• 文章类型: Letter
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  • 文章类型: Journal Article
    背景以能力为基础的本科医学课程具有许多新的元素。很少有作者试图了解学生对课程的看法。在实施课程2年后,我们评估了本科生对各种要素的看法和评分。方法我们纳入240名学生(2019年和2020年入学)。通过电子邮件向所有学生发送了邀请函和信息表,通知他们有关学习的信息,保持他们的身份保密和默示同意。设计了基于5点Likert量表的经过验证的问卷,其中包括35个封闭式问题,激发了学生对新课程各个要素的看法,并设计了1至5的评分量表。数据收集是使用Google表单完成的。结果在240名受访者中,192(80%)对基础课程有积极的看法,态度,道德和沟通技巧,早期临床暴露和社区卫生访问。一体化教学,小组教学和评估被认为不太积极(62.9%-75%),而自我导向学习收到的积极回应最低(57%-58%)。作为医生的培训,被认为最有价值的元素是早期临床暴露(70.4%)和社区卫生访视(70.4%),而最少的是日志(35.5%)和反思(34.2%).结论学生发现早期临床暴露和社区健康访问是最有价值的元素,而自我导向学习,日志和反思被评为最不有用的。
    Background The competency-based undergraduate medical curriculum has a number of new elements. Few authors have attempted to understand the students\' viewpoints on the curriculum. We assessed undergraduate students perspectives and ratings about various elements after 2 years of implementation of the curriculum. Methods We included 240 students (2019 and 2020 admission). An invitation letter-cum-information sheet was sent to all the students by email informing them about the study, keeping their identity confidential and the implied consent. A validated questionnaire based on a 5-point Likert scale including 35 closed-ended questions eliciting the students\' perception on various elements of the new curriculum and a rating scale from 1 to 5 was designed. Data collection was done using Google forms. Results Of the 240 respondents, 192 (80%) had positive perceptions for the Foundation Course, Attitude, Ethics and Communication skills, Early Clinical Exposure and Community Health Visits. Integrated Teaching, Small Group Teaching and Assessments were viewed less positively (62.9%-75%) and Self-directed Learning received the lowest positive responses (57%-58%). For training as a doctor, the elements considered most valuable were Early Clinical Exposure (70.4%) and Community Health Visits (70.4%) while the least were Logbooks (35.5%) and Reflections (34.2%). Conclusions Students found Early Clinical Exposure and Community Health Visits the most valuable elements whereas Self-directed Learning, Logbooks and Reflections were rated as the least useful.
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  • 文章类型: Journal Article
    背景循证研究有助于卫生部门制定预防卫生政策的决策,疾病的诊断和治疗。医学研究不在本科课程中教授。研究表明,研究知识的属性,本科生对研究的认识和实际参与度很低。我们开发并验证了一个模块,并通过使用结构化模块的介入研讨会对本科生进行了研究技能培训。方法我们在阿德斯医学科学与研究所社区医学系采用混合方法进行了参与式行动研究,Bathinda,旁遮普.核心委员会开发了一个结构化模块,并在内部和外部进行了验证。该模块的试点测试是通过以研讨会的形式向46名学生提供的。为了进行统计分析,百分比协议,有效性指数,中位数(四分位数间距),使用满意度百分比和Wilcoxon符号检验。结果构建的结构化和验证模块具有较高的人脸效度(>90%)和内容效度(CVI=0.975)。该模块已成功通过现场和在线模式进行交付的试点测试。实习生和MBBS学生对研讨会的满意度为91%和100%,模块的总体评分为74%和91%,和100%的教师。在研讨会后的所有变量中,知识和技能得分均显着较高,p<0.001。所有学生在研究技能方面都取得了令人满意的成绩。结论使用结构化验证模块的教学研究提高了学生与研究相关的知识和技能。学生和教师都对结构化模块的使用感到满意。
    Background Evidence-based research aids in decision-making in the health sector for developing health policies for prevention, diagnosis and treatment of diseases. Medical research is not taught in the undergraduate curriculum. Studies show that attributes of research knowledge, awareness and practical involvement in research are low among undergraduate students. We developed and validated a module and trained undergraduate students in research skills through an inter-ventional workshop using the structured module. Methods We did this participatory action research with a mixed-methods approach in the Department of Community Medicine at Adesh Institute of Medical Sciences and Research, Bathinda, Punjab. A structured module was developed by the core committee and validated internally and externally. Pilot testing of the module was done by delivering it in the form of a workshop to 46 students. For statistical analysis, percentage agreements, validity indices, median (interquartile range), satisfaction percentages and Wilcoxon sign test were used. Results The structured and validated module was established to have high face validity (>90%) and content validity (CVI=0.975). The module was successfully pilot tested for delivery through both onsite and online modes. The satisfaction percentage with the workshop was 91% and 100% and overall rating of the module was 74% and 91% by interns and MBBS students, and 100% by faculty. The scores of knowledge and skills were found to be significantly higher on all variables post workshop with p<0.001. All students scored satisfactory grades for research skills. Conclusions Teaching research using a structured validated module improved the knowledge and skills related to research among students. Both students and faculty were satisfied with the use of the structured module.
