UNASSIGNED: Shock is a life-threatening condition amongst hospitalized patients and requires urgent management to avoid mortality. Early exposure is vital for educational and patient safety purposes.
UNASSIGNED: We developed a 90-minute shock day session that provided internal medicine interns with a cognitive framework for the initial diagnosis and management of shock, which they applied to two simulations. The first simulation involved a patient with septic shock, and the second involved a patient with cardiogenic shock. Critical action checklists were used to assess learners and guide structured debriefs after each simulation. Medical decision-making and communication frameworks were presented through a presession video and a chalk talk. The curriculum was evaluated using pre- and postintervention surveys to assess knowledge and confidence.
UNASSIGNED: Forty-eight interns participated in the session in 2022 and 2023. We observed an increase in the percentage of learners correctly answering a knowledge-based question regarding the amount of fluid administered to a patient in septic shock (pre: 33%, post: 62%, p < .01), as well as increases in learner-reported confidence in leading a rapid response (pre: 9%, post: 62%) and in managing undifferentiated shock (pre: 13%, post: 56%), septic shock (pre: 20%, post: 83%), cardiogenic shock (pre: 2%, post: 54%), hemorrhagic shock (pre: 20%, post: 73%), and anaphylactic shock (pre: 22%, post: 54%, all ps < .01).
UNASSIGNED: Employing a variety of pedagogical methods, we demonstrated that intern knowledge and confidence regarding the management of a hypotensive patient during a rapid response can be increased through participation in our curriculum.

BACKGROUND: There is little to no data evaluating long term usage of point of care ultrasound (POCUS) after a training intervention for medical students. The purpose of this study was to examine the impact of an intensive POCUS training program on medical student\'s usage at 9-months post-program.
METHODS: This was a prospective cross-sectional study of rising second year medical students who participated in a 2-week summer POCUS training program. Instruction consisted of 8 h of asynchronous online didactic material, 2-4 h of daily hands-on instructor-led and independent scanning, and instruction on how to teach POCUS. Students were assessed pre- and post-program, and again at 9 months post-program to evaluate POCUS usage.
RESULTS: A total of 56 students participated in the program over 2 summers; 52 (92.9%) responded to the 9-month post-program survey. At 9 months, 49 (94.2%) of students taught POCUS after the program to peers or faculty. Students reported serving as a POCUS instructor in 283 subsequent teaching sessions accounting for 849 h of POCUS instruction time. Six (11.5%) students were involved in the creation of a POCUS interest group on their regional campus, 7 (13%) created a POCUS curriculum for their student interest group, and 4 (7.7%) created an opt-in co-curricular POCUS program for students at their regional campus. Three (5.8%) students did not serve as educators after the program and only one student reported not using POCUS again after the program.
CONCLUSIONS: After a 2-week intensive POCUS training program for medical students, the majority of students demonstrated continued involvement in POCUS learning and education at 9-month follow-up including serving as peer instructors and assisting with limitations in financial resources and trained faculty.

BACKGROUND: Medical educators strive to improve their curricula to enhance the student learning experience. The use of high-fidelity simulation within basic and clinical medical science subjects has been one of these initiatives. However, there is paucity of evidence on using simulation for teaching pharmacology, especially in the Middle East and North Africa region, and the effectiveness of this teaching modality, relative to more traditional ones, have not been sufficiently investigated. Accordingly, this study compares the effects of high-fidelity simulation, which is designed in alignment with adult and experiential learning theories, and traditional case-based tutorial sessions on the performance and perception of undergraduate Year 2 medical students in pharmacology in Dubai, United Arab Emirates.
METHODS: This study employed a convergent mixed methods approach. Forty-nine medical students were randomly assigned to one of two groups during the 16-week pharmacology course. Each group underwent one session delivered via high-fidelity simulation and another via a case-based tutorial. A short multiple-choice question quiz was administered twice (immediately upon completion of the respective sessions and 5 weeks afterwards) to assess knowledge retention. Furthermore, to explore the students\' perceptions regarding the two modes of learning delivery (independently and in relation to each other), an evaluation survey was administered following the delivery of each session. Thereafter, the iterative joint display analysis was used to develop a holistic understanding of the effect of high-fidelity simulation in comparison to traditional case-based tutorial sessions on pharmacology learning in the context of the study.
RESULTS: There was no statistically significant difference in students\' knowledge retention between high-fidelity simulation and case-based tutorial sessions. Yet, students expressed a greater preference for high-fidelity simulation, describing the corresponding sessions as more varied, better at reinforcing learning, and closer to reality. As such, the meta-inferences led to expansion of the overall understanding around students\' satisfaction, to both confirmation and expansion of the systemic viewpoint around students\' preferences, and lastly to refinement in relation to the perspective around retained knowledge.
CONCLUSIONS: High-fidelity simulation was found to be as effective as case-based tutorial sessions in terms of students\' retention of knowledge. Nonetheless, students demonstrated a greater preference for high-fidelity simulation. The study advocates caution in adapting high-fidelity simulation, where careful appraisal can lend itself to identifying contexts where it is most effective.

