntary surveys, we collected data to measure satisfaction among obstetrics and gynecology clerkship students and facilitators following each education session. Results: Capturing six clerkships spanning 9 months, 116 students participated, and 64 students completed the satisfaction survey, with 97% agreeing that the session was helpful in applying knowledge and principles to common clinical scenarios. Most students (96%) self-reported that they achieved the session's learning objectives utilizing prework and interactive small-group teaching. Nine clinical instructors completed the survey; all agreed the provided materials allowed them to facilitate active learning, and the majority (89%) agreed they spent less time preparing to teach this curriculum compared to traditional didactics. Discussion: This interactive flipped classroom session meets clerkship learning objectives related to the management of pregnancy and labor using standardized materials. The curriculum reduced preparation time for clinical educators as well.