Paving the Path to Patient-Centered Healthcare in Africa: Insights From a Student Led Initiative.

Patient-centered care (PCC) is a key domain of healthcare quality. Its importance is driven by evidence-based medicine, the predominance of chronic conditions requiring self-care, and the recognition of the priority of patient goals, values, priorities, and preferences in determining care plans. This article emphasizes the urgent need for Africa to develop PCC and a workforce committed to its implementation, as well as highlights an initiative by African medical students to champion PCC continent-wide. Embracing this transformative approach presents Africa with an unprecedented opportunity to improve care for each person. Through a comprehensive exploration of unique strategies and considerations in African health professions education, this viewpoint seeks to spark dialogue and inspire action towards a future where patient-centered care is the foundation of healthcare delivery in Africa.

An Interactive Mapping and Case Discussion Seminar Introducing Medical Students to Climate Change, Environmental Justice, and Health.

Introduction: Integrating climate change and health into a medical school curriculum is critical for future physicians who will manage health crises caused by a rapidly changing climate. Although medical schools have increasingly included climate change in the curriculum, there remains a need to address the link between the climate crisis, environmental justice, and historical policies that shape environmental health disparities in local communities. Methods: In academic years 2021-2022 (AY22) and 2022-2023 (AY23), second-year medical students participated in a 2.5-hour seminar utilizing didactic teaching and small breakout groups that included interactive mapping activities and case scenarios. Learner knowledge and attitudes were self-assessed using pre- and postcurriculum surveys and a quiz. Qualitative thematic and content analysis was used to evaluate short-answer quiz responses and feedback. Results: Of 357 students who participated in the seminar, 208 (58%) completed both the precurriculum and postcurriculum surveys. Self-assessed ability increased significantly for all educational objectives across both years. Attitudes on the importance of climate change knowledge for patient health also improved from a mean of 3.5 precurriculum to 4.2 postcurriculum (difference = 0.7, p < .01) in AY22 and from 3.6 pre- to 4.3 postcurriculum (difference = 0.7, p < .01) in AY23 on a 5-point Likert scale. Discussion: This climate change and health session highlighting the link between environmental policy and climate change health vulnerability in the local context was successful in improving students' self-assessed ability across all stated educational objectives. Students cited the interactive small-group sessions as a major strength.

Perceptions of medical students on narrow learning objectives and structured debriefing in medical escape rooms: a qualitative study.

BACKGROUND: Escape rooms are increasingly used in medical education as a complementary learning technique or even alternative to traditional educational approaches. Few studies focus on debriefing following medical escape rooms and how escape rooms can be used to achieve pre-defined learning objectives. Evaluating the use of narrow learning objectives may increase the depth of reflections and transform an engaging team event into an effective learning opportunity. This study aimed to explore participants' experiences and perceived learning outcomes of narrow learning objectives in a medical escape room with debriefing. METHODS: In this explorative, qualitative study, participants saw a video lecture, participated in an escape room experience, and in a following debriefing. Throughout this learning session, the learning objectives concerned "exchange of information" and are therefore relatively narrow. Participants then participated in a semi-structured focus group interview and completed a demographic questionnaire. Participants were volunteer final-year medical students. Focus group interview recordings were transcribed and analysed using systematic text condensation. RESULTS: Thirty-two students in eight groups completed the study. Five themes were described in the analysis of the focus group interviews: Experience with the narrow learning objectives, topics discussed in the debriefing, learning mechanisms, learning outcomes concerning exchange of information and influences of the learning approach. CONCLUSIONS: Narrow learning objectives and structured debriefing seem to increase perceived learning depth of medical escape room sessions. Using semi-structured debriefing still allows for discussions of other elements relevant to the students. CLINICAL TRIALS: Clinical.trials ID NCT04783259.

A cross-sectional study on personal values of medical students: the differences from their instructors, their associations with mental wellbeing, and the influences of gender.

