BACKGROUND: This study aimed to evaluate the impact of urology-led male genitourinary (GU) exam training on internal medicine residents' proficiency and confidence in conducting and interpreting GU exams. The study addre...BACKGROUND: This study aimed to evaluate the impact of urology-led male genitourinary (GU) exam training on internal medicine residents' proficiency and confidence in conducting and interpreting GU exams. The study addresses a critical gap in formal GU education, which is essential for improving care for male patients with GU complaints in primary care settings. APPROACH: In this single-institution prospective study, a 45-min hands-on course was conducted over six weekly sessions for all internal medicine residents using simulated models with normal and abnormal pathologies. Didactics were created and facilitated by one urology attending and two residents. Pre- and post-course surveys assessing prior GU exam education, likelihood and comfort performing GU exams and confidence in interpreting findings were distributed. Levels of comfort/confidence were interpreted using a 5-point scale (very uncomfortable = 0, uncomfortable = 1, neither/nor = 2, comfortable = 3, very comfortable = 4). EVALUATION: Fifty-five participants completed the pre-course and 74 completed the post-course survey. Over half of the participants (56%) had no prior formal GU exam education. After course completion, participants felt significantly more comfortable performing a testicular/scrotal exam (2 ± 0.82 vs. 2.96 ± 0.47; p < 0.0001) and DRE (2.04 ± 0.86 vs. 2.89 ± 0.50; p < 0.0001) and were significantly more confident interpreting findings of the testicular/scrotal exam (1.85 ± 0.83 vs. 2.93 ± 0.51; p < 0.0001) and DRE (1.70 ± 0.86 vs. 2.74 ± 0.62; p < 0.0001). Overall, 89% reported they were more likely to perform a male GU examination after course completion. IMPLICATIONS: Formal GU exam education improves internal medicine residents' comfort and confidence in performing and interpreting GU exams, potentially leading to better diagnostic outcomes and access to care for male patients.
BACKGROUND: Artificial Intelligence (AI) is increasingly relevant to medical training, yet formal AI instruction remains limited. This study examined medical students' awareness, perceived access to AI-integrated learnin...BACKGROUND: Artificial Intelligence (AI) is increasingly relevant to medical training, yet formal AI instruction remains limited. This study examined medical students' awareness, perceived access to AI-integrated learning tools, and views on institutional readiness. METHODS: A cross-sectional survey of 391 medical students from > 30 countries (January-February 2025) measured AI awareness, proficiency, access to AI-enabled tools, institutional preparedness and perceived barriers. ANOVA, t-tests and χ tests examined differences by training stage, institution type and World Bank country classification. RESULTS: Awareness was high (91.6%, 358/391), yet only 58.1% (227/391) reported access to AI-integrated tools. Proficiency increased by training stage (F(2,388) = 5.6, p = 0.004), but did not differ by institution type (t = -0.86, p = 0.39) or World Bank classification (t = -1.16, p = 0.25). Although 82.1% (321/391) expressed interest in structured AI training, only 34.5% (135/391) believed their institution was prepared. Reported barriers included lack of training, cost and concerns about reliability. CONCLUSIONS: Findings indicate a need for structured AI education emphasizing applied skills, ethics and critical appraisal to align student demand with institutional readiness.
