Introducción: La fuga de cerebros de médicos de países de ingresos medianos- bajos a países de ingresos altos es un fenómeno creciente que contribuye a las desigualdades mundiales en salud. Las estrategias de retención son difíciles de implementar localmente y de dirigir específicamente a la población en riesgo de migrar. Hipotetizamos que los estudiantes de Medicina que son ayudantes tienen mayores intenciones de migrar para ejercer la Medicina en el extranjero. Métodos: Estudiantes de Medicina de Argentina fueron invitados a una encuesta online de 22 preguntas de opción múltiple basada en la encuesta de la Red LIRHUS, previamente utilizada en América Latina. Resultados: Se enrolaron 2.301 estudiantes de Medicina. La mayoría eran jóvenes (23 [20-25] años), solteras (90%) y mujeres (79%). La mayoría estudiaba en universidades públicas (87%). La intención de migrar para ejercer la Medicina en el extranjero fue más frecuente entre los ayudantes (36% vs 31%; χ2 = 4,4982; p = 0,0339). Después de ajustar por sexo y edad, ser ayudante se asoció con la intención de migrar para ejercer la Medicina (OR = 1,26; IC 95% 1,02 - 1,55; p = 0,002). Conclusiones: Los ayudantes argentinos tienen mayor riesgo de migrar para ejercer la Medicina en el exterior. Dado su alto perfil académico, se trata de recursos humanos valiosos formados con la financiación pública de un país de ingresos medianos-bajos, cuya pérdida puede contribuir a las desigualdades en salud. Es un subgrupo fácilmente identificable y accesible hacia el que se pueden dirigir políticas de retención locales.

OBJECTIVE: The aim of the study was to determine the risk factors for binge-watching (BW) among Polish medical and non-medical students.
METHODS: A STROBE-compliant cross-sectional observational study, was carried out in Poland from July 2022 - March 2023. The web-based survey consisted of a personal questionnaire, a Binge-Watching Behaviour Questionnaire, a Scale of Motivation for Watching TV Series, a shortened version of the Ryff Well-Being Scale, and the De Jong Gierveld Loneliness Scale. Inclusion criteria were being a student and providing informed consent to participate. The study involved 726 respondents (70.5% female) with an average age of 22.41 (SD=3.89), including 308 (44%) medical students.
RESULTS: In the group of Polish medical students, the regression model was well-fitted F(10,287)=30.189; p<0.001, R2=0.496, and the risk factors were escape motivation (β=0.416; p<0.001), psychological well-being (β=-0.165; p=0.003), emotional loneliness (β=0.152; p=0.014), and social loneliness (β=-0.118; p=0.031). Among Polish students of other majors, the regression model was well-fitted F(10,378)=46.188; p<0.001, R2=0.538, and the influence of escape motivation (β=0.456; p<0.001), entertainment motivation (β=0.258; p<0.001), the psychological well-being of students (β=-0.134; p=0.004), and emotional loneliness (β=0.111; p=0.032) was demonstrated.
CONCLUSIONS: Students are in a high-risk group for behavioural addiction known as binge-watching. Emotional loneliness, the desire to escape from everyday life problems, and reduced psychological well-being intensified binge-watching in all the studied groups. Entertainment motivation and social loneliness differentiated the groups of Polish medical and non-medical students in terms of BW risk factors.

UNASSIGNED: Higher education attempts to ameliorate the learning experience through match between learning subjects and students\' learning styles.
UNASSIGNED: This study evaluates the efficacy of three different instructional modalities aimed at teaching veterinary students how to make simple suture knots.
UNASSIGNED: A cohort of 43 fourth-year students were split into 3 groups and provided with different instructional modalities: presentation with pictures and descriptions, hard copy text, and muted video. The student\'s surgical simulation performance was evaluated. Then, they answered a 23 question-survey, Fleming VARK questionnaire based, investigating their learning profile. Kruskal Wallis test evaluated different instructional modalities effect on student\'s performance. The chi-square test assessed differences between instructional modalities and learning profiles, profile self evaluation, and training session comprehension.
UNASSIGNED: Students showed auditory unimodal VARK profile (16/43), did not know their learning profile (26/43), and favored personalized teaching strategies (43/43). No differences were found for: surgical performance, except for forceps handling; and between instructional modalities: either for learning profiles (p-value = 0.43), or profile self evaluation (p-value = 0.42). Differences were found between instructional modalities and training session comprehension. As limitations, auditory instructional modalities, participants\' age, and gender were not recorded or evaluated.
UNASSIGNED: Our study provides feedback on modern teaching modalities in which students play a key role. Participants showed a variety of learning profiles although displaying no significant performance differences.

