The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our profession.We contend that t...The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our profession.We contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of individuals.Additionally,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational abilities.Importantly,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their curricula.While we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.展开更多
Ioannis Solos Ph.D.,M.D.(China),L.Ac.currently serves as President and CEO at the Saint George Clinic and Research Institute,Scottsdale,AZ.,and Associate Editor for Chinese Medicine and Culture.Professor Solos has ear...Ioannis Solos Ph.D.,M.D.(China),L.Ac.currently serves as President and CEO at the Saint George Clinic and Research Institute,Scottsdale,AZ.,and Associate Editor for Chinese Medicine and Culture.Professor Solos has earned his Master of Medicine in Traditional Diagnosis at the Beijing University of Chinese Medicine,and his Medical Ph.D.in Chinese and Western Integrative Medicine at the Jinan University in Guangzhou.He practices and teaches integrative clinical medicine,Jing Fang(经方TCM formulas),martial lineage acupuncture,and his personalized style of“tendon and fascia reconditioning manipulations for bone and joint disease”.展开更多
The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner,his public disclosure of the poor conditions at many medical schools provided a means to ga...The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner,his public disclosure of the poor conditions at many medical schools provided a means to galvanize all the constituencies needed for reform to occur.He could say what other reformers could not,due to their links to the medical education community.But now we are again going back to a pre-Flexnerian state due to multiple reasons such as gradually diminishing importance of basic science subjects for the students,the decline in the number and quality of investigator initiated research among clinical researchers,lesser emphasis to bedside training by means of detailed clinical examination and making appropriate observation of signs to reach to a diagnosis rather than over reliance on the laboratory tests and radiological modalities for the diagnosis,poor exposure to basic clinical skills starting from college throughout residency and the trend of disrespect and absenteeism from both theoretical and clinical/practical classes.The attitude of students is just to complete their required attendance so that they are not barred from appearing in examinations.This de-Flexnerization trend and regression to pre-Flexnerian era standards,ideologies,structures,processes,and attitudes,are bound to beget pre-Flexnerian outcomes,for you get what you designed for.展开更多
The“New Medical Education”is a new requirement for the development of medical education in the new era.As a key and core element of the construction of the“New Medical Education,”the engagement in teaching work of...The“New Medical Education”is a new requirement for the development of medical education in the new era.As a key and core element of the construction of the“New Medical Education,”the engagement in teaching work of university teachers is a key issue that determines the level of teaching development of university teachers and affects the quality of talent cultivation in universities.Using the literature review method,this study analyzed 39 relevant literatures retrieved from China National Knowledge Infrastructure(CNKI)from 1997 to 2023.The concept,connotation,current situation,influencing factors,and improvement strategies of teaching engagement by university teachers were reviewed and summarized.The results showed that the issue of teaching engagement by university teachers has not received high attention in the field of higher education,especially in higher medical education,which has not yet been reported.Although the overall number of literature is not large,some of the conclusions have important implications for the next research on the influencing factors and mechanisms of double-qualified teacher engagement in higher medical colleges.展开更多
Dear Editor,The application of ChatGPT in medical education has made remarkable progress,such as automated scoring,teaching assistance,personalized learning,research assistance,quick access to information,generating c...Dear Editor,The application of ChatGPT in medical education has made remarkable progress,such as automated scoring,teaching assistance,personalized learning,research assistance,quick access to information,generating case scenarios and exam questions,content creation for learning facilitation and language translation.As a result,a subset of the medical school faculty has swiftly embraced these innovations[1,2].展开更多
After six years'medical reform,about 7.8 billion person-times of medical service has been achieved by2014,and the number of persons covered by basic medical insurance for urban employees,basic medical insurance fo...After six years'medical reform,about 7.8 billion person-times of medical service has been achieved by2014,and the number of persons covered by basic medical insurance for urban employees,basic medical insurance for urban residents,and new rural cooperative medical insurance exceeded 1.3 billion,of which the coverage ratio reached as high as over 95%,establishing the largest basic medical security network in the world.展开更多
L.David Marquet,a decorated Navy Captain,transformed an under performing submarine crew by empowering his subordinates to be leaders and reach their full potential.He called this intent-based leadership(IBL).What woul...L.David Marquet,a decorated Navy Captain,transformed an under performing submarine crew by empowering his subordinates to be leaders and reach their full potential.He called this intent-based leadership(IBL).What would happen if Marquet’s model were implemented in Graduate Medical Education(GME)?In this letter to the editor,we summarize the potential of the IBL model in graduate medical education as opposed to the traditional leaderfollower method.IBL harnesses human productivity toward the shared goals of GME,which are patient care and trainee learning.This shift in mindset could lead both teachers and trainees to focus more on the real reason that we undertake GME and change behaviors for the better.We suggest that IBL can and should be adopted in GME and propose that both patients and providers will benefit from this action.展开更多