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  • 文章类型: Journal Article
    背景:基于过程的教学是一种新的教育模式。SPARK病例数据库是一个免费的医学影像病例数据库。本文旨在探讨基于SPARK病例数据库的过程式教学在肌肉骨骼系统放射学实践教学中的应用。
    方法:纳入117名三年级医学生。他们被分成A组,B,C和D根据课程安排。A组和B组同时参加实验课,A是实验组,B为对照组。C组和D组同时参加实验课,C是实验组,D为对照组。实验组使用SPARK病例数据库,对照组采用传统教学模式进行学习。四组学生分别在理论课结束后进行测试,在实验课之前,实验课之后,和一周后的实验课比较结果。最后,所有学生都使用SPARK案例数据库进行研究,并在实验课后一个月进行了测试,以比较它们的差异。
    结果:A组和B组理论课后的分数为(100.0±25.4),(101.0±23.8)(t=-0.160,P>0.05),C组和D组为(94.7±23.7),(92.1±18.6)(t=0.467,P>0.05)。A组和B组实验班前后和实验班后一周得分分别为(84.1±17.4),(72.1±21.3)(t=2.363,P<0.05),(107.6±14.3),(102.1±18.0)(t=1.292,P>0.05),(89.7±24.3),(66.6±23.2)(t=3.706,P<0.05)。C组和D组评分分别为(94.0±17.3)分,(72.8±25.5)(t=3.755,P<0.05),(107.3±20.3),(93.1±20.9)(t=2.652,P<0.05),(100.3±19.7),(77.2±24.0)(t=4.039,P<0.05)。A组和B组实验班后一个月的成绩为(86.6±28.8),(84.5±24.0)(t=0.297,P>0.05),C组和D组为(95.7±20.3),(91.7±23.0)(t=0.699,P>0.05)。
    结论:基于SPARK病例数据库的过程式教学可以提高学生肌肉骨骼系统的放射学实践能力。
    BACKGROUND: Process-based teaching is a new education model. SPARK case database is a free medical imaging case database. This manuscript aimed to explore the application of the process-based teaching based on SPARK case database in the practice teaching of radiology in the musculoskeletal system.
    METHODS: 117 third year medical students were included. They were divided into Group A, B, C and D according to the curriculum arrangement. Group A and B attended the experimental class at the same time, A was the experimental group, B was the control group. Group C and D attended experimental classes at the same time, C was the experimental group, D was the control group. The experimental group used SPARK case database, while the control group used traditional teaching model for learning. The four groups of students were respectively tested after the theoretical class, before the experimental class, after the experimental class, and one week after the experimental class to compare the results. Finally, all students used SPARK case database to study, and were tested one month after the experimental class to compare their differences.
