Medical Education[JOURNAL]
Sun
200 papers
Virtual reality enhances ophthalmic anatomy learning: experimental evidence on comparable outcomes with peer and expert facilitators.
Soylu A, Üçgül AY, Alkan R … +9 more , Aktepe-Teke G, Akdağ İ, Özkan E, Atalay HT, Uysal BS, Tarlan B, Kıyak YS, Bilgihan K, Peker TV
BMC Med Educ · 2026 Jun · PMID 42323612 · Full text
BACKGROUND: The aim of this study is to evaluate the effectiveness of virtual reality (VR) for learning ophthalmic anatomy and to determine whether peer-assisted facilitation produces learning outcomes comparable to expe...
BACKGROUND: The aim of this study is to evaluate the effectiveness of virtual reality (VR) for learning ophthalmic anatomy and to determine whether peer-assisted facilitation produces learning outcomes comparable to expert-assisted facilitation among preclinical medical students. A secondary objective was to contextualize learning outcomes by comparing performance of preclinical students with that of senior medical students receiving expert-assisted VR instruction. METHODS: This is a prospective controlled experimental study with repeated-measures assessments. Second-year (preclinical) medical students without prior formal ophthalmic anatomy instruction were recruited voluntarily (peer-assisted n = 31, expert-assisted n = 32). Exclusion criteria included previous VR-based ophthalmic anatomy training, history of severe motion sickness or vertigo, or refusal to provide consent. In addition, fifth-year medical students undertaking their ophthalmology clerkship participated in a parallel prospective pre-post cohort (n = 61 baseline; n = 55 completed the intervention). All participants first attended a conventional didactic lecture on ophthalmic anatomy. Second-year students then completed an immersive VR learning session exploring a stereoscopic 3D model of the globe and adnexa using a head-mounted display. Sessions were facilitated either by an anatomy faculty expert or by trained peer facilitators. Fifth-year students completed the same instructional sequence with expert-assisted VR only. The primary outcome was change in anatomy knowledge measured by a 20-item assessment administered at baseline (T0), after didactic instruction (T1), and after VR (T2). RESULTS: Among second-year students, knowledge scores improved significantly across timepoints (repeated-measures ANOVA: F(2,124) = 251.0, p<.001, η²ₚ=0.802). Post-VR scores were comparable between peer-assisted and expert-assisted groups (15.1 ± 3.1 vs. 15.2 ± 3.4; t(61 =-0.12, p=.905, d=-0.03). Simulator sickness scores were low and did not differ between groups (4.2 ± 4.0 vs. 3.7 ± 3.7; p=.649), and satisfaction ratings were high in both conditions. Among fifth-year students, knowledge scores also increased significantly across instructional stages (F(2,106) = 33.4, p<.001, η²ₚ=0.387). Despite higher baseline scores among senior students (t(121)=-3.17, p=.002), post-VR performance was comparable between cohorts (t(115) = 1.11, p=.269). CONCLUSIONS: Peer-assisted facilitation produced learning outcomes comparable to expert-assisted instruction while maintaining high learner satisfaction and minimal simulator sickness. These findings suggest that peer facilitation may represent a scalable approach for implementing VR-based anatomy education.
Effect of low-dose, high-frequency advanced life support training versus annual full-day training on simulation-based resuscitation performance: a randomized controlled trial.
Moll L, Riessen R, Dahlmann P … +1 more , Häske D
BMC Med Educ · 2026 Jun · PMID 42323602 · Full text
BACKGROUND: Skill decay in advanced life support (ALS) is well documented, yet optimal training frequency remains unclear. This trial compared low-dose, high-frequency ALS training with annual full-day training regarding...
BACKGROUND: Skill decay in advanced life support (ALS) is well documented, yet optimal training frequency remains unclear. This trial compared low-dose, high-frequency ALS training with annual full-day training regarding simulation-based resuscitation performance after one year. METHODS: In this randomized, controlled, simulation-based trial, 35 emergency medical services (EMS) professionals were allocated to either low-dose, high-frequency ALS training (intervention group, n = 18) or a single annual full-day ALS training (control group, n = 17). Performance was assessed at baseline and after 12 months using a validated 29-item rating instrument covering technical and non-technical skills (NTS), with items rated on a 5-point Likert scale (1 = poor performance, 5 = excellent performance). The primary endpoint was the overall performance score for resuscitation management, defined as the mean across all items. Secondary endpoints included domain-specific performance scores (NTS, defibrillation-related, and cardio-pulmonary resuscitation [CPR] items), calculated as the mean scores for each domain, as well as time to key interventions. RESULTS: After 12 months, the intervention group showed significantly higher overall performance scores than the control group (4.7 ± 0.2 vs. 4.2 ± 0.3; p < 0.001). The largest between-group difference was observed for NTS (4.8 ± 0.2 vs. 3.9 ± 0.5; p < 0.001). Scores for defibrillation-related and CPR-related items were also significantly higher in the intervention group. Time to CPR initiation (13 ± 2 s vs. 18 ± 7 s; p = 0.015), rhythm analysis (29 ± 9 s vs. 45 ± 24 s; p = 0.015), supraglottic airway insertion (51 ± 13 s vs. 68 ± 30 s; p = 0.013), as well as hands-off time (4 ± 1 s vs. 6 ± 3 s; p = 0.002) were significantly shorter in the intervention group. The rating instrument demonstrated good reliability (Cronbach's alpha 0.793; intraclass correlation coefficient 0.794, 95% confidence interval 0.718-0.854). CONCLUSION: Low-dose, high-frequency ALS training resulted in higher simulation-based resuscitation performance scores than annual full-day training, particularly for non-technical skills and time-critical processes. TRIAL REGISTRATION: The study is registered in the German Register of Clinical Studies under the ID DRKS00024822.