Background: Assessment is the systematic collection, review, and use of information about educational programs undertaken to improve teaching and learning. It ensures quality in training programmes, motivates, and dir...Background: Assessment is the systematic collection, review, and use of information about educational programs undertaken to improve teaching and learning. It ensures quality in training programmes, motivates, and directs students’ learning. Assessment is also used for verification of achievement of objectives of training, feedback to students, licencing, certification, and screening of students for advanced training. It is guided by several principles, including the aims of the assessment (why assess), who to assess, timing (when to assess), what to assess, methods (how to assess), and the criteria for determining the usefulness of the assessment. Objective: To describe the assessment methods used during clinical years of the undergraduate programme at Moi University School of Medicine (MUSOM) and determine the student’s perspectives concerning the comprehensiveness, relevance, objectivity of various assessment methods and challenges faced. Methodology: The study was carried out at MUSOM and a cross-sectional study design was employed. Ten study participants were studied using convenience sampling. Data were collected using an interview guide and was analyzed using content analysis. An informed consent was obtained from the study participants. Results: The methods used during clinical years at MUSOM for assessing knowledge and its applications include multiple-choice questions (MCQ), short answer questions (SAQ), modified essay questions (MEQ), long essay questions (LEQ), and oral exam. Whereas the methods for assessing clinical competence include long case, short cases, objective structured clinical examinations (OSCE), and logbook. Students felt that MCQs were comprehensive, objective, and relevant to the curriculum content. They reported that feedback was not provided after assessments. Conclusion: The assessment methods used at MUSOM during clinical years include MCQ, SAQ, MEQ, LEQ, Short cases, long cases, and OSCE. Students reported varied perceptions of the different assessment methods but favored MCQ and OSCE over other formats for assessing knowledge and clinical skills respectively.展开更多
Continuing medical education(CME)is rapidly evolving into competency-based continuing professional development(CPD)and this is driving change in self-directed CPD programs undertaken by individual practitioners as wel...Continuing medical education(CME)is rapidly evolving into competency-based continuing professional development(CPD)and this is driving change in self-directed CPD programs undertaken by individual practitioners as well as CPD programs or frameworks offered by CPD educators.This progression is being led by many factors including the rapid change in medical knowledge and medical practitioners along with changes in patients and society,healthcare systems,regulators and the political environment.We describe our experiences primarily concerning low-resource environments,in creating the International Council of Ophthalmology(ICO)Guide to Effective CPD/CME and in developing a CPD program for the Cambodian Ophthalmological Society(COS)twinned with the Royal Australian and New Zealand College of Ophthalmologists(RANZCO).At the conclusion of the project,47(100%)Cambodian practicing ophthalmologists were registered in the CPD program and 21(45%)were actively participating in the online COS-CPD program recording.We discuss challenges in CPD,propose solutions to overcome them and recommend developing research in CPD as needed to effectively enhance educational activities with impact in public health.展开更多
It is a fact that in most of the rural settings,especially in low-and middle-income nations,the access to health care services and facilities is quite difficult.The primary reason for origin of this problem lies in th...It is a fact that in most of the rural settings,especially in low-and middle-income nations,the access to health care services and facilities is quite difficult.The primary reason for origin of this problem lies in the fact that a major proportion of medical professionals are not willing to serve in rural areas.This is in turn can be linked with the obvious geographical disparity in distribution of medical colleges in both rural and urban settings,with most of them being present in urban locations.In order to accomplish the vision to create a cadre of competent medical professionals,who are fit to work in the capacity of a primary health care physician,it is an indispensable requirement to sensitize and give adequate number of learning experiences pertaining to rural medical education.The process of planning and execution of rural medical education needs careful and systematic consideration,otherwise we will find ourselves short in achieving the intended learning outcomes.To conclude,rural medical education is an important aspect of the medical training.It is high time that all the stakeholders join their hands and work together to improve the competence level of medical students and play our part in the making of a community health physician.展开更多
Dear Editor:Simulation has made significant in-roads into the provision of medical education over the past twenty years^([1]).Simulation made its first impact in specialities such as emergency medicine and anaesthetic...Dear Editor:Simulation has made significant in-roads into the provision of medical education over the past twenty years^([1]).Simulation made its first impact in specialities such as emergency medicine and anaesthetics;however,it is now being used as an educational modality in a diverse range of specialities-from general practice to psychiatry.Perhaps the greatest pointer of the success of simulation is that it is now increasingly being seen as embedded in medical education and no longer some-展开更多
Introduction: Education and skill enhancement in palliative and end of life care is rarely part of the foundational medical education curriculum. The progress of student physicians tends to be measured by their abilit...Introduction: Education and skill enhancement in palliative and end of life care is rarely part of the foundational medical education curriculum. The progress of student physicians tends to be measured by their ability to synthesize and demonstrate basic medical knowledge and clinical skills but offers little assessment of the maturation of attitudes or their values. The University of New England College of Osteopathic Medicine (UNECOM), immerses second year medical students in a hospice home for 48 hours to enhance students’ perspectives in interprofessional palliative and end of life care. Methods: This project utilized qualitative ethnographic and autobiographic research designs. Two female second year medical students (27 y/o & 26 y/o) were immersed for 48 hours into a local hospice home, sleeping in a bed where others had died, to answer the question: “What is it like for ME to live in the Hospice Home for 48 hours and how does this contribute to my future as a practitioner?” Data were collected in the form of journal notes for pre-fieldwork, fieldwork, and post-fieldwork and included subjective and objective reporting of observations, experiences, and patient/family encounters. Analyses included journal review and thematic categorization and coding through content analysis. Results: Themes common to both students that factored in the research question and their prior stated interest areas of medical humanities and person-centered care at end of life were identified. Three themes were selected for this article: 1) Person-Centered Experiences, 2) Spectrum of Communication, and 3) Introspection: Attitudes and Values. The process of living in the hospice home for 48 hours revealed students’ attitudes about various disease processes, their personal experiences with death and dying, and their assumptions about how patients approach death. Conclusion: This Hospice Home Immersion project provided both an educational approach and learning environment that was effective in advancing medical students’ attitudes, skills, and knowledge as evidenced by their self-reported life altering learning about end of life and palliative care.展开更多
