Medical Education[JOURNAL]
Sun
200 papers
Comparing undergraduate learning outcomes and experiences across code-based and non-code-based statistical software platforms in courses utilizing the Passion-Driven Statistics curriculum.
Dierker L, Rosenbaum J, Pugh B … +1 more , Rose J
BMC Med Educ · 2026 Jul · PMID 42402579 · Full text
This study examines whether undergraduate students in an introductory statistics course report different learning outcomes and experiences based on whether they use code-based or non-code-based statistical software. The...
This study examines whether undergraduate students in an introductory statistics course report different learning outcomes and experiences based on whether they use code-based or non-code-based statistical software. The sample included 2,241 students enrolled in courses using the Passion-Driven Statistics curriculum across 61 post-secondary institutions. Seventy-two percent of participants learned a code-based platform (R, SAS, Stata, Python), while 27.6% learned a non-code-based platform (SPSS, Excel, JMP, StatCrunch). Mixed-effects cumulative logit and logistic regression models were used to compare outcomes between groups while accounting for clustering of students within courses and adjusting for student demographics and academic background. Students in code-based courses had higher odds of reporting that they worked harder and found the course more challenging than those in non-code-based courses. At the same time, learning a code-based platform was positively associated with perceived gains in analyzing data for patterns, greater excitement about learning new concepts, and increased interest in conducting research. However, students learning code-based software reported feeling less prepared for advanced disciplinary coursework or thesis work. Overall, the results suggest that learning to work with code is associated with greater engagement and interest in data-driven work, even as it introduces greater challenges. These findings highlight the potential value of incorporating code-based statistical tools into undergraduate curricula while also underscoring the importance of supporting students through the initial learning curve.
Simulation-based education in undergraduate psychiatry: a focused review and interpretive analysis of clinical competence representation.
Pulido FR, García ÁR, Estebaranz NC
BMC Med Educ · 2026 Jul · PMID 42402572 · Full text
BACKGROUND: Simulation-based education has become an established component of medical training and is increasingly used in undergraduate psychiatry. While previous studies have primarily examined its effectiveness for de...
BACKGROUND: Simulation-based education has become an established component of medical training and is increasingly used in undergraduate psychiatry. While previous studies have primarily examined its effectiveness for developing clinical skills, less attention has been given to how different dimensions of psychiatric competence are represented within simulation-based educational and assessment frameworks. This review explores the representation of behavioural, relational and integrative competencies in simulation-based undergraduate psychiatric education. METHODS: A focused review was conducted following PRISMA principles. Electronic databases were searched to identify studies examining simulation-based education in undergraduate psychiatry. Eligible studies involved undergraduate medical students and the use of standardized or simulated patients in psychiatric teaching or assessment. Data were analysed using a narrative and interpretive synthesis informed by contemporary literature on professional competence, clinical reasoning and psychiatric practice. RESULTS: Four studies met the inclusion criteria. Across the reviewed literature, behavioural competencies, including interviewing skills, information gathering and psychopathological assessment, were consistently represented. Relational competencies, such as empathy, communication and therapeutic engagement, were also explicitly addressed. In contrast, integrative competencies involving formulation, contextual understanding, biopsychosocial synthesis and clinical judgement were rarely operationalised as explicit assessment constructs. Although integrative reasoning appeared to be implicitly required within complex clinical encounters, it remained comparatively less visible within published educational and assessment frameworks. CONCLUSIONS: Simulation-based education contributes to the development of important clinical skills in undergraduate psychiatry. The findings suggest that behavioural and relational competencies are consistently represented within simulation-based educational and assessment approaches, whereas integrative competence is less frequently operationalised as an explicit construct. The concept of competence representation offers a useful perspective for understanding how psychiatric competence is conceptualised and assessed and may inform future developments in simulation-based psychiatric education.
The Clinical Mentorship Program: a mixed-methods evaluation of a community-based medical education pathway program for high school students.
Hunt VM, Cheng J, de Lomba WC … +1 more , Warrier S
BMC Med Educ · 2026 Jul · PMID 42401988 · Full text
Students from low-income and underrepresented backgrounds face structural barriers to entering medicine, including limited access to early clinical exposure, physician guidance, and professional networks. To address thes...
Students from low-income and underrepresented backgrounds face structural barriers to entering medicine, including limited access to early clinical exposure, physician guidance, and professional networks. To address these disparities, medical students at the Warren Alpert Medical School of Brown University created a year-long Clinical Mentorship Program (CMP) for high school students in Woonsocket, Rhode Island. The intervention combined monthly after-school instruction on basic science content and clinical skills by medical students with structured hospital-based shadowing and guided discussion with resident physicians. Using a mixed-methods pre-post design, the intervention evaluated changes in educational motivation, clinical self-efficacy, medical knowledge, awareness of other academic enrichment programs, and physician access and comfort. High school students demonstrated significant gains in motivation to attend college, understanding of cardiopulmonary anatomy and physiology, understanding of physician roles, comfort interacting with physicians, self-reported physician access, and awareness of local educational opportunities. Qualitative findings highlighted the importance of experiential learning, guided shadowing, a clearer understanding of medical careers, and persistent structural barriers. These findings suggest that community-based programs that leverage local resources, networks, and infrastructure to combine medical education with guided clinical exposure may be feasible entry points into the medical pipeline for students confronting complex socioeconomic disadvantages.
