Four-year longitudinal culinary and lifestyle medicine track for undergraduate medical students: development and implementation.

The importance of culinary and lifestyle medicine education to combat the growing burden of chronic disease is gaining recognition in the United States. However, few medical schools offer in-depth training with a 4-year longitudinal track. The Culinary and Lifestyle Medicine Track (CLMT) is a 4-year curriculum thread created at West Virginia University School of Medicine to address the need for comprehensive culinary and lifestyle medicine education. CLMT teaches concepts of healthy nutrition, physical activity, stress management, and restorative sleep. CLMT students complete approximately 300 h of in-person and virtual culinary and lifestyle medicine education, including hands-on teaching kitchens, distributed over the preclinical and clinical years. Students are selected into the track prior to matriculation after an application and interview process. The students have exceeded expectations for scholarly and community activity. Track graduates have entered into primary care as well as specialty and surgical residencies, demonstrating that lifestyle education plays a role for students interested in a wide range of careers. Exit survey responses from learners reflected tangible and intangible benefits of participation and offered constructive feedback for improvement. Presented here are the components of the curricular design, implementation, and initial outcomes.

Negative Impact of Smaller Hometown Size on the Educational Experience of Medical Students: A Nationwide Study in Saudi Arabia.

Background and objective Saudi Arabia's rapid medical education expansion has posed unique challenges for its students, particularly concerning specialty selection. Having broad exposure to medical specialties is crucial for making informed decisions. This study explores how the size of students' hometowns influences their exposure to their preferred specialty, thereby affecting their choice. Methods Our cross-sectional study collected data from medical students in their 4th and 5th years, interns, and graduates across Saudi Arabia. An electronic survey gathered information about medical specialty choice, interest levels, students' self-ranking compared to their peers, and level of exposure to the chosen specialty. Overall exposure to specialties was quantified by tallying participants' experiences in preclinical observerships, didactic lectures, research projects, core and elective rotations, and attended conferences. We divided the students into three city sizes: primary urban centers, intermediate urban cities, and small townships and compared the outcomes between these three groups. Results Responses were obtained from 1,072 participants, with 424 (39.6%) from primary urban centers, 367 (34.2%) from intermediate urban cities, and 281 (26.2%) from small townships. Student hometown size was an independent predictor of specialty exposure, with students from smaller cities reporting lower exposure scores (OR = 0.73, (0.63-0.84), p<0.01). The study also identified gender disparities in exposure, with female students found to be correlated with a lower exposure score (OR = 0.72, (0.58-0.89), p<0.01). Conclusion City size is a significant determinant of specialty exposure for Saudi medical students. These findings highlight the need for initiatives that promote equal educational experiences, ensuring comprehensive specialty exposure to all students.

Combatting Neurophobia: A Proposed Preliminary Educational Model to Promote Neurophilia.

When we reflect on medical education as a whole, novelty in structure and content promotes growth and enhances student outcomes. The teaching of neurology is no different and presents a more unique hurdle in its instruction considering the well-described phenomenon of neurophobia. With the burden of neurological diseases on the rise, there is a heightened demand for medical educators to understand the possible causes of this educational misalignment and implement solutions necessary to ensure adequate education of students. In this study, we describe a novel approach to neurology education for second-year medical students to stimulate neurophilia, incorporating evidence-based approaches within the identified areas-Active Learning Pedagogies, Diagnostic and Clinical Reasoning, Use of Technology, Field Exposure and Mentorship, and Innovation. Students demonstrated superior academic performance on the National Board of Medical Examiners (NBME) neurology assessments and generally positive feedback on the use of innovative approaches to teaching and learning. Overall, we propose this method of teaching neurology as a model educational platform that aims to reduce neurophobia and promote neurophilia.

Medical Students' Perceptions and Use of Formal and Informal Curriculum Resources.