<strong>Background:</strong> This study aimed to determine the level of continuing medical education (CME) of medical imaging technicians in French-speaking West Africa. <strong>Materials and methods...<strong>Background:</strong> This study aimed to determine the level of continuing medical education (CME) of medical imaging technicians in French-speaking West Africa. <strong>Materials and methods:</strong> This opinion survey was administered to radiology technicians in French-speaking West Africa from 1<sup>st</sup> June to 31<sup>st</sup> October 2020, <em>i.e.</em> over a period of 5 months concerning their level of CME and their need for CME. <strong>Results:</strong> Out of 100 technicians, 69% were men. The mean age was 40 years, with extremes ranging from age 23 to age 57. The majority of technicians (64%) worked in the public sector and 78% had work experience of less than 11 years. Most technicians were holders of a Bachelor’s degree (73%). The types of CMEs they knew were congresses, seminars, and modular training in 46% of the cases. The most available CMEs were seminars (63%). All technicians agreed on the need for CME and 96% said it had an impact on the delivery of radiology services. Technicians who had received CME at least once represented 61%. For 90% of technicians, the specific CME sought was management in radiology (33.33%) and radiation protection (25.81%). <strong>Conclusion:</strong> The need for CME is increasingly indisputable to radiology technicians in French-speaking West Africa;however, it remains a luxury for them, due to its scarcity and its high cost.展开更多
Introduction: Medical student training and experiences in nursing homes are often viewed as negative;however, long-term care services represent a growing aspect of our medical system that receives little attention in ...Introduction: Medical student training and experiences in nursing homes are often viewed as negative;however, long-term care services represent a growing aspect of our medical system that receives little attention in medical education. The University of New England College of Osteopathic Medicine Learning by Living Nursing Home Immersion Project accelerates students learning about older adult care and the importance of empathy. Methods: Learning by Living applies qualitative ethnographic/autobiographic research methods to answer the question: “What is it like for me to live the life of an older adult nursing home resident?” Two first year medical students (female, 25 y/o & male, 27 y/o) were “admitted” into two different nursing homes for 11 days each. The students were wheelchair reliant from their assigned diagnoses of dominant-side paralysis secondary to stroke and aspiration pneumonia;requiring standard procedures of care experienced by older adults residents with similar conditions. Data were collected in the form of journal notes for pre-fieldwork, fieldwork, and post-fieldwork and included subjective and objective reporting of observations, experiences, and resident encounters. Analyses included journal review and thematic categorization and coding through content analysis. Results: Four themes of significance intersected for the two medical students: 1) control;2) quality of life;3) communication;and 4) isolation. Being immersed in nursing home life provided the students with firsthand experiences of loss and challenges faced by nursing home residents. This aided students’ learning about empathy and communication as key components of providing health care. Conclusion: This experience imparted knowledge to the medical students’ about aging, dignity, and the importance of making meaningful connections in order to thrive. These insights provided a gateway to establish a model of patient-centered care that is comprehensive and empathic for the older adult population.展开更多
Ophthalmology is an integral part of general practice education,and it is of great significance to have some knowledge on ophthalmology even if the general practitioner is not an ophthalmologist.The subject characteri...Ophthalmology is an integral part of general practice education,and it is of great significance to have some knowledge on ophthalmology even if the general practitioner is not an ophthalmologist.The subject characteristics,the traditional mode of teaching,and the cognitive deviation of students have greatly influenced its teaching quality.The application of team-based learning(TBL)in ophthalmology education responds to the demand of modern medical education.Building a team,designing questions that combine theory and clinical practice,as well as employing a fair scoring system can stimulate students’learning interest and improve their learning autonomy and ability to ask questions and solve problems.展开更多
With the development of information technology, big data has been widely used in medical education in China. Through the analysis of the definition, characteristics and development process of big data, summarized the ...With the development of information technology, big data has been widely used in medical education in China. Through the analysis of the definition, characteristics and development process of big data, summarized the transformation of domestic big data medical education mode compared with the traditional medical education mode in the teaching mode reform, research method innovation, teaching courses optimization, teaching key extension and the teaching quality monitoring. Based on this, this paper expounds the impact and challenge of big data on medical education, and makes an outlook on its development prospect, indicating that the future development of big data will be open, popular and trending. At the same time, some suggestions on further optimization direction of China's big data medical education are put forward.展开更多
BACKGROUND Healthcare professionals need to be prepared to promote healthy lifestyles and care for patients.By focusing on what students should be able to perform one day as clinicians,we can bridge the gap between me...BACKGROUND Healthcare professionals need to be prepared to promote healthy lifestyles and care for patients.By focusing on what students should be able to perform one day as clinicians,we can bridge the gap between mere theoretical knowledge and its practical application.Gender aspects in clinical medicine also have to be considered when speaking of personalized medicine and learning curricula.AIM To determine sets of intellectual,personal,social,and emotional abilities that comprise core qualifications in medicine for performing well in anamnesis-taking,in order to identify training needs.METHODS An analysis of training clinicians’conceptions with respect to optimal medical history taking was performed.The chosen study design also aimed to assess gender effects.Structured interviews with supervising clinicians were carried out in a descriptive study at the Medical University of Vienna.Results were analyzed by conducting a qualitative computer-assisted content analysis of the interviews.Inductive category formation was applied.The main questions posed to the supervisors dealt with(1)Observed competencies of students in medical history taking;and(2)The supervisor’s own conceptions of"ideal medical history taking".RESULTS A total of 33 training clinicians(n=33),engaged in supervising medical students according to the MedUni Vienna’s curriculum