BACKGROUND: Personal values of Thai medical students have been observed to be diverging from those of their seniors, but the differences remain uncharacterized. Despite its potential association with mental wellbeing, the issue remain unexplored in the population. This study aimed to explore (1) the difference in personal values between medical students and instructors and (2) the association between student's value adherence to mental well-being and the interaction by gender. METHODS: An online survey was performed in 2022. Participants rated their adherence to five groups of values, namely, Self-Direction, Hedonism, Achievement & Power, Universalism & Benevolence, and Tradition. Participants also rated their mental wellbeing. Comparisons were made between the personal values of students and instructors. The association between the personal values of students and their mental wellbeing and the interaction between values and gender were analyzed in linear regression. RESULTS: Compared to instructors, students rated higher on Universalism & Benevolence, marginally higher on Hedonism, and lower on Tradition. Students' ratings on Self-Direction, Universalism & Benevolence, and Tradition predicted better mental wellbeing. Their rating on Hedonism predicted poorer mental wellbeing, the effect of which was marginally stronger in males. Ratings on Achievement & Power marginally predicted poorer mental wellbeing in females. CONCLUSION: Difference in personal values between medical students and instructors have been observed. Some of these values hold potentials over student's mental wellbeing. Curricular and medical school environmental accommodation for the changes in the characters of learners may be necessary to mitigate the adverse effects on their mental wellbeing and foster development of desirable professional characteristics.

Prevalence and correlates of medical student mistreatment in Nigeria: A narrative review.

Mistreatment in medical education encompasses various forms of abusive behavior, often indicating a disregard for students' dignity and interfering with the learning process. This review paper aims to investigate the prevalence, patterns, and correlates of medical student mistreatment in Nigerian medical education and shed light on its impact on students' well-being. A literature search was conducted in August 2023 using Medline, Google Scholar, and Web of Science databases to identify relevant studies on the mistreatment of Nigerian medical students. Inclusion criteria encompassed all studies written in English, regardless of study design, while editorials, reviews, and opinion articles were excluded. Six studies with a total sample size of 1432 were included in the review. The review revealed high mistreatment rates, ranging from 46% to 91%, with verbal abuse being the most common form. Male students were more likely to experience mistreatment, while females had higher rates of sexual abuse. Perpetrators included male and female healthcare professionals, with consultants and resident doctors as common perpetrators. Age and study level were associated with mistreatment experiences. Consequences of mistreatment included emotional distress, depression, loss of self-confidence, academic disillusionment, substance abuse, and suicidal thoughts. Reporting rates were low due to a lack of awareness, fear of reprisal, and perceived futility. The findings underscore the need for institutions to create a supportive environment, raise awareness of available support systems, and implement policies to prevent mistreatment. Future research should focus on larger-scale studies with diverse samples and longitudinal designs to address limitations in the current literature.

IDEAL: Maintaining PHC-focused training in a MBChB programme through a COVID-induced innovation.

Responding to the need for authentic clinical training for students in the context of coronavirus disease 2019 (COVID-19), the Stellenbosch University Faculty of Medicine and Health Sciences developed an innovative 12-week longitudinal, integrated rotation for pre-final-year medical students, the Integrated Distributed Engagement to Advance Learning (IDEAL) rotation. This saw 252 students being placed across 30 primary and secondary healthcare facilities in the Western and Northern Cape provinces. With a focus on service learning, the rotation was built on experiences and research of members of the planning team, as well as partnership relationships developed over an extended period. The focus of student learning was on clinical reasoning through being exposed to undifferentiated patient encounters and the development of practical clinical skills. Students on the distributed platform were supported by clinicians on site, alongside whom they worked, and by a set of online supports, in the form of resources placed on the learning management systems, learning facilitators to whom patient studies were submitted and wellness supporters. Important innovations of the rotation included extensive distribution of clinical training, responsiveness to health service need, co-creation of the module with students, the roles of learning facilitators and wellness supporters, the use of mobile apps and the integration of previously siloed learning outcomes. The IDEAL rotation was seen to be so beneficial as a learning experience that it has been incorporated into the medical degree on an ongoing basis.Contribution: Longitudinal exposure of students to undifferentiated patients in a primary health care context allows for integrated, self-regulated learning. This provides excellent opportunities for medical students, with support, to develop both clinical reasoning and practical skills.

Understanding of 'generalist medical practice' in South African medical schools.

