Medical Education

医学教育
  • 文章类型: Journal Article
    3D扫描和打印技术正在迅速发展,并为在大体解剖学教育中使用提供了巨大的潜力。使用人体捐赠者创建数字扫描和3D打印模型引起了人们对捐赠者知情同意的道德担忧。潜在的商品化,以及获取和存储潜在可识别的解剖复制品。本文回顾了现有文献,描述了这些新兴技术应用的伦理意义,现有已发布的管理和共享2D成像的最佳实践,以及目前学术界捐赠计划对这些最佳实践的坚持。我们得出的结论是,知情同意对于人类供体和人类供体衍生材料的所有用途至关重要,并且目前在遵守已建立的管理和共享来自人类供体的3D数字内容的最佳实践方面存在相当大的差异。我们提出了一个新的简化框架,用于对捐赠者衍生的教材以及数字共享所需的相应同意级别进行分类。该框架提出了相对于广义的人类捐赠者和人类捐赠者来源材料的同等最低程度的特定同意,不同的教材(即人造塑料模型)。同样,我们建议,集体前进的道路应该包括建立一个集中的,数字人类捐赠者3D内容的安全存储库,作为一种积累机制,调节,并控制适当同意的人类捐赠者衍生的3D数字内容的分发,这也将增加道德创造的人类衍生教材的可用性,同时阻止商品化。
    3D scanning and printing technologies are quickly evolving and offer great potential for use in gross anatomical education. The use of human body donors to create digital scans and 3D printed models raises ethical concerns about donor informed consent, potential commodification, and access to and storage of potentially identifiable anatomical reproductions. This paper reviews available literature describing ethical implications for the application of these emerging technologies, existing published best practices for managing and sharing 2D imaging, and current adherence to these best practices by academic body donation programs. We conclude that informed consent is paramount for all uses of human donor and human donor-derived materials and that currently there is considerable diversity in adherence to established best practices for the management and sharing of 3D digital content derived from human donors. We propose a new and simplified framework for categorizing donor-derived teaching materials and the corresponding level of consent required for digital sharing. This framework proposes an equivalent minimum level of specific consent for human donor and human donor-derived materials relative to generalized, nonidentical teaching materials (i.e., artificial plastic models). Likewise, we propose that the collective path forward should involve the creation of a centralized, secure repository for digital human donor 3D content as a mechanism for accumulating, regulating, and controlling the distribution of properly consented human donor-derived 3D digital content that will also increase the availability of ethically created human-derived teaching materials while discouraging commodification.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目标:尽管美国外国出生人口有所增加,移民和难民健康(IRH)方面的医学教育机会仍然有限。我们总结了已发布的IRH课程的发现,并提供了将IRH纳入儿科住院医师计划的建议。
    方法:我们对描述设计的文章进行了文献综述,实施,或评估美国本科和研究生医学学员的IRH课程。
    结果:文献综述确定了来自21个机构的36篇文章,描述了37个独特的课程。三个课程包括儿科住院医师计划。通常教授的主题包括文化谦逊,解释器使用,和移民身份是健康的社会决定因素。连续性诊所存在以移民为重点的培训经验,难民或寻求庇护者诊所,和专门的选修/轮换。课程最常被描述为独立的选修课/轮换。
    结论:IRH课程提供了发展临床护理技能的机会,倡导,以及与移民人口的社区伙伴关系。儿科住院医师计划应将IRH课程与现有的学习重点保持一致,支持和聘请具有IRH专业知识的教师,并与具有专业知识的社区组织合作。课程还可以考虑如何最好地支持对专注于移民人口的职业感兴趣的学习者。需要进一步的工作来建立能力和经过验证的工具,以衡量IRH课程的受训者满意度和临床能力。
    OBJECTIVE: Despite increases in the US foreign-born population, medical education opportunities in immigrant and refugee health (IRH) remain limited. We summarize findings for published IRH curricula and offer recommendations for integrating IRH into pediatric residency programs.