Comparison of 3D model-based and slide-based teaching for afferent and efferent spinal cord pathways: a pre-test/post-test study.
Ömerli̇ A, Aslantaş HK
BMC Med Educ · 2026 Jul · PMID 42401970 · Full text
BACKGROUND: Understanding the organization of afferent and efferent spinal cord pathways can be challenging for students due to their complex spatial relationships. This study aimed to develop a three-dimensional (3D) ed...
BACKGROUND: Understanding the organization of afferent and efferent spinal cord pathways can be challenging for students due to their complex spatial relationships. This study aimed to develop a three-dimensional (3D) educational model demonstrating these pathways and to compare student learning outcomes between model-based instruction and conventional slide-based teaching. METHODS: A pre-test/post-test educational study was conducted with second-year dental students (n = 60). Transverse sections of the C4 and T7 vertebrae were designed and 3D-printed at four times their anatomical size. A spinal cord model made of modeling clay was placed within the vertebral canal, and afferent and efferent pathways were represented using color-coded cables. Students completed a 15-item multiple-choice pre-test assessing baseline knowledge of spinal cord pathways and were allocated into two groups. Group 1 (n = 30) received conventional slide-based instruction, while Group 2 (n = 30) was taught using the 3D model. After the instructional sessions, students completed the same test as a post-test. Within-group and between-group comparisons were analyzed using paired-sample and independent-sample t-tests. RESULTS: Both instructional approaches resulted in significant improvements in post-test scores. In the slide-based instruction group, mean scores increased from 5.00 ± 1.98 to 8.47 ± 2.54 (p < 0.001). In the 3D model group, mean scores increased from 4.77 ± 2.39 to 10.27 ± 2.29 (p < 0.001). The mean improvement was significantly greater in the 3D model group (5.50 ± 3.07) compared with the slide-based group (3.47 ± 2.70) (p = 0.007). The effect size for the difference between groups was moderate to large (Cohen's d ≈ 0.70). CONCLUSION: Both instructional methods improved short-term knowledge of spinal cord pathways; however, model-based instruction was associated with greater learning gains. These findings suggest that three-dimensional models may serve as a useful supplementary tool in neuroanatomy education. Further studies using validated assessment tools and evaluating long-term knowledge retention are needed to confirm these findings.
Perceptions of medical dramas among medical students in the West Bank, Palestine: a cross-sectional study.
Dababseh BH, Suboh MW, Ismail II … +5 more , Ikhlayel AG, Dabbas O, Khdeir DNA, Dababseh A, Atatre MH
BMC Med Educ · 2026 Jul · PMID 42401946 · Full text
BACKGROUND: Medical dramas are widely consumed by medical students globally and may constitute an informal or hidden curriculum influencing professional identity, empathy, and ethical reasoning. Palestinian medical stude...
BACKGROUND: Medical dramas are widely consumed by medical students globally and may constitute an informal or hidden curriculum influencing professional identity, empathy, and ethical reasoning. Palestinian medical students represent an understudied population navigating a resource-constrained and geopolitically complex healthcare context. OBJECTIVES: To investigate the perceptions of Palestinian medical students regarding medical dramas, including viewing habits, assessments of clinical and ethical realism, psychological and behavioural impacts, and the potential role of such media as an informal educational resource. METHODS: A cross-sectional study was conducted among 638 undergraduate medical students from five universities in the West Bank, Palestine, using convenience and snowball sampling. Data were collected via an online structured questionnaire adapted and culturally validated from the Czarny et al. (2008) instrument, incorporating forward-back translation, pilot testing (n = 15), and internal consistency assessment (Cronbach's alpha = 0.81). Descriptive statistics and Chi-square tests were applied. RESULTS: Mean age was 21.1 ± 1.65 years; 66.8% were female. Most participants (73.4%) had watched medical dramas, primarily via digital streaming platforms. While 77.3% perceived clinical scenes as only slightly or moderately realistic, 41.9% considered ethical content to be moderately accurately depicted. Approximately 46.6% reported increased empathy and 47.2% reported increased study motivation. Drama viewers were significantly more likely to rate informal sources-family (p < 0.001), friends (p = 0.021), and online news (p = 0.037)-as important for ethical guidance, compared with non-viewers. CONCLUSIONS: Palestinian medical students engage substantially with medical dramas and appraise their content critically. Associations between drama viewing and increased empathy, study motivation, and reliance on informal ethical guidance sources suggest a potential hidden-curriculum effect. Given the cross-sectional design and convenience sampling, causal inferences cannot be drawn. These findings support cautious integration of medical dramas into bioethics and professionalism curricula as supplementary teaching tools.
Self-directed learning readiness in preclinical medical education: Patterns, variation, and academic outcomes from a mixed longitudinal and cross-sectional study.
Boadum O, Wilson TD, Thompson K … +2 more , Robertson EM, Notebaert A
BMC Med Educ · 2026 Jul · PMID 42401920 · Full text
BACKGROUND: The transition from undergraduate education to medical school demands increasing learner autonomy and self-regulation. Guided by Zimmerman's Self-Regulated Learning (SRL) theory and Grow's Staged Self-Directe...
