Project description:Data from the British Society of Rheumatology demonstrate a lack of exposure to rheumatology for medical students, potentially impacting career choice. We conducted a Systematic Literature Review (SLR) on quantity, type and quality of rheumatology teaching for undergraduate medical students. This SLR was registered on PROSPERO (CRD42023472169). Articles published in English-language until February 2024 were included. Information was extracted on demographics, method(s) and hours for rheumatology teaching, and students' and educators' feedback, where reported. Eight cross-sectional studies were included, published between 1981 and 2024. Studies were conducted in UK (3); USA (2); Australia (1); Pan-European (1) and Uganda (1). Year of rheumatology teaching at medical school was reported in four studies (three UK; one USA). The three UK studies taught rheumatology in the latter years of study; in the USA study, rheumatology was taught every year. Duration of exposure to rheumatology was 15-96 h per student. Reported teaching methods included lecture-based, rheumatology inpatient service, shadowing consultations and patient education. Student feedback was available in one (UK based) study- four students felt they had limited exposure to rheumatology; eight considered it "niche". Factors identified for poor exposure to rheumatology included lack of full-time rheumatologists on the school's faculty; lack of specialty training programmes in local hospitals; greater emphasis on acute specialties (e.g. emergency medicine). Exposure to and student awareness of clinical rheumatology has markedly decreased over time. Given the ageing population and increase in multimorbidity, there is a need to increase exposure and encourage entry to rheumatology training. Key Points • There are clear differences between the methods of rheumatology teaching between institutions and countries. • Teaching hours dedicated to undergraduate rheumatology education have overall markedly decreased over time, resulting in variable student awareness of the depth and breadth of this speciality. • The overall lack of exposure to rheumatology in undergraduate programmes has been associated with a lack of uptake of rheumatology as a career amongst medical students globally. • Our results indicate a need for a minimum required number of hours of teaching dedicated to rheumatology, delivered by specialists as well as a standardised undergraduate curriculum of competencies to better reflect the needs of our increasingly ageing and multimorbid population.
Project description:Palliative care is central to the role of all clinical doctors. There is variability in the amount and type of teaching about palliative care at undergraduate level. Time allocated for such teaching within the undergraduate medical curricula remains scarce. Given this, the effectiveness of palliative care teaching needs to be known.ObjectivesTo evaluate the effectiveness of palliative care teaching for undergraduate medical students.DesignA systematic review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Screening, data extraction and quality assessment (mixed methods and Cochrane risk of bias tool) were performed in duplicate.Data sourcesEmbase, MEDLINE, PsycINFO, Web of Science, ClinicalTrials.gov, Cochrane and grey literature in August 2019. Studies evaluating palliative care teaching interventions with medical students were included.Results1446 titles/abstracts and 122 full-text articles were screened. 19 studies were included with 3253 participants. 17 of the varied methods palliative care teaching interventions improved knowledge outcomes. The effect of teaching on clinical practice and patient outcomes was not evaluated in any study.ConclusionsThe majority of palliative care teaching interventions reviewed improved knowledge of medical students. The studies did not show one type of teaching method to be better than others, and thus no 'best way' to provide teaching about palliative care was identified. High quality, comparative research is needed to further understand effectiveness of palliative care teaching on patient care/clinical practice/outcomes in the short-term and longer-term.Prospero registration numberCRD42018115257.