    METHODS: We performed a literature review of articles describing the design, implementation, or assessment of IRH curricula for US-based undergraduate and graduate medical trainees.
    RESULTS: The literature review identified 36 articles from 21 institutions describing 37 unique curricula. Three curricula included pediatric residency programs. Commonly taught topics included cultural humility, interpreter use, and immigration status as a social determinant of health. Immigrant-focused training experiences existed at continuity clinics, clinics for refugees or asylum seekers, and dedicated electives/rotations. Curricula were most frequently described as stand-alone electives/rotations.
    CONCLUSIONS: IRH curricula provide opportunities to develop skills in clinical care, advocacy, and community partnerships with immigrant populations. Pediatric residency programs should align the IRH curriculum with existing learning priorities, support and hire faculty with expertise in IRH, and partner with community organizations with expertise. Programs can also consider how to best support learners interested in careers focusing on immigrant populations. Further work is needed to establish competencies and validated tools measuring trainee satisfaction and clinical competency for IRH curricula.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:有效的指导是医学教育的重要组成部分,对所有利益相关者都有好处。近年来,导师的概念化已经超越了传统的二元经验导师-新手导师关系,包括小组和同伴指导。现有的导师理论不承认导师的个性化,不断发展,目标驱动,和特定于环境的性质。论证了传统因果观念的局限性,这篇综述的目的是系统地搜索文献,以确定指导是否可以被视为一个复杂的适应系统(CAS)。
    方法:使用Krishna的系统循证方法进行了系统的范围审查,以研究医学生和居民在普通内科和相关亚专业中的指导和CAS的陈述2000年1月1日至12月31日在PubMed上发表的文章,Embase,PsycINFO,ERIC,谷歌学者,和Scopus数据库。纳入的文章进行了主题和内容分析,确定并组合主题以创建域,这是讨论的框架。
    结果:审查了5,704份摘要,对134篇全文进行了评估,共纳入216篇文章。这些领域描述了指导关系和指导方法如何体现CAS的特征,并且指导通常表现为实践社区(CoP)。指导的类似CAS的功能通过CoP显示,有明显的界限,螺旋指导轨迹,以及纵向指导支持和评估过程。
    结论:认识到作为CAS的指导需要重新思考设计,支持,评估,以及对导师的监督和导师的作用。需要进一步的研究,以更好地评估指导过程,并为导师提供最佳的培训和支持。
    BACKGROUND: Effective mentorship is an important component of medical education with benefits to all stakeholders. In recent years, conceptualization of mentorship has gone beyond the traditional dyadic experienced mentor-novice mentee relationship to include group and peer mentoring. Existing theories of mentorship do not recognize mentoring\'s personalized, evolving, goal-driven, and context-specific nature. Evidencing the limitations of traditional cause-and-effect concepts, the purpose of this review was to systematically search the literature to determine if mentoring can be viewed as a complex adaptive system (CAS).
    METHODS: A systematic scoping review using Krishna\'s Systematic Evidence-Based Approach was employed to study medical student and resident accounts of mentoring and CAS in general internal medicine and related subspecialties in articles published between 1 January 2000 and 31 December 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles underwent thematic and content analysis, with the themes identified and combined to create domains, which framed the discussion.
    RESULTS: Of 5,704 abstracts reviewed, 134 full-text articles were evaluated, and 216 articles were included. The domains described how mentoring relationships and mentoring approaches embody characteristics of CAS and that mentorship often behaves as a community of practice (CoP). Mentoring\'s CAS-like features are displayed through CoPs, with distinct boundaries, a spiral mentoring trajectory, and longitudinal mentoring support and assessment processes.