BACKGROUND: In South Africa, medical students are expected to have acquired a generalist competence in medical practice on completion of their training. However, what the students and their preceptors understand by 'generalist medical practice' has not been established in South African medical schools. AIM: This study aimed to explore what the students and their preceptors understood by 'generalist medical practice'. SETTING: Four South African medical schools: Sefako Makgatho Health Sciences University, University of KwaZulu-Natal, Walter Sisulu University and the University of the Witwatersrand. METHODS: The exploratory descriptive qualitative design was used. Sixteen focus group discussions (FGDs) and 27 one-on-one interviews were conducted among students and their preceptors, respectively. Participants were recruited through purposive sampling. The inductive and deductive data analysis methods were used. The MAXQDA 2020 (Analytics Pro) software was used to arrange data, yielding 2179 data segments. RESULTS: Ten themes were identified: (1) basic knowledge of medicine, (2) first point of contact with all patients regardless of their presenting problems, (3) broad field of common conditions prevalent in the community, (4) dealing with the undifferentiated patient without a diagnosis, (5) stabilising emergencies before referral, (6) continuity, (7) coordinated and (8) holistic patient care, necessitating nurturance of doctor-patient relationship, (9) health promotion and disease prevention, and (10) operating mainly in primary health care settings. CONCLUSION: The understanding of 'generalist medical practice' in accordance with internationally accepted principles augurs well in training undergraduate medical students on the subject. However, interdepartmental collaboration on the subject needs further exploration.Contribution: The study's findings can be used as a guide upon which the students' preceptors and their students can reflect during the training in generalist medical practice.

Teaching Medical Students Rapid Ultrasound for shock and hypotension (RUSH): learning outcomes and clinical performance in a proof-of-concept study.

BACKGROUND: Point-of-care ultrasound (POCUS) is a critical diagnostic tool in various medical settings, yet its instruction in medical education is inconsistent. The Rapid Ultrasound for Shock and Hypotension (RUSH) protocol is a comprehensive diagnostic tool, but its complexity poses challenges for teaching and learning. This study evaluates the effectiveness of a single-day training in RUSH for medical students by assessing their performance in clinical scenarios. METHODS: In this prospective single-center observational proof-of-concept study, 16 medical students from Saarland University Medical Center underwent a single-day training in RUSH, followed by evaluations in clinical settings and on a high-fidelity simulator. Performance was assessed using a standardized scoring tool and time to complete the RUSH exam. Knowledge gain was measured with pre- and post-training written exams, and diagnostic performance was evaluated with an objective structured clinical examination (OSCE). RESULTS: Students demonstrated high performance in RUSH exam views across patients (median performance: 85-87%) and improved scanning times, although not statistically significant. They performed better on simulators than on live patients. Written exam scores significantly improved post-training, suggesting a gain in theoretical knowledge. However, more than a third of students could not complete the RUSH exam within five minutes on live patients. CONCLUSIONS: Single-day RUSH training improved medical students' theoretical knowledge and simulator performance but translating these skills to clinical settings proved challenging. The findings suggest that while short-term training can be beneficial, it may not suffice for clinical proficiency. This study underscores the need for structured and possibly longitudinal training programs to ensure skill retention and clinical applicability.

Matching Against Men: 5 Years of Residency Match Data Show Disparities Still Exist.

OBJECTIVES: Despite progress toward equal representation by sex in medical practice, women remain underrepresented in many specialties. This study sought to examine the current state of gender equality among recently graduated doctors in multiple specialties. METHODS: Deidentified demographics, standardized examination scores, and Match results were gathered for 829 graduates. Participants were selected from an allopathic medical school between 2016 and 2020. Nineteen students (2.29%) were excluded from the study. Descriptive statistics were calculated, and χ2 tests for independence were used to compare proportions between reported sex and specialty and program Match results. One-way analysis of variance was then performed to test for differences in US Medical Licensing Examination Step 1 and Step 2 scores between sexes. P < 0.05 was considered statistically significant. RESULTS: Of the 829 individuals studied, 44.6% were women. A significantly smaller proportion of women matched into the most competitive specialties, despite no significant difference in US Medical Licensing Examination Step 1 scores between sexes. Furthermore, there was an overall significant trend of women matching into more competitive programs for any given specialty. CONCLUSIONS: In this study, we found that men matched into more highly competitive specialties, whereas women matched into more competitive residency program locations. Further research is needed to determine why women matched into specific specialties at lower rates than their male peers and seek to understand how sex affects the narrative of specialty choice.

Art-based observational training for medical students and surgical residents in two Dutch museums.