BACKGROUND: The transition from undergraduate education to medical school demands increasing learner autonomy and self-regulation. Guided by Zimmerman's Self-Regulated Learning (SRL) theory and Grow's Staged Self-Directed Learning Model, this study examined how self-directed learning readiness (SDL-R), encompassing learning motivation, planning and implementation, self-monitoring, and interpersonal communication varies across the preclinical curriculum and how these domains relate to academic performance. METHODS: A mixed longitudinal and repeated cross-sectional study (2022-2024) was conducted among preclinical medical students (N = 807 responses; 434 unique students from three cohorts, Classes of 2025-2027) at an LCME-accredited US medical school. All enrolled first- and second-year students were eligible; recruitment was voluntary via web-based REDCap surveys administered once per semester. Linear mixed-effects models evaluated within-student change in total SDL-R and its four domains across semesters. Ordinary least-squares regression with cluster-robust standard errors assessed the contribution of standardized subscale scores to cumulative grade point averages. Bonferroni correction was applied within each family of comparisons, with effect sizes and 95% confidence intervals reported. RESULTS: SDL-R scores varied across preclinical semesters in a pattern consistent with developmental progression, with a modest decline in first-year Spring followed by recovery through year two. Planning and implementation was the strongest positive predictor of GPA in Year 1 (β = 0.142, p = .004) and in the combined model (β = 0.154, p < .001). The SDL-R domains collectively explained 22.2% of GPA variance in Year 1 (R² = 0.222) and 9.0% in Year 2 (R² = 0.090); the combined model explained 15.0% (R² = 0.150). Interpersonal communication showed a significant negative partial association with GPA, consistent with a statistical suppressor effect. Second-year students, older learners, males, and higher-achieving students showed higher SDL-R levels. CONCLUSION: SDL-R is a dynamic, context-sensitive competency during preclinical training, with planning and implementation as its strongest academic predictor. Targeted curricular interventions that scaffold metacognitive planning, self-monitoring, and adaptive strategy use may enhance both academic performance and lifelong learning capacity.
Extended reality and web-based imaging in case-based anatomy education: a two-year study of knowledge retention on anomalies and variations.
Aytaç G, Kalehuawehe K, Pagat S … +5 more , Oktay C, Rettenmeier C, Lee UY, Romine R, Lozanoff S
BMC Med Educ · 2026 Jul · PMID 42401913 · Full text
BACKGROUND: This prospective repeated-measures quasi-experimental educational study, conducted across two consecutive first-year medical school cohorts, aimed to develop and implement case-based learning (CBL) modules us...
BACKGROUND: This prospective repeated-measures quasi-experimental educational study, conducted across two consecutive first-year medical school cohorts, aimed to develop and implement case-based learning (CBL) modules using three-dimensional (3D) models and magnetic resonance imaging (MRI) within an extended reality (XR) environment. The intervention integrated anatomical variations and anomalies to enhance immediate learning and long-term knowledge retention. METHODS: MRI data from selected donors at the John A. Burns School of Medicine (JABSOM) were used to create XR-CBL modules. First-year medical students from the classes of 2024 (Cohort 2021) (n = 61) and 2025 (Cohort 2022) (n = 67) participated. Before the session, students received an email detailing the activity. During the gross anatomy laboratory, they accessed a website to explore cases featuring learning objectives, clinical and radiological data, 3D models, and MRIs. The XR experience utilized desktop-based XR technology. An assessment was administered before, immediately after, and eight weeks post-intervention. Students also completed a mixed-format feedback survey. RESULTS: A repeated-measures ANOVA revealed a significant effect of the intervention on student performance across both cohorts. For Cohort 2021, Wilks' Lambda = 0.384, F (2, 59) = 47.27, p < 0.001, partial η² = 0.616. For Cohort 2022, Wilks' Lambda = 0.30, F (2, 65) = 72.72, p < 0.001, partial η² = 0.691. Follow-up pairwise comparisons with Bonferroni adjustments indicated significant improvements from pre-test to post-test and from pre-test to post-post-test for both cohorts (p < 0.01). There was no significant difference between the post-test and post-post-test scores (p = 1.00). In Cohort 2021, mean scores significantly increased from pre-test (3.9 ± 1.9) to post-test (6.2 ± 2.6) and were maintained at post-post-test (6.3 ± 1.7). Similarly, Cohort 2022 demonstrated significant gains from pre-test (4.3 ± 1.6) to post-test (7.6 ± 2.2), with high retention at post-post-test (6.3 ± 2.4). Pairwise comparisons confirmed that improvements from baseline were significant (p < 0.01), while no significant decay occurred between post- and post-post-assessments (p = 1.00). CONCLUSIONS: Incorporating multimodal resources, including anatomical variations and anomalies through CBL, into the gross anatomy laboratory was associated with significant score improvements and positive student perceptions. Learners reported that the interactive, imaging-based tools helped them better understand complex anatomical relationships, particularly when anatomical variability was highlighted.
A study on the application of the remote multidisciplinary team teaching model in clinical postgraduate education of urology.
Zhuang W, Lin H, Xu S … +6 more , Yan J, Liu Z, He Q, Li Y, He W, Guo Y
BMC Med Educ · 2026 Jul · PMID 42401905 · Full text
BACKGROUND: Postgraduate medical education increasingly requires learners to develop clinical reasoning, manage uncertainty, integrate heterogeneous clinical information and collaborate across disciplines. Multidisciplin...