The relationship between future anxiety and global climate change awareness among physiotherapy students in Turkey: a cross-sectional study.
Akaras E, Sözlü U
BMC Med Educ · 2026 Jun · PMID 42323599 · Full text
BACKGROUND: The climate crisis is not just an environmental issue; it's a profound public health emergency that is deeply affecting the mental well-being of young people, leading to widespread eco-anxiety. As the future...
BACKGROUND: The climate crisis is not just an environmental issue; it's a profound public health emergency that is deeply affecting the mental well-being of young people, leading to widespread eco-anxiety. As the future frontline of healthcare, physiotherapy students will inevitably have to manage the health consequences of climate change. Yet, we know surprisingly little about how prepared they are specifically, how their own awareness of the crisis connects with their anxiety about the future. This exploratory study aimed to provide preliminary findings on the relationship between global climate change awareness and future anxiety among physiotherapy students in Turkey. METHODS: We conducted a cross-sectional study with 394 physiotherapy students (mean age 21.3 ± 3.0; 74.6% female) from the state universities. Using an online survey, we gathered data on their demographic and social characteristics, along with their scores on two validated scales: the Awareness Scale of University Students About Global Climate Change (ASUSGCC) and the Future Anxiety Scale for University Students (FASUS). We analyzed the data using Pearson correlation to examine the relationship between climate change awareness and future anxiety, and univariable linear regression analyses to explore factors associated with climate change awareness. RESULTS: Overall, students reported a moderate level of climate change awareness (ASUSGCC mean: 3.4 ± 0.7) and a notable level of future anxiety (FASUS mean: 61.6 ± 8.6). We found a statistically significant, positive, but weak correlation between total climate awareness and total future anxiety (r = 0.168, p < 0.01). The regression analyses showed that several variables were statistically associated with higher awareness scores, although the explained variance was low. Female gender (β = 0.273, p = 0.001), environmental volunteering (β = 0.180, p = 0.019), and more frequent use of social media for climate-related information (β = 0.167, p = 0.001) were associated with higher climate change awareness. Higher total future anxiety was weakly but statistically significantly associated with higher awareness scores (β = 0.013, p = 0.001). In subscale-level analyses, Future Fear was also weakly associated with awareness (β = 0.009, p = 0.015). Previous environmental training was not significantly associated with climate change awareness (p = 0.466). CONCLUSIONS: Among physiotherapy students, climate change awareness was weakly but statistically significantly associated with future anxiety. Environmental volunteering and more frequent exposure to climate-related content on social media were also associated with higher awareness scores, whereas previous environmental training was not significantly associated with awareness. However, given the cross-sectional design and possible self-selection into volunteering, these findings should be interpreted as associations rather than evidence that volunteering increases awareness. Future longitudinal or intervention-based studies are needed to examine whether structured environmental engagement can improve climate literacy in physiotherapy education.
Construction of a faculty competency model for medical simulation education integrated with GenAI: a multi-method quantitative study based on the perspective of medical students.
Zhu-Ge Y, Yao XT, Mei HX … +2 more , Yao HX, Chen Q
BMC Med Educ · 2026 Jun · PMID 42323590 · Full text
BACKGROUND: The rapid advancement of Generative Artificial Intelligence (GenAI) is reshaping the landscape of medical simulation education, necessitating the enhancement of faculty competencies to effectively integrate e...
BACKGROUND: The rapid advancement of Generative Artificial Intelligence (GenAI) is reshaping the landscape of medical simulation education, necessitating the enhancement of faculty competencies to effectively integrate evolving knowledge systems with GenAI for collaborative decision-making. However, current educational technologies face systemic limitations, including fragmented functionality, a disconnect between conventional and GenAI-driven teaching approaches, and a lack of dynamic capability assessment tools. Constructing a standardised capability scale is crucial to overcoming adaptation bottlenecks. METHODS: Grounded in the integrated Technological Pedagogical Content Knowledge (TPACK) framework, this research proposed a two-round Delphi method to construct a faculty competency assessment scale, with stratified sampling involving 434 participants from clinical medicine, medical technology, and nursing fields. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to test model fit (CFI = 0.939, RMSEA = 0.117). This proposed research was not registered as a clinical trial. RESULTS: The resulting 16-item scale exhibited strong psychometric properties, demonstrating excellent internal consistency (Cronbach's α = 0.979), sampling adequacy (KMO = 0.961), and significant sphericity (Bartlett's test, p < 0.001). No factor covariance was detected, and item consensus was high (Kendall's W = 0.761, p < 0.001). The model showed acceptable fit (χ²/df = 6.893). CONCLUSION: This empirically validated and standardised assessment model provides robust support for integrating GenAI with simulation-based health sciences education. It offers a foundational framework for advancing faculty competency development and fostering adaptive, technology-enhanced teaching practices, while noting that the scale primarily captures ethical awareness rather than comprehensive governance competence. TRIAL REGISTRATION: Not applicable. As this research did not involve clinical interventions, trial registration was not required.
Education and training for health professionals on disability inclusion: a scoping review.
Gölz L, Rosenhan J, Kamenov K … +1 more , Prodinger B
BMC Med Educ · 2026 Jun · PMID 42323554 · Full text
BACKGROUND: Persons with disabilities continue to experience profound and avoidable health inequities. Health professionals play a key role in addressing these inequities yet often lack the competencies and preparedness...