standards,agreed to be enrolled in the study and met inclusion criteria.The qualitative content analysis revealed the following themes relevant to taking an anamnesis:(1)Knowledge;(2)Soft skills(relationship-building abilities,trust,and attitude);(3)Methodical skills(structuring,precision,and completeness of information gathering);and(4)Environmental/contextual factors(language barrier,time pressure,interruptions).Overall,health care professionals consider empathy and attitude as critical features concerning the quality of medical history taking.When looking at physicians’theoretical conceptions,more general practitioners and psychiatrists mentioned attitude and empathy in the context of"ideal medical history taking",with a higher percentage of females.With respect to observations of students’history taking,a positive impact from attitude and empathy was mainly described by male health care professionals,whereas no predominance of specialty was found.Representatives of general medicine and internal medicine,when observing medical students,more often emphasized a negative impact on history taking when students lacked attitude or showed non-empathetic behavior;no gender-specific difference was detected for this finding.CONCLUSION The analysis reveals that for clinicians engaged in medical student education,only a combination of skills,including adequate knowledge and methodical implementations,is supposed to guarantee acceptable performance.This study’s findings support the importance of concepts like relationship building,attitude,and empathy.However,there may be contextual factors in play as well,and transference of theoretical concepts into the clinical setting might prove challenging.展开更多
China has the largest population in the world and has a huge medical needs.Research on China’s health workforce indicate that China encounter problems of shortages,imbalances and maldistribution in medical resources....China has the largest population in the world and has a huge medical needs.Research on China’s health workforce indicate that China encounter problems of shortages,imbalances and maldistribution in medical resources.Until 2014,China’s total health workforce are 10.2 million,of which licensed doctors are 2.4 million and licensed assistant doctors are 0.5 million(1).Most of these doctors are distributed in state-owned health institutions in relatively developed areas,working as civil servants,rather than independent medical professionals.Taking eye care as an example,there was only about 26 ophthalmologists per million population in China according to the latest domestic survey in 2016(2).And it is reported that cataract surgery rate in China is lagging behind.Only 1,425 people per million received cataract surgery in 2014,while about 5,000 people per million receive such surgery in India and 8,000 people in the US every year(3).Additionally,China has been suffering a high attrition rate among physicians and medical graduates over the past 10 years,going with low physician production,and rapid population growth(4).Based on its national conditions,China institute double reforms of its health-care systems and medical education.展开更多
The University of New England College of Osteopathic Medicine (UNECOM) Hospice Immersion project was piloted in 2014 in southern Maine. It was designed and implemented as an experiential medical education learning mod...The University of New England College of Osteopathic Medicine (UNECOM) Hospice Immersion project was piloted in 2014 in southern Maine. It was designed and implemented as an experiential medical education learning model whereby medical students were “admitted” into the local Hospice Home to live there for 48 hours. Until this project, palliative and end of life care education at US Medical Schools and specifically UNECOM were accomplished through traditional medical education methods. The Hospice Immersion project utilizes qualitative ethnographic and autobiographic research designs, whereby a unique environment or “culture” (Hospice Home) is observed and life experiences of the medical student before, during, and immediately after the immersion are reported by him/her. The purpose of the Hospice Immersion project is to provide second year medical students with firsthand experiences of living in the Hospice Home for 48 hours to answer the question: “What it is like FOR ME to live in the Hospice Home?” The results focus on the students’ common themes that include 1) Unknown Territory;2) Support;3) Role of Staff;4) Role of Immersion Learning in Palliative and End of Life Care;5) Facing Death and Dying;and 6) Clinical Pearls. This project humanizes dying and death, solidified student realization that dying is a part of life and what an honor it is to be a part of the care process that alleviates pain, increases comfort, values communication, and human connections. Students report new found skills in patient care such as the 1) importance of physical touch;2) significance of communication at the end of life for the patient, family, and staff;3) the value of authenticity and sincerity that comes from being comfortable with oneself, which allows silence to communicate caring;4) connection with and awareness of the person (rather than their terminal illness) and their family;and 5) the importance of speaking with patients and their families about end of life plans in advance. Although this is a time intensive experience for the faculty member and the Hospice Home staff, the depth of learning experienced by the students and opportunities to advance medical education in death and dying are well worth the efforts.展开更多
Objective: Using simulation in medical education was introduced in the 17th century, applying different techniques. The introduction of using simulated patients (SP) was also of great importance in both learning and e...Objective: Using simulation in medical education was introduced in the 17th century, applying different techniques. The introduction of using simulated patients (SP) was also of great importance in both learning and evaluation processes. Aims: This current study aims at assessing medical students’ perception about the use of well-trained drama students from the school of Arts in simulated session of breaking bad news encounter. Study Design: This is a per- and post-test study. Methods: 112 students were asked to fill a pre-validated questionnaire, who trained from January 2017 till the end of July 2017 pre- and post-exposure to simulated clinical encounter, where one well trained senior drama student played the role of patient, one student played the doctor who would break the bad news (BBN), debriefing before the encounter, and discussion after took place. Another validated questionnaire was distributed after the encounter, to assess the students’ experience. Statistical analysis was done using SPSS version 20. Results: Scores of all questions showed statistically significant improvement after the simulation session (p-value Conclusion: Simulation encounter, using drama students who are well-trained in human grief reaction, making BBN learning more positive and effective, merging two faculties improved the learning experience of both medical and Drama students.展开更多
基金Supported by the Brazilian National Council for Scientific and Technological Development(CNPq),No.312499/2022-1São Paulo Research Foundation(FAPESP),No.2023/00823-9,and No.2023/01251-9.