Background: Art-based education is gaining interest in the medical field, particularly in specialties with a strong visual focus. Visual arts are increasingly used for the development of observational skills and social competencies. While content and objectives of art-based programs widely differ across medical faculties in the Netherlands, the diverse range of options underscore the interest in and the potential of this educational approach. In this report, we explore the value of art-based observational training for medical students and surgical residents in two prominent Dutch museums in Amsterdam and Rotterdam, respectively. Methods: Our program, conducted at the Rijksmuseum in Amsterdam and Depot Boijmans van Beuningen Museum in Rotterdam engaged medical students (n=24) and surgeons (in training) (n=66) in an interactive workshop focused on art observation led by an experienced art-educator and a clinical professional. Learning objectives were defined and a post-workshop questionnaire was devised to evaluate participants' perceptions, with a specific focus on contribution of the program to professional development. Results: Both residents and surgeons acknowledged that the program had a positive impact on their professional skills. The program learned them to postpone their judgements and contributed to the awareness of their personal bias. Notably, medical students believed in the program's potential contribution to their professional development. Surgeons were more critical in their evaluation, emphasizing the challenge of sustainable improvement of skills within the limited duration of the course. Conclusions: An interactive art-based medical education program was offered to medical students, PhD students, house officers, surgical residents and surgeons in two well known Dutch museums. Participants expressed enthusiasm for the innovative educational approach they experienced at the museums. They learned about the importance of critical observation in their professional work, handling of ambiguity and got the opportunity to practice both observational and communicational skills in a creative manner. The findings indicate that medical students and surgical residents can benefit from art-based observational training, using art as a vehicle to develop their professional competencies.

Students' Perception of Online Platform Based Tutorial in Physiology Curriculum.

Tutorial is one of the effective ways of interactive small group teaching activity sessions. The tutorial is a short series of classes that is ideally conducted in the small group. The use of media in the form of online platforms in tutorials could be very useful. Aims of the study to evaluate the response and perception of students about the small group learning activities like Online platform tutorials in the medical undergraduate Physiology curriculum. This was the cross-sectional study done in the Physiology Department, AIIMS, Bhopal, India from 2022 to 2023 which involved first-year MBBS students (n=39). Five online platforms-based tutorials were taken whereby five topics- one for each system were discussed. In this form of tutorial, 20 to 25 minutes were focussed on discussion, followed by assessment by multiple choice questions through an online platform. Perceptions of students were assessed through a predesigned validated questionnaire, which involved open-ended and close-ended questions. Likert scale questionnaires were also used. The chi-square test and odds ratio was used to see the difference between categorical variable (yes vs. no). The mean and Median score of the Likert scale was reported. The major issue faced was the failure to promote writing skills followed by connectivity problems. Seventy-eight percent (78.0%) of participants liked this form of tutorial, and 94.0% of participants advocated using it in the future. Online platform-based tutorials motivated 84.0% of students to learn topics in a better way. However, 41.0% feared that it does not involve communication and 92.0% opined that writing skill is not promoted. Online platform-based tutorials should be used in the Physiology curriculum. However, infrastructure in the form of prior training and internet connection must be provided. Conventional forms of tutorial should also be used to promote communication and writing skills.

Acute Muscle Rigidity Secondary to Tetanus: A Toxicology Simulation Case for Fourth-Year Medical Students.

Introduction: Tetanus is uncommon in the United States secondary to vaccination. However, vaccination hesitancy is increasing. This case challenges medical students to consider tetanus in the differential and understand its complications. Methods: Fourth-year medical students took a pretest on the neurotransmitter glycine and associated disease states. They received two 10-minute lectures on glycine and acid-base abnormalities. Students then participated in a simulation featuring a 27-year-old man bitten by a dog, resulting in tetanus. Required equipment included a mannequin with monitor, a defibrillator, and personal protective equipment. Critical actions consisted of learners dividing up roles amongst each other, using closed-loop communication, placing the patient on a cardiac monitor, choosing to establish IV access and intubate the patient, starting IV fluids, and administering tetanus immunoglobulin. The case ended after 20 minutes. Outcome measurements encompassed performance on a posttest and critical actions. Results: Twenty students participated. Mean pretest and posttest scores were 69.5 and 92.5, respectively (p < .001). All groups completed the items on the critical actions checklist within a 20-minute time frame. Discussion: Rising vaccine hesitancy may increase the likelihood of physicians encountering new cases of tetanus and require them to perform lifesaving management of a patient presenting with muscle rigidity. This simulation provides learners with hands-on experience caring for a patient with tetanus and muscle rigidity. It can improve their knowledge of recognition, assessment, and decision-making toward lifesaving management of tetanus by allowing them to practice their skills in a safe environment.

Developing a framework for promoting interest and engagement of scholarship of teaching and learning for medical students.