BACKGROUND: Postgraduate medical education increasingly requires learners to develop clinical reasoning, manage uncertainty, integrate heterogeneous clinical information and collaborate across disciplines. Multidisciplinary team (MDT) teaching may provide a clinically situated learning environment in which trainees can observe and participate in complex decision-making. However, evidence on the use of remote MDT teaching in urology postgraduate education remains limited. METHODS: This randomized controlled study included 76 professional master's students rotating through a surgical standardized residency training base. Students were assigned to a remote MDT teaching group or a conventional teaching group, with 38 students in each group. The remote MDT intervention was delivered as a structured teaching package that included pre-session case preparation, remote multidisciplinary case discussion, expert-guided case analysis, post-session reflection and iterative feedback. Outcomes included theoretical knowledge, clinical decision-making, practical skills, questionnaire-based evaluation of the teaching model and overall competency. RESULTS: Students in the remote MDT group achieved higher scores than those in the conventional teaching group in theoretical knowledge, clinical decision-making, questionnaire-based evaluation and overall competency. No significant between-group difference was observed in practical skills. The pattern of findings suggested that the remote MDT model had a stronger effect on outcomes requiring information integration, clinical reasoning and collaborative decision-making than on procedural performance. CONCLUSIONS: Remote MDT teaching may be a useful component of urology postgraduate education, particularly for learning outcomes related to clinical reasoning and knowledge integration. Its value appears to derive not only from remote delivery, but also from the structured organization of preparation, multidisciplinary discussion, reflection and feedback. Procedural skill development remains dependent on supervised hands-on practice. Future multicentre studies are needed to confirm these findings and to examine which components of the intervention contribute most to learning. TRIAL REGISTRATION: Not applicable.
Nationwide survey of formal mentorship characteristics and perceptions among resident physicians in Japan.
Katayama K, Nishizaki Y, Kikukawa M … +8 more , Takada T, Nagasaki K, Shimizu T, Yamamoto Y, Watari T, Tokuda Y, Chopra V, Ohira Y
BMC Med Educ · 2026 Jul · PMID 42401899 · Full text
BACKGROUND: Mentorship is considered essential in residency training, yet its structure and quality in Japan remain unclear. METHODS: We conducted a nationwide, multi-center descriptive study of postgraduate year (PGY) 1...
BACKGROUND: Mentorship is considered essential in residency training, yet its structure and quality in Japan remain unclear. METHODS: We conducted a nationwide, multi-center descriptive study of postgraduate year (PGY) 1-2 residents who completed both the General Medicine In-Training Examination (GM-ITE) and a formal mentorship survey in 2024. Residents who declined participation, provided no response to the survey, had incomplete survey responses, or did not have a formal mentor were excluded. RESULTS: Of 9,179 residents who took the GM-ITE, 3,877 from 570 hospitals were analyzed. Most reported having one mentor (71.6%), and mentors were predominantly male (72.9%). Only 61.0% of programs offered lectures on mentorship. Overall, 46.1% of residents did not perceive feedback as specific or actionable, whereas 69.3% reported trusting their mentors. Mentoring interactions were relatively limited, with 60.4% of residents reporting meeting less than once a month. CONCLUSIONS: Among residents with formally assigned mentors, important gaps remained in mentor diversity, feedback quality, and mentoring engagement. Efforts to strengthen mentor training, improve feedback practices, and promote more structured mentoring interactions may help optimize residents' educational and professional development.
Knowledge, attitudes, practices and clinical preparedness regarding porcelain laminate veneers among dental interns.
Yazar MU, Yanıkoğlu N, Ökten T
BMC Med Educ · 2026 Jul · PMID 42401895 · Full text
BACKGROUND: In recent years, increasing aesthetic expectations have led to a growing demand for porcelain laminate veneer treatments. This study aims to address a gap in the literature by evaluating the knowledge, attitu...
BACKGROUND: In recent years, increasing aesthetic expectations have led to a growing demand for porcelain laminate veneer treatments. This study aims to address a gap in the literature by evaluating the knowledge, attitudes, and practices of undergraduate dental students regarding porcelain laminate veneers, within the context of updated dental curricula, thereby providing insight into their current level of theoretical understanding and clinical preparedness. METHODS: This study employed a descriptive cross-sectional design. The sample consisted of final-year students from the Faculty of Dentistry at Atatürk University. A total of 150 students were invited to participate; those who agreed and completed the questionnaire in full were administered a KAP-based survey adapted for porcelain laminate veneer applications. RESULTS: A total of 134 dental interns participated in the study, of whom 61.9% were female and 38.1% were male. Based on objective assessments, the level of theoretical knowledge was found to be high, with correct response rates ranging between 85% and 94% for many items; however, lower success rates were observed in technically demanding aspects, such as cement thickness effects on shade selection (28.4%) and preparation classifications (45.5%). Subjective evaluations revealed limited clinical experience and self-confidence; notably, only 32.1% of participants had encountered a laminate veneer case in clinical practice. While no significant difference was found in theoretical knowledge levels by gender (p = 0.083), male participants demonstrated significantly higher self-perceived clinical confidence scores compared to females (p = 0.024). A weak negative correlation was observed between objective knowledge scores and self-perceived clinical confidence scores (r = -0.201, p = 0.020). CONCLUSIONS: Despite a high level of theoretical knowledge among dental interns, this theoretical knowledge was not reflected in students' self-perceived clinical preparedness and confidence. Furthermore, a weak negative correlation was identified between objective knowledge and self-perceived clinical confidence scores, suggesting these constructs are related but distinct. These findings highlight the need to strengthen simulation-based training, clinical case exposure, and complication management within undergraduate prosthodontic education.