文摘The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our profession.We contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of individuals.Additionally,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational abilities.Importantly,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their curricula.While we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.
文摘Ioannis Solos Ph.D.,M.D.(China),L.Ac.currently serves as President and CEO at the Saint George Clinic and Research Institute,Scottsdale,AZ.,and Associate Editor for Chinese Medicine and Culture.Professor Solos has earned his Master of Medicine in Traditional Diagnosis at the Beijing University of Chinese Medicine,and his Medical Ph.D.in Chinese and Western Integrative Medicine at the Jinan University in Guangzhou.He practices and teaches integrative clinical medicine,Jing Fang(经方TCM formulas),martial lineage acupuncture,and his personalized style of“tendon and fascia reconditioning manipulations for bone and joint disease”.
文摘The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner,his public disclosure of the poor conditions at many medical schools provided a means to galvanize all the constituencies needed for reform to occur.He could say what other reformers could not,due to their links to the medical education community.But now we are again going back to a pre-Flexnerian state due to multiple reasons such as gradually diminishing importance of basic science subjects for the students,the decline in the number and quality of investigator initiated research among clinical researchers,lesser emphasis to bedside training by means of detailed clinical examination and making appropriate observation of signs to reach to a diagnosis rather than over reliance on the laboratory tests and radiological modalities for the diagnosis,poor exposure to basic clinical skills starting from college throughout residency and the trend of disrespect and absenteeism from both theoretical and clinical/practical classes.The attitude of students is just to complete their required attendance so that they are not barred from appearing in examinations.This de-Flexnerization trend and regression to pre-Flexnerian era standards,ideologies,structures,processes,and attitudes,are bound to beget pre-Flexnerian outcomes,for you get what you designed for.
基金2022 Education and Teaching Reform Research Project of Xi’an Medical University,“Construction and Practice of Teaching Quality Assurance System in Three-Level Teaching Bases of General Practice Medicine Under the‘Internet+’Model”(Project number:2022JG-05)2021 Shaanxi Undergraduate and Higher Continuing Education Teaching Reform Research Project of Shaanxi Provincial Department of Education,“Construction of Teaching Staff Based on‘Online Learning Platform for Clinical Teachers of the First Affiliated Hospital of Xi’an Medical University’and Construction and Practice of Quality Assurance System”(Project number:21BZ066)。
文摘The“New Medical Education”is a new requirement for the development of medical education in the new era.As a key and core element of the construction of the“New Medical Education,”the engagement in teaching work of university teachers is a key issue that determines the level of teaching development of university teachers and affects the quality of talent cultivation in universities.Using the literature review method,this study analyzed 39 relevant literatures retrieved from China National Knowledge Infrastructure(CNKI)from 1997 to 2023.The concept,connotation,current situation,influencing factors,and improvement strategies of teaching engagement by university teachers were reviewed and summarized.The results showed that the issue of teaching engagement by university teachers has not received high attention in the field of higher education,especially in higher medical education,which has not yet been reported.Although the overall number of literature is not large,some of the conclusions have important implications for the next research on the influencing factors and mechanisms of double-qualified teacher engagement in higher medical colleges.
文摘Dear Editor,The application of ChatGPT in medical education has made remarkable progress,such as automated scoring,teaching assistance,personalized learning,research assistance,quick access to information,generating case scenarios and exam questions,content creation for learning facilitation and language translation.As a result,a subset of the medical school faculty has swiftly embraced these innovations[1,2].
文摘After six years'medical reform,about 7.8 billion person-times of medical service has been achieved by2014,and the number of persons covered by basic medical insurance for urban employees,basic medical insurance for urban residents,and new rural cooperative medical insurance exceeded 1.3 billion,of which the coverage ratio reached as high as over 95%,establishing the largest basic medical security network in the world.