BACKGROUND: Clinical clerkships are essential for Dutch medical students to gain practical experience, but the learning environment in these rotations is often suboptimal. Hierarchical structures and cultural resistance...BACKGROUND: Clinical clerkships are essential for Dutch medical students to gain practical experience, but the learning environment in these rotations is often suboptimal. Hierarchical structures and cultural resistance to feedback can discourage students from voicing their concerns, limiting opportunities for mutual growth. To address this, we developed the Feedback and Feedforward Conversations (FFCs), inspired by healthcare 'mirror meetings', to foster bidirectional feedback in a psychologically safe setting. APPROACH: The FFCs consist of three phases: (1) Students share their experiences, while faculty listen silently with their backs turned; (2) students and faculty reflect separately, identifying key topics; and (3) a structured dialogue explores solutions and opportunities for improvement. Meetings were held quarterly in 2022 with small groups of students and faculty, facilitated in offsite, informal settings to ensure openness. EVALUATION: Reflections from post-meeting focus groups informed refinements, including structuring discussions around care delivery, collaboration and personal experiences. The evaluation highlighted the FFCs' strengths in fostering psychological safety, enhancing educational value and promoting meaningful relationships. Faculty found emotionally delivered feedback particularly impactful. IMPLICATIONS: The FFCs highlight the value of authentic student-faculty dialogue, emphasizing reciprocal feedback as a catalyst for professional growth and system improvement. The FFC tool shows potential for improving educational environments and fostering a culture of continuous learning. Future research should explore FFCs' broader applicability and long-term impact on clinical training and healthcare quality.
BACKGROUND: Grading medical student patient notes (PNs) is resource-intensive. Natural language processing (NLP) offers a promising solution to automatically grade PNs. We deployed an automated grading system that uses N...BACKGROUND: Grading medical student patient notes (PNs) is resource-intensive. Natural language processing (NLP) offers a promising solution to automatically grade PNs. We deployed an automated grading system that uses NLP and explored the perceived value of PN feedback. APPROACH: The automated system graded written notes after two standardized patient encounters by third-year medical students. The system generated an individualized report on 'items found' and 'items not found' in the history, physical examination, and diagnosis sections, which was shared with students for feedback via a web-based interface. By rotation, block students received either the automated case feedback first or the faculty-written model note feedback first (the pre-intervention baseline). EVALUATION: After reviewing feedback, students completed surveys for both automated feedback and model note feedback and participated in follow-up focus groups. In total, 44 students received feedback, 37 completed surveys, and 28 participated in focus groups. Qualitative themes that emerged suggested the automated feedback was visually appealing and allowed for easy comparison of items found vs. missing, which would help improve students' documentation skills. Model note appeared trustworthy. IMPLICATIONS: We found automated systems can be a potential tool for formative feedback on note writing activity although in terms of quality it does not surpass the pre-existing feedback methods, such as model note feedback used in our study. Order effects may have influenced these perceptions and the small sample size limits generalizability. Tested software had occasional errors in recognizing a phrase or showing a false positive.
Teachers in the health professions increasingly see the benefits of involving patients in their educational activities and are looking for good practice guidelines on how best to do this, especially when they lack experi...Teachers in the health professions increasingly see the benefits of involving patients in their educational activities and are looking for good practice guidelines on how best to do this, especially when they lack experience. Patient partners say that they often do not get the information they need in order to understand expectations and prepare effectively for their teaching role. In collaboration with patient partners, we developed a checklist in the form of a parallel document, one side for instructors and one side for patient partners. The checklist is in four parts and covers the things for teachers and patients to do before, during and after an educational activity. The checklist has been used by patient partners and instructors in a wide range of health professions at two institutions. It provides a concise and comprehensive reminder for instructors, empowers patients to ask for the information they need and is a template that can be customised for different contexts.
BACKGROUND: Resident-as-teacher (RaT) curricula are often time-limited experiences without opportunities to practice real-world teaching. We implemented a longitudinal RaT programme with self-study resources and opportun...BACKGROUND: Resident-as-teacher (RaT) curricula are often time-limited experiences without opportunities to practice real-world teaching. We implemented a longitudinal RaT programme with self-study resources and opportunities for residents to engage in real-world teaching experiences. APPROACH: We incorporated RaT curricula guidelines and grounded the programme in the theories of experiential learning and deliberate practice. We asked medical students and interns to evaluate residents' teaching skills using the teaching effectiveness instrument (TEI) on a monthly basis. We fit a repeated measures mixed linear model adjusting for residents' year of training to compare TEI scores over time for residents in the RaT programme and residents who were not enrolled. We stratified residents by year of training and used a Student's t-test to compare School of Medicine (SOM) evaluations across groups. EVALUATION: Twenty-eight residents took part in the study, 14 in each group. There was no significant increase in TEI scores of RaT residents (increase of 0.38 each quarter; 95% CI -1.41, 2.17; p = 0.42), and the change in TEI scores over time was no different than the comparison group (slope difference 0.26; 95% CI -2.34, 2.85; p = 0.85). PGY3 residents in the RaT group had higher SOM evaluation scores in the 'Effectiveness' and 'Feedback' domains. IMPLICATION: RaT enrolment was not associated with a faster rate of change in TEI scores but was associated with higher SOM evaluations for PGY3 residents. The curricular and study design provides an example of how to implement and evaluate a longitudinal RaT programme centred on real-world teaching experiences with objective teaching measures.
