• 文章类型: Journal Article
    虽然客观临床结构化考试(OSCE)是一种全球公认的有效方法,可以评估本科医学生的临床技能,最近的渥太华能力评估会议引发了关于欧安组织未来和创新的激烈辩论。这项研究旨在全面了解过去几十年来欧安组织的全球研究活动,并找出其改进的线索。我们对截至2024年3月发表的OSCE论文进行了文献计量和科学计量分析。我们包括了对整体科学生产力的描述,以及对主要主题和国际科学合作的无监督分析。从Scopus数据库中总共确定了3,224个项目。出版物突然激增,特别是与虚拟/远程OSCE有关,从2020年到2024年。我们在出版物和引文数量方面确定了领先的期刊和国家。一个共同出现的术语网络确定了与OSCE不同研究主题相对应的三个主要集群。与OSCE性能和可靠性相关的两个相连的集群,和学生体验的第三个集群,心理健康(焦虑),和感知,与前两个集群的联系很少。最后,美国,联合王国,和加拿大在涉及其他欧洲国家的国际科学网络中的科学出版物和合作方面被确定为领先国家(荷兰,比利时,意大利)以及沙特阿拉伯和澳大利亚,并揭示了与亚洲国家缺乏重要合作。已经确定了改善OSCE研究的各种途径:i)通过现场和远程OSCE之间的比较研究来发展远程OSCE,并发布国际建议,以在大学和国家之间共享远程OSCE;ii)在主要合作国家的支持下促进国际合作研究;iii)调查学生表现与焦虑之间的关系。
    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.
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  • 文章类型: Journal Article
    背景:监测医学生在本科学习期间的职业意向可以帮助解决医生短缺的问题,特别是在一般实践中。本研究旨在调查医学生职业开放性的变化,学士学位期间医疗职业选择的吸引力和决定因素。
    方法:设计是横截面,招募所有在苏黎世四个不同教育轨道之一开始学士学位课程的医学生,瑞士,2019年秋季(第一次调查),2022年夏季完成(第二次调查)。使用结构化的在线问卷评估了学生对不同医疗职业选择的吸引力和决定因素的看法。两个时间点之间的绝对变化以总体百分比和教育轨道报告。回归分析用于检查学生特征和职业选择的决定因素与每种选择的吸引力之间的关联。
    结果:我们在学士学位课程开始时调查了354名医学生,在结束时调查了433名医学生(参与率:71.1%和86.9%,分别)。总的来说,接受所有拟议医疗职业选择的学生比例下降(从52.8%降至43.8%,p=0.004)。门诊妇科或儿科的吸引力增加(从27.4%增加到43.4%,p<0.001),而普通和专科住院护理的吸引力下降(从47.8%下降到40.3%,p=0.05,从71.1%到61.1%,p分别=0.006)。认为兼职工作的学生比例有所增加,自主性和与患者的关系是重要的职业决定因素(从47.3%到64.7%,p<0.001;从63.3%到77.8%,p<0.001;从80.8%到89.3%,p=0.002),而声誉和职业机会的重要性下降(从42.6%下降到26.2%,p<0.001;从79.2%到63.6%,p分别<0.001)。兼职工作的重要性以及与患者的关系与全科医生的吸引力呈正相关。
    结论:在学士学位课程期间,职业在一般实践中的吸引力趋于下降,但兼职工作的重要性,自主性和与患者的关系作为职业决定因素增加。帮助学生了解这些决定因素如何与一般实践相关,可能会增加他们对该行业的兴趣。
    背景:不适用。
    BACKGROUND: Monitoring the career intentions of medical students during their undergraduate studies could help to address the shortage of physicians, particularly in general practice. This study aimed to investigate changes in medical students\' career openness, attractiveness and determinants of medical career choice during their bachelor\'s studies.
    METHODS: The design was cross-sectional, recruiting all medical students who started a bachelor\'s program in one of the four different educational tracks in Zurich, Switzerland, in the fall of 2019 (first survey) and completed it in the summer of 2022 (second survey). Students\' perceptions of the attractiveness and determinants of different medical career options were assessed using a structured online questionnaire. Absolute changes between the two-time points were reported in percentage points overall and by educational track. Regression analysis was used to examine the association of student characteristics and determinants of career options with the attractiveness of each option.