    RESULTS: The scores after the theoretical class of Group A and B were (100.0 ± 25.4), (101.0 ± 23.8)(t=-0.160, P > 0.05), Group C and D were (94.7 ± 23.7), (92.1 ± 18.6)(t = 0.467, P > 0.05). The scores of Group A and B before and after the experimental class and one week after the experimental class were respectively (84.1 ± 17.4), (72.1 ± 21.3)(t = 2.363, P < 0.05), (107.6 ± 14.3), (102.1 ± 18.0)(t = 1.292, P > 0.05), (89.7 ± 24.3), (66.6 ± 23.2)(t = 3.706, P < 0.05). The scores of Group C and D were (94.0 ± 17.3), (72.8 ± 25.5)(t = 3.755, P < 0.05), (107.3 ± 20.3), (93.1 ± 20.9)(t = 2.652, P < 0.05), (100.3 ± 19.7), (77.2 ± 24.0)(t = 4.039, P < 0.05). The scores of Group A and B for one month after the experimental class were (86.6 ± 28.8), (84.5 ± 24.0)(t = 0.297, P > 0.05), and Group C and D were (95.7 ± 20.3), (91.7 ± 23.0)(t = 0.699, P > 0.05).
    CONCLUSIONS: The process-based teaching based on SPARK case database could improve the radiology practice ability of the musculoskeletal system of students.
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  • 文章类型: Journal Article
    大学放射科培训已经在放射科进行了多年,放射科医生发挥他们的专业作用。然而,教育需求和科学协会的领导使放射科越来越多地参与培训,尽管它必须在超负荷的专业环境中完成,在这些环境中,医学生可以被视为一个缺点。然而,放射科医生必须在未来医生的放射学培训中发挥重要作用,以优化诊断成像技术的使用,并通过向我们的部门介绍那些表现出最充分的个人概况的医学生来提高专业的未来。放射科是通过增加医疗保健成果来取得成功的地方,通过放射科医生和医学生之间富有成效的互动,研究结果和放射学的知名度。
    University Radiology training has been carried out for years out of the Radiology Departments, where radiologists play their professional role. However, the educational needs and the leadership of the Scientific Societies make the Radiology Departments to be involved more and more in that training, though it has to be done in overloaded professional environments where medical students can be seen as a drawback. Nevertheless, radiologists must play an important role in the Radiology training of the future doctors for optimising the use of diagnostic imaging techniques and enhance the future of the specialty by bringing to our Departments those medical students who had demonstrated the most adequate personal profiles. The Radiology Department is that place to succeed by increasing the healthcare outcomes, the research results and the visibility of Radiology through a fruitful interaction between radiologists and medical students.
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  • 文章类型: Journal Article
    在身体形象研究中,生殖器的身体形象没有得到显著的关注。该项目旨在探索如何通过共同设计和开发教育资源,在有阴茎的人中培养积极的生殖器形象。参与者是澳大利亚的22人,他们被确定为有阴茎,并参与了共同设计焦点小组的三个阶段。主题和内容分析用于生成跨数据的主题,每个阶段通知下一个阶段,最终在最后阶段向参与者展示原型资源。在主要的顺性男性样本中,人们一致认为,一个简短的,动画,教育视频可能有潜力在有阴茎的人身上促进积极的生殖器形象。对于视频内容,参与者不支持围绕阴茎大小的挑战社会信息,即“越大越好”。相反,参与者支持纳入有关阴茎功能范围的信息,促进对阴茎大小/外观的接受,并且无论阴茎大小如何,都可以实现亲密关系。最终原型视频的总体反馈是积极的。据我们所知,我们描述了第一个为阴茎患者共同设计的教育资源,并有助于理解这个未被研究的主题。
    Within body image research, genital body image has not received significant attention. This project aimed to explore how positive genital body image could be fostered among people with a penis by co-designing and developing an educational resource. Participants were 22 people in Australia who identified as having a penis and were involved in three phases of co-design focus groups. Thematic and content analyses were used to generate themes across the data with each phase informing the next, culminating in a prototype resource being shown to participants in the final phase. Amongst the predominantly cisgender men sample, there was consensus that a brief, animated, educational video could have potential in promoting a positive genital body image in people with a penis. For video content, participants were not supportive of challenging societal messaging around penis size that \"bigger is better\". Instead, participants supported the inclusion of information about the range of penile functions, promoting acceptance of penile size/appearance and that fulfilling intimate relationships were possible irrespective of penis size. The feedback was positive overall for the final prototype video. To our knowledge, we describe the first co-designed educational resource for people with a penis and contribute to the understanding of this understudied topic.
