BACKGROUND: In the present assessment environment in undergraduate medical education at U.S. medical schools, the prevalence and implementation of Entrustable Professional Activities (EPAs) in internal medicine (IM) clerkships are not well understood.
OBJECTIVE: To describe the prevalence and approach to EPA use in U.S. IM clerkships.
METHODS: Cross-sectional, nationally representative survey of core IM clerkship directors.
METHODS: One-hundred forty IM clerkship directors at Liaison Committee on Medical Education-accredited U.S./U.S. territory-based allopathic medical schools with membership in the Clerkship Directors in Internal Medicine (CDIM) as of December 2022.
METHODS: Use of EPAs in IM core clerkships, including use for grading, types of EPAs, use of supportive measures for assessment, and current validity frameworks.
RESULTS: The survey response was 80% (112/140); two additional respondents completed the section on EPA use (n = 114). Approximately half of respondents (47%) reported their IM clerkship used EPAs. Among schools accredited after 1977, a higher percentage was associated with having incorporated EPAs (p = 0.03). The Association of American Medical Colleges Core EPAs for Entering Residency (CEPAER) was the most common framework used by Clerkship Directors (CDs) for developing EPAs (55%). Most CDs (56%) used EPAs for both formative and summative assessments, and approximately half of CDs (48%) used EPAs for a portion of the final grade determination. CDs who used EPAs were no more likely to report efforts to ensure the validity of assessment, the use of faculty development, or that written assessments were a valid measure of students\' performance compared to those who did not use EPAs.
CONCLUSIONS: Although EPAs have experienced substantial uptake in the IM clerkship and contribute to formative and summative assessment of learners, their use does not appear to be associated with enhanced efforts to obtain validity information.

BACKGROUND: Clinical practitioners think of frequent causes of diseases first rather than expending resources searching for rare conditions. However, it is important to continue investigating when all common illnesses have been discarded. Undergraduate medical students must acquire skills to listen and ask relevant questions when seeking a potential diagnosis.
METHODS: Our objective was to determine whether team-based learning (TBL) focused on clinical reasoning in the context of rare diseases combined with video vignettes (intervention) improved the clinical and generic skills of students compared with TBL alone (comparator). We followed a single-center quasi-experimental posttest-only design involving fifth-year medical students.
RESULTS: The intervention group (n = 178) had a significantly higher mean overall score on the objective structured clinical examination (OSCE) (12.04 ± 2.54 vs. 11.27 ± 3.16; P = 0.021) and a higher mean percentage score in clinical skills (47.63% vs. 44.63%; P = 0.025) and generic skills (42.99% vs. 40.33%; P = 0.027) than the comparator group (n = 118). Success on the OSCE examination was significantly associated with the intervention (P = 0.002).
CONCLUSIONS: The TBL with video vignettes curriculum was associated with better performance of medical students on the OSCE. The concept presented here may be beneficial to other teaching institutions.

Radiology teaching for undergraduate medical students is often limited in amount and lacking a longitudinal approach spanning multiple years. At our institution, we had a goal to develop a formal and sustainable radiology curriculum. There were sequential changes made to the curriculum over several years and here, the successes, challenges, and lessons learned are outlined. Alongside these elements, student radiology quiz results and survey data over several years are also summarized. Curricular development included integrated anatomy and radiology sessions, revamped lectures focusing on interactivity and eliminating unnecessary redundancies across the multi-year curriculum, radiology media files to supplement problem-based learning, clinical skills videos, and a pre-clerkship radiology bootcamp elective.