Introduction  Resource overload describes the feeling medical students experience in choosing formal (faculty-prescribed) and informal study resources (not faculty-prescribed). This study aims to characterize students' use and perceptions of formal and informal study resources to inform their use in medical education. Methods  This is a mixed-methods study utilizing a convenience sample of first-year medical students enrolled at the University of Central Florida College of Medicine during the academic year 2020-2021. A 40-question, five-point Likert scale, survey based on Keller's Attention, Relevance, Confidence, and Satisfaction (ARCS) Model of Motivational Design was distributed to medical students during the end of their first year of medical school. Multivariate analysis of variance determined differences between formal and informal resources for each construct. Interviews were also conducted by first-year medical students and analyzed using thematic analysis. Learning logs were completed during the beginning of the medical students' second year to assess daily study habits. Results  Fifty-one students completed the survey with a response rate of 42.5%. Informal resources scored higher across all constructs: attention (formal: 3.4±1.2, informal: 4.0±1.1; p<.0125), relevance (formal: 3.8±1.1, informal: 4.3±1.0; p<.0125), confidence (formal: 3.2±1.2, informal: 4.1±1.1; p<.0125), satisfaction (formal: 2.8±1.2, informal: 3.6±1.2; p<.0125) (Likert scale 1-5, Mean±SD). Students found formal resources lacked depth and organization while informal resources allowed for concise understanding with retention cues. Learning log data reported similar use of formal and informal resources during week 1 (88.2% formal vs. 87.8% informal) and week 2 (84.6% formal vs. 82.6% informal). Conclusions  Students preferred informal resources based on ARCS constructs. However, the actual usage of formal and informal resources was similar. Formal resources align more with curricular assessments, but informal resources aid student retention and understanding. Therefore, students find both formal and informal resources necessary for success. Faculty should consider integrating informal curriculum resources to optimize student learning.

Commentary: Is There a Lack of Insight on the Anatomy Teaching Adaptations Made by "Cadaver-Free" Medical Schools in Response to the COVID-19 Pandemic?

The COVID-19 pandemic negatively impacted anatomy education as it ceased face-to-face anatomy teaching sessions and laboratory practicals. In the past 2 years, a growing body of literature has been dedicated to the adaptations made in the teaching of anatomy predominantly by medical schools who employ cadaveric dissection and prosection-based practicals to teach anatomy. Despite this, there is dearth of evidence in terms of the challenges that medical schools who do not use cadaveric dissection or prosected specimens to teach anatomy faced as well as the adaptations they made in response to the pandemic.

Analysis of Pre-clerkship Medical Students' Perceptions and Performance During the COVID-19 Pandemic.

Purpose: Virtual instruction became the primary educational delivery method for pre-clerkship medical students during the COVID-19 pandemic. The aims of this study were to evaluate the effectiveness of a virtual and blended pre-clerkship curriculum and to assess its impact on students. Methods: We surveyed 223 1st- and 2nd-year medical students (MS1s and MS2s) enrolled at the Paul L Foster School of Medicine. We analyzed student satisfaction with their courses, along with summative exam scores, compared to previous academic years. Results: The survey was completed by 125 of 223 students (56%). Most students changed their study methods (78%), experienced technical issues (85%), and had difficulty communicating with faculty (62%). MS1s were significantly more likely than MS2s to report difficulty in adjusting to virtual instruction (p = 0.037) and a negative impact on their learning skills (p = 0.005) and academic performance (p = 0.003). Students reported the virtual environment negatively affected their social skills (77%), connectedness to peers (89%), and professional development (62%). MS1s were more likely than MS2s to perceive a negative effect on their sense of wellness (p = 0.002). The overall satisfaction with the courses was similar to previous academic years. Student performance in the summative examination of the first virtually delivered unit was lower (p = 0.007) than the previous year's cohorts. Conclusion: The difference in MS1s and MS2s perceptions of virtual and blended instruction highlights the importance of face-to-face learning during the first year. Benefits and drawbacks were identified which may help inform educators when designing future learning models. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01723-6.

Pandemic-Era Digital Education: Insights from an Undergraduate Medical Programme.

