Perceptions and use of evidence-based revision methods among undergraduate medical students.

Objective: To assess awareness, perceptions and use related to evidence-based revision methods by undergraduate medical students. METHODS: The descriptive cross-sectional study was conducted in three medical colleges of Rawalpindi, Islamabad, Pakistan, from December 01, 2019, to January 31, 2020, after approval from the ethics review committee of Army Medical College, Rawalpindi. The sample comprised undergraduate medical students of either gender. Data was collected online using a 10-item standardised questionnaire. Students were asked about the revision methods they used routinely and their perceptions of conventional and evidence-based revision methods. Data was analysed using SPSS 23. RESULTS: Of the total 136 respondents, 92(67%) were females and 44(32.3%) were male students. The response from preclinical and clinical years was 67 (50.7%) and 69(49.2%), respectively. Highlighting was the most widely used revision method among students (70 (51%) students), followed by re-reading important points (65 (47.7%) students). 126 (92%) students had the opinion that conventional revision methods were effective learning tools. Only 52 (38.2%) students were aware of the term 'evidence-based revision methods'. Digital tools based on principles of evidence-based revision were used by a minority of students which included use of online question banks by 21 (15.4%) students, osmosis by 40 (29.4%) students, sketchy pharma by 35 (25%)students, flashcards by 19 (14%) and picmonic by only 3 (2.2%). More than 114 (80%) students responded that they wanted evidence-based revision methods to be incorporated into curriculum, and 116 (85%) students said they would like to have a workshop on these techniques. Conclusion: Most medical students were not aware of and were not using evidence-based revision methods, and relied on conventional revision tools. They were, however, eager to learn about newer revision strategies.

Systems approach in planetary health education for medical students: a mixed methods study.

BACKGROUND: Introducing students to the "planetary health lenses" perspective is crucial. Comprehensive strategies for teaching this perspective are lacking, especially in the domains of "interconnection within nature (IWN)" and "systems thinking/complexity." There is also a scarcity of studies assessing medical students' opinions on planetary health and evaluating teaching strategies. OBJECTIVE: To understand Brazilian medical students' perceptions and knowledge of planetary health (PH) and evaluate the application of the educational material "Patient and Clinic through the Lens of Planetary Health," which addresses "IWN" and "complexity" through the sociological lens of Actor-Network Theory, in an integrative course at a medical school in Brazil. METHODS: A mixed-methods, quasi-experimental design involving two medical student classes during 2022/2023. Participants completed a questionnaire on sociodemographic data; pre- and post-intervention closed-ended questions about perceptions related to PH, and an open-ended questionnaire on experience and learning. Each student group presented a portfolio under the planetary health lenses regarding a real patient, developing a network diagram that described the social network involving both human and non-human actors with which this person is interconnected. The cohorts participated in "IWN" activities: a contemplative trail or reflection on belonging to the planet. RESULTS: Ninety-six students and 9 professors participated. The majority of students (66.7%) reported significant or extremely significant learning from the sessions. There was an increase in perception of the need for physicians to incorporate PH into their clinical practice (p = 0.002; r = 0.46) and an intensification of the sense of interconnection with the environment (p = 0.003; r = 0.46). There was a gain in knowledge about how many diseases were related to PH (p < 0.02 for all 13 listed diseases). The majority (83%) found the sessions relevant or highly relevant and commented on their impact, both professionally and personally. CONCLUSIONS: Teaching PH in a medical school allowed students to learn from the patient's perspective, considering psychosocial and environmental determinants, about the intrinsic interdependence between population's health and PH. This strategy made a significant contribution by proposing pioneering didactics and offering valuable insights into the challenges and nuances of teaching PH.

Improving the ability to discriminate medical multiple-choice questions through the analysis of the competitive examination to assign residency positions in Spain.