    CONCLUSIONS: Recognizing mentorship as a CAS demands the rethinking of the design, support, assessment, and oversight of mentorship and the role of mentors. Further study is required to better assess the mentoring process and to provide optimal training and support to mentors.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    批判性思维(CT)的发展已成为高等教育的普遍目标。对文献进行了系统回顾,以评估当前使用的教学实践在培养本科医学生的CT/临床推理(CR)/临床判断(CJ)技能和/或倾向方面的有效性。
    PubMed,从2010年1月到2021年4月,使用预定义的布尔表达式搜索了WebofScience和Scopus数据库。
    在最初确定的3221篇文章中,使用PICOS方法纳入33篇文章。从这些,21(64%)报告了CR教学实践,12(36%)报告了CT教学实践。
    总的来说,教学实践,如认知/视觉表现,模拟,文学曝光,测试增强和基于团队的学习,临床病例讨论,基于错误的学习,基于游戏的学习似乎可以增强CT/CR技能和/或倾向。需要进一步的研究来确定最佳时机,在医学教育中有效促进CT/CR的教学干预的持续时间和方式。
    UNASSIGNED: The development of critical thinking (CT) has been a universal goal in higher education. A systematic review of the literature was conducted to evaluate the effectiveness of currently used pedagogical practices to foster CT/ clinical reasoning (CR)/ clinical judgment (CJ) skills and/or dispositions in undergraduate medical students.
    UNASSIGNED: PubMed, Web of Science and Scopus databases were searched from January 2010 to April 2021 with a predefined Boolean expression.
    UNASSIGNED: Of the 3221 articles originally identified, 33 articles were included by using PICOS methodology. From these, 21 (64%) reported CR pedagogical practices and 12 (36%) CT pedagogical practices.
    UNASSIGNED: Overall, pedagogical practices such as cognitive/visual representation, simulation, literature exposure, test-enhancing and team-based learning, clinical case discussion, error-based learning, game-based learning seem to enhance CT/CR skills and/or dispositions. Further research is required to identify the optimal timing, duration and modality of pedagogical interventions for effectively foster CT/CR in medical education.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    精神智力(SI)是一个独立于灵性的概念,一种可以训练和发展的统一和综合的智力,允许人们利用灵性来加强日常互动和解决问题,以一种灵性转化为行动。为了全面绘制和分析SI的当前知识,并了解其对心理健康和人类互动的影响,我们按照乔安娜·布里格斯研究所的方法进行了范围审查,在PubMedCentral上搜索“精神智慧”,Scopus,WebOfScience,和PsycInfo。使用经过验证的SI仪器和可重复的方法进行定量研究,截至2022年1月1日发布,包括在内。选定的参考文献由两名审阅者独立评估,任何分歧都由第三位审稿人解决。使用先前开发和试点的数据提取工具提取数据。从这次搜索中,共纳入了67项研究的69份手稿.大多数研究(n=48)是在教育(n=29)和医疗保健(n=19)环境中进行的,随着精神智力自我报告清单(SISRI-24)成为评估SI的主要工具(n=39)。分析显示与SI有几个显著的相关性:弹性(n=7),一般,心理,和精神健康(n=6),情商(n=5),以及良好的社会行为和沟通策略(n=5)。相反,与倦怠和应激呈负相关(n=5),以及抑郁和焦虑(n=5)。这些发现促使人们对将SI概念纳入世界卫生组织修订的健康定义进行了讨论,并强调了SI培训作为预防性健康措施的重要性。
    主要发现:这项对精神智力的范围审查发现,与韧性呈正相关,一般,精神和精神健康,情商,以及有利的社会行为和沟通策略,与倦怠呈负相关,压力,抑郁症,和焦虑。增加的知识:精神智力是一种包容各方的方式,从实践中,日常解决问题的观点,可以训练对个人整体健康有几个好处,同时也促进了个人在社会行为和技能方面的实质性成长。全球健康对政策和行动的影响:迫切需要精神智力培训,并应将其纳入幼儿时期的全球教育计划,作为一项健康促进战略,旨在建立一个更具弹性和同情心的社会。
    Spiritual Intelligence (SI) is an independent concept from spirituality, a unifying and integrative intelligence that can be trained and developed, allowing people to make use of spirituality to enhance daily interaction and problem solving in a sort of spirituality into action. To comprehensively map and analyze current knowledge on SI and understand its impact on mental health and human interactions, we conducted a scoping review following the Joanna Briggs Institute methodology, searching for \'spiritual intelligence\' across PubMedCentral, Scopus, WebOfScience, and PsycInfo. Quantitative studies using validated SI instruments and reproducible methodologies, published up to 1 January 2022, were included. Selected references were independently assessed by two reviewers, with any disagreements resolved by a third reviewer. Data were extracted using a data extraction tool previously developed and piloted. From this search, a total of 69 manuscripts from 67 studies were included. Most studies (n = 48) were conducted in educational (n = 29) and healthcare (n = 19) settings, with the Spiritual Intelligence Self Report Inventory (SISRI-24) emerging as the predominant instrument for assessing SI (n = 39). Analysis revealed several notable correlations with SI: resilience (n = 7), general, mental, and spiritual health (n = 6), emotional intelligence (n = 5), and favorable social behaviors and communication strategies (n = 5). Conversely, negative correlations were observed with burnout and stress (n = 5), as well as depression and anxiety (n = 5). These findings prompt a discussion regarding the integration of the SI concept into a revised definition of health by the World Health Organization and underscore the significance of SI training as a preventative health measure.