The undergraduate medical programme at Newcastle University (NU) includes a fundamental 'Essentials of Medical Practice' (EOMP) phase comprising the first 2 years of study. This period is designed to support entrants in their transition from further education into the advanced study and practice of clinical medicine. The anatomical sciences of gross anatomy, histology and embryology, and life sciences including physiology, pharmacology and genetics are key disciplines taught within the integrated case-based EOMP curriculum. Learners apply basic science knowledge to clinical scenarios during training in practical examination, communication and reasoning skills. Within the modern pedagogic landscape, the development and introduction of technology-enhanced learning strategies have enhanced the provision of remote learning resources in pre-clinical education. However, the emergence of COVID-19 has resulted in widespread technological challenges for educators and learners, and has raised pedagogic, logistical and ethical concerns. Nonetheless, the pandemic has produced favourable conditions for the creation of valuable digital visualisation strategies for learning and teaching, and for developing and modernising universal approaches to remote education. Here, we describe our technology-enhanced adaptations to COVID-19 across the domains of teaching, learning and academic support for pre-clinical learners studying basic life sciences and clinical skills. Moreover, we outline research-informed digital visualisation solutions to pandemic-era challenges and reflect upon experiences gained within our own educational context. In doing so, we provide insights into the impacts and successes of our interventions. While providing a record of unprecedented contemporary circumstances, we also aim to utilise our observations and experiences of COVID-19 pedagogy when developing ongoing strategies for delivering curricula and futureproofing educational practice.

Solutions, enablers and barriers to online learning in clinical medical education during the first year of the COVID-19 pandemic: A rapid review.

AIMS: The COVID-19 pandemic has seen a major disruption to undergraduate and postgraduate clinical medical education. The aim of this rapid review was to identify and synthesize published literature relating to the solutions, enablers and barriers to online learning implemented in clinical medical education during the first year of the COVID-19 pandemic. METHODS: All articles published before March 2021 in peer-reviewed journals, including MedEdPublish, that described authors' experience of online learning in response to the COVID-19 pandemic. A descriptive analysis of the solutions and a qualitative template analysis of enablers and barriers. RESULTS: 87 articles were identified for inclusion. Face to face teaching was maintained with interactive approaches between learners and/or learners and teachers. Several innovative solutions were identified. The enablers were a readiness and rapid response by institutions, with innovation by teachers. The barriers were the lack of planning and resources, usability problems and limited interactivity between teachers and students. CONCLUSIONS: Important and timely evidence was obtained that can inform future policy, practice and research. The findings highlighted the urgent need to use rapid design and implementation methods with greater explicit descriptions in published articles to ensure applicability to other contexts.

Guidance of critical thinking of clinical medical students in disease-centered PBL integrated course: taking diabetes as example / 中华医学教育探索杂志

Disease-centered problem-based learning (PBL) integrated course inspires the thinking of medical students in the case scenario to stimulate students' motivation of active learning. In this paper, the study of diabetes cases was taken as an example. Through the design of PBL cases, the scenario was reconstructed and information was provided step by step, so as to induce the students to discuss and learn the related knowledge of glucose metabolism and understand the predisposing factors of diabetes. Furthermore, students' critical thinking could be inspired through the information of the misdiagnose and mistreatment to recognize the clinical presentation and inducement of diabetic ketoacidosis. This teaching model is conducive to the cultivation of medical students' questioning spirit and critical thinking, laying a foundation for the cultivation of innovative medical talents.

Randomized Trial of a Year-Long USMLE Step 1 Preparation Near-Peer Teaching Program.

Near-peer teaching (NPT) is a peer-assisted learning method that has been adopted by medical schools as studies have reported benefits to both tutors and tutees. Published studies suggest students may benefit from NPT programs when preparing for the US Medical Licensing Examination (USMLE) Step 1 exam, but they did not use a randomized controlled trial methodology. To determine the impact of a year-long NPT preparation program for the Step 1 examination, we conducted a randomized-controlled trial among second-year medical students at New York Medical College during the 2017-2018 and 2018-2019 academic years. Students who enrolled in the study were invited to complete a post-exam survey, and Step 1 examination scores of intervention and control groups were compared, controlling for preexisting academic differences and demographic traits. While the majority of students reported NPT program participation was a valuable use of their time, we found no significant difference in Step 1 scores between intervention and control groups. Notably, students identifying as female, underrepresented in medicine (UIM) or socioeconomically disadvantaged (SED) enrolled in higher proportions compared to the combined M2 student body of the 2017-2018 and 2018-2019 academic years. Our results may highlight the limitations of NPT programs for board examination preparation and inform the future design of peer-assisted learning programs within medical schools.

