Mindfulness training in medical education as a means to improve resilience,empathy,and mental health in the medical profession

The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our profession.We contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of individuals.Additionally,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational abilities.Importantly,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their curricula.While we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.

Designing a medical ethics curriculum in ophthalmology

Ethical principles form a bedrock to medical practice in any specialty,guiding physicians to appropriate attitudes and behaviors.A formal ethics curriculum can be difficult to generate de novo in an ophthalmology training program.A number of barriers exist in most ophthalmology departments:trainees may think ethics is of secondary importance compared to core basic and clinical science topics;most ophthalmology faculty have no formal degree in medical ethics;there is limited didactic time with competing academic,clinical,and surgical priorities;work-hours regulations may limit the time available to deliver“para-professional”lectures;and there is a belief that the medical ethics lectures during medical school is a sufficient amount of coursework to last through a physician’s career with no need for continuing professional development.The four pillars of medical ethics are beneficence,non-maleficence,autonomy,and justice.In addition,morals,ethics,and professionalism are important aspects of sound medical practice.A curriculum specific to medical ethics in ophthalmology can be developed in any of our sub-specialties and include lectures,curated readings,case rounds,and clinic wrap-up sessions.Ethical considerations are part of everyday clinical practice,and a structured ethics curriculum can be incorporated into ophthalmology training programs.The concept of backward design can be used to structure the curriculum,starting with the expected outcome,then designing authentic assessments,and finally putting together a learning plan that has students actively involved in ethical discussions.This paper will provide a guide to developing an ethics curriculum for an ophthalmology training program utilizing the concept of backwards design and guide the reader through the process of developing expected learning outcomes,authentic assessments,and a unified learning plan.

Flexner has fallen:Transitions in medical education system across time,a gradual return to pre-Flexnerian state(de-Flexnerization)

The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner,his public disclosure of the poor conditions at many medical schools provided a means to galvanize all the constituencies needed for reform to occur.He could say what other reformers could not,due to their links to the medical education community.But now we are again going back to a pre-Flexnerian state due to multiple reasons such as gradually diminishing importance of basic science subjects for the students,the decline in the number and quality of investigator initiated research among clinical researchers,lesser emphasis to bedside training by means of detailed clinical examination and making appropriate observation of signs to reach to a diagnosis rather than over reliance on the laboratory tests and radiological modalities for the diagnosis,poor exposure to basic clinical skills starting from college throughout residency and the trend of disrespect and absenteeism from both theoretical and clinical/practical classes.The attitude of students is just to complete their required attendance so that they are not barred from appearing in examinations.This de-Flexnerization trend and regression to pre-Flexnerian era standards,ideologies,structures,processes,and attitudes,are bound to beget pre-Flexnerian outcomes,for you get what you designed for.

Path Breakthrough of Medical Humanities Education From the Perspective of“All-Staff,Whole-Process,and All-Round Education”

Medical education is an important cornerstone for the development of healthcare,and medical humanities education,as an integral part of medical education,plays an irreplaceable role in cultivating people’s health guardians with high medical ethics.We adopted the method of stratified random sampling to select 309 students and 107 faculty members from three independent medical colleges in Sichuan province as the research subjects and distributed questionnaire surveys investigating in three dimensions:overall cognition of medical humanities,evaluation of medical humanistic qualities,and the current situation of medical humanities education,supplemented by an in-depth literature review and interviews with subject matter experts.We found that“tech-centrism”still has a great influence,the self-evaluation of medical students’humanistic quality is generally not high,the educational concept of“emphasizing professional skills over morality”of faculty and staff is still quite prevalent,and there is still the“last mile”phenomenon in medical humanities education.In order to promote the integrated development of“new medicine”and“new liberal arts”and break the barriers of“tech-centrism”and“instrumental rationality,”it is necessary to change the educational concept and strengthen the education of all employees,break through the bottleneck of internships and strengthen the whole process of education,integrate educational resources and strengthen all-round education,improve the incentive mechanisms,strengthen the assessment methods,and provide Chinese wisdom and Chinese solutions for the development of medical humanities education.