BACKGROUND: The scholarship of teaching and learning (SoTL) is a field of academic research that focuses on improving learning through reflective and informed teaching. Currently, most SoTL-related work is faculty-driven; however, student involvement in SoTL has been shown to benefit both learners and educators. Our study aims to develop a framework for increasing medical students' interest, confidence, and engagement in SoTL. METHODS: A student-led SoTL interest group was developed and a year-round program of SoTL was designed and delivered by student leaders of the group under the guidance of a faculty advisor. Individual post-session surveys were administered to evaluate participants' perceptions of each session. Pre- and post-program surveys were administered to evaluate the program impact. RESULTS: The year-round SoTL program consistently attracted the participation of medical students and faculty. Survey responses indicated strong medical student interest in the program and positive impact of the program. Increased interest and confidence in medical education research were reported by the student participants. The program design provided opportunities for student participants to network and receive ongoing feedback about medical education research they were interested or involved in. CONCLUSION: Our study provides insights for developing a framework that other institutions can reference and build upon to educate and engage students in SoTL.

Assessment the awareness of vitamin D deficiency among the general population in Syria: an online cross-sectional study.

BACKGROUND: Vitamin D deficiency is an importance preventable problem in the global and associates with lack levels of awareness about vitamin D. According to prior studies, in the Arab world, there is low of knowledge and awareness toward vitamin D deficiency. The target of our study is evaluating the knowledge level about vitamin D deficiency and determining the associated factors with levels of awareness of its. METHOD: This online cross-sectional study was performed in Syria between 25 February to 29 March 2023 to assess the levels of knowledge about vitamin D deficiency among general Syrian population. The study's survey was obtained from previously published research and we conducted a pilot study to assure the validity and clarity questionnaire. All Syrian individuals aged 18 or older who were able to read and write and willing to participate were included, while, non-Syrian nationality individuals and all medical staff (doctors, nurses, and medical students…), as well, those under 18 age were excluded. The questionnaire consisted of 23 questions separated into four categories. The first section was sociodemographic information of the study population. The second section measured the level awareness of the study population regarding the benefits of vitamin D. In addition, the third and fourth part evaluated knowing of the respondents about sources of and toxicity consequences of vitamin D. The data were analyzed by utilizing multivariate logistic regression in IBM, SPSS V.28 version. RESULTS: Overall, 3172 of the study population accepted to participate in this research and 57.9% the majority of them were aged in the range among 18 and 28. While, the average age of the respondents were 30.80 ± 11.957. Regarding with the awareness toward knowledge of advantages and source of vitamin D and outcomes of vitamin D toxicity. Most of the participants mentioned that vitamin D is used to treat bone disease and rickets and contributes in maintaining calcium and phosphates (91.4% and 84.6%, respectively). Whereas, more than half of them reported that sun exposure does not cause vitamin D poisoning and that vegetarians are more likelihood to have vitamin D than non-vegetarians, (54.1% and 54.9%, respectively). Only, age and occupation out of nine predictors variables were significantly correlated with adequate knowledge of Vitamin D (p-value < 0.05). The respondents aged more than 60 years were high probability to have good recognition of Vitamin D than participants aged between 18 and 28 years. (OR = 7.95). Retired participants have shown lower aware of Vitamin D 0.38 times than students. CONCLUSION: Our research revealed that most of the participated individuals have sufficient comprehension about vitamin D, despite, there were significant gap. Health education via programs by government health-care agencies, NGOs and social workers is necessary to increase the awareness and knowledge toward benefits, source, deficiency and toxicity of vitamin D to avoid injury several diseases such as rickets.

Learning styles, academic performance and mental health among medical students in King Faisal University, Saudi Arabia.

OBJECTIVE: To assess the prevalence of various learning styles and their correlation with academic performance and mental health of medical students. METHODS: The cross-sectional study was conducted at the King Faisal University, Houfof, Saudi Arabia, from January to June 2019, and comprised medical students regardless of gender or the academic year. Data was collected using the Visual Aural Read/write Kinesthetic questionnaire. Depression Anxiety Stress Scales-21 was used to assess mental health. Data was analysed using SPSS 22. RESULTS: Of the 315 students, 179(57%) were males and 136(43%) were females. Overall, 152(48.3%) subjects preferred multimodal, while 163(51.7%) preferred unimodal style; 93(29%) aural, 53(16.8%) visual, 11(3.5%) read/write and 6(1.9%) kinesthetic. Males preferred visual and quardimodal styles of learning, while females preferred aural learning (p<0.05). Academic achievement was associated with learning style (p<0.05), but no relationship was observed between depression scores and learning styles (p>0.05). CONCLUSIONS: The most preferred learning styles among medical students were found to be aural and bimodal.

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.