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  • 文章类型: Journal Article
    目的:本研究提出了自然人类颞骨之间解剖细节的可视化和识别的比较,它分别来自三维打印,以及从CBCT获得的虚拟模型。
    方法:样本由牙科本科生组成(UE组,n=22),放射学和成像研究生(P-RI组,n=20),和法医牙本质学研究生(P-FO组,n=24)。所有参与者都参加了有关颞骨专门解剖学的理论课程,随后对10个确定的结构进行了标记。
    结果:在所有组中,在自然骨和打印的三维模型中正确识别的数量相似(p>0.05)。虚拟模型显示3组中正确结构的数量显着降低(p<0.05)。总的来说,与本科生相比,研究生的准确答案百分比明显更高。大多数研究生认为打印的三维模型可以代替天然骨骼来教授解剖学,而本科生不同意或不确定(p<0.05)。关于虚拟断层图像,在所有群体中,学生不同意或不确定它的使用将有利于替代天然骨骼。
    结论:三维和虚拟模型可作为解剖学教学的辅助工具,用自然骨骼补充实践学习。
    OBJECTIVE: The current study proposes the comparison of the visualization and identification of anatomical details between natural human temporal bone, its respective copy from three-dimensional printing, and the virtual model obtained from CBCT.
    METHODS: The sample consisted of undergraduate students in Dentistry (Group UE, n = 22), Postgraduate students in Radiology and Imaging (Group P-RI, n = 20), and Postgraduate students in Forensic Odontology (Group P-FO, n = 24). All participants attended a theoretical class on specialized anatomy of the temporal bone and subsequently performed the markings of 10 determined structures.
    RESULTS: The number of correct identifications was similar in natural bone and printed three-dimensional models in all groups (p > 0.05). The virtual model showed a significantly lower number of correct structures (p < 0.05) in the 3 groups. In general, there were significantly higher percentages of accurate answers among postgraduate students compared to undergraduate students. Most graduate students believed that the printed three-dimensional model could be used to teach anatomy in place of natural bone, while undergraduate students disagreed or were unsure (p < 0.05). Regarding the virtual tomographic image, in all groups, students disagreed or were not sure that its use would be beneficial in replacing natural bone.
    CONCLUSIONS: Three-dimensional and virtual models can be used as auxiliary tools in teaching anatomy, complementing practical learning with natural bones.
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  • 文章类型: Journal Article
    英国面临医学生对全科医学(GP)的兴趣下降,对其医疗系统至关重要。这一趋势危及初级保健的可持续性和更广泛的医疗基础设施。需要创新的教育方法来提高对一般实践的认识。
    为了评估整合创新教育策略的试点计划对医学生对全科医学的看法的影响,旨在强调英国医学教育和初级保健未来的潜在改革。
    对来自伦敦玛丽女王大学的18名五年级医学生进行的一项纵向试点研究在36个月内采用了多样化的教育方法。该方案包括指导,讲故事,社区家访,交互式患者病例,和GP专科诊所,涵盖六个GP实践领域。通过中期安置和安置结束问卷收集数据,以评估学生对GP职业的看法和兴趣。
    该计划显著提高了学生对一般实践的看法。指导和讲故事使人们对GP的复杂性和影响的欣赏增加了83%至94%。社区家访提高了67%至89%的参与者的文化敏感性和整体健康观点。交互式患者病例和GP专科诊所尤其是对GP多学科性质的深入理解。接触GP主导的研究和商业计划,提高了一般实践中的创业和创新机会的意识。
    创新的教育策略可以极大地影响医学生对一般实践的看法和兴趣。研究表明,丰富医学教育与现实世界的经验,导师,全面的全科医生接触可以对抗兴趣下降,展示一般实践作为一个充满活力和充实的职业。
    UNASSIGNED: The UK faces a decline in medical students\' interest in general practice (GP), crucial for its healthcare system. This trend endangers primary care sustainability and broader healthcare infrastructure, necessitating innovative educational approaches to improve perceptions of general practice.
    UNASSIGNED: To assess the impact of a pilot programme integrating innovative educational strategies on medical students\' perceptions of general practice, aiming to highlight potential reforms for medical education and primary care\'s future in the UK.