Headache education in medical schools in Türkiye: the perspective of final-year medical students.
Polat B, Toplutaş E, Şahan Ilgaz H … +4 more , Bulut S, Yalınay Dikmen P, Karadaş Ö, Özge A
BMC Med Educ · 2026 Jul · PMID 42401888 · Full text
BACKGROUND: Healthcare professionals' knowledge and training are important contributors to adequate medical care for headache disorders. Since most headaches are treated in primary care, undergraduate medical education r...
BACKGROUND: Healthcare professionals' knowledge and training are important contributors to adequate medical care for headache disorders. Since most headaches are treated in primary care, undergraduate medical education represents an important stage for strengthening headache-related knowledge and clinical preparedness. This study aimed to evaluate headache education among final-year medical students in Türkiye. METHODS: This cross-sectional, web-based survey study was conducted among final-year medical students from ten medical faculties in Türkiye between June and December 2022. A 32-item questionnaire developed by the authors was used to assess headache-related educational exposure, self-reported preparedness, and theoretical knowledge. Thirteen knowledge-based questions were used to calculate the total knowledge score. Descriptive statistics, group comparisons, and Spearman correlation analysis were performed. RESULTS: A total of 523 final-year medical students participated. The mean knowledge score was 9.14 ± 1.87 out of 13. Although 94.8% reported receiving headache education, only 46.5% had received outpatient clinic-based training, 11.7% had attended a headache subspecialty clinic, and 9.6% were familiar with the national headache guideline. Participants who had received didactic headache education scored higher than those who had not (9.18 vs. 8.37; mean difference 0.81, 95% CI 0.09 to 1.54; p = 0.019), as did those who had received outpatient clinic-based training (9.38 vs. 8.93; mean difference 0.45, 95% CI 0.13 to 0.77; p = 0.009) and those who had received structured instruction on headache history-taking (9.30 vs. 8.58; mean difference 0.72, 95% CI 0.34 to 1.11; p = 0.001). Higher total headache-related lesson time was weakly but significantly correlated with higher knowledge scores (Spearman's rho = 0.12, 95% CI 0.04 to 0.21; p = 0.005). Most participants reported feeling insufficiently prepared to treat pregnant women with migraine, as well as pediatric and geriatric patients with migraine. CONCLUSIONS: The findings suggest that undergraduate headache education in Türkiye may benefit from further curricular strengthening, particularly through structured teaching, clinical exposure, and improved familiarity with headache management guidelines. Further studies using validated tools and longitudinal designs are needed to evaluate the educational and clinical impact of such interventions.
Clinical instructors' leadership styles and their relationship with clinical belongingness among nursing students: a cross-sectional study.
Namdari S, Mousavi SK, Kamali M … +1 more , Mollaei F
BMC Med Educ · 2026 Jul · PMID 42399972 · Full text
BACKGROUND: Clinical belongingness is one of the most important needs of nursing students for optimal performance in learning environments and, therefore, is of particular importance in clinical education. The present st...
BACKGROUND: Clinical belongingness is one of the most important needs of nursing students for optimal performance in learning environments and, therefore, is of particular importance in clinical education. The present study investigated the relationship between clinical instructors' leadership styles and clinical belongingness among undergraduate nursing students. METHODS: This cross-sectional study was conducted between January and February 2025 among undergraduate nursing students from the fourth to eighth semesters at two nursing schools affiliated with Zanjan University of Medical Sciences, Iran. A total of 274 eligible students were invited to participate. After excluding 21 incomplete questionnaires, data from 253 students were analyzed. Data were collected using a demographic questionnaire, the Multifactor Leadership Questionnaire (MLQ-6 S), and the Belongingness Scale-Clinical Placement Experience (BES-CPE). Data were analyzed using descriptive and inferential statistics, including independent t-test, ANOVA, Pearson correlation, and multiple regression analyses, with a significance level of 0.05. RESULTS: The mean total score of clinical belongingness in students was 100.04 ± 20.47, which is moderate. From their perspective, the highest and lowest mean scores of clinical instructors' leadership styles were for transactional (3.86/average per item) and transformational (1.91/average per item), respectively. Also, there was a statistically significant relationship between transformational and transactional leadership styles and clinical belongingness, and these two styles were associated with 18% of the variance in students' clinical belongingness. CONCLUSION: The results of this study showed a positive relationship between clinical instructors' leadership styles and clinical belongingness among nursing students. Therefore, it is recommended to provide training opportunities that familiarize clinical instructors with different leadership styles and encourage the use of leadership approaches that are associated with higher levels of clinical belongingness among nursing students.
Contemporary challenges for a curriculum to foster interest in surgical careers: a multicentric study on the evolving needs of female medical students to consider a career as a surgeon in Germany.
Kelter R, Dango S
BMC Med Educ · 2026 Jul · PMID 42399949 · Full text
Early obstacles to career progression of women in surgery present a major challenge in a variety of surgical subspecialties. Although there is a variety of literature on the attitudes and needs of female residents and tr...
Early obstacles to career progression of women in surgery present a major challenge in a variety of surgical subspecialties. Although there is a variety of literature on the attitudes and needs of female residents and trainees to foster interest in a career as a surgeon, there is a lack of research about the perspectives of female medical students about a possible career as a surgeon. In this paper, we report the results of a multicentric study on the evolving needs of female medical students to consider a career as a surgeon in Germany. We confirm several results mentioned in the available literature on the topic, but also add novel insights, in particular, which attitudes and obstacles already shape earlier than during trainee programmes or residency, namely, during medical school. Our results indicate that a curriculum to foster interest in surgical careers has to incorporate three core ingredients: (1) Effective concepts against gender discrimination, (2) measures to work towards more flexible work times and better work-life-balance of female surgeons and (3) an increase in female role models and mentoring programmes, tailored specifically for female medical students.