Addressing Bias Toward Overweight Patients: a Training Program for First-Year Medical Students.

BACKGROUND: Physicians may have biases toward overweight patients which likely influences clinical judgments and can lead to disparities in patient care. An increasing number of adults are considered overweight/obese, so it is important to address these biases in training future physicians. METHODS: Forty-five first-year medical students participated in art museum programs and physician presentations, or were part of the control group. Four validated measures Beliefs About Obese Persons Scale, Attitudes Toward Obese Persons Scale, Fat Phobia Scale, and the Harvard Implicit Association Test (IAT) and researcher-generated questions, measured levels of bias before and after study activities. RESULTS: All participants demonstrated decreased bias. ANCOVA analysis did not reveal significant differences between the experimental and control groups. However, prior to the study 75% of participants had "preference for thin individuals." Forty percent of those participating in study activities indicated a positive change by associating more positive traits with obese body shapes, compared to 29% of the control group. Study activities were rated positively. DISCUSSION/CONCLUSION: The art museum was an engaging/relaxing place for reflection on body types and biases. Physicians provided important instruction for normalization/de-stigmatization of patient care. Although there were no significant findings, the study has raised questions for continuing this work. What are most effective ways/times to address weight bias within the medical school curriculum? Could this work extend to other marginalized patient groups? The diversity in art and humanities creates a rich resource for discussing viewpoints and experiences. The small number of participants and the timing/lack of focus in museum sessions are noted as limitations.

Designing and Implementing a Novel Virtual Rounds Curriculum for Medical Students' Internal Medicine Clerkship During the COVID-19 Pandemic.

Introduction: During the COVID-19 pandemic, third-year medical students were temporarily unable to participate in onsite clinical activities. We identified the curricular components of an internal medicine (IM) clerkship that would be compromised if students learned solely from online didactics, case studies, and simulations (i.e., prerounding, oral presentations, diagnostic reasoning, and medical management discussions). Using these guiding principles, we created a virtual rounds (VR) curriculum to provide IM clerkship students with clinical exposure during a virtual learning period. Methods: Held three times a week for 2 weeks, VR consisted of three curricular components. First, clerkship students prerounded on an assigned hospitalized patient by remotely accessing the electronic health record and calling into hospital rounds. Second, each student prepared an oral presentation on their assigned patient. Third, using videoconferencing, students delivered these oral presentations to telemedicine VR small groups consisting of three to four students and three tele-instructors. Tele-instructors then provided feedback on oral presentations and taught clinical concepts. We assessed the effectiveness of VR by anonymously surveying students and tele-instructors. Results: Twenty-nine students and 34 volunteer tele-instructors participated in VR over four blocks. A majority of students felt VR improved their prerounding abilities (86%), oral presentation abilities (93%), and clinical reasoning skills (62%). All students found small group to be useful. Discussion: VR allowed students to practice rounding skills in a supportive team-based setting. The lessons learned from its implementation could facilitate education during future pandemics and could also supplement in-person clerkship education.

The design and implementation of a longitudinal social medicine curriculum at the University of Vermont's Larner College of Medicine.

BACKGROUND: Despite an abundant literature advocating that social determinants of health (SDH) be taught during undergraduate medical education, there are few detailed descriptions of how to design and implement longitudinal core curricula that is delivered to all students and accomplishes this goal. METHODS: In this paper, we describe the design and implementation of a social medicine curriculum at the University of Vermont's Larner College of Medicine (UVM Larner). Using Kern's principles, we designed a longitudinal curriculum that extends through both preclinical and clinical training for all students and focused on integrating SDH material directly into basic science and clinical training. RESULTS: We successfully developed and implemented two primary tools, a "Social Medicine Theme of the Week" (SMTW) in preclinical training, and SDH rounds in the clinical setting to deliver SDH content to all learners at UVM Larner. CONCLUSIONS: Extensive student-faculty partnerships, robust needs assessment, and focusing on longitudinal and integrated SDH content delivery to all students were key features that contributed to successful design and implementation.