    Main findings: This scoping review of Spiritual Intelligence found positive correlations with resilience, general, mental and spiritual health, emotional intelligence, and favourable social behaviours and communication strategies, and negative correlations with burnout, stress, depression, and anxiety.Added knowledge: Spiritual Intelligence is an all-inclusive way to approach spirituality from a practical, daily problem-solving perspective that can be trained with several benefits for personal overall health, while also fostering substantial personal growth in social behaviors and skills.Global health impact for policy and action: Spiritual Intelligence training is urgently needed and should be integrated into global educational programs from early childhood as a health promotion strategy aiming to foster a more resilient and compassionate society.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    手术室(OR)中的次优团队合作是导致手术患者可预防并发症的重要因素。指定行为对于缩小医疗保健中的证据与实践差距至关重要。当前的团队合作干预措施,然而,还没有以这种方式合成。本范围审查旨在通过根据行动绘制现有文献来确定手术期间使用的可操作策略,演员,上下文,目标,时间(AACTT)框架。数据库MEDLINE(医学文献分析和在线检索系统),Embase,护理和相关健康文献累积指数(CINAHL),教育资源信息中心(ERIC),科克伦,Scopus,和PsycINFO从开始到2022年4月5日进行了搜索。筛选和数据提取由成对的独立审阅者一式两份进行。删除重复项后,搜索确定了9,289个参考。在249项被认为有资格纳入的研究中,根据AACTT框架,可以映射八种类型的团队合作干预:捆绑/清单,协议,审计和反馈,临床实践指南,环境变化,认知援助,教育,和其他),然而,许多人对所涉及的演员和行动模棱两可。根据ACCTT元素的明确说明,包含的101种协议干预措施似乎是OR最可行的措施之一,在今后的工作中,应评估和比较其有效性。
    Suboptimal teamwork in the operating room (OR) is a contributing factor in a significant proportion of preventable complications for surgical patients. Specifying behaviour is fundamental to closing evidence-practice gaps in healthcare. Current teamwork interventions, however, have yet to be synthesized in this way. This scoping review aimed to identify actionable strategies for use during surgery by mapping the existing literature according to the Action, Actor, Context, Target, Time (AACTT) framework. The databases MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), Cochrane, Scopus, and PsycINFO were searched from inception to April 5, 2022. Screening and data extraction were conducted in duplicate by pairs of independent reviewers. The search identified 9,289 references after the removal of duplicates. Across 249 studies deemed eligible for inclusion, eight types of teamwork interventions could be mapped according to the AACTT framework: bundle/checklists, protocols, audit and feedback, clinical practice guidelines, environmental change, cognitive aid, education, and other), yet many were ambiguous regarding the actors and actions involved. The 101 included protocol interventions appeared to be among the most actionable for the OR based on the clear specification of ACCTT elements, and their effectiveness should be evaluated and compared in future work.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    基于价值的医学教育对于提供有质量保证的以患者为中心的医疗保健服务至关重要。当前审查的目的是探讨在医学课程中采用基于价值的方法的必要性,确定优点,制定实施基于价值的课程的逐步计划,并确定潜在的问题和克服它们的策略。在医学课程中实施基于价值的方法需要采取系统和逐步的方法,以确保获得最大的利益。然而,这种实施可能伴随着多重挑战,我们将需要医学教育工作者和大学管理人员的积极参与来克服它们。基于价值的医学教育的提供有望为未来的医疗保健专业人员做好准备,以提供以患者为中心的护理。这就需要采取多管齐下的方法,以确保这种价值驱动的教学被整合到现有的医学教育模式中,因为它将显著改善患者的预后和健康。