INTRODUCTION: Psychometrics plays a vital role in evaluating educational research, including the analysis of multiple-choice exams. This study aims to improve the discriminatory ability of the "Médico Interno Residente" (MIR) medical exam in Spain, used to rank candidates for specialized healthcare training, through psychometric analysis. METHODS: We analyzed 2,890 MIR exam questions from 2009 to 2021 (totaling 147,214 exams), categorizing them based on methodology and response type. Evaluation employed classical test theory and item response theory (IRT). Classical test theory determined difficulty and discrimination indices, while IRT assessed the relationship between knowledge levels and question performance. RESULTS: Question distribution varied across categories and years. Frequently addressed knowledge areas included various medical specialties. Non-image-associated clinical cases were the easiest, while case-based clinical questions exhibited the highest discriminatory capacity, differing significantly from image-based case or negative questions. High-quality questions without images had longer stems but shorter answer choices. Adding images reduced discriminatory power and question difficulty, with image-based questions being easier. Clinical cases with images had shorter stems and longer answer choices. CONCLUSIONS: For improved exam performance, we recommend using a clinical case format followed by direct short-answer questions. Questions should be of low difficulty, providing clear and specific answers based on scientific evidence and avoiding ambiguity. Typical clinical cases with key characteristic features should be presented, excluding uncertain boundaries of medical knowledge. Questions should have lengthy stems and concise answer choices, minimizing speculation. If images are used, they should be typical, clear, consistent with the exam, and presented within clinical cases using clinical semiotics and propaedeutics.

Factors affecting pharmacology learning in integrated PBL in diverse medical students: a mixed methods study.

INTRODUCTION: Problem-based learning (PBL) was introduced to address passive teaching limitations. However, it is not fully characterised as a teaching modality in pharmacology. The present study investigated the factors affecting pharmacology learning in an integrated PBL-based curriculum in diverse learners. METHODS: Year 1 undergraduate medical students from two cohorts at St. George's University of London and University of Nicosia, participated. Statistical analysis of pharmacology knowledge scores, at the beginning (pre-test) and end of the academic year (post-test), investigated readiness to benefit from PBL based on diverse student characteristics (educational background, age, gender, country of origin, ethnicity, native language, PBL experience). Focus groups/interviews and a survey investigated aspects of integrated PBL impacting learning in depth. RESULTS: Pre- and post-test scores were positively correlated. Students with biomedical sciences degrees performed better at the pharmacology pre- and post-tests, while post-graduate degree holders performed better only at the pre-test. Effect size was of moderate magnitude. However, progress in learning (post-test performance after controlling for pre-test scores) was unaffected. Qualitative analysis revealed three major themes: 1) PBL as a learning environment; 2) PBL as a learning environment in pharmacology; and 3) PBL as a learning environment and confidence in prescribing. Under theme one, skill development, knowledge acquisition through collaboration and self-directed learning, group dynamics and preferred teaching methods were discussed. Under theme two, contextual learning, depth of knowledge and material correctness were raised. Under theme 3, students expressed variability in prescribing confidence. They perceived that learning could be improved by better integration, further references earlier on, more lectures and PBL facilitators with greater content expertise. The survey findings were consistent with those from focus groups/interviews. CONCLUSION: Pharmacology learning in a PBL-based curriculum is facilitated by constructive, collaborative and contextual learning. While baseline pharmacology knowledge may be advantageous, the other aforementioned characteristics studied may not affect readiness to benefit from PBL. However, further instructional scaffolding is needed, for example through further resources, lectures and self-assessment. The results from our study can inform evidence-based curriculum reform to support student learning further. Addressing learning needs could ultimately contribute to reducing medication errors through effective training of future prescribers.

Validation of clinical simulation scenarios for the teaching of soft skills in child-centered care.