Potential and limitations of ChatGPT and generative artificial intelligence in medical safety education

The primary objectives of medical safety education are to provide the public with essential knowledge about medications and to foster a scientific approach to drug usage.The era of using artificial intelligence to revolutionize medical safety education has already dawned,and ChatGPT and other generative artificial intelligence models have immense potential in this domain.Notably,they offer a wealth of knowledge,anonymity,continuous availability,and personalized services.However,the practical implementation of generative artificial intelligence models such as ChatGPT in medical safety education still faces several challenges,including concerns about the accuracy of information,legal responsibilities,and ethical obligations.Moving forward,it is crucial to intelligently upgrade ChatGPT by leveraging the strengths of existing medical practices.This task involves further integrating the model with real-life scenarios and proactively addressing ethical and security issues with the ultimate goal of providing the public with comprehensive,convenient,efficient,and personalized medical services.

Current Situation and Improvement Strategies of Teaching Engagement by Teachers in Higher Medical Colleges Under the Background of“New Medical Education”

The“New Medical Education”is a new requirement for the development of medical education in the new era.As a key and core element of the construction of the“New Medical Education,”the engagement in teaching work of university teachers is a key issue that determines the level of teaching development of university teachers and affects the quality of talent cultivation in universities.Using the literature review method,this study analyzed 39 relevant literatures retrieved from China National Knowledge Infrastructure(CNKI)from 1997 to 2023.The concept,connotation,current situation,influencing factors,and improvement strategies of teaching engagement by university teachers were reviewed and summarized.The results showed that the issue of teaching engagement by university teachers has not received high attention in the field of higher education,especially in higher medical education,which has not yet been reported.Although the overall number of literature is not large,some of the conclusions have important implications for the next research on the influencing factors and mechanisms of double-qualified teacher engagement in higher medical colleges.

Analysis of Professional Quality Cultivation Strategies for Infant and Child Care Service Talents from the Perspective of Collaboration of Medical Care,Parenting,and Education,and Integration of Industry and Education

The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements related to the infant care industry chain.This integration targets pediatrics talent training in nine infant care positions,including nursing,infant health care and management,and child rehabilitation,to ensure that the capabilities and quality of professional talents can meet the health care needs of infants and young children.This article briefly explains the background of the“collaboration of medical care,parenting,and education,and integration of industry and education.”It analyzes the necessity of cultivating infant and child care service talents based on the perspective of“collaboration of medical care,parenting,and education,and integration of industry and education.”Based on this perspective,we conducted an in-depth study of the cultivation of professional qualities of infant and child care service talents.

Embracing different languages and local differences:Coconstructive patient simulation strengthens host countries’clinical training in psychiatry

BACKGROUND Global education in psychiatry is heavily influenced by knowledge from Western,high-income countries,which obscures local voices and expertise.AIM To adapt a human simulation model to psychiatric education in a context that is specific to local languages and cultures.METHODS We conducted an observational study consisting of six human simulation sessions with standardized patients from two host countries,speaking their native languages,and following an adaptation of the co-constructive patient simulation(CCPS)model.As local faculty became increasingly familiar with the CCPS approach,they took on the role of facilitators—in their country’s native language.RESULTS Fifty-three learners participated:19 child and adolescent psychiatry trainees and 3 faculty members in Türkiye(as a group that met online during 3 consecutive months);and 24 trainees and 7 faculty in Israel(divided into 3 groups,in parallel in-person sessions during a single training day).Each of the six cases reflected local realities and clinical challenges,and was associated with specific learning goals identified by each case-writing trainee.CONCLUSION Human simulation has not been fully incorporated into psychiatric education:The creation of immersive clinical experiences and the strengthening of reflective practice are two areas ripe for development.Our adaptations of CCPS can also strengthen local and regional networks and psychiatric communities of practice.Finally,the model can help question and press against hegemonies in psychiatric training that overshadow local expertise.

Evaluation of Clinician Training in Autism Screening, Care Management, and Patient Education

Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.