    Value-based medical education is essential for the provision of quality-assured patient-centered healthcare services. The purpose of the current review is to explore the need for the adoption of a value-based approach in medical curriculum, identify the merits, devise a stepwise plan for the implementation of a value-based curriculum, and identify the potential concerns and the strategies to overcome them. The implementation of a value-based approach in medical curricula requires a systematic and stepwise approach to ensure the attainment of maximum benefits. However, this implementation can be accompanied by multiple challenges, and we will require the active involvement of medical educators and college administrators to overcome them. The delivery of value-based medical education is expected to prepare the future cohort of healthcare professionals to deliver patient-centered care. This calls for the need to adopt a multipronged approach to ensure that this value-driven teaching is integrated into the existing model of delivery of medical education, as it will significantly improve patient outcomes and well-being.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    传统的医学教育模式是采用说教式讲座,其中教师以结构化的方式向大量学生传播所需的信息。本综述的目的是探索医学教育中逃生室的范围和需求,并确定在医学院设计逃生室以培训本科医学生时需要考虑的潜在因素。逃生室原则上是指互动和身临其境的学习环境,从某种意义上说,作为这些房间一部分的学生面临着一个难题或挑战或一项任务,这些任务必须在规定的时间段内解决,才能最终逃离房间。这是这些会议的最终目标。逃生室的成功取决于其设计方式,就他们参与参与者和促进合作的能力而言。总之,在医学教育中使用逃生室是一种克服传统策略局限性的创新教学方法。承认逃生室在发展批判性思维和团队合作技能方面的优点,每一个医疗机构都必须探索这种可能性,并在他们的环境中引入它,以确保医学生的体验式和长期学习。
    The conventional mode of medical education is delivered using didactic lectures, wherein teachers disseminate the desired information to a large number of students in a structured manner. The purpose of the current review is to explore the scope and need of escape rooms in medical education and identify the potential considerations to be acknowledged while designing an escape room in a medical college for training undergraduate medical students. Escape rooms in principle refer to the learning environments that are interactive and immersive, in the sense that students who are part of these rooms are posed with a puzzle or a challenge or a task that must be solved by them within a defined period of timeframe to eventually escape from the room, which is the ultimate goal of such sessions. The success of escape rooms is determined depending by the way it has been designed, in terms of their ability to engage the involved participants and promote collaboration. In conclusion, the employment of escape rooms in medical education is an innovative teaching-learning method to overcome the limitations of conventional strategies. Acknowledging the merits of escape rooms in the development of critical thinking and teamwork skills, it is the need of the hour that every medical institution must explore the possibility and introduce it within their settings to ensure experiential and long-term learning among medical students.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    在医疗保健领域,共享决策(SDM)是指协作过程,其中患者和医疗保健专业人员相互合作,就将对患者实施的医疗护理种类做出知情和共识的决定。本综述的目的是探索医疗保健中的SDM,确定医学教育的作用,并确定培训和评估本科医学生与SDM相关能力的方法。在PubMed和GoogleScholar搜索引擎上对与该主题相关的所有材料进行了广泛搜索,并根据其与当前评论目标的适用性选择了29篇文章并进行了分析。搜索中使用的关键字仅包括标题中的学习资源(即共享决策[ti]和患者[ti];共享决策[ti]和医学教育[ti];共享决策[ti]和评估[ti];共享决策[ti]和自我评估[ti];共享决策[ti];共享决策[ti])。在医学教育领域,SDM的推广基本上需要多管齐下的方法,以使其融入医学课程。然而,我们必须记住,除非有评估方法的补充,否则仅仅是教学方法不会改善它,否则,我们将无法取得持续的成果。总之,医学教育和医疗保健行业的SDM代表了从传统范式到以患者为中心的方法的变革性转变,赋予患者和医疗保健提供者权力。包括初露头角的医学生.小时的需要是倡导和鼓励SDM在医学课程中的结构化整合,并通过定期评估来支持这一点。