Skill-based competencies, not traits, are associated with design thinking-aligned teaching behaviours in nursing education: a cross-sectional survey.
Liu HY
BMC Med Educ · 2026 Jul · PMID 42399925 · Full text
BACKGROUND: Healthcare systems' growing complexity has driven the adoption of design thinking (DT) pedagogies to cultivate creativity, collaboration, and adaptive expertise among nursing graduates. Faculty teaching behav...
BACKGROUND: Healthcare systems' growing complexity has driven the adoption of design thinking (DT) pedagogies to cultivate creativity, collaboration, and adaptive expertise among nursing graduates. Faculty teaching behaviours play a critical role in how DT curricula are enacted, yet it remains unclear whether skill-based DT competencies or trait-based dispositions are more strongly associated with DT-aligned teaching behaviours. This study examined their relative and indirect associations among interdisciplinary faculty involved in DT-integrated nursing education in Taiwan. METHODS: A cross-sectional survey was conducted with 95 faculty members from 12 Taiwanese institutions offering DT-integrated nursing courses. Measures included the 14-item Creative Teaching Behaviours Scale (CTBS) as a proxy for DT-aligned teaching behaviours, the 18-item Creative Synthesis Inventory-Taiwan version (CSI-TW) for skill-based DT competencies, and the 9-item Design Thinking Traits Questionnaire-Taiwan version (DTTQ-TW) for trait-based DT dispositions. Analyses included exploratory group comparisons, hierarchical multiple regression, and mediation analysis, controlling for demographic characteristics and DT-related teaching experience. RESULTS: Faculty with higher CTBS scores demonstrated significantly higher levels of both skill-based and trait-based DT competencies at the descriptive level. Hierarchical regression analysis showed that skill-based DT competencies (β = 0.429, p < 0.05) and DT teaching experience (β = 0.379, p < 0.05) were independently associated with DT-aligned teaching behaviours, explaining 27.2% of the variance. Trait-based DT dispositions did not contribute additional explanatory value once skills were taken into account (ΔR² = 0.001, p = 0.784). Mediation analysis further suggested an indirect association, whereby trait-based DT competencies were related to teaching behaviours through skill-based competencies, with no detectable direct association. CONCLUSIONS: Within this cross-sectional sample, DT-aligned teaching behaviours were more closely associated with skill-based DT competencies and accumulated teaching experience than with trait-based dispositions. The findings are consistent with a distal-proximal interpretation derived from social cognitive theory and suggest that faculty development initiatives should prioritise sustained, hands-on training in DT process skills and authentic teaching practice opportunities rather than trait-based selection.
Framing analysis as a pedagogical tool for broadening medical students' understanding of cancer: a course evaluation.
Breivik J, Lie HC
BMC Med Educ · 2026 Jul · PMID 42399918 · Full text
BACKGROUND: Cancer is a complex phenomenon encompassing a range of cultural and biomedical dimensions. Traditional medical curricula often fail to reflect this complexity, highlighting the need for interdisciplinary appr...
BACKGROUND: Cancer is a complex phenomenon encompassing a range of cultural and biomedical dimensions. Traditional medical curricula often fail to reflect this complexity, highlighting the need for interdisciplinary approaches that help medical students develop a more integrated understanding of disease by connecting diverse knowledge, patient perspectives, and societal contexts. This study evaluates how framing analysis-a method from communication studies-can be used as a pedagogical tool to broaden medical students' understanding and critical thinking about complex health issues, using cancer as a key example. METHODS: We conducted a course evaluation of a two-week elective titled "Cancer Communication" within the University of Oslo's medical program, offered annually to approximately 20 third-year students. Working in teams, students explored research questions related to cancer communication through lectures, workshops, guided research, and excursions. They learned framing analysis by applying a published tool for examining public cancer discourse. Anonymous pre-course free associations and post-course reflections were analyzed thematically to identify changes in students' understanding of cancer during the course. Students' team presentations, orally evaluated as part of the final course examination, supported our assessment of how students applied framing analysis to cancer-related communication topics. RESULTS: Students' initial responses reflected relatively simple and emotionally charged associations with cancer, often centered on fear, death, treatment burden, and familiar cancer stereotypes. Their post-course reflections suggested increased media literacy, critical thinking, and the ability to integrate multiple narratives about cancer. In their final presentations, students applied framing analysis to critically evaluate media portrayals and reflect on how different framings shape public and professional perceptions of disease. The post-course reflections further suggested greater empathy for cancer patients and an increased awareness of social and cultural influences on medical practice. CONCLUSIONS: Integrating framing analysis into medical education appeared to broaden students' understanding of cancer as a multidimensional phenomenon, supporting reflective and interdisciplinary thinking and encouraging them to move beyond traditional biomedical perspectives. These findings suggest that framing analysis and similar communication-based approaches may serve as useful pedagogical tools in health professions education to enhance critical reflection.
Associations between nutrition knowledge and anthropometric indicators in a pre-professional health population: a cross-sectional study.