Project description:PhenomenonResearch literacy remains important for equipping clinicians with the analytical skills to tackle an ever-evolving medical landscape and maintain an evidence-based approach when treating patients. While the role of research in medical education has been justified and established, the nuances involving modes of instruction and relevant outcomes for students have yet to be analyzed. Institutions acknowledge an increasing need to dedicate time and resources towards educating medical undergraduates on research but have individually implemented different pedagogies over differing lengths of time.ApproachWhile individual studies have evaluated the efficacy of these curricula, the evaluations of educational methods and curriculum design have not been reviewed systematically. This study thereby aims to perform a systematic review of studies incorporating research into the undergraduate medical curriculum, to provide insights on various pedagogies utilized to educate medical students on research.FindingsStudies predominantly described two major components of research curricula-(1) imparting basic research skills and the (2) longitudinal application of research skills. Studies were assessed according to the 4-level Kirkpatrick model for evaluation. Programs that spanned minimally an academic year had the greatest proportion of level 3 outcomes (50%). One study observed a level 4 outcome by assessing the post-intervention effects on participants. Studies primarily highlighted a shortage of time (53%), resulting in inadequate coverage of content.InsightsThis study highlighted the value in long-term programs that support students in acquiring research skills, by providing appropriate mentors, resources, and guidance to facilitate their learning. The Dreyfus model of skill acquisition underscored the importance of tailoring educational interventions to allow students with varying experience to develop their skills. There is still room for further investigation of multiple factors such as duration of intervention, student voluntariness, and participants' prior research experience. Nevertheless, it stands that mentoring is a crucial aspect of curricula that has allowed studies to achieve level 3 Kirkpatrick outcomes and engender enduring changes in students.Supplementary informationThe online version contains supplementary material available at 10.1007/s40670-020-01183-w.
Project description:BackgroundPatient-clinician communication training is a core component of the undergraduate medical program. As with all areas of medicine, the best available evidence for teaching these skills should be incorporated into training programs. Examining the volume, type and design-quality of publications in this field can help to determine whether research is following a natural scientific progression to inform interactional skills training. This study aimed to review: (i) whether the proportion of publications examining teaching interactional skills to undergraduate medical students by study type, across three time-periods (2007-2008, 2011-2012, 2015-2016), changed over time (i.e. measurement, descriptive or interventions studies); and (ii) the proportion of intervention studies meeting Cochrane Effective Practice and Organisation of Care (EPOC) research design criteria.MethodsMedline, PubMed, PsycInfo and the Cochrane Database were searched for studies published in English from 2007 to 2016. Title and abstract reviews were performed for the included years. Articles were examined against the inclusion/exclusion criteria and those included were coded into descriptive, measurement or intervention categories.ResultsA total of 243 relevant publications were identified. Fifty-two were published from 2007 to 2008, 75 from 2011 to 2012 and 116 from 2015 to 2016. Most identified studies were descriptive (63%), followed by measurement studies (22%) and intervention studies (15%). The proportion of descriptive studies increased significantly over time. However, the proportion of intervention studies did not change and the proportion of measures studies significantly decreased. Of the 37 intervention studies identified within the three time-periods, only 16 (43%) met EPOC study design criteria.ConclusionsThe largest proportion of identified studies were descriptive, however, descriptive research is not sufficient to ensure communication skills training can effectively improve interactions between clinicians and patients. A more rigorous approach to research in this area is needed to inform education strategies.
Project description:BackgroundClinical reasoning involves the application of knowledge and skills to collect and integrate information, typically to arrive at a diagnosis, implement appropriate interventions, solve clinical problems, and improve the quality of health care and patient outcomes. It is a vital competency that medical students must acquire, as it is considered the heart of medicine.PurposeThis scoping review aimed to identify and summarize the existing literature on learning and teaching strategies for improving clinical reasoning skill in undergraduate medical education.MethodsWe conducted electronic searches in Scopus, PubMed/Medline (NLM), Web of Science (WOS), and ERIC to retrieve articles published between January 1, 2010, and March 23, 2024. We also performed hand searches by scanning the reference lists of included studies and similar reviews and searching three key journals. After removing duplicates, two reviewers independently extracted data from primary articles using a standard data extraction form. The authors used Arksey and O'Malley's framework.ResultsAmong the 46581 retrieved records, 54 full-text articles were included in the present review. We categorized the educational strategies based on their aspects, focus, and purpose. Included studies used various educational strategies for improving clinical reasoning skill in undergraduate medical education by serial cue or whole clinical cases that presented as process-oriented or knowledge-oriented.ConclusionThis scoping review investigated various dimensions of educational intervention for improving clinical reasoning skill in undergraduate medical education. There is a need for more precision studies with larger sample sizes, designing studies according to randomized controlled trials standards, determining MCID, or performing meta-analyses to acquire robust and conclusive results.