Simulation 2.0: Integrating Basic Scientists and Clinicians in a Simulation Environment.

An increasing number of medical schools are implementing curricular changes that better integrate clinical and basic sciences throughout all four years of medical school. One of the most frequently cited reasons is to improve medical student clinical reasoning skills while simultaneously aiming to decrease the attrition of basic science knowledge. Multiple pedagogical strategies have been explored to achieve this goal. We have found that simulation is a viable medium to integrate basic science within standardized patient encounters for early medical students.

Addressing Implicit Bias in First-Year Medical Students: a Longitudinal, Multidisciplinary Training Program.

BACKGROUND: Studies show that implicit bias among healthcare providers contributes to health disparities. Despite this knowledge, most medical school curricula lack formal methods for assessing and reducing implicit bias among medical students. PURPOSE: The purpose of this study was to create a longitudinal, multidisciplinary training program for first-year medical students to reduce implicit bias toward skin tone, to increase awareness of personal bias, and to measure changes in bias after a targeted intervention. METHODS: First-year medical students participated in a three-part implicit bias training program that included visits to an art museum, a lecture on medical anthropology, and an interactive sociological discussion about bias in medical research. A control group did not participate in the training. All participants took the Harvard Implicit Association Test for Skin Tone and completed a questionnaire assessing awareness of implicit bias before and after the study activities were administered. RESULTS: All participants indicated a bias toward light skin tone. In addition, a stronger bias score in the pre-test correlated with a stronger belief that the scores were inaccurate. Neither the experimental group nor the control group demonstrated a significant change in implicit bias, but the experimental group trended toward a decrease in bias. Power analysis suggested that significant results may have been obtained with a larger sample size. All participants indicated an awareness that implicit biases affect the provision of healthcare. When prompted to reflect on these biases, the experimental group provided richer, more detailed personal accounts of implicit bias in the healthcare environment after participating in the study. CONCLUSIONS: First-year medical students who participated in this study were aware that implicit bias affects the provision of healthcare and therefore plays a role in perpetuating health disparities. However, they were less able to recognize bias in themselves. Providing opportunities for medical students to recognize and confront their own implicit biases is an important goal. This study suggests that a longitudinal, multidisciplinary curricular approach to building awareness and reducing implicit bias can produce promising results in medical students. We anticipate that further development and refinement of curricular activities may lead to significant results.

Interprofessional Education: Oral Health in the Medical Curriculum.

Schools of medicine and dentistry on the same geographical campus have an opportunity to promote oral health by training physicians to become more skilled in screening for oral disease in addition to counseling and referring patients to dental health professionals.

Feedback Quality Using an Observation Form.

BACKGROUND: Direct observations with focused feedback are critical components for medical student education. Numerous challenges exist in providing useful comments to students during their clerkships. Students' evaluations of the clerkship indicated they were not receiving feedback from preceptors or house officers. OBJECTIVE: To encourage direct observation with feedback, Structured Patient Care Observation (SPCO) forms were used to evaluate third-year medical students during patient encounters. DESIGN: In 2014-2015, third-year medical students at a Midwestern medical school completing an 8-week pediatrics clerkship provided experiences on inpatient wards and in ambulatory clinics. Students were expected to solicit feedback using the SPCO form. RESULTS/FINDINGS: A total of 121 third-year medical students completed the pediatrics clerkship. All of the students completed at least one SPCO form. Several students had more than one observation documented, resulting in 161 SPCOs submitted. Eight were excluded for missing data, leaving 153 observations for analysis. Encounter settings included hospital (70), well-child visits (34), sick visits (41), not identified (8). Observers included attending physicians (88) and residents (65). The SPCOs generated 769 points of feedback, comments coalesced into themes of patient interviews, physical examination, or communication with patients and family. Once themes were identified, comments within each theme were further categorized as either actionable or reinforcing feedback. DISCUSSION: SPCOs provided a structure to receive formative feedback from clinical supervisors. Within each theme, reinforcing feedback and actionable comments specific enough to be useful in shaping future encounters were identified.