    UNASSIGNED: A longitudinal pilot study with eighteen fifth-year medical students from Queen Mary University of London employed a diverse educational approach over thirty-six months. The programme encompassed mentorship, storytelling, community home visits, interactive patient cases, and GP speciality clinics, covering six GP practice domains. Data were collected through mid-placement and end-of-placement questionnaires to evaluate students\' perceptions and interest in GP careers.
    UNASSIGNED: The programme significantly improved students\' perceptions of general practice. Mentorship and storytelling saw an 83% to 94% increase in appreciation for GP complexities and impact. Community home visits enhanced cultural sensitivity and holistic health views among 67% to 89% of participants. Interactive patient cases and GP speciality clinics notably advanced understanding of GP\'s multidisciplinary nature. Exposure to GP-led research and business initiatives heightened awareness of entrepreneurial and innovative opportunities within general practice.
    UNASSIGNED: Innovative educational strategies can substantially influence medical students\' perceptions and interest in general practice. The study suggests that enriching medical education with real-world experiences, mentorship, and comprehensive general practice exposure can counter declining interest, showcasing general practice as a dynamic and fulfilling career.
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  • 文章类型: Journal Article
    背景:来自不同国家的研究报告了医学生在学习的第一年和最后一年之间的道德能力停滞或倒退,各种教育干预措施的价值仍然不确定。
    方法:我们使用道德能力测验(MCT)来测量道德能力的C分数,以确定2022/2023学年捷克共和国两所医学院的一年级和五年级医学生之间的MCTC分数变化,并分析与C分数相关的因素(观察性研究)。此外,对于一年级的学生来说,我们比较了医学伦理学课程干预前后的MCT结果(介入研究).我们使用横断面和描述性设计进行观察性研究。学生完成了MCT,由两个道德困境(工人困境和医生困境)组成,用C分数测量的结果,代表道德能力。
    结果:总计,685名学生参加了观察性研究。目的1:通过对C评分的分析,我们观察到一年级和五年级医学生的道德能力下降(p<.001)。目标2:我们没有观察到性别的统计学显着影响(p=0.278),或自我评估的宗教信仰(p=.163)。目的3:在介入研究中,440名学生参加了前测,422名学生参加了后测。统计学显著性检验发现干预后学生的道德能力没有改善(p=.253)。
    结论:医学生在医学教育中表现出道德能力的回归;在医学生的五年级中,这一水平较低,与没有性别影响的一年级医学生相比,或者自我评价的宗教信仰。尽管由多种医学伦理学教学工具组成的教育干预(PBL,CBL,KMDD和StorED)并没有导致道德能力的提高,这种干预的纵向效果还有待观察。
    BACKGROUND: Studies from different countries report a stagnation or regression of moral competence in medical students between the first and the last year of their studies, and the value of various educational interventions remains uncertain.
    METHODS: We used Moral Competence Test (MCT) to measure C-scores of moral competence to determine the change in the MCT C-scores between the first- and the fifth-year medical students from two medical schools in the Czech Republic in the academic year 2022/2023 and to analyze factors associated with the C-scores (observational study). In addition, for the first-year students, we compared the results of the MCT before and after an intervention in medical ethics curriculum (interventional study). We used a cross-sectional and descriptive design for the observational study. Students completed the MCT, consisting of two moral dilemmas (Worker´s Dilemma and Doctor´s Dilemma), the results measured by the C-score, which represents moral competence.
    RESULTS: In total, 685 students participated in the observational study. Objective 1: based on the analysis of the C-score, we observed a decrease in moral competence between the first and the fifth-year medical students (p < .001). Objective 2: we did not observe a statistically significant effect of gender (p = .278), or self-rated religiosity (p = .163). Objective 3: in the interventional study, 440 students participated in the pretest and 422 students participated in the posttest. The test of statistical significance found no improvement in students\' moral competence after the intervention (p = .253).
    CONCLUSIONS: Medical students show a regression in moral competence during medical education; it was lower in medical students in their fifth year, compared to the first-year medical students without the effect of gender, or self-rated religiosity. Although educational intervention consisting of multiple tools of medical ethics teaching (PBL, CBL, KMDD and StorED) did not lead to increase in moral competence, the longitudinal effect of such intervention remains to be seen.