Lule NO, Celik F, Meric CS … +1 more , Kilic EB
BMC Med Educ · 2026 Jul · PMID 42399902 · Full text
BACKGROUND: Anthropometric indicators are widely used to assess nutritional status and obesity-related health risks; however, body mass index (BMI) alone may inadequately reflect central adiposity. Nutrition knowledge ha...
BACKGROUND: Anthropometric indicators are widely used to assess nutritional status and obesity-related health risks; however, body mass index (BMI) alone may inadequately reflect central adiposity. Nutrition knowledge has been associated with healthier dietary behaviors, yet evidence linking detailed anthropometric and body composition measures with nutrition knowledge remains limited, particularly among pre-professional health students. This study aimed to examine the associations between general nutrition knowledge and anthropometric and body composition indicators among midwifery students. METHODS: This cross-sectional study included 126 first-year female midwifery students (mean age: 19.83 ± 1.08 years). Anthropometric measurements (BMI, waist circumference [WC], waist-to-hip ratio [WHR], waist-to-height ratio [WHtR], and neck circumference [NC]) and body composition parameters were assessed using standardized procedures and bioelectrical impedance analysis. Nutrition knowledge was evaluated using the General Nutrition Knowledge Questionnaire-Revised (GNKQ-R). Pearson correlation, group comparisons (t-test/ANOVA), and multivariable linear regression analyses were performed. Subscale analyses were adjusted for multiple testing using the Benjamini-Hochberg false discovery rate method. RESULTS: Higher GNKQ-R total scores were significantly associated with lower BMI (r = - 0.27), WC (r = - 0.36), WHR (r = - 0.23), WHtR (r = - 0.36), and body fat percentage (BF%) (r = - 0.25), and with higher fat-free mass percentage (all p < 0.05). Among GNKQ-R subscales, Healthy food choices and Diet-disease relationships demonstrated the most consistent inverse associations with adiposity-related measures. Group-based analyses showed progressively lower nutrition knowledge scores across increasing WC, WHtR, and body fat risk categories. In multivariable models adjusted for age and income-expense status, WHtR demonstrated the largest independent inverse association with GNKQ-R total score (β = -0.339, p < 0.001). BMI and BF% were also independently associated, although with lower explanatory power. CONCLUSION: Among midwifery students, higher nutrition knowledge was associated with more favorable anthropometric and body composition profiles, particularly indicators of central adiposity. Within this relatively homogeneous cohort of young, predominantly normal-weight female students, WHtR showed the strongest association with nutrition knowledge among the anthropometric indicators assessed. These findings should be interpreted in light of the cross-sectional design and the limited range of behavioral and sociodemographic variables assessed. Further research is needed to clarify the underlying mechanisms and to determine whether similar associations are observed in more diverse student populations.
Curricular advances to develop medical students' knowledge, skills, and attitudes in health advocacy.
Agrawal N, Mullur R, Whalen HK … +7 more , Garell C, Gragnani CM, Hotez E, Lee AJ, Jackson NJ, Quiros PA, Arnold W
BMC Med Educ · 2026 Jul · PMID 42399901 · Full text
BACKGROUND: The American Medical Association's Declaration of Professional Responsibility is an important covenant obligating present-day physicians to transcend personal beliefs and affiliations to advocate for changes...
BACKGROUND: The American Medical Association's Declaration of Professional Responsibility is an important covenant obligating present-day physicians to transcend personal beliefs and affiliations to advocate for changes that alleviate suffering and promote human health. Despite this recognition of advocacy as a pillar of physician duty, advocacy training in undergraduate medical education remains variable across institutions, elective in nature, and often insufficient in developing trainees' professional identities and competence as health advocates. METHODS: Educators at the UCLA David Geffen School of Medicine designed and delivered a novel half-day session required for all first-year medical students to nurture their professional identities as health advocates and empower them with knowledge, skills, and attitudes (KSA) needed to give voice to issues impacting the patients and communities they serve. Students attended a shared didactic followed by two focused workshops. The session was conducted annually from 2023-2025. Pre- and post-session data was collected after each iteration to evaluate changes in KSA. RESULTS: A total of 509 first-year medical students participated in the session from 2023-2025 with 477 (94%) partaking in the session synchronously. All 509 participants (100%) completed at least one survey, and 361 (71%) completed both pre- and post-surveys. Pooled data showed that participation led to statistically significant improvement on a 7-point Likert scale at similar rates in all three cohorts in each of the measured domains: knowledge (Δ1.45, p < 0.001), skills (Δ1.37, p < 0.001), and attitudes (Δ0.44, p < 0.001). CONCLUSIONS: A required half-day advocacy session supported trainees in developing their professional identities and acquiring foundational KSA needed to fulfill their roles as health advocates. Implementing this session across institutions can broaden its impact. Longitudinal data collection can clarify its long-term influence on physician engagement in advocacy and on health outcomes of patients and communities.
Competency based medical education: assessment of procedural and cognitive skills in gastroenterology residency training.
Cooper J, Gozdzik M, Lai H … +2 more , Silverman JA, Kroeker KI
BMC Med Educ · 2026 Jul · PMID 42399892 · Full text
INTRODUCTION: Competence by Design (CBD) was implemented in Canada to assess physician trainees' ability to demonstrate competence via entrustable professional activities (EPAs) utilizing the Ottawa Surgical Competency O...