文摘L.David Marquet,a decorated Navy Captain,transformed an under performing submarine crew by empowering his subordinates to be leaders and reach their full potential.He called this intent-based leadership(IBL).What would happen if Marquet’s model were implemented in Graduate Medical Education(GME)?In this letter to the editor,we summarize the potential of the IBL model in graduate medical education as opposed to the traditional leaderfollower method.IBL harnesses human productivity toward the shared goals of GME,which are patient care and trainee learning.This shift in mindset could lead both teachers and trainees to focus more on the real reason that we undertake GME and change behaviors for the better.We suggest that IBL can and should be adopted in GME and propose that both patients and providers will benefit from this action.
文摘Background: Assessment is the systematic collection, review, and use of information about educational programs undertaken to improve teaching and learning. It ensures quality in training programmes, motivates, and directs students’ learning. Assessment is also used for verification of achievement of objectives of training, feedback to students, licencing, certification, and screening of students for advanced training. It is guided by several principles, including the aims of the assessment (why assess), who to assess, timing (when to assess), what to assess, methods (how to assess), and the criteria for determining the usefulness of the assessment. Objective: To describe the assessment methods used during clinical years of the undergraduate programme at Moi University School of Medicine (MUSOM) and determine the student’s perspectives concerning the comprehensiveness, relevance, objectivity of various assessment methods and challenges faced. Methodology: The study was carried out at MUSOM and a cross-sectional study design was employed. Ten study participants were studied using convenience sampling. Data were collected using an interview guide and was analyzed using content analysis. An informed consent was obtained from the study participants. Results: The methods used during clinical years at MUSOM for assessing knowledge and its applications include multiple-choice questions (MCQ), short answer questions (SAQ), modified essay questions (MEQ), long essay questions (LEQ), and oral exam. Whereas the methods for assessing clinical competence include long case, short cases, objective structured clinical examinations (OSCE), and logbook. Students felt that MCQs were comprehensive, objective, and relevant to the curriculum content. They reported that feedback was not provided after assessments. Conclusion: The assessment methods used at MUSOM during clinical years include MCQ, SAQ, MEQ, LEQ, Short cases, long cases, and OSCE. Students reported varied perceptions of the different assessment methods but favored MCQ and OSCE over other formats for assessing knowledge and clinical skills respectively.
文摘Continuing medical education(CME)is rapidly evolving into competency-based continuing professional development(CPD)and this is driving change in self-directed CPD programs undertaken by individual practitioners as well as CPD programs or frameworks offered by CPD educators.This progression is being led by many factors including the rapid change in medical knowledge and medical practitioners along with changes in patients and society,healthcare systems,regulators and the political environment.We describe our experiences primarily concerning low-resource environments,in creating the International Council of Ophthalmology(ICO)Guide to Effective CPD/CME and in developing a CPD program for the Cambodian Ophthalmological Society(COS)twinned with the Royal Australian and New Zealand College of Ophthalmologists(RANZCO).At the conclusion of the project,47(100%)Cambodian practicing ophthalmologists were registered in the CPD program and 21(45%)were actively participating in the online COS-CPD program recording.We discuss challenges in CPD,propose solutions to overcome them and recommend developing research in CPD as needed to effectively enhance educational activities with impact in public health.
文摘It is a fact that in most of the rural settings,especially in low-and middle-income nations,the access to health care services and facilities is quite difficult.The primary reason for origin of this problem lies in the fact that a major proportion of medical professionals are not willing to serve in rural areas.This is in turn can be linked with the obvious geographical disparity in distribution of medical colleges in both rural and urban settings,with most of them being present in urban locations.In order to accomplish the vision to create a cadre of competent medical professionals,who are fit to work in the capacity of a primary health care physician,it is an indispensable requirement to sensitize and give adequate number of learning experiences pertaining to rural medical education.The process of planning and execution of rural medical education needs careful and systematic consideration,otherwise we will find ourselves short in achieving the intended learning outcomes.To conclude,rural medical education is an important aspect of the medical training.It is high time that all the stakeholders join their hands and work together to improve the competence level of medical students and play our part in the making of a community health physician.
文摘Dear Editor:Simulation has made significant in-roads into the provision of medical education over the past twenty years^([1]).Simulation made its first impact in specialities such as emergency medicine and anaesthetics;however,it is now being used as an educational modality in a diverse range of specialities-from general practice to psychiatry.Perhaps the greatest pointer of the success of simulation is that it is now increasingly being seen as embedded in medical education and no longer some-
文摘Introduction: Education and skill enhancement in palliative and end of life care is rarely part of the foundational medical education curriculum. The progress of student physicians tends to be measured by their ability to synthesize and demonstrate basic medical knowledge and clinical skills but offers little assessment of the maturation of attitudes or their values. The University of New England College of Osteopathic Medicine (UNECOM), immerses second year medical students in a hospice home for 48 hours to enhance students’ perspectives in interprofessional palliative and end of life care. Methods: This project utilized qualitative ethnographic and autobiographic research designs. Two female second year medical students (27 y/o & 26 y/o) were immersed for 48 hours into a local hospice home, sleeping in a bed where others had died, to answer the question: “What is it like for ME to live in the Hospice Home for 48 hours and how does this contribute to my future as a practitioner?” Data were collected in the form of journal notes for pre-fieldwork, fieldwork, and post-fieldwork and included subjective and objective reporting of observations, experiences, and patient/family encounters. Analyses included journal review and thematic categorization and coding through content analysis. Results: Themes common to both students that factored in the research question and their prior stated interest areas of medical humanities and person-centered care at end of life were identified. Three themes were selected for this article: 1) Person-Centered Experiences, 2) Spectrum of Communication, and 3) Introspection: Attitudes and Values. The process of living in the hospice home for 48 hours revealed students’ attitudes about various disease processes, their personal experiences with death and dying, and their assumptions about how patients approach death. Conclusion: This Hospice Home Immersion project provided both an educational approach and learning environment that was effective in advancing medical students’ attitudes, skills, and knowledge as evidenced by their self-reported life altering learning about end of life and palliative care.