Interactivity software tools for teaching in ophthalmology

The use of interactive audience software,such as audience response systems(ARS),in medical education has become increasingly popular in recent years.This technology allows instructors to engage students in real time,encouraging active participation and promoting effective learning.The benefits of interactive audience software in medical education include increased student engagement,promotion of active learning,and enhanced learning outcomes.However,there are also several challenges to its implementation,including technical difficulties,careful planning and preparation,over-reliance on technology,and ethical concerns related to privacy and data security.The cost of implementing interactive audience software may also be a barrier for some institutions.This paper specifically reviews six interactive software platforms,including Socrative,Quizizz,Pear Deck,Slido,Wooclap and ClassPoint.These platforms allow for real-time assessment of student understanding,feedback,and participation.They also enable instructors to adjust their teaching strategies based on student responses and feedback.Overall,interactive audience software has shown great potential to enhance learning and engagement in medical education.It is important for instructors to carefully consider the benefits and challenges of its implementation.While the cost of implementing interactive audience software may be a barrier for some institutions,there are free and low-cost options available.

Revolutionizing Healthcare—The Integration of Virtual Worlds, AR, and Metaverse Technology

This paper explores the transformative impact of virtual worlds, augmented reality (AR), and the metaverse in the healthcare sector. It delves into the ways these technologies are reshaping patient care, medical education, and research, while also addressing the challenges and opportunities they present. The paper highlights the potential benefits of these technologies and emphasizes the need for comprehensive regulatory frameworks and ethical guidelines to ensure responsible integration. Finally it outlines their transformative impact and discusses the challenges and opportunities they present for the future of healthcare provision.

Simulation Training for Laparoscopic Surgery Can Improve Minimally Invasive Surgical Techniques for Interns and Probationers

Objective: The clinical clerkship and practice stage plays a pivotal role in the transition of medical students from theoretical knowledge to practical application, bridging the gap between classroom learning and real-life clinical experience. In order to improve the teaching quality of interns and probationers, we try to let them practice the skills of laparoscopic surgery in the early stage, and summed up a set of evaluation methods that can be widely used in medical education. Methods: From September 2019 to December 2019, a total of 54 interns and 72 trainees were selected as research objects. They were assigned to training sessions and their proficiency was assessed before and after the training. The change in proficiency is compared to determine whether the training course is valuable. Results: Before the operation training, the interns scores were BP 17.3 3.1, CC 17.9 3.4, KT 16.4 3.4, LS 16.7 3.3. The results of probationers were BP 16.9 2.7, CC 16.8 2.8, KT 15.2 1.6, and LS 14.8 2.2. After completing the operations training, the results of interns were BP 21.1 1.9, CC 20.6 2.7, KT 19.6 3.0, and LS 20.9 1.4. The probationers scores were BP 19.3 3.2, CC 19.6 3.5, KT 19.6 2.6, and LS 20.0 2.4. After the operation training, the performance of the intern group was better than that before the training (P < 0.05). The same is true of the probationer group. The time-consuming intern examinations were BP 147.9 38.5 s, CC 123.2 28.7 s, KT 82.6 24.1 s and LS 162.5 31.1 s. The examination time of probationers were BP 179.9 46.4 s, CC 132.1 24.3 s, KT 109.3 27.5 s and LS 210.0 58.8 s. Conclusion: Simulation training for laparoscopic surgery can improve minimally invasive surgical techniques for interns and probationers.

Cross-sectional study of the educational background and trauma knowledge of trainees in the “China trauma care training” program

Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in the China trauma care training(CTCT)program in addition to their post-course test results to provide support for the development of trauma care training programs and trauma systems in China.Methods:A cross-sectional study was conducted by collecting demographic information,hospital-related information and trauma knowledge of the trainees from 19 regions in China.All participants were assessed by questionnaires collecting the socio-demographic data,the trauma care knowledge levels and the information of the hospitals.Results:There were 955 males(78.9%)and 256 females(21.1%)enrolled.Among them,854 were physicians(70.5%),357 were registered nurses(29.5%).In addition,64 of them also played an administrative role in the hospitals(5.3%).The score of the trainees who were members of the emergency department staff(72.59±14.13)was the highest among the scores of all the personnel surveyed,followed by those of the trainees from the intensive care unit(ICU)(71.17±12.72),trauma surgery department(67.26±13.81),orthopedics department(70.36±14.48),general surgery department(69.91±14.79)and other departments(69.93±16.91),P=0.031.The score of the professors(73.09±15.05)was higher than those of the associate professors(72.40±14.71),lecturers(70.07±14.25)and teaching assistants(67.58±15.16),P<0.0001.The score of the individuals who attended experts’trauma lectures(72.22±14.45)was higher than that of individuals who did not attend the lectures(69.33±15.17),P=0.001.The mean scores before and after the training were 71.02±14.82 and 84.24±13.77,respectively,P<0.001.The mean score of trauma knowledge after the training of trainees from different provinces and with different educational backgrounds was higher than that before the training,with a statistically significant difference(P<0.05).Conclusions:The level of trauma knowledge of trauma care providers was associated with their department,professional position and previous participation in related academic conferences.Trauma care experience and participation in academic lectures and training program including CTCT may effectively improve individuals’level of trauma knowledge.

Medical simulation-based education improves medicos' clinical skills

Clinical skill is an essential part of clinical medicine and plays quite an important role in bridging medicos and physicians. Due to the realities in China, traditional medical education is facing many challenges. There are few opportunities for students to practice their clinical skills and their dexterities are generally at a low level. Medical simulation-based education is a new teaching modality and helps to improve medicos＇ clinical skills to a large degree. Medical simulation-based education has many significant advantages and will be further developed and applied.

Chinese medical service and medical education in urgent need of reform in the context of public welfare-based medical reform

After six years＇medical reform,about 7.8 billion person-times of medical service has been achieved by2014,and the number of persons covered by basic medical insurance for urban employees,basic medical insurance for urban residents,and new rural cooperative medical insurance exceeded 1.3 billion,of which the coverage ratio reached as high as over 95%,establishing the largest basic medical security network in the world.

A comparison of handheld and standard ultrasound in Swiss medical students

BACKGROUND:The use of ultrasound(US)within healthcare has inspired the development of new US technology.There have been few studies comparing the use of handheld US to standard US for medical education.This research aims to determine whether a handheld US device can provide a comparable primary learning experience to that of a standard US machine.METHODS:Over two days of instruction,participants were taught and evaluated on core US fundamentals.The standard group received instruction on standard US machines,while the handheld group received instruction on handheld US devices.Participants completed a qualitative survey regarding their experience.Six hundred and four images were obtained and graded by two emergency medicine physicians.RESULTS:A total of 119 Swiss medical students were enrolled in our study.There was no statistically significant difference in the US assessment measurements,except for faster endpoint septal separation(EPSS)vascular setup time in the handheld group(P=0.001).There was no statistically significant difference in participants’perceived difficulty of US learning(P=0.198),comfort level(P=0.188),or self-estimated capability to perform US in the future(P=0.442).There was no statistically significant difference in the percentage of correctly obtained images(P=0.211)or images that were clinically useful(P=0.256).The median quality score of images obtained by the standard group was eight compared to seven in handheld group(P<0.01).CONCLUSION:Our data suggest a handheld US machine can perform as well as a standard US machine as an educational tool despite sacrifices in image quality.

From nuclear submarines to graduate medical education: applying David Marquet's intent-based leadership model

L.David Marquet,a decorated Navy Captain,transformed an under performing submarine crew by empowering his subordinates to be leaders and reach their full potential.He called this intent-based leadership(IBL).What would happen if Marquet’s model were implemented in Graduate Medical Education(GME)?In this letter to the editor,we summarize the potential of the IBL model in graduate medical education as opposed to the traditional leaderfollower method.IBL harnesses human productivity toward the shared goals of GME,which are patient care and trainee learning.This shift in mindset could lead both teachers and trainees to focus more on the real reason that we undertake GME and change behaviors for the better.We suggest that IBL can and should be adopted in GME and propose that both patients and providers will benefit from this action.