BACKGROUND: Persons with disabilities continue to experience profound and avoidable health inequities. Health professionals play a key role in addressing these inequities yet often lack the competencies and preparedness to provide equitable and rights-based care. To advance disability inclusion within health professions education, clarity is needed on which themes are currently represented in existing education and trainings. The objectives of this scoping review are 1) to describe how disability-related content has been incorporated into education and training for health professionals, and 2) to identify the key themes addressed in the existing literature. METHODS: A scoping review was conducted following the methodological framework by Arksey and O'Malley and the PRISMA-ScR reporting guidelines. Literature published between January 2011 and August 2024 was searched in MEDLINE, Web of Science, Google, Google Scholar, and relevant organisational websites. Both academic and grey literature were included. Data were charted according to study characteristics, educational scope, understanding of disability, involvement of persons with disabilities, teaching format, and targeted health professionals. An inductive thematic analysis identified key themes addressed in education and training. RESULTS: A total of 172 publications met the inclusion criteria. The majority originated from the Region of the Americas and the European Region and were locally or nationally implemented initiatives. Nineteen distinct themes were identified. These themes ranged from themes such as conceptual understanding of disability and the perspectives of persons with disabilities to specific themes such as discrimination and violence or costs and time management. Most training interventions were small sessions or modules rather than longitudinal curricula, and few used validated tools to evaluate learning outcomes. CONCLUSIONS: Disability-related education and training for health professionals are expanding but remain fragmented and context-specific. There is an urgent need for globally aligned competency standards to guide curriculum development, for longitudinal integration of disability inclusion throughout training, and for the use of reliable evaluation frameworks. Strengthening competency- and human rights-based education is essential to prepare health professionals to deliver equitable, inclusive, and high-quality care for persons with disabilities. TRIAL REGISTRATION: Clinical trial number not applicable.
Pharmacy students' perspectives and training needs on simulation-based interprofessional education at a University in Southwestern Uganda: a qualitative study.
Kyomya J, Najjuma JN, Atwiine F … +6 more , Lukyamuzi EJ, Musinguzi P, Maleka E, Maling S, Muhindo R, Wonde SG
BMC Med Educ · 2026 Jun · PMID 42321782 · Full text
BACKGROUND: Pharmacy graduates are expected to collaborate effectively within interprofessional healthcare teams. However, current training lacks structured opportunities for interprofessional learning. Simulation-based...
BACKGROUND: Pharmacy graduates are expected to collaborate effectively within interprofessional healthcare teams. However, current training lacks structured opportunities for interprofessional learning. Simulation-based interprofessional education (sim-IPE) offers a promising approach to address this gap. This study explored the training needs and perceptions of pharmacy students regarding sim-IPE at Mbarara University of Science and Technology (MUST). METHODS: We conducted a formative qualitative study among pharmacy students and faculty at MUST in October 2025. In-depth interviews were conducted with 14 fourth-year pharmacy students, and key informant interviews with three purposively selected faculty members involved in curriculum design. Data was collected using interview guides developed based on the Theoretical Domains Framework. Audio-recorded data were transcribed verbatim, cleaned and analyzed in NVivo version 14 using framework analysis. RESULTS: Four themes emerged. First, the current clinical training was constrained by limited clinical training exposure, preceptor shortages, and siloed learning. Second, barriers to IPE included professional hierarchy, low student confidence, scheduling conflicts, and limited simulation capacity. Third, the enablers for successful implementation included skilled facilitation, curriculum integration, institutional support, and simulation's safe learning environment. Fourth, effective communication skills, pharmaceutical care, and interprofessional collaboration competencies were identified as essential needs for effective participation. Participants anticipated benefits for professional development and patient care from interprofessional learning. CONCLUSION: Pharmacy students and faculty perceived sim-IPE as a valuable approach for addressing gaps in current clinical training and strengthening readiness for collaborative practice. The main training needs identified were communication skills, role clarity, teamwork, pharmaceutical care competencies, and confidence to contribute within interprofessional teams. Implementation will require attention to professional hierarchy, faculty preparation, curriculum integration, scheduling, and simulation resources. These findings provide practical guidance for the design of a contextually appropriate sim-IPE module for undergraduate pharmacy students in Uganda and similar resource-constrained health professions education settings.
Pharmacists' perspectives on medication therapy management training needs for chronic disease care in Indonesian primary healthcare centers: a qualitative study across 32 provinces.
Rendrayani F, Alfian SD, Nguyen T … +1 more , Puspitasari IM
BMC Med Educ · 2026 Jun · PMID 42321770 · Full text
BACKGROUND: Chronic diseases place a growing burden on health systems and require effective strategies to support long-term medication use. Medication Therapy Management (MTM) has been shown to improve clinical outcomes...
BACKGROUND: Chronic diseases place a growing burden on health systems and require effective strategies to support long-term medication use. Medication Therapy Management (MTM) has been shown to improve clinical outcomes in chronic disease care, but its implementation depends on pharmacists' competencies and access to structured training. In Indonesia, MTM remains inconsistently implemented in primary healthcare centers (PHCs), and pharmacists have reported competency gaps in the absence of standardized training. Evidence to inform context-specific training design is limited. The objective of this study was to explore and identify Indonesian PHC pharmacists' perspectives on training for chronic-disease MTM, including their needs, preferences, perceived challenges, and facilitators. METHODS: This paper reports the qualitative component of a larger mixed-methods study. A qualitative descriptive study was conducted using six focus group discussions (FGDs) with 32 PHC pharmacists from 32 provinces in Indonesia. Participants were purposively selected based on their experience in PHCs (≥ 6 months). All audio recordings were transcribed verbatim and then analyzed using an inductive thematic approach in Atlas.ti. To strengthen the credibility of the findings, we used triangulation, member checking, and peer debriefing during the analysis. RESULTS: The analysis generated four themes: needs, preferences, challenges, and facilitators. Pharmacists emphasized a need for standardized, competency-based, and practice-oriented MTM training. They strongly preferred content that aligned with daily practice and focused on prevalent chronic diseases. However, they also identified several contextual challenges that might influence implementation, including geographical and cost barriers, limited digital access, and competing responsibilities. Institutional and policy support, as well as post-training mechanisms, were considered factors that may facilitate learning sustainability and implementation in routine care. CONCLUSIONS: Pharmacists in Indonesian PHCs perceive clear needs, preferences, challenges, and facilitators for MTM training. These findings can inform the development of context-sensitive, competency-based training programs. Embedding such training into continuing professional development frameworks is recommended to strengthen its sustainability and long-term impact, contributing to health professions education for primary care pharmacists.