Health data show that there are differences in clinical management based on gender. One hypothesis is that these differences in management are not intentional discrimination but are the result of implicit and unconscious biases on the part of healthcare providers. These biases influence the clinical reasoning and practice of providers. This article, using clinical examples, illustrates how reflective practice is integrated into medical teaching in Lausanne to enable students to identify their biases, control them and ensure fair and relevant care. Students are also prompted to reflect on their social positionality, as thematising the power dynamics around knowledge and social interactions helps to better understand and prepare for medical practice.
Les données en santé font état de différences de traitement médical en fonction du genre. L’une des hypothèses est que ces différences de traitement ne sont pas des discriminations intentionnelles, mais relèvent de biais implicites et inconscients des soignant-e-s. Ces biais ont une influence sur les raisonnements et la pratique clinique des soignant-e-s. Cet article, à l’aide d’exemples cliniques, illustre comment la pratique réflexive est intégrée à l’enseignement en médecine à Lausanne afin de permettre aux étudiant-e-s d’identifier leurs biais, de les contrôler et d’assurer des soins équitables et pertinents. Il est également proposé aux étudiant-e-s de réfléchir à leur positionnement social, car thématiser les dynamiques de pouvoir autour des savoirs et des interactions sociales permet de mieux comprendre et préparer la pratique médicale.

BACKGROUND: Nowadays, there is a growing need for competence in bronchoscopy. However, traditional mentorship-based training presents limitations in learning consistency, subjective evaluation, and patient safety concerns. Simulation-based training has gained attention for its potential to enhance skill acquisition and objective assessment. This study explores the effectiveness of self-driven bronchoscopy simulation training using high-fidelity (HFM) and low-fidelity (LFM) models on novice medical students.
METHODS: Medical students without prior bronchoscopy experience were randomly assigned to a self-learn using either HFM or LFM for 4 hours. Pre and posttests were conducted to evaluate the students\' knowledge and skill gains with a modified Bronchoscopy Skills and Tasks Assessment Tool. After their test results, students were asked to answer a questionnaire based on a Likert Scale to assess their satisfaction with self-learning.
RESULTS: The results revealed significant progression in both groups, but the HFM group outperformed the LFM group in terms of total score, knowledge, skills, and procedure duration. Participant satisfaction with the educational process was generally high in both groups. However, this study has certain limitations, such as a small sample size, a short training period, and the absence of real evaluation in patients.
CONCLUSIONS: This study demonstrates the efficacy of self-driven bronchoscopy simulation training using HFM and LFM of bronchoscopy, with HFM offering superior gain for skill and knowledge. Larger-scale and long-term studies are recommended to further investigate the effectiveness of this self-learning and retention of the bronchoscopy knowledge.

BACKGROUND: Clinical teaching during encounters with real patients lies at the heart of medical education. Mixed reality (MR) using a Microsoft HoloLens 2 (HL2) offers the potential to address several challenges: including enabling remote learning; decreasing infection control risks; facilitating greater access to medical specialties; and enhancing learning by vertical integration of basic principles to clinical application. We aimed to assess the feasibility and usability of MR using the HL2 for teaching in a busy, tertiary referral university hospital.
METHODS: This prospective observational study examined the use of the HL2 to facilitate a live two-way broadcast of a clinician-patient encounter, to remotely situated third and fourth year medical students. System Usability Scale (SUS) Scores were elicited from participating medical students, clinician, and technician. Feedback was also elicited from participating patients. A modified Evaluation of Technology-Enhanced Learning Materials: Learner Perceptions Questionnaire (mETELM) was completed by medical students and patients.
RESULTS: This was a mixed methods prospective, observational study, undertaken in the Day of Surgery Assessment Unit. Forty-seven medical students participated. The mean SUS score for medical students was 71.4 (SD 15.4), clinician (SUS = 75) and technician (SUS = 70) indicating good usability. The mETELM Questionnaire using a 7-point Likert Scale demonstrated MR was perceived to be more beneficial than a PowerPoint presentation (Median = 7, Range 6-7). Opinion amongst the student cohort was divided as to whether the MR tutorial was as beneficial for learning as a live patient encounter would have been (Median = 5, Range 3-6). Students were positive about the prospect of incorporating of MR in future tutorials (Median = 7, Range 5-7). The patients\' mETELM results indicate the HL2 did not affect communication with the clinician (Median = 7, Range 7-7). The MR tutorial was preferred to a format based on small group teaching at the bedside (Median = 6, Range 4-7).
CONCLUSIONS: Our study findings indicate that MR teaching using the HL2 demonstrates good usability characteristics for providing education to medical students at least in a clinical setting and under conditions similar to those of our study. Also, it is feasible to deliver to remotely located students, although certain practical constraints apply including Wi-Fi and audio quality.