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  • 文章类型: Journal Article
    背景:同情与改善患者预后呈正相关,优质护理评级,和医疗保健提供者的福祉。通过强有力和有意义的教育举措支持和培养医疗保健提供者的同情心一直受到缺乏概念清晰度的阻碍。同情领域的内容覆盖不足,以及缺乏经过验证的评估工具。EnACT计划旨在通过证据知情,以能力为基础,应用,同情培训计划提供给在各种临床环境中工作的医疗保健提供者。在这项研究中,我们描述了该程序的开发和初步验证,这将在即将到来的随机对照可行性试验(RCfT)中提供信息并进行进一步评估。
    方法:使用多方法设计来探索学习者的需求,经验,以及与该计划相关的结果。培训前和培训后的调查和定性访谈(培训后1个月)进行了26名在急性护理和临终关怀工作的医疗保健提供者学习者。定量措施评估专业履行/倦怠,提供同情心的自信,学习者满意度,同情能力。定性访谈探索了学习者对该计划的体验,将学习融入他们的专业实践,和方案建议。
    结果:学习者表现出相对较高的自我评估的同情能力和培训前的专业成就感以及较低的倦怠水平。培训后,学习者对培训计划表现出高度的同情心信心和满意度。尽管有高水平的同情心能力预培训,观察到训练后同情能力的统计学显著提高.主题分析确定了与学习者在培训日的总体经验以及将学习和资源整合到其专业实践中相关的五个关键主题:(1)初学者的思想:学习者的基线态度以及对必要性和可行性的假设同情培训;(2)学习者对培训计划的经验;(3)学习者的成果:将理论融入实践;(4)创造同情心文化;(5)学习者反馈。
    结论:研究结果表明,EnACT计划是可行的,严谨,和有效的培训计划,以增强医疗保健提供者的同情心。它以证据为基础,患者知情,临床相关内容;课堂互动练习;学习者工具包;以及旨在改善临床文化学习者实践的情境化方法,有望随着时间的推移维持学习和临床影响,这将在随机对照可行性试验(RCfT)中进一步评估。
    BACKGROUND: Compassion is positively associated with improved patient outcomes, quality care ratings, and healthcare provider wellbeing. Supporting and cultivating healthcare providers\' compassion through robust and meaningful educational initiatives has been impeded by a lack of conceptual clarity, inadequate content coverage across the domains of compassion, and the lack of validated evaluation tools. The EnACT program aims to address these gaps through an Evidence-informed, competency-based, Applied, Compassion Training program delivered to healthcare providers working in various clinical settings. In this study, we describe the development and initial validation of the program, which will inform and be further evaluated in a forthcoming Randomised Controlled feasibility Trial (RCfT).
    METHODS: A multimethod design was used to explore learner needs, experiences, and outcomes associated with the program. Pre- and post-training surveys and qualitative interviews (1 month post training) were conducted among twenty-six healthcare provider learners working in acute care and hospice. Quantitative measures assessed professional fulfillment/burnout, self-confidence in providing compassion, learner satisfaction, and compassion competence. Qualitative interviews explored learners\' experiences of the program, integration of learnings into their professional practice, and program recommendations.
    RESULTS: Learners exhibited relatively high self-assessed compassion competence and professional fulfillment pre-training and low levels of burnout. Post-training, learners demonstrated high levels of compassion confidence and satisfaction with the training program. Despite high levels of reported compassion competence pre-training, a statistically significant increase in post-training compassion competence was noted. Thematic analysis identified five key themes associated with learners\' overall experience of the training day and integration of the learnings and resources into their professional practice: (1) A beginner\'s mind: Learner baseline attitudes and assumptions about the necessity and feasibility of compassion training; (2) Learners\' experiences of the training program; (3) Learner outcomes: integrating theory into practice; (4) Creating cultures of compassion; and (5) Learner feedback.
    CONCLUSIONS: Findings suggest that the EnACT program is a feasible, rigorous, and effective training program for enhancing healthcare provider compassion. Its evidence-based, patient-informed, clinically relevant content; interactive in class exercises; learner toolkit; along with its contextualized approach aimed at improving the clinical culture learners practice holds promise for sustaining learnings and clinical impact over time-which will be further evaluated in a Randomized Controlled feasibility Trial (RCfT).
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