BACKGROUND: Jigsaw method is a structured cooperative-learning technique that lays the groundwork towards achieving collective competence, which forms the core of effective clinical practice. It promotes deep learning and effectively enhances team-work among students, hence creating a more inclusive environment.
OBJECTIVE: Present study was designed to introduce jigsaw model of cooperative learning to early-year undergraduate medical students, measure its effectiveness on their academic performance, and evaluate the perspectives of both students and faculty members regarding the same.
METHODS: It was a mixed method research, involving eighty second-year undergraduate medical students. The jigsaw cooperative learning approach was introduced in two themes within neurosciences module. Students were divided into two equal groups, with one group experiencing typical small-group discussions (SGDs) in first theme and other group exposed to jigsaw approach. The groups were then reversed for second theme. Following the activity, an assessment comprising multiple-choice-questions was conducted to evaluate the impact of jigsaw technique on students\' academic performance, with scores from both groups compared. Student perspectives were gathered through self-designed and validated questionnaire, while faculty perceptions were obtained through focus group discussions. Quantitative data were analyzed using SPSS v22, while thematic analysis was performed for qualitative data.
RESULTS: The students of jigsaw group displayed significantly higher median assessment score percentage compared to control group (p = 0.003). Moreover, a significantly greater number of students achieved scores ≥ 60% in jigsaw group compared to control group (p = 0.006). The questionnaire responses indicated a favorable perception of this technique among students, in terms of acceptance, positive interdependence, improvement of interpersonal skills, and comparison with typical SGDs. This technique was also well-perceived within the educational context by faculty members.
CONCLUSIONS: The jigsaw method is associated with higher levels of academic performance among students when compared to typical small-group discussion. The students and faculty perceived this technique to be an effective cooperative learning strategy in terms of enhanced student engagement, active participation, and a sense of inclusivity.

Emergency medicine clerkships have become more prevalent in the third year of medical school, a time when students are immersed in the core clinical training of their undergraduate medical education. There is little guidance for clinician educators, however, on how to effectively scaffold learning for third-year medical students when rotating in the emergency department (ED) during core clerkships. The authors sought to provide best practices in teaching to leverage the rich learning environment of the ED - regardless of their specialty selections. Based on an extensive review of the literature spanning on-shift teaching, feedback, clinical medicine, and bedside teaching, the following twelve tips are offered to guide the instruction of the undifferentiated third-year medical student in the ED.

BACKGROUND: Musculoskeletal (MSK) injuries and diseases place a significant burden on the health care system. Despite this, research indicates that physician training in the area of MSK medicine has historically been inadequate, with a majority of medical students feeling that their training in MSK medicine is lacking. The goal of this investigation was to evaluate the efficacy of a new preclinical MSK curriculum that was implemented within a nationally accredited allopathic medical program.
METHODS: Retrospective analysis was completed on five consecutive years (2017-2021) of preclinical MSK curricular data for 549 medical students, including mid and end-of-course examinations and end-of-course student satisfaction surveys. Both parametric and non-parametric methods of analysis were used to examine within and between class differences (P < 0.05).
RESULTS: The new MSK curriculum covered 15 of 16 \"core or must know\" topics in MSK medicine, and academic performance was consistently high over the 5-year period of analysis (final course marks ranged from 76.6 ± 7.1 to 81.4 ± 8.1; failures/year: range from 0 to 4), being equal or above levels of student performance observed for other courses delivered during preclinical studies. Likert data from end-of-course surveys demonstrated that feedback was overwhelmingly positive (overall course satisfaction ranged from a low of 3.07/4.00 to a high of 3.56/4.00) and indicated that students felt that the new preclinical MSK curriculum did effectively support medical student learning and knowledge retention.
CONCLUSIONS: Results are expected to help advance the current body of knowledge that is dedicated to improving physician learning and knowledge retention in the area of MSK medicine and provides a curricular model that could be used by other nationally accredited medical programs to help enhance MSK learning at the preclinical levels of physician training.

Regional anatomy teaching forms a cornerstone of undergraduate medical education. Owing to an increase in teaching and learning content throughout the medical curriculum in recent years, contact hours and overall course durations in anatomy are under review worldwide. This study aimed to assess whether shortening the course content duration impacts learning gain and the ability to identify anatomical structures correctly. Undergraduate medical students of the Johannes Kepler University Linz (JKU; n = 310) and at the Medical University of Graz (MUG; n = 156) participating in regional anatomy courses were included. Whole body regional anatomy courses, including hands-on dissection and accompanying lectures, were delivered over one or three months. Course content and examination mode were kept consistent, while the duration of knowledge delivery was one or three months, respectively. Objective structured practical examinations (OSPE) were then carried out on prosections for the neck, thorax, and abdomen. 3-month course exposure resulted in significantly higher OSPE scores for the neck (49 vs. 37%), thorax (65 vs. 54%), and abdomen (65 vs. 45%), respectively. Further evaluation of the utility of different embalming types yielded higher 3-month scores in the neck and thorax regions with Thiel-embalmed tissues and thorax and abdomen regions in ethanol-glycerin-embalmed tissues. Course exposure over a more extended period, like three months, appears to be highly beneficial.