The application of the image-guidance system in the sinus endoscopic surgery teaching / 中华医学教育探索杂志

Anatomy and surgery teaching has always been a difficulty in clinical medical education. In particular, the anatomy and surgery teaching under the endoscope is more difficult to learn and under-stand because of the visual differences with the direct vision. If the students misunderstand, it may lead to the severe surgical complications. We applied the image-guidance technology in the teaching of rhinology endoscope surgery, which can help teachers to teach the sinonasal anatomical structure and give an accurate explanation of surgical procedures. According to the questionnaire survey, 96.23% (51/53) of the students thought the method was effective and clear, and 98.11% (52/53) of them thought the method was better than the traditional teaching method of nasal endoscope. By this technology, the students can acquire a deeper understanding of the anatomy and surgery procedure. It especially fits the surgery teaching of the sinonasal occupying lesion.

Developing medical education capacity in Russia: twenty years of experience.

BACKGROUND: The partnership between Yale University (USA) and Kazan State Medical University (KSMU, Russia) was established in 1996 and transitioned to Western Connecticut Health Network (WCHN)/University of Vermont Robert Larner, M.D. College of Medicine (USA) in 2012 with the goal of modernizing medical education at KSMU primarily through introduction of the American medical education structure, role modeling, and educational capacity building. It was centered on the formation of a select group of Russian junior faculty members familiar with American medical education who would then initiate a gradual change in medical education at KSMU. Here we describe the 20 year partnership, rooted in local capacity building, through which a sustainable, mutually rewarding international collaboration was established. In addition, we evaluate the program's outcomes and impact on medical education at Kazan State Medical University, and assess its influence on Russian program participants. METHODS: Senior residents and faculty were sent to KSMU to conduct teaching sessions with local faculty and trainees. Their responsibilities included familiarizing Russian colleagues with specific topics in clinical medicine, importing knowledge about the basics of teaching, clinical epidemiology and evidence based medicine, and creating, in consistency with the American model, a "Clinical Teaching Team Structure" that integrates patient care with clinical education. Furthermore, 44 of selected KSMU members, including 13 junior faculty (29.5%), 14 clinical PhD students (31.8%), 12 interns/residents (27.3%), and five medical students (11.4%), were trained at Yale/WCHN or one of their major affiliated community hospitals for a period of 1 to 12 months for a total of 844 participant-weeks of training. RESULTS: Thirty (68.2%) individuals who were trained in the U.S. are currently working in Kazan primarily as faculty at KSMU. Among them, three trainees (10%) have become heads of their department, eight (26.7%) hold senior faculty positions, and two (6.7%) have clinical and educational administrative leadership positions. Two major clinical departments have adopted the "Clinical Teaching Team Structure." As a result of the collaboration, three teaching courses - Evidence-Based Medicine, Tropical Medicine, and HIV/AIDS Medicine - have been designed and incorporated into the curriculum. CONCLUSION: This partnership has been instrumental in introducing the American medical education model and expanding the medical knowledge of faculty, residents, and students of KSMU on infectious diseases, HIV/AIDS, tropical medicine, renal diseases, and global health topics. Capacity building through the Yale/WCHN-KSMU exchange program has greatly contributed to the quality of medical education at Kazan State Medical University.

Scientific research ability cultivation's status quo and reform suggestion of eight-year clinical medical education program / 基础医学与临床

Capcity building for scientific research ability cultivation is an important component of 8-year curriculum of clinical medical education .Research skills has increasingly become one of the important factors to evaluate medi-cal school and hospital .We summarized cultivation characters of the accredited schools , which has experimented 8-year clinical medical education program .And put forward suggestions for scientific research ability cultivation ,in or-der to provided reference for reformation of 8-year clinical medical education .