Project description:IntroductionMentoring has become a prevalent educational strategy in medical education, with various aims. Published reviews of mentoring report very little on group-based mentorship programs. The aim of this systematic review was to identify group-based mentorship programs for undergraduate medical students and describe their aims, structures, contents and program evaluations. Based on the findings of this review, the authors provide recommendations for the organization and assessment of such programs.MethodsA systematic review was conducted, according to PRISMA guidelines, and using the databases Ovid MEDLINE, EMBASE, PsycINFO and ERIC up to July 2019. Eight hundred abstracts were retrieved and 20 studies included. Quality assessment of the quantitative studies was done using the Medical Education Research Study Quality Instrument (MERSQI).ResultsThe 20 included studies describe 17 different group mentorship programs for undergraduate medical students in seven countries. The programs were differently structured and used a variety of methods to achieve aims related to professional development and evaluation approaches. Most of the studies used a single-group cross-sectional design conducted at a single institution. Despite the modest quality, the evaluation data are remarkably supportive of mentoring medical students in groups.DiscussionGroup mentoring holds great potential for undergraduate medical education. However, the scientific literature on this genre is sparse. The findings indicate that group mentorship programs benefit from being longitudinal and mandatory. Ideally, they should provide opportunities throughout undergraduate medical education for regular meetings where discussions and personal reflection occur in a supportive environment.
Project description:BackgroundTraditional radiology education for medical students predominantly uses textbooks, PowerPoint files, and hard-copy radiographic images, which often lack student interaction. PACS (Picture Archiving and Communication System) is a crucial tool for radiologists in viewing and reporting images, but its use in medical student training remains limited.ObjectiveThis study investigates the effectiveness of using PACS (Picture Archiving and Communication System) for teaching radiology to undergraduate medical students compared to traditional methods.MethodsFifty-three medical students were divided into a control group (25 students) receiving traditional slide-based training and an intervention group (28 students) using PACS software to view complete patient images. Pre- and post-course tests and satisfaction surveys were conducted for both groups, along with self-evaluation by the intervention group. The validity and reliability of the assessment tools were confirmed through expert review and pilot testing.ResultsNo significant difference was found between the control and intervention groups regarding, gender, age, and GPA. Final multiple-choice test scores were similar (intervention: 10.89 ± 2.9; control: 10.76 ± 3.5; p = 0.883). However, the intervention group demonstrated significantly higher improvement in the short answer test for image interpretation (intervention: 8.8 ± 2.28; control: 5.35 ± 2.39; p = 0.001). Satisfaction with the learning method did not significantly differ between groups (intervention: 36.54 ± 5.87; control: 39.44 ± 7.76; p = 0.129). The intervention group reported high familiarity with PACS capabilities (75%), CT principles (71.4%), interpretation (64.3%), appropriate window selection (75%), and anatomical relationships (85.7%).ConclusionPACS-based training enhances medical students' diagnostic and analytical skills in radiology. Further research with larger sample sizes and robust assessment methods is recommended to confirm and expand upon theses results.