Effect of basic life support training on the knowledge and skills of first aid of first year medical students

Objective:To determine the timing of first aid training in the medical school curriculum and the training method with the 8-hour first aid training given to the first-grade students of the faculty of medicine.Method:The study was conducted prospectively with 168 first year medical students at Faculty of Medicine,Maltepe University in October 2019.An 8-hour course plan consisting of theoretical and practical applications was prepared.Theoretical courses included cardiopulmonary resuscitation,basic life supports,epileptic seizures,heatstroke,aspiration,and drowning issues,while practical applications included cardiopulmonary resuscitation techniques,basic life support scenarios,Heimlich’s Maneuver and the coma position.Students were sent a link consisting of 17 questions created with Google forms at the beginning and the end of the course.Learned knowledge was measured with the posttest,and pre-and post-training results were compared.Results:A significant increase was found in the rate of correct answers compared to the pre-training period.Even the rate of correct post-test answers increased significantly in all questions;the increase in the questions related to the subjects supported by practical applications was more remarkable.It was found that more incorrect answers were given to questions about environmental injuries.Conclusions:It is possible to improve the public recognition of first aid,even with one day of theoretical and practical training.Thus,adding first aid practical courses to the first-year medical school curriculum and raising awareness at an earlier age will play an essential role in medical education.

Assessment Methods Used during Clinical Years of Undergraduate Medical Education at Moi University School of Medicine, Kenya

Background: Assessment is the systematic collection, review, and use of information about educational programs undertaken to improve teaching and learning. It ensures quality in training programmes, motivates, and directs students’ learning. Assessment is also used for verification of achievement of objectives of training, feedback to students, licencing, certification, and screening of students for advanced training. It is guided by several principles, including the aims of the assessment (why assess), who to assess, timing (when to assess), what to assess, methods (how to assess), and the criteria for determining the usefulness of the assessment. Objective: To describe the assessment methods used during clinical years of the undergraduate programme at Moi University School of Medicine (MUSOM) and determine the student’s perspectives concerning the comprehensiveness, relevance, objectivity of various assessment methods and challenges faced. Methodology: The study was carried out at MUSOM and a cross-sectional study design was employed. Ten study participants were studied using convenience sampling. Data were collected using an interview guide and was analyzed using content analysis. An informed consent was obtained from the study participants. Results: The methods used during clinical years at MUSOM for assessing knowledge and its applications include multiple-choice questions (MCQ), short answer questions (SAQ), modified essay questions (MEQ), long essay questions (LEQ), and oral exam. Whereas the methods for assessing clinical competence include long case, short cases, objective structured clinical examinations (OSCE), and logbook. Students felt that MCQs were comprehensive, objective, and relevant to the curriculum content. They reported that feedback was not provided after assessments. Conclusion: The assessment methods used at MUSOM during clinical years include MCQ, SAQ, MEQ, LEQ, Short cases, long cases, and OSCE. Students reported varied perceptions of the different assessment methods but favored MCQ and OSCE over other formats for assessing knowledge and clinical skills respectively.

Continuing professional development:progress beyond continuing medical education

Continuing medical education(CME)is rapidly evolving into competency-based continuing professional development(CPD)and this is driving change in self-directed CPD programs undertaken by individual practitioners as well as CPD programs or frameworks offered by CPD educators.This progression is being led by many factors including the rapid change in medical knowledge and medical practitioners along with changes in patients and society,healthcare systems,regulators and the political environment.We describe our experiences primarily concerning low-resource environments,in creating the International Council of Ophthalmology(ICO)Guide to Effective CPD/CME and in developing a CPD program for the Cambodian Ophthalmological Society(COS)twinned with the Royal Australian and New Zealand College of Ophthalmologists(RANZCO).At the conclusion of the project,47(100%)Cambodian practicing ophthalmologists were registered in the CPD program and 21(45%)were actively participating in the online COS-CPD program recording.We discuss challenges in CPD,propose solutions to overcome them and recommend developing research in CPD as needed to effectively enhance educational activities with impact in public health.