    RESULTS: We surveyed 354 medical students at the beginning and 433 at the end of the bachelor\'s program (participation rate: 71.1% and 86.9%, respectively). Overall, the proportion of students open to all proposed medical career options decreased (from 52.8% to 43.8%, p = 0.004). The attractiveness of outpatient gynecology or pediatrics increased (from 27.4% to 43.4%, p < 0.001), whereas the attractiveness of both general and specialized inpatient care decreased (from 47.8% to 40.3%, p = 0.05 and from 71.1% to 61.1%, p = 0.006 respectively). There was an increase in the proportion of students who perceived part-time work, autonomy and relationships with patients as important career determinants (from 47.3% to 64.7%, p < 0.001; from 63.3% to 77.8%, p < 0.001; from 80.8% to 89.3%, p = 0.002 respectively), while the importance of reputation and career opportunities decreased (from 42.6% to 26.2%, p < 0.001; from 79.2% to 63.6%, p < 0.001 respectively). The importance of part-time work and relationships with patients were positively associated with the attractiveness of general practice.
    CONCLUSIONS: During the bachelor\'s program, the attractiveness of a career in general practice tended to decrease, but the importance of part-time work, autonomy and relationships with patients as career determinants increased. Helping students understand how these determinants relate to general practice may increase their interest in the profession.
    BACKGROUND: Not applicable.
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  • 文章类型: Journal Article
    背景:在COVID-19大流行期间,大型面对面会议大多被取消,以避免进一步的疾病传染。医生继续要求改变形式,以参与终身医学教育计划,传统的面对面会议模式需要重新考虑。因此,国家骨科协会的一个地区分支机构试图将面对面的会议转移到虚拟平台上。这项研究旨在调查在COVID-19大流行期间将大型面对面会议过渡到虚拟模型的影响,特别是检查每个类型的会议的出席率的任何差异。
    方法:在这项回顾性观察研究中,分析了虚拟会议的776名参与者和面对面会议的575名参与者。机构根据其在中心城市和两个相邻城市的位置进行分类。附属机构分为住院医师培训医院,综合医院,私人诊所。计算了虚拟会议年和亲自会议年之间的参与者数量和比例的变化。
    结果:虚拟会议参与者的数量显着大于面对面会议参与者的数量(P=0.01)。尽管两年来参与者最多的是中心城市,来自两个相邻城市的参与者比例增加。虽然住院医师培训医院和私人诊所的参加者比例有所下降,来自综合医院的参与者比例增加。
    结论:我们实施了一个虚拟平台,以应对COVID-19大流行期间与终身医学教育相关的挑战。虚拟平台对于必须为遍布广泛地理区域的成员定期举办终身医学教育计划的组织可能很有帮助。
    BACKGROUND: During the COVID-19 pandemic, large in-person conferences were mostly cancelled to avoid further disease contagion. Physicians continued to demand changes in form to enable participation in lifelong medical education programs, and the traditional model of in-person conferences needed to be rethought. As such, a regional branch of the national orthopedic association tried to move in-person conferences onto a virtual platform. This study aimed to investigate the effect of transitioning large in-person conferences to a virtual model during the COVID-19 pandemic, especially examining any differences in the attendance of each type of conference.
    METHODS: In this retrospective observational study, 776 participants in virtual conferences and 575 participants in in-person conferences were analyzed. Institutions were classified based on their location in a central city and two neighboring cities. Affiliated institutions were divided into resident training hospitals, general hospitals, and private clinics. The change in the number and proportion of participants between the virtual conference year and in-person conference year was calculated.
    RESULTS: The number of virtual conference participants was significantly greater than that of in-person conference participants (P = 0.01). Although the highest number of participants was from central city for both years, the proportion of participants from the two neighboring cities increased. Although the proportion of participants from resident training hospitals and private clinics decreased, the proportion of participants from general hospitals increased.
    CONCLUSIONS: We implemented a virtual platform to tackle challenges associated with lifelong medical education during the COVID-19 pandemic. The virtual platforms can be helpful for organizations that must hold regular lifelong medical education programs for members spread across a wide geographic region.