Exploring the perspectives of undergraduate allied health sciences, dentistry and nursing students regarding the unpaid clinical placements.
Shah SGH, Asim N, Junaid SM … +2 more , Jamil B, Basit A
BMC Med Educ · 2026 Jun · PMID 42321760 · Full text
BACKGROUND: Clinical placements are essential for developing competence and professional identity in health professions education. In Pakistan, many undergraduate students in Allied Health Sciences, Dentistry, and Nursin...
BACKGROUND: Clinical placements are essential for developing competence and professional identity in health professions education. In Pakistan, many undergraduate students in Allied Health Sciences, Dentistry, and Nursing complete unpaid clinical placements, which may impose financial, emotional, and educational challenges. Limited multidisciplinary qualitative research exists to understand these experiences. OBJECTIVE: To explore the perspectives of undergraduate allied health sciences, dentistry and nursing students regarding the unpaid clinical placements. METHODS: The qualitative study design involved semi-structured interviews with 22 undergraduate students of Dentistry, Nursing, and Allied Health Sciences programmes in various institutions in Khyber Pakhtunkhwa, Pakistan. Purposive sampling was used to recruit participants. Interviews were held in the Urdu language, taped and transcribed verbatim. Thematic analysis of data was performed in six phases as developed by Braun and Clarke. The use of reflexive note-taking, member checking, and audit trail were strategies used to increase rigor. Informed consent was received and ethical approval granted by the Ethics Review Board KMU-IHPER. The study was carried out in secrecy and anonymity. RESULTS: Five major themes emerged: 1. Managing Daily Costs and Practical Challenges of Clinical Rotations. 2. Emotional and Psychological Strain During Clinical Placements 3. Gaps in Supervision and Professional Support 4. Challenges Within the Clinical Learning Environment and Workload 5. Shaping Professional Identity and Motivation Through Clinical Exposure The results were subsequently explained through the Hierarchy of Needs invented by Abraham Maslow, which suggested that the physiological and safety needs that were not met, including financial strain and lack of support, inhibited the capacity of students to participate in higher-order learning, which consequently influenced their well-being and formation of professional identities.
Contemporary perspectives and debates in student ultrasound education: exploring didactic elements and theoretical aspects.
Recker F, Sänger SL, Dong Y … +12 more , Gschmack A, Jenssen C, Möller K, Neubauer R, Blaivas M, Prats MI, Ruppert J, Sirli R, Weimer J, Westerway SC, Zervides C, Dietrich CF
BMC Med Educ · 2026 Jun · PMID 42321756 · Full text
BACKGROUND: Medical ultrasound education is evolving, embracing various teaching methods such as classical, e-learning, and hands-on approaches. The integration of ultrasound into medical school curricula has highlighted...
BACKGROUND: Medical ultrasound education is evolving, embracing various teaching methods such as classical, e-learning, and hands-on approaches. The integration of ultrasound into medical school curricula has highlighted the importance of blended learning, although there is limited literature on specific learning theories and pedagogical concepts. Medical ultrasound learning is unique, requiring psychomotor and technical skills in probe handling, anatomical and clinical knowledge, and cognitive abilities for image interpretation. METHODS: A review of literature in a systematic way was conducted across multiple databases, including PubMed, Embase, and Scopus, using predefined search terms such as "ultrasound education," "e-learning," "simulation-based ultrasound," and "peer-assisted learning ultrasound." The search targeted studies focusing on undergraduate medical education and ultrasound instruction. Following duplicate removal, two independent reviewers screened titles and abstracts, with eligible full-text articles assessed against inclusion criteria. Studies were included if they addressed didactic ultrasound teaching methods and reported on educational outcomes relevant to medical students or trainees. RESULTS: The inverted classroom approach, where preparatory material is studied before class, was effective in ultrasound education. Blended learning, an educational approach that combines traditional classroom instruction with online learning activities and resources, enhanced both cognitive understanding and practical skills. Simulation-based training emerged as valuable, providing safe environments for learning and is applicable across pre-clinical and clinical phases. The study also assessed the advantages and limitations of simulation-based training and e-learning. DISCUSSION: The paper highlights the need for diverse teaching methodologies in ultrasound education. It emphasizes that while traditional methods may be cost-effective, modern approaches, such as blended learning and simulation-based training, offer more engaging, practical, and efficient learning experiences. Integrating these methods within existing curricula enhances ultrasound training quality, advocating for an interdisciplinary and technologically adapted approach. CONCLUSION: The study concludes that a blend of traditional and contemporary teaching methods, including e-learning and simulation, is essential for effective ultrasound education in medical studies. Adapting to technological advancements and diverse learning styles is crucial in preparing students for modern healthcare demands.
Exploring the impact of immersive reality for enhancing clinical training in dental education: a systematic review.
Ruslin M, Sjamsudin E, Hanafiah OA … +6 more , Stevanie C, Kurniawan SH, Anshar M, Boffano P, Forouzanfar T, Sukotjo C
BMC Med Educ · 2026 Jun · PMID 42321750 · Full text
BACKGROUND: The acquisition of advanced dental skills typically necessitates extensive practical training. Currently, immersive reality (IR) represents an innovative approach that combines the physical and virtual worlds...