Consultations with children and their families are complex and require soft skills. However, there is a gap in the medical curriculum concerning these skills, especially as encounter training is often adult-centered. We developed, validated, and applied simulation scenarios that prioritize active participation of children to train soft skills in child-centered care for undergraduate medical students. This is a methodological study to develop three scenarios and a checklist of what is expected. The content was validated by 18 experts. A pre-test was carried out for adjustments. Then, the simulations were applied and evaluated by 18 medical undergraduate students. They included the participation of 6 pediatric simulated patients aged 9-12 years trained by a drama teacher. According to the results, the scenarios and checklist proved to be valid instruments in content terms (ICV-I > 0.8). The scripts were followed by the simulated pediatric patients, but they had difficulty mimicking a hypoactive state. Some were anxious, but everyone enjoyed participating in the feedback. The simulated parents had difficulty participating and giving space to the child's speech. Participants assessed that the simulations performed as they were proposed and, after experimenting them, felt more prepared. The simulations provided an opportunity for students to practice soft skills by interacting with children in a safe environment. Using children as simulated patients is feasible but presents some challenges. Our study has expanded the ways in which children's health content can be taught. We are investigating whether this training leads to better patient outcomes in real clinical settings.

Cultivating compassion in medicine: a toolkit for medical students to improve self-kindness and enhance clinical care.

BACKGROUND: Compassionate care lies at the foundation of good patient care and is a quality that patients and providers continue to value in the fast-paced setting of contemporary medicine. Compassion is often discussed superficially in medical school curricula, but the practical aspect of learning this skill is often not taught using a formal framework. In the present work, the authors present an 8-session curriculum with a mindfulness-based approach to compassion that addresses this need. It is hypothesized that students in this curriculum will improve in their levels of compassion based on validated scales. METHODS: The curriculum was delivered to fourth-year medical students at Renaissance School of Medicine at Stony Brook University who had just completed their clerkship year. It was developed as a customizable set of modules that could be delivered in various ways. The students were taught with evidence-based cognitive exercises followed by group discussions and written reflections based on compassion-focused thematic questions. All students completed a pre- and post-Self-Compassion Scale, Compassion Scale, and Toronto Mindfulness Scale. Students in this course were compared with students in different courses about non-clinical topics delivered at the same time. Wilcoxon Signed Rank tests and Mann Whitney U tests were used to assess potential associations between pre- and post-survey responses for the validated scales and subscales. RESULTS: 17 fourth-year medical students completed pre- and post-course tests, 11 participated in the compassion curriculum while 6 participated from the other courses. Before any of the courses began, all students performed similarly on the pre-test across all scales. The students in the compassion curriculum demonstrated a significant increase in their total Self-Compassion score by 8.7 [95% CI 4.3 to 13.2] points (p = 0.008), total Compassion score by 6.0 [95% CI 1.4 to 10.6] points (p = 0.012), and the curiosity component of the Toronto Mindfulness Scale by 4.4 [95% CI 1.0 to 7.7] points (p = 0.012). There was no statistically significant difference between pre- and post-tests among the non-compassion curriculum students in the aforementioned scales (p = 0.461, p = 0.144, p = 0.785, respectively). CONCLUSIONS: Our results indicate that the students in our course developed an enhanced ability to engage in self-compassion, to understand the shared human experience, and to be motivated to act to alleviate suffering. Regardless of a program's existing compassion education, this customizable model allows for easy integration into a medical student's crowded curriculum. Furthermore, although teaching compassion early and often in a clinician's training is desirable, our study that targeted fourth-year medical students suggests an additional benefit of rekindling the loss of compassion well described in a medical student's clinical years.

Comparison of empathy profiles of medical students at the start and in the advanced clinical phase of their training.