BACKGROUND: Refugees remain a marginalized population and are exposed to a variety of discriminatory processes, among them Othering which categorizes people as belonging or not-belonging according to certain ascribed characteristics. We explored how the narrative construction of refugee patients by medical students constitutes a form of Othering.
METHODS: Using story completion, 124 5th year medical students at the Martin- Luther- University Halle-Wittenberg in October 2019 wrote a fictional story in response to a story stem situated in a medical practice. In a comparative approach, one patient presenting with abdominal pain lacks further characterization (version A) and the other is a refugee (version B). The stories were coded using qualitative content analysis by Mayring with a focus on content and narrative strategies (plot structure and perspective).
RESULTS: We identified four themes: characters, medical condition, access to care and provision of substandard care. The stories were predominantly framed with a medical or an interaction-based plot structure and written from a process-oriented perspective. The themes in version B, supported by their use of narrative strategies, were largely contextualized within the patients\' history of migration. An empathic depiction of patient B and the students\' compassion for the patients facing substandard care were key motifs as well.
CONCLUSIONS: The perception of the version B patients predominantly as refugees establishes their construction as an Other. The students\' compassion acts as a representation of societal inequalities and remains an inept response without the tools to counter underlying discriminatory structures. Based on a discourse of deservingness, compassion alone therefore perpetuates Othering and highlights the need for structural competency training in medical school.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is one of the most common reproductive endocrinological disorders affecting 6%-8% of women in reproductive years. An early liberal PCOS screening appears to be a cost-effective strategy, benefiting earlier diagnosis and intervention.
OBJECTIVE: The objectives are to measure the prevalence of PCOS and factors associated with PCOS among young girl students of a University in Central Gujarat.
METHODS: All consenting girl medical students enrolled in MBBS curriculum during 2013-2017 were given a self-administered questionnaire (for signs and symptoms of PCOS), taking due prior permissions; during January 2018-June 2019. Using Rotterdam (2006) criteria, those who were screened for PCOS were subjected to abdominal ultrasonography (USG) and if required, laboratory investigations (random blood sugar, thyroid-stimulating hormone, and free testosterone). The proportion of young women having PCOS as per the Rotterdam and European Society for Human Reproduction and Embryology (EHSRE) Criteria are reported.
RESULTS: The study enrolled 308 girl medical students. More than one-tenth of the study participants (11.7%, 36/308) had confirmed PCOS (Rotterdam Criteria). As per the EHSRE criteria, 24/36 had classic PCOS, 11/36 had ovulatory phenotype, and 01/36 had the non-hyperandrogenic phenotype PCOS. USG was required in 123/308 (39%); of which 91 consented and 16/91 (18%) had conclusive PCOS. Twenty-three girls required laboratory investigations, of which two had abnormal values suggestive of PCOS. Irregular menses and hirsutism were significantly associated with the PCOS (P < 0.05).
CONCLUSIONS: The proportion of young medical students with PCOS was 12%. Irregular menses and hirsutism were significantly associated with PCOS.