BACKGROUND: The acquisition of advanced dental skills typically necessitates extensive practical training. Currently, immersive reality (IR) represents an innovative approach that combines the physical and virtual worlds, providing an optimal learning experience for students. Despite the potential significance of immersive reality (IR) technology in dental education, the impact remains under-studied. This systematic review aimed to provide a thorough review of the benefits of IR technology in dental education. METHODS: Searches were conducted in PubMed, Embase, and Cochrane databases covering the years 2014 to 2025. The studies selected for inclusion focused on the effects and benefits of using immersive reality technology in dental training, comparing it to traditional dental training methods. Two independent researchers reviewed the selected studies, concentrating on aspects such as training duration, procedural time and errors, and the enhancement of knowledge and skills. RESULTS: 13 studies were included. The main findings indicated that IR technology in dental education reduced procedural time and shortened training durations, decreasing errors while contributing to knowledge and skills development. Overall, these findings collectively provide strong evidence of the benefits of IR technology in dental education. CONCLUSIONS: Integrating immersive reality into dental education offers a beneficial approach to support student engagement and skill development for future clinical practice. TRIAL REGISTRATION: PROSPERO CRD42024617799.
A laddered training model for breast surgery specialists: development and validation of a CBME-based precision education framework.
Xu K, Jiang L, Zhang Y … +4 more , Du Y, Shen Y, Chen Y, Shao Y
BMC Med Educ · 2026 Jun · PMID 42321739 · Full text
OBJECTIVE: This study aimed to develop a stepwise training model for breast surgery residents and evaluate its efficacy in improving operative skills, clinical decision-making, and patient management competencies within...
OBJECTIVE: This study aimed to develop a stepwise training model for breast surgery residents and evaluate its efficacy in improving operative skills, clinical decision-making, and patient management competencies within a Competency-Based Medical Education (CBME) framework. METHODS: The study was conducted in the Breast Surgery Department of the Second Affiliated Hospital, Zhejiang University School of Medicine. Twenty surgical residents in their second or third year of standardized training were enrolled and randomly allocated to an experimental group (n = 10, receiving stepwise training) or a control group (n = 10, receiving conventional training). The stepwise training program consisted of three progressive levels: basic skills (L1), minor procedures (L2), and advanced procedures (L3), spanning a 6-month period. Outcome measures included the pathological concordance rate of mass puncture biopsies (L1), catheterization success rate of venous access port implantation (L2), and operative time for breast-conserving surgery performed under supervision (L3). Statistical analyses were performed to compare outcomes between the two groups. RESULTS: The pathological concordance rate for mass puncture biopsies was 98.0% in the experimental group, significantly higher than 86.0% in the control group (P = 0.009). The catheterization success rate was 96% in the experimental group compared to 80% in the control group (P = 0.012). Operative time for supervised breast-conserving surgery was significantly shorter in the experimental group (120 ± 15 min) than in the control group (180 ± 20 min, P < 0.001). CONCLUSION: The stepwise training model significantly enhanced clinical competencies, surgical performance, and training outcomes among breast surgery residents through its structured, competency-based approach. This model offers a scalable and effective pathway for specialized training in breast surgery.
Academic medicine career intentions among medical residents: a social cognitive career theory approach.
Deledalle A, Bour V, Galharret JM … +5 more , Sarda É, Gourraud PA, Cohen F, Lemarchand P, Congard A
BMC Med Educ · 2026 Jun · PMID 42321734 · Full text
BACKGROUND: Academic medicine (AM) careers combine research, teaching, and patient care, yet their attractiveness has declined in recent years, particularly among women, who remain underrepresented in this field. Previou...
BACKGROUND: Academic medicine (AM) careers combine research, teaching, and patient care, yet their attractiveness has declined in recent years, particularly among women, who remain underrepresented in this field. Previous research highlights the central role of interest in research, but the cognitive and contextual processes underlying academic career intentions during residency remain insufficiently understood. Social Cognitive Career Theory (SCCT) provides a relevant framework for examining how individual cognitions and learning experiences jointly shape career intentions. METHODS: This cross-sectional study included 1,570 French medical residents who completed an online questionnaire. Guided by the SCCT framework, we examined the relationships between learning experiences (academic satisfaction and perceived stress), self-efficacy, outcome expectations (operationalized through work centrality), professional interest in research, and intention to pursue a career in academic medicine. Hierarchical ordinal regression models were used to predict AM career intention, and structural equation modeling was conducted to investigate the formation of professional interest in research. Gender and prior research experiences (master's or PhD) were examined as moderating factors. RESULTS: Overall, residents reported low intention to pursue a career in academic medicine, with women expressing significantly lower intentions than men. Professional interest in research emerged as the strongest predictor of AM career intention, followed by research experiences and mentorship. Outcome expectations, measured through work centrality, also contributed significantly to career intentions. Structural equation modeling supported key assumptions of SCCT: perceived stress was negatively associated with self-efficacy, academic satisfaction was positively associated with outcome expectations, and work centrality played a central role in shaping professional interest in research. Gender differences in career intentions were largely explained by disparities in learning experiences and research opportunities rather than by differences in outcome expectations. Moderation analyses suggested gender-specific patterns at advanced levels of research involvement. CONCLUSIONS: These findings support the relevance of SCCT for understanding academic medicine career intentions and highlight the central role of professional interest in research and contextual learning experiences. Promoting positive learning environments, providing early and structured research exposure, and ensuring access to mentorship may represent key levers for fostering academic career engagement and addressing gender disparities in academic medicine.
Psychological resilience moderates the association between adverse academic events and probable anxiety disorder in Chinese clinical medicine postgraduates: a cross-sectional study.