Background: The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) cites empathy as a basic competence for medical doctors. Based on a multidimensional concept of clinical empathy, empathy profiles of medical students at the start of their training and in the 9th semester were identified and compared in order to draw conclusions for the conception of effective course offers. Method: Using the Saarbrücker Personality Questionnaire on Empathy (SPF-IRI), self-rated empathy was recorded in a cross-sectional study of medical students (1st semester: N=192/9th semester: N=221). Two Stage Clustering was performed for data analysis. Result: Three empathy profiles which could be meaningfully delineated by content were identified: 1. reflected, functional empathy, 2. unreflected, burdensome empathy and 3. distancing and avoidance. Students in the 9th semester mostly tended toward unreflected, burdensome empathy. Only one-third appeared capable of feeling empathy with patients while at the same time adequately regulating their own emotions and thus protecting themselves from emotional overload. Conclusion: An adequately reflected and functional empathy among medical students can neither be assumed at the start of their training, nor do existing course offers appear to provide sufficient training for this. Empathy should thus be implemented as a competence which needs to be promoted over the entire course of study. Emotion regulation plays a key role.

A national survey to assess the state of anatomy teaching in France across various disciplines and professions.

PURPOSE: To investigate the current practices in anatomy teaching at French universities in 2023. METHODS: On January 10, 2023, a questionnaire was sent to all members of the official list of the French Medical College of Professors of Anatomy. Each Anatomy centre was asked to complete this online form only once. The questionnaire covered several key themes, including broad questions, dissections practices, "virtual" dissections, teaching methods and teaching staff. RESULTS: The questionnaire was completed by 26/28 anatomy centres. Access to body donor dissection is reported to be mandatory in 15 of the 26 centers (58%), optional in 10 centers (38%), and "tolerated" in one center (4%). Fifteen of 26 centers (58%) reported having a virtual dissection table for teaching anatomy. Concerning the teaching of anatomy via live ultrasound, 10 out of 26 centers (38%) reported providing it. Regarding the teaching methods used for medical students, chalk and board lectures are the most common method, although the intensity of use varies. Most lectures are given with chalk and board in 42% (11/26) of the centers. In about 73% (19/26) of the centers, tablet lectures are used. Regarding anatomy teachers, it was reported that in 24/26 anatomy centres (92%), more than 50% of the courses for medical students are taught by professors holding the chair of anatomy (21/26 professors (81%), 3/26 associate professors (12%)). CONCLUSION: The present study endeavors to contribute to the existing body of knowledge on anatomy education by offering insights into the current practices in French universities.

[Medical escape games: experimenting with a new teaching method]. / Jeu d'évasion médical : expérimentation d'une nouvelle méthode pédagogique.

With escape games gaining in popularity, we decided to adapt the concept of an existing medical escape game to the needs of our family medicine residents, by simulating clinical situations and creating puzzles with medical content. This activity was a fun way to integrate theoretical learning while developing a number of CanMEDS roles. Overall, the residents were very satisfied with the topics chosen and the interactive aspect of the experience. This escape game requires few resources, is adaptable to different environments and can be adjusted according to students' needs.

Preparedness of Undergraduate Medical Students for Online Learning.

OBJECTIVE: To determine the preparedness of the first-year undergraduate medical students toward online learning. STUDY DESIGN: Descriptive study. Place and Duration of the Study: The study was conducted at the Department of Medical Education, Fazaia Ruth Pfau Medical College, Air University, Karachi, Pakistan, from September to December 2021. METHODOLOGY: The study participants were first-year undergraduate medical students. A pre-validated instrument developed by Lesley University in July 2014 named 'The Prospective Online Student Readiness Questionnaire' was used. Permission was taken via email. The questionnaire has two parts. Section A consists of the demographic characteristics. Section B evaluates the student's readiness for online learning. RESULTS: Data from 81 respondents were collected through an online questionnaire. The results showed that internet self-efficacy, self directed learning, learner control, and learner style have a positive and significant relationship with students' preparedness for e-learning. CONCLUSION: Students are aware of the use of technology. They could be more comfortable working independently at the beginning of the course. Online environment and communication for learning purposes with peers also appear to be weak areas. Students prefer visual aids for learning, and very few enjoy raising their hands in class to answer questions. They are confident in social communications but need more confidence in using online tools for effective online communication and posting questions on online forums during discussions. KEY WORDS: Medical students, Online learning, preparedness, Self-efficacy, Self-directed learning.