I am a healer, yet sometimes I do more harm than good…David Hilfiker, 1984.
UNASSIGNED: Medical error is common and significantly impacts patients, physicians, learners, and public perception of the medical system; however, residents receive little formal training on this topic. Research on error response in practicing physicians is limited, and even more so on medical education interventions to improve this. This study evaluates a curriculum developed to foster the sharing of faculty medical error stories, practice of constructive coping strategies, and growth in resident confidence in managing error.
UNASSIGNED: Researchers identified factors related to effective physician error management and recovery to develop a targeted intervention for family medicine residents. The intervention consisted of three one hour didactic sessions in a medium-sized midwestern, urban family medicine residency program over the course of 6 months. Instructional methods included guided reflection after mentor storytelling, small group discussion, role play, and self-reflection.
UNASSIGNED: Of the 30 residents, 22 (73%) completed the preintervention survey, and 15 (50%) completed the postintervention survey. While most residents reported having experienced error (55%), fewer than half of the residents reported they knew what to do when faced with medical errors (46%). This increased to 93% after intervention. Personal error stories from mentors were the most desired type of training reported by residents preintervention, but this was surpassed by legal and malpractice concerns in the postintervention survey. Rates of reported error story sharing increased after the intervention. Residents reported self-efficacy (I can be honest about errors) and self-awareness (I acknowledge when I am at increased risk for error) also increased with intervention. However, these changes did not reach statistical significance.
UNASSIGNED: Family medicine residents are receptive to learning from peers and mentors about error management and recovery. A brief intervention can impact the culture around disclosure and support. Future research should focus on the impact of targeted interventions on patient-oriented outcomes related to medical error.

Background Residents and fellows as educators (RFAE) programs typically focus on clinical teaching skills in single departments, which may not be sustainable for those with limited trainees or faculty. Objective To determine the feasibility and value of a 2-week interdepartmental RFAE elective for advanced teaching skill development and transition to practice as clinician educators. Methods Facilitated discussion, simulation, and critiqued peer presentations developed participants\' skills in teaching, curriculum design, professional development, and scholarship. Assessments in this prospective intervention included 2 self-reported surveys addressing: (1) teaching process and motivation (Conceptions of Learning and Teaching [COLT]), and (2) skills and attitudes. We administered both surveys at baseline, immediate-post, and 3-month-post elective with data compared across time points using Kruskal-Wallis tests. Program evaluation comprised daily open-ended surveys on engagement and an end-of-course feedback survey. Results There were 79 participants from 2019 to 2023. Survey response rates were 84.8% (67 of 79) at baseline, 58.2% (46 of 79) immediate-post, and 51.9% (41 of 79) 3-month-post. Most participants were residents (89.9%, 71 of 79), female (60.8%, 48 of 79), from pediatrics and/or medicine departments (77.2%, 61 of 79), and in their final year of training (77.2%, 61 of 79). COLT factor orientation to professional practice scores increased in the immediate-post (3.3) compared to baseline (2.5) surveys (P=.008). Teaching skills attitudes scores increased for all questions in 3-month-post compared to baseline surveys. In open-ended questions, participants emphasized the importance of professional development sessions in guiding their careers toward medical education. Conclusions This interdepartmental elective was feasible, favorably received, and sustained over time, with observed changes in participants\' teaching skills attitudes.

Background: There is an insufficient understanding of factors that impede nursing students\' learning of healthcare-associated infection prevention and control in developing countries. This study aimed to explore current challenges in healthcare-associated infection control and prevention education in the nursing curriculum in two Vietnamese and two Cambodian universities. Methods: Exploratory research was conducted through consultation of education programs and a qualitative study design utilizing interviews and focus group discussions. Data collection was conducted through interviews with university board members and focus group discussions with lecturers and tutors. The data were analyzed by using content analysis methods. Results: The research results indicated that there were three generic themes of challenges in teaching HAIs-PC in nursing education in Vietnam and Cambodia. They were Implementation of healthcare associated infections prevention and control education into nursing curriculum, Positive aspects fostering healthcare associated infections prevention and control learning, Negative aspects hindering healthcare associated infections prevention and control learning. Conclusions: The study results provided evidence of challenges in healthcare associated infections prevention and control education in some Asia higher education institutions. To improve professional safety, universities should pay more attention to developing appropriate teaching methods for healthcare-associated infections prevention and control education to improve students\' practice outcomes.