文摘<strong>Background:</strong> This study aimed to determine the level of continuing medical education (CME) of medical imaging technicians in French-speaking West Africa. <strong>Materials and methods:</strong> This opinion survey was administered to radiology technicians in French-speaking West Africa from 1<sup>st</sup> June to 31<sup>st</sup> October 2020, <em>i.e.</em> over a period of 5 months concerning their level of CME and their need for CME. <strong>Results:</strong> Out of 100 technicians, 69% were men. The mean age was 40 years, with extremes ranging from age 23 to age 57. The majority of technicians (64%) worked in the public sector and 78% had work experience of less than 11 years. Most technicians were holders of a Bachelor’s degree (73%). The types of CMEs they knew were congresses, seminars, and modular training in 46% of the cases. The most available CMEs were seminars (63%). All technicians agreed on the need for CME and 96% said it had an impact on the delivery of radiology services. Technicians who had received CME at least once represented 61%. For 90% of technicians, the specific CME sought was management in radiology (33.33%) and radiation protection (25.81%). <strong>Conclusion:</strong> The need for CME is increasingly indisputable to radiology technicians in French-speaking West Africa;however, it remains a luxury for them, due to its scarcity and its high cost.
文摘Introduction: Medical student training and experiences in nursing homes are often viewed as negative;however, long-term care services represent a growing aspect of our medical system that receives little attention in medical education. The University of New England College of Osteopathic Medicine Learning by Living Nursing Home Immersion Project accelerates students learning about older adult care and the importance of empathy. Methods: Learning by Living applies qualitative ethnographic/autobiographic research methods to answer the question: “What is it like for me to live the life of an older adult nursing home resident?” Two first year medical students (female, 25 y/o & male, 27 y/o) were “admitted” into two different nursing homes for 11 days each. The students were wheelchair reliant from their assigned diagnoses of dominant-side paralysis secondary to stroke and aspiration pneumonia;requiring standard procedures of care experienced by older adults residents with similar conditions. Data were collected in the form of journal notes for pre-fieldwork, fieldwork, and post-fieldwork and included subjective and objective reporting of observations, experiences, and resident encounters. Analyses included journal review and thematic categorization and coding through content analysis. Results: Four themes of significance intersected for the two medical students: 1) control;2) quality of life;3) communication;and 4) isolation. Being immersed in nursing home life provided the students with firsthand experiences of loss and challenges faced by nursing home residents. This aided students’ learning about empathy and communication as key components of providing health care. Conclusion: This experience imparted knowledge to the medical students’ about aging, dignity, and the importance of making meaningful connections in order to thrive. These insights provided a gateway to establish a model of patient-centered care that is comprehensive and empathic for the older adult population.
文摘Ophthalmology is an integral part of general practice education,and it is of great significance to have some knowledge on ophthalmology even if the general practitioner is not an ophthalmologist.The subject characteristics,the traditional mode of teaching,and the cognitive deviation of students have greatly influenced its teaching quality.The application of team-based learning(TBL)in ophthalmology education responds to the demand of modern medical education.Building a team,designing questions that combine theory and clinical practice,as well as employing a fair scoring system can stimulate students’learning interest and improve their learning autonomy and ability to ask questions and solve problems.
文摘With the development of information technology, big data has been widely used in medical education in China. Through the analysis of the definition, characteristics and development process of big data, summarized the transformation of domestic big data medical education mode compared with the traditional medical education mode in the teaching mode reform, research method innovation, teaching courses optimization, teaching key extension and the teaching quality monitoring. Based on this, this paper expounds the impact and challenge of big data on medical education, and makes an outlook on its development prospect, indicating that the future development of big data will be open, popular and trending. At the same time, some suggestions on further optimization direction of China's big data medical education are put forward.