A cross-disciplinary approach to learning medical physiology and behavioral skills involving drama students performing as simulated patients.

The early years of physiology education in medical curricula provide unique challenges. As well as inculcating concepts that are seen as difficult, modern curricula require that students learn in context in case-based learning courses. Additionally, regulating bodies stress that the soft skills of compassion, communication, and empathy are embedded throughout curricula. This has driven work in our organization involving drama and final-year medicine students during which they collaborate in realistic simulations of doctor/patient interactions. We adapted this transdisciplinary approach to second-year physiology tutorials. This emphasized the holistic importance of physiology to patient care, while also embedding "human factors" skills from the very earliest stages of the curriculum. After preparing by attending acting classes based on aspects of Konstantin Stanislavski's "System," the authors supervised tutorials in which drama students participated in a "physiology of hypofertility" session for second-year medical students, playing a 34-year-old woman with premature menopause (or their partner). Opinion (from all students) was evaluated by Likert questionnaires (which included open questions). A focus group of drama students was also interviewed, and the conversation was recorded for thematic analysis. Positive Likert scores were recorded for the authenticity of the tutorials, skills development, fostering empathy, and motivating students to improve. All participants evaluated the tutorial as highly enjoyable. These scores are reflected in positive open commentary on the questionnaires and in the focus group interviews. The results suggest that even basic science tutorials give opportunities for interdisciplinary study and enhancement of behavioral skills while gaining enthusiastic student acceptance.NEW & NOTEWORTHY This work details how physiology tutorials for early years medical students are transformed by taking the clinical case off the two-dimensional page and instead having the case scenario acted by drama students. This adds context and authenticity. The benefits are twofold: emphasizing the importance of physiology to the budding clinician and embedding empathy and compassion from the earliest points in a clinician's career.

Rad Path in a Flash: Creation of the First AMSER Sponsored Digital Flashcard Deck and a Review of Digital Flashcard Use among? Medical Students.

RATIONALE AND OBJECTIVES: Digital flashcards are an increasingly popular study method for medical students today. The purpose of this study is to assess students' opinions on digital flashcards and to evaluate the need for radiology-focused digital flashcards. We created the first official Radiology-Pathology (Rad-Path) Correlation course digital flashcard deck sponsored by the Alliance of Medical Student Educators in Radiology (AMSER), and evaluated its effectiveness in increasing medical students' confidence levels of understanding Rad-Path concepts. MATERIALS AND METHODS: A 16-question survey was developed and publicly shared with medical students to assess the need for a high-quality radiology deck. In addition, students who trialed the AMSER Rad-Path Anki deck were assessed on their confidence of radiology pathology concepts prior to and after using these digital flashcards. RESULTS: 185 survey responses were received for the first survey about digital flashcard use. Overall, 87.6% of medical student respondents had used digital flashcards during medical school, and 33.5% had used digital flashcards to study radiology topics specifically. 67.6% of respondents stated they would use a digital flashcard deck if sponsored by an academic radiology society. Regarding the survey of the students who used the AMSER Rad-Path flashcards, 31 responses were received in the pre- and follow-up survey. Mean confidence in understanding the radiology pathology learning objectives increased when the Rad-Path Anki deck was utilized, and students rated the flashcards favorably. CONCLUSION: Students reported a high use of digital flashcards for studying topics in medical school. We identified a perceived need in students for a series of high-quality digital flashcards covering radiology topics. We created the first deck of AMSER Rad-Path flashcards which was well received by the medical students.

Improving undergraduate education of occupational health and occupational medicine appling massive open online courses & problem-based learning.

