BMC Medical Education

The clinical environments are more complex, diverse and rapidly changing. Patients’ conditions were chronic and complexed, healthcare providers require clinical reasoning for patient safety care. One of the learning methods to foster clinical reasoning is simulation education. The aim of this study was to develop a simulation education debriefing protocol that can improve clinical reasoning. This study was conducted following steps. For the first step, the literature review was performed to constitute a preliminary debriefing protocol. Secondly, content validity was evaluated by five simulation learning experts. Thirdly, in-depth interview was conducted to re-examine content validity with education experts. Finally, the final debriefing protocol was applied to 7 undergraduate nursing students to examine feasibility of the protocol. The protocol consisted of debriefing steps, learning outcome, clinical reasoning attributes, core questions and guideline for instructor. Results of applicability of debriefing protocol represented that participants mentioned their reasoning competency was improved and understood the overall flow of reasoning. The debriefing protocol is important to educate healthcare providers ‘clinical reasoning. It would be able to contribute to develop healthcare providers’ clinical competencies.

Chronic fatigue syndrome (CFS) affects at least 4 million people in the United States, yet only 16% of people with CFS have received a diagnosis or medical care for their illness. Educating health care professionals about the diagnosis and management of CFS may help to reduce population morbidity associated with CFS. This report presents findings over a 5-year period from May 2000 to June 2006 during which we developed and implemented a health care professional educational program. The objective of the program was to distribute CFS continuing education materials to providers at professional conferences, offer online continuing education credits in different formats (e.g., print, video, and online), and evaluate the number of accreditation certificates awarded. We found that smaller conference size (OR = 80.17; 95% CI 8.80, 730.25), CFS illness related target audiences (OR = 36.0; 95% CI 2.94, 436.34), and conferences in which CFS research was highlighted (OR = 4.15; 95% CI 1.16, 14.83) significantly contributed to higher dissemination levels, as measured by visit rates to the education booth. While print and online courses were equally requested for continuing education credit opportunities, the online course resulted in 84% of the overall award certificates, compared to 14% for the print course. This remained consistent across all provider occupations: physicians, nurses, physician assistants, and allied health professionals. These findings suggest that educational programs promoting materials at conferences may increase dissemination efforts by targeting audiences, examining conference characteristics, and promoting online continuing education forums.

Medical students’ propensity to develop mental morbidity has been described for decades but remains unresolved. To assess student mental health person-centred and longitudinally, we have been investigating a cohort of German students since October 2019. After their first semester under ‘normal’ conditions, rapid changes became necessary due to the COVID-19 situation. In line with the initial aim, we investigated students’ change of mental health, perceived learning environment and burdens in the ‘new normal’. Students in a newly founded German medical study programme (n = 63) answered a questionnaire each semester (October 2019 = entering medical school; December 2019 = ‘old normal’; June 2020 = ‘new normal’; December 2020 = ‘new normal’) on their well-being (FAHW-12), burnout (Maslach Inventory), depression (PHQ-9), perception of the learning environment (DREEM), burdens and protective attitudes in the ‘new normal’ (items designed for the study). Friedman tests reveal overall significant differences (all p < .001) in depression and burnout (emotional exhaustion, depersonalisation, personal accomplishment); changes in well-being were identified as just non-significant (p = .05). The effects were explained by a significant increase in burnout and depression identified post-hoc from October 2019 to December 2019. No increase in severity was identified in the ‘new normal’ semesters. The learning environment was perceived positively even with a significant improvement for June 2020 (repeated measures ANOVA p < .001). Study-related burdens (e.g. procrastination of online-learning material) took on greater relevance than burdens related to physicians’ occupation (e.g. potential for students' recruitment to the healthcare system during their studies). The ‘new’ when entering medical school had a greater impact on our students’ mental health than the ‘new normal’. The readiness for change in the context of a newly designed study programme may have been beneficial with regard to students’ positively perceived learning environment during the virtual semesters. Monitoring medical students’ mental health longitudinally should be a concern regardless of a pandemic.

Nghiên cứu đã chỉ ra rằng phản hồi theo hình thức tự sự, sự phản ánh (của bản thân) và kế hoạch thực hiện và đánh giá các cải tiến là những yếu tố chính cho phản hồi hiệu quả về hiệu suất lâm sàng. Chúng tôi đã khảo sát số lượng bình luận tự sự do các giảng viên phản hồi, sự phản ánh của học viên và kế hoạch hành động do giảng viên và học viên thực hiện trên một mẫu mini-CEX đã được điều chỉnh để sử dụng trong đào tạo bác sĩ gia đình và khuyến khích giảng viên và học viên cung cấp các bình luận theo hình thức tự sự. Với tầm quan trọng của tính cụ thể như một chỉ số chất lượng phản hồi, chúng tôi đã xem xét thêm tính cụ thể của các bình luận. Chúng tôi đã thu thập và phân tích các mẫu mini-CEX đã được điều chỉnh được hoàn thành bởi các giảng viên và học viên bác sĩ gia đình. Do mỗi học viên có cùng một giảng viên trong suốt một năm, chúng tôi đã sử dụng cặp giảng viên-học viên làm đơn vị phân tích. Chúng tôi đã xác định cho tất cả các mẫu tần suất của các loại bình luận tự sự khác nhau và đánh giá tính cụ thể của chúng trên thang điểm ba: cụ thể, tương đối cụ thể, không cụ thể. Tính cụ thể đã được so sánh giữa các cặp học viên-giảng viên. Chúng tôi đã thu thập 485 mẫu mini-CEX đã được hoàn thành từ 54 học viên (trung bình 8,8 mẫu mỗi học viên; khoảng từ 1 đến 23; SD 5,6). Phản hồi từ giảng viên được cung cấp thường xuyên hơn so với sự phản ánh của học viên, và kế hoạch hành động là rất hiếm. Các bình luận nhìn chung là cụ thể, nhưng cho thấy sự khác biệt lớn giữa các cặp học viên-giảng viên. Tần suất của sự phản ánh và các kế hoạch hành động đã thay đổi, tất cả các bình luận nhìn chung đều cụ thể và có sự khác biệt đáng kể và ổn định giữa các cặp học viên-giảng viên về tính cụ thể của các bình luận. Do đó, chúng tôi kết luận rằng phản hồi không bị xác định bởi công cụ mà chủ yếu bởi người sử dụng. Do đó, các can thiệp nhằm cải thiện hiệu quả giáo dục của quy trình phản hồi nên tập trung nhiều hơn vào người sử dụng thay vì vào công cụ.