Bioethics curriculum for undergraduate medical students: an evaluation study utilizing mixed methods approach.

BACKGROUND: The undergraduate bioethics curriculum introduced in a private medical college in Pakistan in 1988 and revised in 2009 has evolved over time to incorporate globally relevant innovations, including integration of bioethics spirally within an existing problem-based learning curricular framework. The present evaluation study shares the results of this integrated bioethics curriculum delivered for 10 years across the five-year undergraduate medical curriculum. The study assessed the effectiveness of the curriculum in terms of student achievement, appropriateness of course contents and efficiency of instructional methods. METHODS: The study utilized a mixed method sequential explanatory design. The quantitative method was used in the first phase to gather data by utilizing a structured online questionnaire. This was followed by the second phase of qualitative methods to explain the findings of the first phase and enrich the data gathered. This phase was based on focus group discussions and document review. RESULTS: Student and faculty responses showed the curriculum contents to be relevant, informative, and appropriate as per learning objectives and student achievement. Multi-modal instructional methods used were stated to be effective and engaging; small group teaching and shorter sessions suggested to be preferable for fostering discussion and maintaining student engagement and attention. Large class formats were stated to be less effective. Students affirmed the contribution of bioethics education to their personal and professional development and ethical positioning. The majority of students agreed that the curriculum contributed to their knowledge acquisition (60.3-71.2%), skill development (59.41-60.30%) and demonstration of ethical/professional behavior (62.54-67.65%). The ranges indicate agreement with related sets of questions. Participants suggested that the curriculum could be further strengthened by better integration in clinical years, role modelling and providing opportunities for application in clinical health care settings. Moreover, topics like ethical issues related to the use of social media, public health ethics and ethics and law were suggested as additions to the existing curriculum. These findings have regional and global relevance for the development and assessment of effective bioethics curricula. CONCLUSION: An effective bioethics curriculum for undergraduate medical education should run longitudinally across the 5 year curriculum and be integrated in the modules and clerkships. Basic acquisition of knowledge and skills takes place in Years 1 & 2 with reinforcement and application in Years 3-5. Learning embedded in an integrated curriculum can help students recognize, critically analyze and address ethical dilemmas. Involvement and commitment of the clinical faculty is essential for reinforcing the ethical principles and concepts learnt in the earlier years.

Promotion of self-directed learning abilities among Chinese medical students through preparing for career calling and enhancing teaching competencies in medical education: a cross-sectional study.

BACKGROUND: Medical students face a heavy burden as they are tasked with acquiring a vast amount of medical knowledge within a limited time frame. Self-directed learning (SDL) has become crucial for efficient and ongoing learning among medical students. However, effective ways to foster SDL ability among Chinese medical students are lacking, and limited studies have identified factors that impact the SDL ability of medical students. This makes it challenging for educators to develop targeted strategies to improve students' SDL ability. This study aims to assess SDL ability among Chinese medical students and examine the effects of career calling and teaching competencies on SDL ability, as well as the possible mechanisms linking them. METHODS: Data were collected from 3614 respondents (effective response rate = 60.11%) using cross-sectional online questionnaires and analyzed using IBM SPSS Statistics 22.0. The questionnaire comprised a Demographic Characteristics Questionnaire, Self-directed Learning Ability Scale (Cronbach's alpha = 0.962), Teaching Competencies Scale, and Career Calling Scale. RESULTS: The average SDL ability score of Chinese medical students was 3.68 ± 0.56, indicating a moderate level of SDL ability. The six factors of the Self-directed Learning Ability Scale-self-reflection, ability to use learning methods, ability to set study plans, ability to set studying objectives, ability to adjust psychological state, and willpower in studying-accounted for 12.90%, 12.89%, 12.39%, 11.94%, 11.34%, and 8.67% of the variance, respectively. Furthermore, career calling was positively associated with SDL learning ability (ß = 0.295, p < 0.001), and SDL learning ability was positively associated with teaching competencies (ß = 0.191, p < 0.01). Simple slope analysis showed that when the level of teaching competencies was higher, the influence of career calling on SDL ability was stronger. CONCLUSIONS: Chinese medical students' SDL ability has room for improvement. Medical students could strengthen their willpower in studying by setting milestones goals with rewards, which could inspire their motivation for the next goals. Teachers should guide students to learn experience to improve students' reflective ability. Educators play a crucial role in bridging the gap between career calling education and SDL ability enhancement, highlighting the significance of optimal teaching competencies. Colleges should focus on strengthening teachers' sense of career calling and teaching competencies.