INTRODUCTION: Competence by Design (CBD) was implemented in Canada to assess physician trainees' ability to demonstrate competence via entrustable professional activities (EPAs) utilizing the Ottawa Surgical Competency Operating Room Evaluation (O-SCORE); a score originally validated to assess surgical competence. Our study assessed for differences in O-SCORE utilization between non-procedural (cognitive) and procedural EPA assessments in a real-world setting to inform future critical appraisal of CBD. METHODS: Adult Gastroenterology subspecialty EPA assessments from 2019 to 2023 at the University of Alberta were reviewed. Evaluator gender, clinical vs. academic practice, advanced training expertise, EPA type, and O-SCOREs were extracted from each EPA assessment. Competence assessments (achieved, neutral, not achieved) were assigned to each EPA assessment based on local competence committee protocols. Chi-squared testing with 95% confidence intervals were calculated. RESULTS: 2660 EPA assessments were included (1385 cognitive and 1275 procedural). Approximately 70% of total EPA assessments denote competence, with approximately 20% neutral, and < 10% indicating "competence not yet achieved". Proportionally higher cognitive EPA assessments denoted competence compared to procedural EPA assessments (75% vs. 63%, p < 0.01). Evaluator characteristics associated with EPA achievement were male gender, community (vs. academic), and hepatology (vs. luminal GI) practice. DISCUSSION: We report low rates of the full range of O-SCORE utilization and the majority amount of EPA assessments denoting competence. Further the proportion of EPAs assessed as success varied by evaluator characteristics (gender, specialty, and practice type). This stresses the need for continued cycles of critical appraisal to improve faculty assessment and feedback in residency trainee progress.
Boosting electrocardiography leads location training through virtual reality simulation: effects on skill performance and learner satisfaction.
Kermanian F, Safiyari P, Hassanzadeh G … +2 more , Mojtahedzadeh R, Mohammadi A
BMC Med Educ · 2026 Jul · PMID 42399889 · Full text
BACKGROUND: The purpose of this study was to investigate the effect of electrocardiography lead placement training on the performance and satisfaction of medical students using VR and compare it with training on a real p...
BACKGROUND: The purpose of this study was to investigate the effect of electrocardiography lead placement training on the performance and satisfaction of medical students using VR and compare it with training on a real patient and training on a mannequin. METHODS: This was a true experimental study. Ninety undergraduate medical students in the internal medicine rotation course were included in the study. The simulation software for the insertion of electrocardiography lead placement training was designed. The students were then divided into three groups. Practical training for lead placement was conducted via three methods: training on a real patient, a mannequin, and training through VR simulation. The course was evaluated through the DOPS (Direct Observation of Procedural Skills) test and the satisfaction survey form. RESULTS: The analysis of the DOPS test scores revealed a significant difference between the VR group and the other two groups (patient: 15.2 (1.89), mannequin: 15.3 (1.71) and VR: 17.5 (1.35)) (P value < 0.001). The results of the survey also indicated that the satisfaction of the students in the VR group was significantly greater than that of the other two groups of patients: (0.24) 1.74, (0.18) 1.76 and (0.18) 2.35 (P value < 0.001). CONCLUSION: Considering the attractiveness of VR, the use of this software along with other teaching models in anatomy education can increase the motivation and satisfaction of learners.
MEET & MAKE CleaR PROCESS: a new framework for sharing serious information.
Rivière E, Mathé A, Haaser T … +13 more , Micoulaud-Franchi JA, Gonzalez A, Birsan S, Brissaud O, Averous V, Guisset O, Gruson D, Delgado-Piccoli N, Quivy A, Domblides C, Sibon I, Burbaud P, Boyer A
BMC Med Educ · 2026 Jul · PMID 42399873 · Full text
INTRODUCTION: Sharing serious information (SSI) is a critical communication skill for physicians. Existing frameworks vary in their teaching and application, and many physicians desire better training. This study aimed t...
INTRODUCTION: Sharing serious information (SSI) is a critical communication skill for physicians. Existing frameworks vary in their teaching and application, and many physicians desire better training. This study aimed to develop a theory-informed framework and cognitive aid for sharing serious information (SSI) through a multiphased development process involving a systematic review and expert focus groups. METHOD: A multiphased approach was used: (1) a systematic review of four databases (1983-2024) to identify core components of SSI; and (2) twelve multidisciplinary focus groups (2022-2024) using the nominal group technique to integrate these components into a structured framework. A modified PICO/PEO approach (Population, Exposure/Intervention, Outcomes) guided study selection, and the AMSTAR2 tool was only used for quality appraisal of systematic reviews. From 4,892 titles/abstracts, 52 were selected for inclusion. RESULTS: Thematic synthesis identified eight themes for optimal SSI: (1) limiting delay between diagnosis and SSI, (2) preparation time for meetings, (3) patient-centered communication, (4) discussion of emotions, (5) verifying understanding, (6) affirmation of treatment options, (7) offering a confidant, and (8) providing information resources. These themes, interpreted cautiously across heterogeneous evidence sources, informed the development of the MEET & MAKE CleaR PROCESS framework, encompassing preparation (MEET), sharing (MAKE), clarification (CleaR), and ongoing plan (PROCESS). DISCUSSION: The MEET & MAKE CleaR PROCESS framework and its cognitive aid aim to equip educators and clinicians with a structured approach to instructing and managing SSI encounters especially with simulation-based education. We believe this up-to-date framework could minimize the negative impact of SSI on patients, relatives, and physicians.
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