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  • 文章类型: Journal Article
    在COVID-19pandemi期间减少冠状病毒传播的教育活动(离线到在线)的改变对学习策略有影响,这最终可能会影响学习目标的实现。因此,我们使用有效的(p<0.01;双尾皮尔逊相关)和可靠的(r=0.878和r=0.849;CronbachAlpha)在线问卷进行了横断面研究,以评估印度尼西亚人体解剖学讲师和本科医学生在实施在线解剖学学习方面的观点。我们还探讨了他们在COVID-19大流行后的期望和首选的学习方法。使用有目的的采样,467名受访者,由来自六个岛屿41所大学的66名讲师组成(爪哇,苏门答腊,加里曼丹,苏拉威西岛,努沙登加拉和巴布亚)和来自四个岛屿(爪哇,苏门答腊,加里曼丹,巴布亚)被招募。用卡方检验分析分类变量的差异。讲师(74.2%)和学生(63.1%)同意在线学习有效地交付了课程材料(p=0.095)。他们(69.7%的讲师和57.9%的学生)也同意学习时间分配是足够的(p=0.079);此外,讲师(53%)和学生(56.1%)的互动良好(p=0.689)。然而,56.1%的讲师和63.3%的学生在在线实践课程中有问题。他们对在线课程中的问题有不同的看法(69.7%vs36.4%;p<0.01),动机改善(72.7%vs37.4%;p<0.01),和时间管理(87.9%vs58.4%;p<0.01)。根据大学的位置,尤其是在学生的一面,Java专业的学生在这两个方面的比例较高,即学习材料(p<0.01)和讲师-学生互动(p<0.01),在线课堂(p=0.003)和实践环节(p=0.008)中的问题比例较低。大多数受访者(62,2%的Java讲师,71.4%的Java以外的讲师,79.6%的学生在Java,和Java以外的76.6%的学生)在大流行(新常态时代)后更喜欢使用混合学习,并希望继续进行尸体实践课程(Java讲师占82.2%,Java以外的讲师占81.0%,91.1%的学生在Java,和78.3%的学生在Java之外)。总之,研究表明,对在线解剖学学习的满意度在某些方面与受试者的角色(讲师或学生)和大学地区有关。
    The changing of education activities (offline into online) to reduce coronavirus transmission during COVID-19 pandemi has influence on the learning strategies, which ultimately might impact the achievement of learning objectives. Therefore, we conducted a cross-sectional study using a valid (p < 0.01; two-tailed Pearson correlation) and reliable (r = 0.878 and r = 0.849; Cronbach Alpha) online questionnaire to evaluate the perspectives of human anatomy lecturers and undergraduate medical students in Indonesia in implementing the online anatomy learning. We also explored their expectations and preferred learning methods after COVID-19 pandemic. Using purposive sampling, 467 respondents, which consisted of 66 lecturers from 41 universities in six islands (Java, Sumatera, Kalimantan, Sulawesi, Nusa Tenggara and Papua) and 401 students from 19 universities in four islands (Java, Sumatera, Kalimantan, Papua) were recruited. A Chi-square test was used to analyze the differences in categorical variables. The lecturers (74.2%) and students (63.1%) agreed that online learning effectively delivered the course material (p = 0.095). They (69.7% lecturers and 57.9% students) also agreed that learning time allocation was sufficient (p = 0.079); moreover, lecturers (53%) and students (56.1%) had good interaction (p = 0.689). Nevertheless, 56.1% lecturers and 63.3% students had problem during online practical sessions. They had different perspectives about issues during online classes (69.7% vs 36.4%; p < 0.01), motivation improvement (72.7% vs 37.4%; p < 0.01), and time management (87.9% vs 58.4%; p < 0.01). According to the location of the university, especially in the student\'s side, students in Java had higher proportion in the two aspects, i.e. learning material (p < 0.01) and lecturer-student interaction (p < 0.01), and had lower proportion in the problems during online class (p = 0.003) and practical sessions (p = 0.008). Majority of the respondents (62,2% lecturers in Java, 71.4% lecturers outside Java, 79.6% Students in Java, and 76.6% students outside Java) preferred the use of blended learning after the pandemic (new normal era) and expected to continue the cadaveric practical sessions (82.2% lecturers in Java, 81.0% lecturers outside Java, 91.1% students in Java, and 78.3% students outside Java). In conclusion, the study showed that the satisfaction toward online anatomy learning related to the subject\'s role (lecturer or student) and the university region in some aspects.
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  • 文章类型: News
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  • 文章类型: Journal Article
    摘要机器人手术的采用在全球多个外科专业中激增,但是加拿大的吸收速度较慢。加拿大的外科教育者和受训人员面临着与充分暴露有关的潜在挑战,经验,和机器人外科手术的能力。我们进行了一项全国横断面调查,以深入了解监督普外科住院医师和研究金计划的计划负责人对将机器人手术纳入加拿大外科培训计划的看法。尽管大多数学术和学术附属医院都有机器人手术平台,很少有学员接触过任何机器人手术。此外,在机器人手术中提供的培训与毕业后对受训者的预期相关性之间存在差距。在加拿大,需要更多地关注机器人手术在普通外科培训中的整合,以装备学员的职业生涯。
    SummaryThe adoption of robotic surgery has surged globally across multiple surgical specialties, but uptake in Canada has unfolded at a slower pace. Surgical educators and trainees in Canada face potential challenges related to sufficient exposure, experience, and competence in robotic surgical procedures. We conducted a cross-sectional national survey to gain insight into the perspectives of program directors overseeing general surgery residency and fellowship programs on the integration of robotic surgery into Canadian surgical training programs. Despite the presence of robotic surgery platforms at most academic and academic-affiliated hospitals, few trainees have exposure to any robotic surgery. Furthermore, a gap exists between the training provided in robotic surgery and its anticipated relevance to trainees upon graduation. Increased focus on the integration of robotic surgery within general surgical training in Canada is required to equip trainees for their careers.
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  • 文章类型: Editorial
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