Huang L, Kou J, Zhang Y … +4 more , Chen N, Chen J, Zhou X, Wu Y
BMC Med Educ · 2026 Jun · PMID 42321729 · Full text
BACKGROUND: Clinical medicine postgraduates face a heightened risk for mental health problems, particularly anxiety disorder, which is largely due to a high-pressure training environment and prevalent adverse academic ev...
BACKGROUND: Clinical medicine postgraduates face a heightened risk for mental health problems, particularly anxiety disorder, which is largely due to a high-pressure training environment and prevalent adverse academic events. Psychological resilience, defined as the ability to adapt to adversity, is theorized to modify the association of external stressors with mental health problems. However, limited evidence exists regarding its moderating role in this specific population, particularly using rigorous interaction analysis. METHODS: In this cross-sectional study, 1182 clinical medicine postgraduates from a major Chinese medical school completed an anonymous online survey. Exposure to adverse academic events was assessed via an 8-item checklist. Anxiety symptoms were measured using the Generalized Anxiety Disorder scale (GAD-7), and psychological resilience was assessed with the Connor-Davidson Resilience Scale (CD-RISC-10). Hierarchical logistic regression was used to examine associations. The moderating role of psychological resilience was tested using the interaction contrast approach, reporting the Relative Excess Risk due to Interaction (RERI), Attributable Proportion (AP), and Synergy Index (SI). RESULTS: Reporting adverse academic events was strongly associated with probable anxiety disorder (OR = 3.157, 95% CI: 2.284-4.363, p < 0.001), and low psychological resilience was independently associated with higher odds (OR = 3.657, 95% CI: 2.546-5.253, p < 0.001). A significant additive interaction was observed (RERI = 5.308, 95% CI: 1.402-9.214; AP = 0.434, 95% CI: 0.218-0.650; SI = 1.897, 95% CI: 1.218-2.955). Stratified analysis revealed that the association of adverse academic events with probable anxiety disorder was substantially stronger among individuals with low resilience (OR = 12.226, 95% CI: 7.585-19.708) compared to those with high resilience (OR = 3.775, 95% CI: 2.043-6.975). CONCLUSIONS: Adverse academic events are positively associated with probable anxiety disorder among clinical medicine postgraduates. Psychological resilience is a potent factor that modifies this association. These findings highlight the importance of integrating resilience assessment and resilience‑building programs into postgraduate medical education to safeguard trainee mental well-being.
Implementation of a portfolio assignment in the framework of an internship in dental higher education with a focus on preventive dentistry.
Hofmann M, Krebs N, Krämer N
BMC Med Educ · 2026 Jun · PMID 42321703 · Full text
BACKGROUND: Dental higher education requires teaching of critical thinking and reflective skills. Both of which are strengthened by portfolio assignments. The aim of this study was to evaluate how the implementation of a...
BACKGROUND: Dental higher education requires teaching of critical thinking and reflective skills. Both of which are strengthened by portfolio assignments. The aim of this study was to evaluate how the implementation of a portfolio assignment in a preclinical course of dental studies affected the students' understanding of course topics and their motivation to self-reflect. METHODS: Students in a preclinical course focusing on the topic of 'preventive dentistry' in the third semester of dental studies were given a newly developed portfolio assignment that they were to work on throughout the semester in relation to the internship and lecture content. At the end of the semester, the success of the portfolio assignment implementation was measured using a validated evaluation form. The form included two dichotomous items, 14 Likert scale items and two free text fields regarding "portfolio assignment in the context of dental studies", "structure and tasks", "content and knowledge gain", "requirements and scope" and "overall assessment". RESULTS: Students of two consecutive semesters (n = 64), in which the portfolio was implemented for the first time, participated in the portfolio assignment and evaluation process. The evaluation results showed that portfolio assignments and self-reflection tasks have been underrepresented in dental studies to date. In both semesters, the portfolio assignment was rated as good to very good in > 90% of cases. The structure and tasks, as well as the repetition of course content, scope and effort, were rated positively. More than 80% of the students also agreed that the reflection tasks contributed to an increase in engagement with the course content and an awareness of the knowledge gained over the duration of the semester. CONCLUSION: In conclusion, the implementation of a portfolio assignment, including self-reflective elements, into the curriculum revealed to be a promising teaching tool that is well received by students. At the same time, portfolio assignments illustrate not only to students but also to teachers that learning and optimisation is a dynamic process that should be constantly evaluated and adapted in all semesters.
Evaluating clinical psychology doctoral students' competence in delivering CBT for chronic pain.
McCullough MB, Kemp GN
BMC Med Educ · 2026 Jun · PMID 42316225 · Full text
BACKGROUND: Chronic pain affects approximately 20% of adults in the United States and is associated with significant psychological and functional impairment. Cognitive Behavioral Therapy (CBT) is an evidence-based interv...