BACKGROUND: The learning of Occupational Health and Occupational Medicine in undergraduate college students in China has been hindered by various factors. This study aimed to explore the effects of the application of Massive Open Online Courses (MOOC) & Problem-based learning (PBL) in the learning of Occupational Health and Occupational Medicine in undergraduate college students in China. METHODS: Students enrolled in 2017 and 2018 were categorized in the control group and study group, and received PBL learning and MOOC + PBL learning, respectively. The effects of learning were assessed by scores of final exam, satisfaction degree of students, and feedbacks. RESULTS: The mean score of the final exam was not significantly different between the two groups. However, the further comparison by levels of scores showed that the percentages of good and excellent were both significantly higher in the study group than control group. The overall satisfaction degree was significantly higher in the study group than control group. In addition, the scores of the 3 dimensions of satisfaction degree, i.e. learning preparation, learning process, and learning effect, were all significantly higher in the study group than control group. The feedbacks of the students showed that they thought MOOC + PBL learning could better improve the learning efficacy, despite a substantial proportion of students reported that MOOC + PBL learning more time-consuming. CONCLUSIONS: The findings showed that the combination of MOOC and PBL in the learning of Occupational Health and Occupational Medicine is an effective method capable of improving the learning efficacy in college students of Prophylactic Medicine. Further efforts are needed to optimize the MOOC platform to provide a friendlier interface.

Dermatology teaching for undergraduate medical students in clinical routine - a structured four-week curriculum.

BACKGROUND: Dermatology teaching is fundamental for the promotion of young colleagues in our specialty. However, traditional teaching methods are being scrutinized by students of the 'Generation Y and Z', which can pose new challenges for teaching institutions. We therefore aimed to assess the motivational impact and reception of a newly created four-week curriculum containing modernized teaching methods integrated into clinical routine. METHODS: In this single-center study, 67 medical students completed this curriculum composed of weekly learning objectives including knowledge of morphological terms, 10 common dermatoses, communication and presentation skills. The participants provided information on their level of interest in dermatology each week as well as positive and negative aspects of the curriculum. RESULTS: During the curriculum a significant median increase in interest in dermatology was reported with no differences between the genders. Low initial interest could be improved, high initial interest maintained. Participants with an interest in scientific work (20.9%) were more motivated during the curriculum. The variety, quality of teaching and structure were the main aspects rated positively. Suggestions for improvement included the need for more teaching by senior doctors, transfer of responsibility, and a working environment updated to the latest technology standards. CONCLUSION: The presented curriculum was well received by the participants and allowed to better define learning preferences of new generations which can be helpful to modernize traditional teaching methods. Interest in scientific work could be a factor to identify students with a particularly strong interest in dermatology.

Of mice (dogs, horses, sheep) and men: A novel comparative anatomy dissection course in a United Kingdom university.

At the University of Bristol, we established a novel dissection course to complement our anatomy degree. Students enrolled in this undergraduate course are trained as comparative anatomists, with equal time given to both human and veterinary anatomy. Historically, students opted to dissect either human or veterinary donors as part of the course. To fully reflect the comparative nature of the degree, the dissection course was redesigned so students could dissect both human and veterinary specimens as part of the same course. This facilitated a wide-ranging experience of anatomy, encouraging detailed knowledge of a multitude of species and allowing for multifaceted anatomy graduates to be ready for employment in a wide and competitive job market. Across three iterations of the amended version of the course, median marks ranged from 58.7% to 62.0%, with between 22 and 39 students enrolled. In comparison to the course prior to the introduction of the change, median marks ranged from 59.8% to 62.8%, with between 16 and 24 students enrolled. There was no significant difference between marks before or after the introduction of the concurrently comparative aspect. This paper describes the course, with learning materials and assessments considered, along with some reflection on its value. The course offers benefits to students by widening their perspective on anatomical knowledge and making them more equipped for the job market. It also broadens their understanding of form-function relationships. However, student feedback implied that having the choice between human or veterinary dissection was preferable, and this may outweigh the perceived benefits of the course.

Effectiveness of problem-based learning strategies compared to conventional anatomy teaching approaches.