文摘BACKGROUND Healthcare professionals need to be prepared to promote healthy lifestyles and care for patients.By focusing on what students should be able to perform one day as clinicians,we can bridge the gap between mere theoretical knowledge and its practical application.Gender aspects in clinical medicine also have to be considered when speaking of personalized medicine and learning curricula.AIM To determine sets of intellectual,personal,social,and emotional abilities that comprise core qualifications in medicine for performing well in anamnesis-taking,in order to identify training needs.METHODS An analysis of training clinicians’conceptions with respect to optimal medical history taking was performed.The chosen study design also aimed to assess gender effects.Structured interviews with supervising clinicians were carried out in a descriptive study at the Medical University of Vienna.Results were analyzed by conducting a qualitative computer-assisted content analysis of the interviews.Inductive category formation was applied.The main questions posed to the supervisors dealt with(1)Observed competencies of students in medical history taking;and(2)The supervisor’s own conceptions of"ideal medical history taking".RESULTS A total of 33 training clinicians(n=33),engaged in supervising medical students according to the MedUni Vienna’s curriculum standards,agreed to be enrolled in the study and met inclusion criteria.The qualitative content analysis revealed the following themes relevant to taking an anamnesis:(1)Knowledge;(2)Soft skills(relationship-building abilities,trust,and attitude);(3)Methodical skills(structuring,precision,and completeness of information gathering);and(4)Environmental/contextual factors(language barrier,time pressure,interruptions).Overall,health care professionals consider empathy and attitude as critical features concerning the quality of medical history taking.When looking at physicians’theoretical conceptions,more general practitioners and psychiatrists mentioned attitude and empathy in the context of"ideal medical history taking",with a higher percentage of females.With respect to observations of students’history taking,a positive impact from attitude and empathy was mainly described by male health care professionals,whereas no predominance of specialty was found.Representatives of general medicine and internal medicine,when observing medical students,more often emphasized a negative impact on history taking when students lacked attitude or showed non-empathetic behavior;no gender-specific difference was detected for this finding.CONCLUSION The analysis reveals that for clinicians engaged in medical student education,only a combination of skills,including adequate knowledge and methodical implementations,is supposed to guarantee acceptable performance.This study’s findings support the importance of concepts like relationship building,attitude,and empathy.However,there may be contextual factors in play as well,and transference of theoretical concepts into the clinical setting might prove challenging.
文摘China has the largest population in the world and has a huge medical needs.Research on China’s health workforce indicate that China encounter problems of shortages,imbalances and maldistribution in medical resources.Until 2014,China’s total health workforce are 10.2 million,of which licensed doctors are 2.4 million and licensed assistant doctors are 0.5 million(1).Most of these doctors are distributed in state-owned health institutions in relatively developed areas,working as civil servants,rather than independent medical professionals.Taking eye care as an example,there was only about 26 ophthalmologists per million population in China according to the latest domestic survey in 2016(2).And it is reported that cataract surgery rate in China is lagging behind.Only 1,425 people per million received cataract surgery in 2014,while about 5,000 people per million receive such surgery in India and 8,000 people in the US every year(3).Additionally,China has been suffering a high attrition rate among physicians and medical graduates over the past 10 years,going with low physician production,and rapid population growth(4).Based on its national conditions,China institute double reforms of its health-care systems and medical education.
文摘The University of New England College of Osteopathic Medicine (UNECOM) Hospice Immersion project was piloted in 2014 in southern Maine. It was designed and implemented as an experiential medical education learning model whereby medical students were “admitted” into the local Hospice Home to live there for 48 hours. Until this project, palliative and end of life care education at US Medical Schools and specifically UNECOM were accomplished through traditional medical education methods. The Hospice Immersion project utilizes qualitative ethnographic and autobiographic research designs, whereby a unique environment or “culture” (Hospice Home) is observed and life experiences of the medical student before, during, and immediately after the immersion are reported by him/her. The purpose of the Hospice Immersion project is to provide second year medical students with firsthand experiences of living in the Hospice Home for 48 hours to answer the question: “What it is like FOR ME to live in the Hospice Home?” The results focus on the students’ common themes that include 1) Unknown Territory;2) Support;3) Role of Staff;4) Role of Immersion Learning in Palliative and End of Life Care;5) Facing Death and Dying;and 6) Clinical Pearls. This project humanizes dying and death, solidified student realization that dying is a part of life and what an honor it is to be a part of the care process that alleviates pain, increases comfort, values communication, and human connections. Students report new found skills in patient care such as the 1) importance of physical touch;2) significance of communication at the end of life for the patient, family, and staff;3) the value of authenticity and sincerity that comes from being comfortable with oneself, which allows silence to communicate caring;4) connection with and awareness of the person (rather than their terminal illness) and their family;and 5) the importance of speaking with patients and their families about end of life plans in advance. Although this is a time intensive experience for the faculty member and the Hospice Home staff, the depth of learning experienced by the students and opportunities to advance medical education in death and dying are well worth the efforts.
文摘Objective: Using simulation in medical education was introduced in the 17th century, applying different techniques. The introduction of using simulated patients (SP) was also of great importance in both learning and evaluation processes. Aims: This current study aims at assessing medical students’ perception about the use of well-trained drama students from the school of Arts in simulated session of breaking bad news encounter. Study Design: This is a per- and post-test study. Methods: 112 students were asked to fill a pre-validated questionnaire, who trained from January 2017 till the end of July 2017 pre- and post-exposure to simulated clinical encounter, where one well trained senior drama student played the role of patient, one student played the doctor who would break the bad news (BBN), debriefing before the encounter, and discussion after took place. Another validated questionnaire was distributed after the encounter, to assess the students’ experience. Statistical analysis was done using SPSS version 20. Results: Scores of all questions showed statistically significant improvement after the simulation session (p-value Conclusion: Simulation encounter, using drama students who are well-trained in human grief reaction, making BBN learning more positive and effective, merging two faculties improved the learning experience of both medical and Drama students.