Stem cell therapeutics and regenerative medicine have taken a strong foothold in biomedicine. However, most physicians are currently not adequately prepared to identify, refer, and deliver safe regenerative therapies. To understand this gap, we sought to characterize published literature on current physician training in regenerative medicine. Our scoping review describes current training strategies to bridge the gap and integrate such education into medical curricula for adequate training.

Electronic health records (EHR) are becoming increasingly integrated into the clinical environment. With the rapid proliferation of EHRs, a number of studies document an increase in adverse patient safety issues due to the EHR-user interface. Because of these issues, greater attention has been placed on novel educational activities which incorporate use of the EHR. The ICU environment presents many challenges to integrating an EHR given the vast amounts of data recorded each day, which must be interpreted to deliver safe and effective care. We have used a novel EHR based simulation exercise to demonstrate that everyday users fail to recognize a majority of patient safety issues in the ICU. We now sought to determine whether participation in the simulation improves recognition of said issues. Two ICU cases were created in our EHR simulation environment. Each case contained 14 safety issues, which differed in content but shared common themes. Residents were given 10 minutes to review a case followed by a presentation of management changes. Participants were given an immediate debriefing regarding missed issues and strategies for data gathering in the EHR. Repeated testing was performed in a cohort of subjects with the other case at least 1 week later. 116 subjects have been enrolled with 25 subjects undergoing repeat testing. There was no difference between cases in recognition of patient safety issues (39.5% vs. 39.4%). Baseline performance for subjects who participated in repeat testing was no different than the cohort as a whole. For both cases, recognition of safety issues was significantly higher among repeat participants compared to first time participants. Further, individual performance improved from 39.9% to 63.6% (p = 0.0002), a result independent of the order in which the cases were employed. The degree of improvement was inversely related to baseline performance. Further, repeat participants demonstrated a higher rate of recognition of changes in vitals, misdosing of antibiotics and oversedation compared to first time participants. Participation in EHR simulation improves EHR use and identification of patient safety issues.

The current study aimed to evaluate the previously unexplored correlation between undergraduate medical students’ attendance during their surgical clerkship and their academic performance. It also aimed to explore any difference in the attendance rate between male and female students and whether this difference, if present, affects the academic performance. A retrospective descriptive cross-sectional study has been conducted on 331 undergraduate medical students during their surgical clerkships at the College of Medicine and Medical Sciences (CMMS) at Arabian Gulf University (AGU), Bahrain from September 2018 to June 2020. There was a positive statistically significant correlation between students’ attendance during surgical clerkship and academic performance (r = 0.360, P <  0.01). Mean attendance rate was greater in each increasing category of academic performance: 47.95% in the weak category (less than 65%, n = 42), 57.62% in the good performance category (65% to less than 75%, n = 108), 67.82% in the very good performance category (75% to less than 85%, n = 126), 83.16% in the excellent performance category (85% and above, n = 55). The mean attendance rate of male students was 59.76% (SD = 25.73), compared to 66.92% (SD = 24.30) in the female students. T-test indicated that the difference between the mean attendance of the two groups of the students (male, female) was statistically significant (t = 2.483, p <  0.05). On the other hand, the difference between the mean academic performance for the two groups of students, male & female, (t = 0.284, p = 0.777) was not statistically significant. Our study showed a significant relationship between undergraduate medical students’ attendance during their surgical clerkship and their academic performance. Further studies are needed to stratify this correlation according to clinical and theoretical teaching activities. No significant difference was observed in academic performance between female and male students.

Students face hardships in determining what are the main points that need more studying in every subject. Checklists are one of the ways that can help students identify the most important pieces of information. Accordingly, in this study, we aimed at examining the impact of using educational checklists on the learning process of postgraduate students at Nagasaki University, Japan. Thirty-one Master's students, who finished a “how to write a research protocol” course were recruited by sending them an invitation email that had an attached link to a previously developed and tested questionnaire on the SurveyMonkey® platform. After signing the electronic informed consent, twenty-two participants (response rate = 71%) finished the survey. The data was analyzed using Microsoft Excel and expressed in the form of frequencies and percentages. More than half of the students declared that they know the checklist will be used in the course that we investigated. Only two students used checklists as a means of studying (9%). Twelve students (55%) confirmed that no other courses or lessons in the School of Tropical Medicine and Global Health (TMGH) use checklists. No students found the usage of checklists not easy or not practical to apply. Many students thought the length of the checklist was suitable and not too short (64%), although three students (14%) found it lengthy. Moreover, most students described the checklist as beyond good (86%) and they would recommend using a checklist for teaching other college students (73%). Using checklists in education can facilitate the learning process, help in memorization, and deepen the concepts being studied. Further studies are required to examine the impact of checklists in teaching undergraduate students and students from other non-healthcare disciplines.