Objectives: To determine the effectiveness of problem-based learning compared to conventional teaching strategies, and to determine the impact of sub-disciplines of Anatomy on learning outcomes of the subject. METHODS: The cross-sectional, descriptive study was conducted at Bahria University Health Sciences, Karachi, from August to October 2022, and comprised 1st and 2nd year medical students and 1st year dental students of either gender who were being taught by the hybrid method including both conventional and problem-based learning strategies. Data was collected using a questionnaire circulated through Google Forms. It had close-ended questions that were scored on a Likert scale. Anatomy sub-disciplines explored were gross, embryology and histology. Data was analysed using SPSS 23. RESULTS: Of the 251 subjects, 125(49.8%) were males and 126(50.2%) were females. The overall age ranged aged 18- 23 years. There were 115(45.8%) 1st year medical students, 111(44.2%) 2nd year medical students and 25(10%) 1st year dental students. Among 1st year medical students 60(52.17%), among 2nd year medical students 64(57.6%) and among 1st year dental students 14(56%) respondents favoured problem-based learning compared to conventional methodology. Highly significant results were obtained regarding need of topic revision (p<0.001), whether knowledge of conventional teaching method is enough for understanding the clinical scenarios (p=0.017, whether pictures shown during the problem-based learning sessions were enough for understanding anatomy (p=0.035), relevance of questions in oral structured practical examination (p=0.019) and viva (p=0.002). When the participants were asked regarding the anatomy sub-discipline that required revision for comprehensive learning, 72(28.3%) mentioned gross anatomy. CONCLUSIONS: Students considered problem-based learning to be more inducive in enhancing learning compared to conventional teaching.

The professionalism of clinical teachers in clinical education.

BACKGROUND: Professionalism has long been recognised as a core competency for clinical teachers as role models and educators. The present study aimed to evaluate the adherence to professionalism of clinical teachers from the perspectives of resident doctors and undergraduate medical students. METHODS: This is a descriptive and cross-sectional study. All learners, including undergraduate medical students and residents who were studying in the medical school and teaching hospitals affiliated with Shahid Sadoughi University, were entered into this study as evaluators (n = 311). Of these, 151 clinical teachers were assessed by the learners. The students were asked to assess the two clinical teachers with whom they had interacted during the previous month in the clinical department. The Faculty Professionalism Evaluation Questionnaire was used in this study. RESULTS: The results of the confirmatory factor analysis (CFA) confirmed the adequacy of the model. The total mean score was 1.98 (standard deviation=0.36, range = 0.96 to 2.82). In addition, the total mean score of the adherence to professionalism among clinical teachers was reported at the level of "met expectations". The results showed that the teachers' scores in the domains of "doctor-patient relationship" and "doctor-student relationship" were reported under the "met expectations" level. Their scores in the "inter-professional relationship" and "doctor-self relationship" domains were reported as "below expectations". The results showed the scores of teachers' professionalism were significantly lower from the viewpoints of residents than in the perceptions of medical students (p=0.0001). CONCLUSION: The professionalism scores of clinical teachers were evaluated as "below expectations" from the learners' perspectives.

Exploring medical students' perceptions of individual and group-based clinical reasoning with virtual patients: a qualitative study.

BACKGROUND: Virtual Patients are computer-based simulations used to teach and evaluate patient interviews, medical diagnoses, and treatment of medical conditions. It helps develop clinical reasoning skills, especially in undergraduate medical education. This study aimed to and investigate the medical students' perceptions of individual and group-based clinical reasoning and decision-making processes by using Virtual Patients. METHODS: The study group comprised 24 third-year medical students. Body Interact® software was utilized as a VP tool. The students' readiness and the courses' learning goals were considered when choosing the scenarios. Semi-structured interview forms were employed for data collection. MAXQDA 2020 qualitative analysis software was used to analyze the data. The students' written answers were analyzed using content analysis. RESULTS: The participants perceived individual applications as beneficial when making clinical decisions with Virtual Patients, but they suggested that group-based applications used with the same cases immediately following individual applications were a more appropriate decision-making method. The results indicated that students learn to make decisions through trial and error, based on software scoring priorities, or using clinical reasoning protocols. CONCLUSION: In group-based reasoning, the discussion-conciliation technique is utilized. The students stated that the individual decision-making was advantageous because it provided students with the freedom to make choices and the opportunity for self-evaluation. On the other hand, they stated that the group based decision-making process activated their prior knowledge, assisted in understanding misconceptions, and promoted information retention. Medical educators need to determine the most appropriate method when using Virtual Patients, which can be structured as individual and/or group applications depending on the competency sought.