BACKGROUND: Chronic pain affects approximately 20% of adults in the United States and is associated with significant psychological and functional impairment. Cognitive Behavioral Therapy (CBT) is an evidence-based intervention for chronic pain, but there is a shortage of trained providers. The Chronic Pain Management Program (CPMP) was developed to train clinical psychology doctoral students in delivering CBT for chronic pain. This study evaluates the effectiveness of the CPMP in improving trainees' knowledge, clinical experience, and perceptions of their competency in providing CBT-based interventions for chronic pain. METHODS: Sixteen doctoral students completed the CBT for Chronic Pain Competence Scale (CCPCS) before and after participating in the CPMP. The CCPCS, adapted from an existing CBT competence measure, assessed self-reported knowledge, experience, and perceptions related to CBT for chronic pain. Internal consistency was examined using Cronbach's alpha, and paired-samples t-tests were conducted to evaluate pre-to-post training changes. RESULTS: The CCPCS demonstrated strong internal consistency across all subscales. Paired-samples t-tests revealed significant improvements in self-reported knowledge (Cohen's d = -2.85) and experience (Cohen's d = -3.05), suggesting the CPMP effectively enhanced trainees' competence in delivering CBT for chronic pain. However, perceptions of CBT's effectiveness did not significantly change, indicating that attitudes toward CBT may be more resistant to change or that the perception subscale requires refinement. CONCLUSIONS: The CPMP successfully increased trainees' views on their knowledge and experience in CBT for chronic pain, reinforcing the value of structured, interdisciplinary training programs in addressing shortages in psychological treatment of pain management. Future research should further examine the long-term impact of the CPMP on trainee knowledge and skill in delivering CBT for chronic pain and refine assessment tools to better capture changes in clinical attitudes.
Facilitators and barriers to internal evaluation in an Iranian medical Sciences University: a qualitative exploration of faculty perspectives.
Bastani Nejad Z, Tajik F, Fereidouni Z … +3 more , Karimivaselabadi A, Beygi N, Taghinezhad A
BMC Med Educ · 2026 Jun · PMID 42316221 · Full text
BACKGROUND: In response to increasing demands for accountability and quality assurance in higher education, internal evaluation has become a core mechanism for improving educational performance. Internal evaluation refer...
BACKGROUND: In response to increasing demands for accountability and quality assurance in higher education, internal evaluation has become a core mechanism for improving educational performance. Internal evaluation refers to a systematic self-assessment process through which faculty and staff examine educational, research, and administrative performance to identify strengths, weaknesses, and areas for improvement. Faculty members play a central role in implementing internal evaluation; however, their engagement is shaped by multiple facilitators and barriers. Evidence from resource-constrained contexts remains limited, particularly qualitative insights into faculty perceptions. This study qualitatively examines faculty members' perceptions of the facilitators and barriers influencing internal evaluation. METHODS: This qualitative study used a conventional content analysis approach. Semi‑structured interviews were conducted with 16 faculty members at Fasa University of Medical Sciences using purposive sampling until data saturation was achieved. Data were collected between January and October 2025 and analyzed using conventional content analysis. Trustworthiness was ensured using Lincoln and Guba's criteria. RESULTS: Three overarching categories emerged inductively from the data: (1) conceptualizations of internal evaluation, including its role as a systematic performance review, a reflective process for identifying strengths and weaknesses, and a cultural mechanism for promoting quality; (2) facilitators, encompassing individual factors (intrinsic motivation, self-efficacy, training), organizational factors (structural support, adequate infrastructure), and cultural factors (learning-oriented culture, collaboration); and (3) barriers, including individual challenges (resistance to change, workload), organizational constraints (limited resources, inefficient procedures), and cultural obstacles (negative attitudes, interdepartmental tensions). CONCLUSION: Internal evaluation is shaped by intersecting individual, organizational, and cultural dynamics. Recognizing these influences can guide context-appropriate strategies; for example, shifting from a compliance-driven model to a developmental model that emphasizes workload adjustments, targeted capacity building, and transparent feedback loops to increase faculty engagement. CLINICAL TRIAL NUMBER: not applicable.
Investigation of the effect of flipped learning on neuroanatomy education in dentistry faculty students.
Akbaytürk N, Aygün T
BMC Med Educ · 2026 Jun · PMID 42316205 · Full text
OBJECTIVE: Flipped learning is a learning model in which students are active and effective. This study is a quasi-experimental study conducted using a pretest-posttest-follow-up test design with experimental and control...
OBJECTIVE: Flipped learning is a learning model in which students are active and effective. This study is a quasi-experimental study conducted using a pretest-posttest-follow-up test design with experimental and control groups to evaluate the effect of flipped learning on the education of second-year dental students regarding the facial nerve in neuroanatomy. METHODS: The study was conducted with 59 students in the experimental (n = 28) and control (n = 31) groups in the 2nd year of Giresun University Faculty of Dentistry. Data were collected using the "Student Demographic Characteristics Form", "Facial Nerve Anatomy Knowledge Test", and "Flipped Learning Feedback Form". Students in the experimental group were trained using the flipped learning method prepared by the researchers. Students in the control group were trained using the traditional education method. Permission and ethical approval were obtained from the institution where the study was conducted (19.03.2025, no:2025/47). RESULTS: A statistically significant difference was found between the pretest, posttest, and follow-up test scores on the facial nerve anatomy knowledge test for students in the experimental group (p = 0.000). A statistically significant difference was also found between the pretest, posttest, and follow-up test scores for students in the control group (p = 0.022). However, no statistically significant difference was found between the experimental and control groups across all three tests (p > 0.05). Students in the experimental group rated the benefits of the flipped learning method as beneficial, with a median value of 4 (3-4). CONCLUSION: In this study, both flipped learning and the traditional teaching method significantly improved students' knowledge of facial nerve anatomy. However, no statistically significant difference was found between the groups. As a student-centered approach, flipped learning can serve as a complementary method to traditional anatomy education.
Pilot of a blended learning model on medical students' communication skills in the context of digital innovations.
Töpfer J, Fritsch S, Wollny A … +5 more , Romeike B, Endlicher D, Schrötter S, Schmitz S, Ciężka A
BMC Med Educ · 2026 Jun · PMID 42316197 · Full text
BACKGROUND: Effective physician-patient communication is essential for high-quality medical care. However, digital transformation and the increasing use of tools based on artificial intelligence (AI) require new competen...