BACKGROUND: We implemented a virtual reality (VR) communication curriculum, delivered via video teleconferencing, to fourth-year medical students entering paediatric residency. We aimed to assess the impact of a VR curri...BACKGROUND: We implemented a virtual reality (VR) communication curriculum, delivered via video teleconferencing, to fourth-year medical students entering paediatric residency. We aimed to assess the impact of a VR curriculum on attitudes and confidence around motivational interviewing (MI) competencies and measure implementation outcomes related to this novel modality of training. APPROACH: Participants included fourth-year medical students enrolled in a paediatric intern-readiness bootcamp at four US medical schools in spring 2022. The VR curriculum was a 2-h mixed didactic/virtual simulation experience focused on practicing MI competencies in the context of addressing vaccine hesitancy and behavioural health counselling. EVALUATION: A retrospective pre/post Likert-scale survey measured learners' confidence related to curricular communication skills (0 = not at all confident, 4 = very confident). Paired t-tests compared changes in confidence ratings. Descriptive statistics assessed implementation outcomes including feasibility, acceptability, and appropriateness related to the delivery of remote VR simulations (1 = completely disagree, 5 = completely agree). Forty of 53 students (75%) completed the survey. Students' self-reported confidence significantly increased across all communication skills, including using reflection statements, using a presumptive announcement to introduce the influenza vaccine and providing evidence-based behavioural management strategies (all p < 0.01). Students agreed that the VR curriculum was highly feasible, acceptable and appropriate. IMPLICATIONS: VR patient simulations via video teleconferencing may provide a feasible distanced platform for teaching MI skills to medical students. Such remote training may support standardised and equitable high-quality training across institutions.
BACKGROUND: Standard setting is essential for assessing medical students to ensure they meet required competencies for clinical practice. Various methods exist, but no gold standard has been universally adopted. This stu...BACKGROUND: Standard setting is essential for assessing medical students to ensure they meet required competencies for clinical practice. Various methods exist, but no gold standard has been universally adopted. This study aimed to identify the methods of standard setting used in Australian medical schools, and their benefits, limitations and challenges with implementation, to inform a proposal to change standard-setting methods at James Cook University. METHODS: A survey designed to gather detailed information on current standard-setting methods, challenges and satisfaction levels related to exit-level written assessments was sent to the assessment leads of all 21 Australian medical schools with graduating students. Survey data were analysed using descriptive statistics and thematic analysis. RESULTS: All 21 schools participated. Standard-setting methods included Cohen/Modified Cohen (n = 10), Angoff (n = 4), Ebel (n = 4), Hofstee (n = 2) and Objective Borderline method (n = 1). Satisfaction with the most popular method, Cohen/Modified Cohen, was high with a mean of 83% (range 69%-100%), and three additional schools indicated a plan to implement this method in coming years. Common challenges of standard setting in schools using methods other than Cohen/Modified Cohen included panel recruitment, resource management and maintaining assessment quality. Thematic analysis showed stakeholder involvement and the need for additional resources as necessities in implementing effective standard-setting methods. CONCLUSIONS: Cohen method of standard setting is most commonly used for exit-level written examinations at Australian medical schools and is preferred for its efficiency and adaptability. Transitioning to Cohen/Modified Cohen could align JCU practices with those of most other medical schools in Australia.