BACKGROUND: To address the declining numbers of general practitioners (GPs) in rural areas and a lack of medical students pursuing a career in primary care, a general practice-based curriculum coupled with additional university admissions for students has been established at three universities in Hesse, Germany. This study aims to analyze potential topics which students striving to become a GP will benefit from. Teaching such topics will prepare them for their chosen career and working in rural areas. We aimed to explore the views of both specialists and GPs on chief topics and necessary skills in primary care.
METHODS: In our study we used semi-structured interviews with outpatient specialists and specialists in clinical practice and semi-structured group interviews with GPs in training. The topic guide addressed contents of the curriculum for medical students with an extracurricular focus (addressing additional topics) on primary care. Data analysis was carried out using qualitative content analysis according to Mayring.
RESULTS: GPs in training and specialists agreed on the importance of knowledge in the fields of medical history, physical examination, communication as well as common diseases in primary care. Essential competences mentioned were: inducing medical treatment, decision-making and triage, conducting structured conversations, having patient knowledge (hard skills) as well as an interest in continuous learning, empathy, personal commitment, listening and down-to-earthness (soft skills). Case reports, symptom-based learning, practical training, lessons with simulated patients and the integration of role models were regarded as useful teaching methods.
CONCLUSIONS: General practice-based curriculums should not only focus on the transfer of knowledge. Equally important is the training of soft and hard skills to prepare future GPs for their work in primary care. Special teaching methods as well as practical training should be the heart of a newly established curriculum.

Introductory biology for majors is one of the most consequential courses in STEM, with annual enrollments of several hundred thousand students in the United States alone. To support increased student success and meet current and projected needs for qualified STEM professionals, it will be crucial to redesign majors biology by using explicit learning objectives (LOs) that can be aligned with assessments and active learning exercises. When a course is designed in this way, students have opportunities for the practice and support they need to learn, and instructors can collect the evidence they need to evaluate whether students have mastered key concepts and skills. Following an iterative process of review, revision, and evaluation, which included input from over 800 biology instructors around the country, we produced a nationally endorsed set of lesson-level LOs for a year-long introductory biology for major\'s course. These LOs are granular enough to support individual class sessions and provide instructors with a framework for course design that is directly connected to the broad themes in Vision and Change and the general statements in the BioCore and BioSkills Guides. Instructors can implement backward course design by aligning these community endorsed LOs with daily and weekly learning activities and with formative and summative assessments.

In recent years, the concept of One Health (OH) has arisen as an approach that helps to catalyze the creation of transdisciplinary teams needed for surveillance and investigation of emerging disease dynamics. Besides a wealth of descriptions of what the OH approach encompasses, a dearth of information is available regarding the training of individuals in OH competencies. In 2019, the Nigerian Center for Disease Control developed an OH strategic plan to meet the country\'s human, animal, and environmental health challenges. In response to the demand for clinicians, scientists, climatologists, conservationists, and environmentalists, who have expertise in environment, human, plant, and animal health to work collaboratively in addressing OH challenges in Nigeria. An interprofessional group of faculty from the University of Texas Medical Branch, the University of Jos, and the National Veterinary Research Institute convened to develop a novel OH course \'entitled \'One Health for Translational Team Science. The objective of the course was to explore the evolution of an emerging epidemic, capitalizing on various learning environments, including animal, environmental, human, and public health perspectives. The 6-week course comprised of three parts: 2-weeks virtual part of case-based group discussions focusing on animal and environmental aspects, 2 weeks of individual field experiences, and a final virtual part focusing on human health. Pedagogical tools used were: case-based group discussions, breakout group presentations, role-play activities, field project write-up, peer evaluation, group writing assignments, and weekly reflections with the goal of working in teams to develop and practice the fundamental leadership and management skills in addressing emerging public health challenges. Post-course evaluations showed that all participants felt more confident identifying and practicing the necessary attitudes and skills to participate effectively in the evaluation of an outbreak. Furthermore, the roles, responsibilities, and \"One Health ways of thinking\" for the various disciplines and professions involved in improving global health were articulated and identified.

BACKGROUND: Doctoral programs have consistently garnered the attention of policymakers in medical education systems due to their significant impact on the socio-economic advancement of countries. Therefore, various doctoral programs have been implemented with diverse goals. In Iran, a research doctorate program, known as PhD by Research, was introduced primarily to engage in applied research related to healthcare needs. Nevertheless, the achievement of the program\'s goals has been questioned. This study aimed to identify the implementation challenges of the Research Doctorate Program and its solutions in Iran.
METHODS: This descriptive qualitative study followed the Standards for Reporting Qualitative Research: A Synthesis of Recommendations and was conducted in two steps. Firstly, the challenges of the Iranian Ph.D. by research program were identified through the perspectives of the program\'s students and graduates. In the second step, relevant solutions to these challenges were determined by focus groups of key informant experts. The transcripts were analyzed using qualitative content analysis.
RESULTS: Five students and six graduates were interviewed in the first step and seven experts participated in the second one. The challenges and related solutions are explored in four main themes, including: (1) admission criteria, (2) program goals and expected outcomes, (3) curricula, and (4) financial and human resources. The study showed that various dimensions of the doctoral program are not aligned with each other and how to adapt the program in these dimensions.
CONCLUSIONS: The study revealed the importance of a systematic approach in defining various dimensions of doctoral programs according to program goals and provided specific solutions for defining a research doctorate program in the context of a low- and middle-income country.