BACKGROUND: Effective physician-patient communication is essential for high-quality medical care. However, digital transformation and the increasing use of tools based on artificial intelligence (AI) require new competencies that are not yet systematically integrated into medical curricula. Blended learning formats may offer a promising approach to addressing both patient-centered and technology-related communication skills. METHODS: In this pilot study, sixth- and eighth-semester medical students (n = 6) participated in an NKLM-based blended learning elective course. The course combined H5P online modules on narrative and AI-related communication with face-to-face sessions involving standardized patients and structured feedback. A mixed-methods evaluation was conducted to assess feasibility and explore learning outcomes. This included a pre-post questionnaire assessing subjective competence gains and an objective structured clinical examination (OSCE) comparing intervention participants with a control group. RESULTS: The blended learning format was successfully implemented and completed by participating students. Pre-post analyses showed increases across all assessed domains, with larger absolute gains in competencies related to digital innovations than in narrative communication skills. In the OSCE, communication competencies were generally demonstrated across both groups, with the largest performance differences observed in AI-related counselling tasks and consultation closing. CONCLUSIONS: This pilot study supports the feasibility and acceptability of the integrated blended learning course. Exploratory findings suggest potential benefits for both narrative and digital communication competencies, with the strongest gains observed in digital communication competencies. These findings highlight the need to integrate AI- and technology-related communication skills more systematically into medical curricula. Given the exploratory design and small sample size, results should be interpreted as hypothesis-generating.
Preceptor and student gender effects on clerkship assessment scores in medical education.
Kac E, Zapata I, Brooks A … +2 more , Jenks T, Hudgins TL
BMC Med Educ · 2026 Jun · PMID 42316186 · Full text
BACKGROUND: Clerkship evaluations play a critical role in assessing medical student performance and informing residency selection. Prior studies suggest there are gender-related differences in narrative feedback and nume...
BACKGROUND: Clerkship evaluations play a critical role in assessing medical student performance and informing residency selection. Prior studies suggest there are gender-related differences in narrative feedback and numerical evaluations of medical trainees; however, findings remain inconsistent across specialties and institutions. This study examined whether preceptor gender and student gender were associated with differences in clerkship evaluation scores. METHODS: A retrospective analysis was conducted using 6,855 clerkship evaluations from students in the graduating classes of 2022-2024 at a U.S. Osteopathic medical school. Evaluations were completed by 2,425 preceptors across six required clerkships: Family Medicine, Internal Medicine, Obstetrics and Gynecology, Pediatrics, Psychiatry, and Surgery. Associations between preceptor gender, student gender, and evaluation scores were analyzed using generalized linear mixed models, adjusting for academic year and clerkship rotation. RESULTS: Preceptor gender was significantly associated with evaluation scores, with female preceptors assigning modestly lower Total Average and Clinical Competence scores than male preceptors (P < 0.0001). Student gender demonstrated smaller effects, with female students receiving slightly higher Total Average scores (P = 0.0260) and Professionalism scores (P = 0.0026). No significant interaction between preceptor and student gender was observed. Clerkship rotation was strongly associated with evaluation scores, with higher adjusted scores in Family Medicine and Pediatrics and lower in Surgery and Internal Medicine. CONCLUSION: Evaluator characteristics and specialty-specific grading cultures appear to influence numerical clerkship assessments. Although findings may be limited by the single-institution design, these results highlight the potential value of increased standardization and target preceptor development to promote equity and consistency in clinical evaluation.
Online learning resource preferences across learning stages: a cognitive load theory perspective in UK medical students in early years.
Wang Y, Zhang X, Wang C … +2 more , Xing X, Nayak V
BMC Med Educ · 2026 Jun · PMID 42316184 · Full text
BACKGROUND: Online learning resources (OLRs) have become an important part of the education for students in the early years of the medicine programme (Years 1-2) in the UK. There are a variety of OLRs. However, an excess...
BACKGROUND: Online learning resources (OLRs) have become an important part of the education for students in the early years of the medicine programme (Years 1-2) in the UK. There are a variety of OLRs. However, an excessive amount of resources can impose a significant cognitive load. Students selectively use OLRs to avoid cognitive load, forming their preferences for OLRs. When students use OLRs before and after class, as well as before exams, these distinct learning stages involve different learning objectives and challenges. Thus, students' preferences for OLRs may also differ. This study aims to identify how OLRs preferences change across different learning stages (pre-class, post-class, and pre-exam), enabling educators to provide more targeted OLRs support to learners based on an understanding of their cognitive needs. METHODS: This cross-sectional study used a self-administered questionnaire. Participants were early-year medicine undergraduates (Years 1-2) at the University of Exeter. The questionnaire included Likert scales and open-ended questions. To examine undergraduates' OLRs preferences and attitudes, one- and two-way repeated-measures ANOVA analyses were conducted. Qualitative analysis of open-ended responses utilized a framework combining Braun and Clarke's reflexive thematic analysis with Krippendorff's principles of content validity. RESULTS: The most preferred OLRs vary across different learning stages. The highest-scoring OLRs were interactive videos (3.16 ± 0.86, out of 4) in the pre-class stage, optional practice questions (3.65 ± 0.71, out of 4) in the post-class stage, and online mock exams (3.89 ± 0.38, out of 4) in the pre-exam stage. Personal study habits, content value, time cost, and resource delivery are crucial factors that influence learners' preferences. CONCLUSIONS: Learners' preferences for OLRs vary across different stages of the learning process. Understanding these patterns may help educators better align the design and delivery of OLRs with students' perceived needs. For example, providing interactive, vivid, and clearly structured materials during early learning stages and incorporating practice questions or self-assessment opportunities after classes and before examinations may better support learners' preparation and consolidation. While these findings reflect learners' reported preferences rather than objective measures of learning effectiveness, they offer insights that may inform the development of stage-appropriate OLRs.
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