OBJECTIVE: To examine the influence of sleep quality on psychophysiological testing results and autonomic state in university students of both sexes with different habitual physical activity level.
METHODS: One hundred and twenty-four 6th year medical students (88 women and 36 men) and 80 sport science students (42 women and 38 men) underwent a comprehensive psychophysiological study, including 7 tests: simple motor reaction, choice reaction, reaction under conditions of interference, reaction to a moving object, critical fusion frequency, as well as static and dynamic (by profile) dexterity tests. Autonomic status was assessed using heart rate variability, sleep quality and alertness were assessed based on self-report, and in athletes, using the Pittsburgh Sleep Quality Questionnaire (PSQI).
RESULTS: In the male athletes\' group with morning chronotype the sleep quality was better than in medical students. Only female medical students demonstrated a deterioration in praxis with an increase in the severity of evening features in the chronotype and a decrease in self-assessment of sleep quality. Increased sleepiness in the first half hour after awakening significantly reduced the quality of performance of psychometric tests in all subjects. The most informative was critical fusion frequency, which was lower in girls with «poor» sleep, as well as the reaction to a moving object. In addition, sympathetic drive was increased in female medical students with poor self-rated sleep quality.
CONCLUSIONS: A decrease in the quality of sleep in students causes fine motor impairment, mediated by sex, the level of habitual physical activity and circadian chronotype.
UNASSIGNED: Изучить влияние самооценки качества сна на показатели психометрического тестирования и вегетативный статус у студентов разных полов и уровня привычной двигательной активности.
UNASSIGNED: Представлены результаты обследования 124 студентов 6-го курса (88 девушек и 36 юношей), изучающих медицину, и 80 студентов (42 девушки и 38 юношей) специальности «физическая культура». Всем студентам проведено комплексное психофизиологическое исследование, включающее 7 тестов: простую двигательную реакцию, реакцию выбора, реакцию в условиях помехи, реакцию на движущийся объект, критическую частоту слияния мельканий, а также статическую и динамическую (по профилю) координациометрию. Вегетативный статус оценивали по данным вариабельности сердечного ритма, качество сна и активированности — на основании самооценки, а у спортсменов — с использованием Питтсбургского опросника качества сна (PSQI).
UNASSIGNED: Качество сна у юношей-спортсменов, у которых преобладал утренний хронотип, оказалось достоверно лучше, чем у медиков. Только у девушек-медиков обнаружено ухудшение праксиса при увеличении выраженности вечерних черт в хронотипе и снижении самооценки качества сна. Повышенная сонливость в первые полчаса после подъема выраженно снижала качество выполнения психометрических тестов у всех обследованных. Наиболее информативной оказалась критическая частота слияния мельканий, которая была ниже у девушек с «плохим» сном, а также реакция на движущийся объект. Кроме того, только у девушек с «плохим» сном наблюдалось повышение симпатического тонуса вегетативной нервной системы.
UNASSIGNED: Снижение качества сна студентов вызывает нарушения тонкой моторики, опосредованные фактором пола, уровнем привычной двигательной активности и циркадианным хронотипом.

While objective clinical structured examination (OSCE) is a worldwide recognized and effective method to assess clinical skills of undergraduate medical students, the latest Ottawa conference on the assessment of competences raised vigorous debates regarding the future and innovations of OSCE. This study aimed to provide a comprehensive view of the global research activity on OSCE over the past decades and to identify clues for its improvement. We performed a bibliometric and scientometric analysis of OSCE papers published until March 2024. We included a description of the overall scientific productivity, as well as an unsupervised analysis of the main topics and the international scientific collaborations. A total of 3,224 items were identified from the Scopus database. There was a sudden spike in publications, especially related to virtual/remote OSCE, from 2020 to 2024. We identified leading journals and countries in terms of number of publications and citations. A co-occurrence term network identified three main clusters corresponding to different topics of research in OSCE. Two connected clusters related to OSCE performance and reliability, and a third cluster on student\'s experience, mental health (anxiety), and perception with few connections to the two previous clusters. Finally, the United States, the United Kingdom, and Canada were identified as leading countries in terms of scientific publications and collaborations in an international scientific network involving other European countries (the Netherlands, Belgium, Italy) as well as Saudi Arabia and Australia, and revealed the lack of important collaboration with Asian countries. Various avenues for improving OSCE research have been identified: i) developing remote OSCE with comparative studies between live and remote OSCE and issuing international recommendations for sharing remote OSCE between universities and countries; ii) fostering international collaborative studies with the support of key collaborating countries; iii) investigating the relationships between student performance and anxiety.