    In the field of healthcare delivery, shared decision making (SDM) refers to a collaborative process, wherein both patients and the healthcare professionals mutually work to make informed and consensus decisions with reference to the kind of medical care that will be administered to patients. The purpose of the current review is to explore SDM in health care, ascertain the role of medical education, and identify the ways to train and assess undergraduate medical students in competencies pertaining to SDM. An extensive search of all materials related to the topic was carried out on the PubMed and Google Scholar search engines and a total of 29 articles were selected based on their suitability with the current review objectives and analyzed. Keywords used in the search include learning resources in the title alone only (viz. shared decision making [ti] AND patient [ti]; shared decision making [ti] AND medical education [ti]; shared decision making [ti] AND assessment [ti]; shared decision making [ti] AND self-assessment [ti]; shared decision making [ti]; shared decision making [ti]). In the domain of medical education, the promotion of SDM essentially will require a multipronged approach to enable its integration into the medical curriculum. However, we must remember that mere teaching-learning methods would not improve it unless they are supplemented with assessment methods, otherwise, we will fail to deliver sustained results. In conclusion, SDM in medical education and healthcare industry represents a transformative shift from the traditional paradigm to a patient-centered approach that empowers both patients and healthcare providers, including budding medical students. The need of the hour is to advocate and encourage structured integration of SDM in the medical curriculum and support the same with periodic assessments.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    在线案例学习(CBL)是一种教学方法,采用数字平台和虚拟环境的使用与本科医学生讨论临床病例。本综述的目的是探讨在线案例学习的范围和优点,制定在医学院为本科生设计和实施在线CBL课程的计划。这恰好是一种创新的方法,因为学生有机会通过将他们的理论知识实际应用于临床实践来讨论和分析临床病例。像任何教学方法一样,在线CBL会议的有效性还取决于教育工作者在计划阶段所做的努力。由于这些会议将在网上进行,最重要的考虑因素是确保学生能够获得所需的技术。我们都知道,评估驱动学习,确实有必要用适当的形成性评估来补充在线CBL课程中的教学活动。总之,在线CBL是一种有效的教学方法,可以使用灵活的在线平台促进有趣的临床病例的讨论。考虑到该方法的优点以及技术已成为医学教育提供不可或缺的一部分的事实,每个医疗机构都必须探索其基础设施,以便在医学课程中系统地引入在线CBL。
    Online case-based learning (CBL) is a pedagogical approach that employs the use of digital platforms and virtual environments to discuss clinical cases with undergraduate medical students. The purpose of the current review is to explore the scope and merits of online case-based learning, development of a plan for designing and implementing online CBL sessions in a medical college for undergraduate medical students. This happens to be an innovative approach as students get an opportunity to discuss and analyze clinical cases by practically applying their theoretical knowledge to clinical practice. Like any teaching-learning method, the effectiveness of online CBL sessions also depends on the efforts taken by educators in the planning stage. As these sessions will be conducted online, the most important consideration is to ensure that students have access to the required technology. As we all know, assessment drives learning, there is a definite need to supplement teaching-learning activities in online CBL sessions with suitable formative assessments. In conclusion, online CBL is an effective pedagogical approach to promote discussion on interesting clinical cases using flexible online platforms. Considering the merits of the method and the fact that technology has become an integral part of medical education delivery, every medical institute must explore its infrastructure to systematically introduce online CBL within the medical curriculum.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号