Project description:BackgroundMedical students receive limited exposure to the field of plastic surgery because most students will not rotate in plastic surgery, especially those at schools without dedicated plastic surgery residency programs. This study aimed to create and validate a plastic surgery learning module for medical students to dispel media-propagated myths and misrepresentation of the breadth of plastic surgery and equip students with referral-making capabilities.MethodsThe plastic surgery learning module was created using Articulate Storyline 360 (New York, N.Y.). Student participants were recruited from a single medical school across all four classes. Pre- and postmodule surveys were administered via Qualtrics (Provo, Utah). Scores were computed for the general surgical knowledge section and for each specialty referral question.ResultsTwelve students completed usability testing and edits were subsequently made to optimize the module. The module took on average 66 minutes to complete. Sixty-five students (19 MS1, 16 MS2, 15 MS3, 15 MS4) completed efficacy testing. In the premodule survey, students were nearly 100% accurate in identifying breast-related referrals, unlike pediatric/craniofacial (avg: 68%), reconstruction/microsurgery (avg: 64%), and hand/upper extremity (avg: 30%) referrals. Students of all classes exhibited significant improvement in all testing categories except for the breast category, with the most improvement in the hand referrals category. Prior exposure to plastic surgery (57%) correlated with higher premodule hand (P = 0.003) and breast/cosmetic (P = 0.01) referral scores.ConclusionThe plastic surgery learning module shows promise to be a comprehensive yet affordable and time-efficient tool for medical students to learn about basic surgical principles and the scope of plastic surgery.
Project description:ObjectivesAccording to the CanMEDS' Scholar competency, physicians are expected to facilitate the learning of colleagues, patients and other health professionals. However, most medical students are not provided with formal opportunities to gain teaching experience with objective feedback.MethodsTo address this, the University's Medical Education Interest Group (MEIG) created a pilot teaching program in January 2015 entitled 'MedTalks'. Four 3-hour sessions were held at the University Faculty of Medicine, where first and second year medical students taught clinically oriented topics to undergraduate university students. Each extracurricular session included three 30-minute content lectures, and a 90-minute small group session on physical examination skills. Each medical student-teacher received formal feedback from undergraduate students and from faculty educators regarding teaching style, communication abilities, and professionalism. In addition, medical student-teachers self-evaluated their own teaching experience.ResultsOver 50 medical students from the University participated as medical student-teachers. Based on quantitative and qualitative evaluation surveys, 100% of medical students agreed that MedTalks was a useful way to develop teaching skills and 92% gained a greater confidence in individual teaching capabilities, based largely on the opportunity to gain experience (with feedback) in teaching roles.ConclusionsA program designed to give medical students multi-source teaching experience (lecture- and small group-based) and feedback on their teaching (from learners and Faculty observers, in addition to their own self-reflection) can improve medical student confidence and enthusiasm towards teaching. Future studies will clarify if medical student self-perceived enhancements in teaching ability can be corroborated by independent (Faculty, learner) observations of future teaching activity.
Project description:ObjectivesThe objectives of this study were the following: (i) assess interest levels in cardiothoracic surgery (CTS) among UK-based medical students, (ii) identify potential motivators and barriers to pursuing CTS training, (iii) explore the influence of gender on interest in CTS in greater depth.MethodsMedical students from all year groups across UK medical schools were invited to participate in a cross-sectional, national online survey. Responses were collected from 02/12/2019 to 08/12/2019.Results1675 medical students from 31 UK medical schools responded, with an estimated 5.3% response rate. Of the respondents, 33.7% respondents reported having exposure to CTS, primarily through their medical school or through extracurricular activities (48.4% and 38.8%, respectively). When assessing interest in CTS, 31.4% were interested in undertaking a career in CTS, with a larger proportion of students expressing interest with no exposure to CTS than those with exposure. However, interest in pursuing CTS decreased with exposure as medical students transitioned from pre-clinical to clinical stages. Additionally, male participants were more interested in seeking a CTS post than their female counterparts (38% vs. 27.6%). The length of training (p = 0.0009) and competitive nature (p < 0.0001) of gaining a CTS post were the primary deterring factor for female participants, compared to their male counterparts.ConclusionsThis study shows the importance of quality of exposure and its impact on students' interests in pursuing a career in CTS. The negative relationship between exposure and interest in CTS can be associated with the realisation of the challenges that come with pursuing CTS.