Impact of familiarity with the format of the exam on performance in the OSCE of undergraduate medical students - an interventional study.

BACKGROUND: Assessments, such as summative structured examinations, aim to verify whether students have acquired the necessary competencies. It is important to familiarize students with the examination format prior to the assessment to ensure that true competency is measured. However, it is unclear whether students can demonstrate their true potential or possibly perform less effectively due to the unfamiliar examination format. Hence, we questioned whether a 10-min active familiarization in the form of simulation improved medical students´ OSCE performance. Next, we wanted to elucidate whether the effect depends on whether the familiarization procedure is active or passive. METHODS: We implemented an intervention consisting of a 10-min active simulation to prepare the students for the OSCE setting. We compared the impact of this intervention on performance to no intervention in 5th-year medical students (n = 1284) from 2018 until 2022. Recently, a passive lecture, in which the OSCE setting is explained without active participation of the students, was introduced as a comparator group. Students who participated in neither the intervention nor the passive lecture group formed the control group. The OSCE performance between the groups and the impact of gender was assessed using X2, nonparametric tests and regression analysis (total n = 362). RESULTS: We found that active familiarization of students (n = 188) yields significantly better performance compared to the passive comparator (Cohen´s d = 0.857, p < 0.001, n = 52) and control group (Cohen´s d = 0.473, p < 0.001, n = 122). In multivariate regression analysis, active intervention remained the only significant variable with a 2.945-fold increase in the probability of passing the exam (p = 0.018). CONCLUSIONS: A short 10-min active intervention to familiarize students with the OSCE setting significantly improved student performance. We suggest that curricula should include simulations on the exam setting in addition to courses that increase knowledge or skills to mitigate the negative effect of nonfamiliarity with the OSCE exam setting on the students.

Evaluating the Impact of an Adolescent Sexuality Education Workshop on Medical Student Communication in an Objective Structured Clinical Examination.

PURPOSE: Gaps still exist in medical education about the sexual health needs of sexual diverse populations, and little is known about how translatable current learning modules are to patient encounters. Efforts at an academic medical institution have been made to address this need, including a two-hour adolescent sexuality workshop during the Core Clerkship in Pediatrics. This workshop's efficacy was evaluated in an objective structured clinical examination (OSCE) given to rising fourth-year medical students, where the standardized patient case focused on an adolescent cisgender male with dysuria and in a new, same-sex relationship. METHODS: Performance of students who completed the workshop prior to the OSCE (n = 48) were compared to those of students who did not participate in the workshop prior to the OSCE (n = 17). The encounters were recorded and transcribed, and the deidentified transcripts were scored on a rubric focusing on five domains: sexual identity disclosure, behavioral assessment, psychosocial history, counseling and anticipatory guidance, and relationship building. RESULTS: Student's t-test comparison of the scores found significantly higher scores for the psychosocial history domain (p = .04), particularly concerning disclosure of a new boyfriend and recent sexual activity (p = .008), for students who had the workshop before the OSCE. DISCUSSION: Students who took the adolescent sexuality workshop performed better in gathering psychosocial information in an OSCE encounter a sexual minority adolescent. These results affirm prior work that active learning on sexual diverse health in medical school curricula may prepare students for effective engagement with adolescents exploring their sexuality.