BACKGROUND: Incorporating scientific research into undergraduate medical education is necessary for the quality of future health care. However, providing rigorous research training to a large number of medical students at one institution remains one of the major challenges. The authors studied the impact of a curriculum-based Research Training Program (RTP) for all undergraduate students at Zhejiang University School of Medicine (ZUSM) on research productivity and future research interests.
METHODS: Medical students (n = 2,213) from ZUSM who completed the course of RTP between 2013 and 2020 were studied. The authors measured the academic performance, research publications, and research projects of students across years, and evaluated potential factors that contribute to student research productivity and increased interest in future research.
RESULTS: Across the years, there was an increase in the number of student publications, a greater proportion of students with publications, and a greater proportion of projects involving three or more students (P < .01 for all). The academic performance of the course was associated with increased publications (P = .014), whereas overall satisfaction of the course (OR 2.07, 95% CI [1.39, 3.10], P < .001), Skill Composite Score (SCS) (OR 1.70, 95% CI [1.16, 2.50], P = .007), and male gender (OR 1.50, 95% CI [1.06, 2.12], P = .022) were associated with increased future research interests.
CONCLUSIONS: The findings suggest that the curriculum-based RTP improved students\' research productivity, and that overall program satisfaction and self-assessed performance were associated with increased students\' intent to participate in future research.

After introducing what is understood by teaching innovation and its requirements, various methodologies that can be applied in university and radiological teaching are presented, such as: the flipped classroom focuses on the student\'s previous study and the teacher\'s subsequent contribution to resolve doubts or highlight important aspects. Team learning or cooperative teaching allows learning among the students themselves. Problem-based or case-based learning encourages students, in teams or individually, to carry out structured learning based on learning objectives. Teaching based on games or simulation can facilitate knowledge acquisition playfully and practically. Personalized tutoring allows the transmission of knowledge in an individualized way. Various evaluation modalities that can be used for training purposes are also shown.

OBJECTIVE: Clinical settings are increasingly focused on addressing patients\' social needs, thus medical education must prepare future clinicians for this task. Critical consciousness, an awareness that puts health within a broader social, historical, and cultural context, could help shape students\' understanding of patient social needs. Our paper explores how experiential learning through participation in a social care intervention deepened students\' critical consciousness, or their understanding of the systems and structures that make it difficult for patients to meet their basic needs.
METHODS: We conducted one-on-one semistructured interviews with all 24 students who served as advocates for the intervention. Of the 24 advocates, 75% (n = 18) were first-year medical students, 17% (n = 4) were public health students, and 8% (n = 2) were social work students. Interviews were audiorecorded, transcribed verbatim, and analyzed using framework analysis.
RESULTS: We identified themes informed by critical consciousness, including individual (assumptions and biases), interpersonal (communication and relationship), and structural (organization and power) factors. Within these categories, advocates expressed deeper self-awareness of personal biases (individual), the importance of interpersonal communication to build trust with caregivers (interpersonal), and the identification of the structural factors that influence health, such as housing conditions (structural). The advocates highlighted the importance of experiential learning to help them understand social determinants of health. By witnessing multiple patients experiencing social needs, advocates saw the cascading effects of social needs, the structures that make it difficult to meet basic needs, and the effect on health and healthcare behavior.
CONCLUSIONS: Students engaged in the intervention demonstrated the development of critical consciousness. Although limited, our findings suggest that when students engage with patients around social needs, students can better understand the broader social context of patients\' lives. Experiential learning through social care interventions may have the potential to influence critical consciousness development and shape the practice of future clinicians.