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In a recent IJHPR article, Dankner et al. describe a reform in one longitudinal strand within Basic Medical Education i.e.“ public health and preventive medicine curriculum” using a Competency Based Medical Education approach. This reform raises several concerns: What should prompt a medical school to change a curriculum? How should such change be conducted? What kinds of paradigms may inform such a change? What constitutes a success in a curricular reform? And, how can curricular reform be evaluated within a reasonable time framework? This commentary addresses these concerns and concludes that curricular reform should follow as much as possible the current wisdom of educational innovation and change strategy, follow a clear vision, mission, and selected educational paradigm, and pay attention to stakeholders, context, culture and politics. The design should allow for the emergence of unintended consequences. Implementation needs careful planning and monitoring and the evaluation should be multi-faceted. Finally, since all Israeli medical schools are now using the Competency Based Medical Education approach and aligning their curricula and testing accordingly, a fascinating collaborative opportunity exists to professionalize this process and hopefully make a positive impact.

Background The report of the Lancet Commission on medicine, Nazism, and the Holocaust, released in November 2023, calls for this history to be required for all health professions education, to foster morally courageous health professionals who speak up when necessary. Main body The report was released a month after Hamas’ October 7 invasion of Israel, with the accompanying massacre of over 1200 people, taking of civilian hostages, and gender-based violence. These acts constitute crimes against humanity including genocide. Post-October 7, war in Gaza resulted, with a legitimate objective of Israel defending itself within international law. The authors discuss an accompanying Statement to the report condemning Hamas crimes and denouncing the perpetrators’ use of their own civilians as human shields, including in healthcare facilities, and with the Hamas attack unleashing immense and ongoing suffering in Israel and beyond. With some exceptions, the medical literature shows a marked absence of condemnation of Hamas atrocities and includes unsubstantiated criticisms of Israel’s military. A significant surge in global antisemitism including on university campuses since October 7, 2023, has occurred; and health professionals, according to the Commission, have a special responsibility to fight antisemitism and discrimination of all kinds. In this context, the authors discuss the controversy and criticism regarding diversity, equity, and inclusion education programs (“DEI”) including such programs failing to protect Jews on campuses, especially as the U.S. President Biden’s “The U.S. National Strategy to Counter Antisemitism,” released in May 2023, calls for the inclusion of issues of antisemitism and religious discrimination within all DEI education programs. The authors support an evidence-based approach to the Hamas massacre, its aftermath and its relevance to health professionals both within medicine and their global citizenship, including refuting the international community accusations and anti-Israel libel. Conclusions The report of the Lancet Commission on medicine, Nazism, and the Holocaust has striking relevance to the Hamas massacre of October 7, 2023 and its aftermath. This is further conveyed in an accompanying Statement, that describes the report’s implications for contemporary medicine, including: 1) provision of skills required to detect and prevent crimes against humanity and genocide; (2) care for victims of atrocities; (3) upholding the healing ethos central to the practice of medicine; and (4) fostering history-informed morally courageous health professionals who speak up when necessary.

Reflective capacity has been described as an essential characteristic of professionally competent clinical practice, core to ACGME competencies. Reflection has been recently linked to promoting effective use of feedback in medical education and associated with improved diagnostic accuracy, suggesting promising outcomes. There has been a proliferation of reflective writing pedagogy within medical education to foster development of reflective capacity, extend empathy with deepened understanding of patients’ experience of illness, and promote practitioner well-being. At Alpert Med, “interactive” reflective writing with guided individualized feedback from interdisciplinary faculty to students’ reflective writing has been implemented in a Doctoring course and Family Medicine clerkship as an educational method to achieve these aims. Such initiatives, however, raise fundamental questions of reflection definition, program design, efficacy of methods, and outcomes assessment. Within this article, we consider opportunities and challenges associated with implementation of reflective writing curricula for promotion of reflective capacity within medical education. We reflect upon reflection.

OBJECTIVE To describe physicians’ patterns of using an Electronic Medical Record (EMR) system; to reveal the underlying cognitive elements involved in EMR use, possible resulting errors, and influences on patient–doctor communication; to gain insight into the role of expertise in incorporating EMRs into clinical practice in general and communicative behavior in particular. DESIGN Cognitive task analysis using semi-structured interviews and field observations. PARTICIPANTS Twenty-five primary care physicians from the northern district of the largest health maintenance organization (HMO) in Israel. RESULTS The comprehensiveness, organization, and readability of data in the EMR system reduced physicians’ need to recall information from memory and the difficulty of reading handwriting. Physicians perceived EMR use as reducing the cognitive load associated with clinical tasks. Automaticity of EMR use contributed to efficiency, but sometimes resulted in errors, such as the selection of incorrect medication or the input of data into the wrong patient’s chart. EMR use interfered with patient–doctor communication. The main strategy for overcoming this problem involved separating EMR use from time spent communicating with patients. Computer mastery and enhanced physicians’ communication skills also helped. CONCLUSIONS There is a fine balance between the benefits and risks of EMR use. Automaticity, especially in combination with interruptions, emerged as the main cognitive factor contributing to errors. EMR use had a negative influence on communication, a problem that can be partially addressed by improving the spatial organization of physicians’ offices and by enhancing physicians’ computer and communication skills.

In this time of rapidly-changing science, technology, healthcare and society, the education of aspiring professionals and the training of seasoned practitioners must intentionally place human relationships at the centre of service delivery. Reflecting on our own experiences, gained over many years in practice, we argue that despite the proliferation of technology in every aspect of our lives, both patients and practitioners ultimately desire a human-centric approach. To consider the impact of such a paradigm on the future education needs of those working in data-driven and technology-enabled care, a multifactorial approach is required consisting of seven different dimensions: the changing nature of healthcare relationships; addressing disparities; human-centred design and innovation; effective digital technology education; prioritising professionals’ wellbeing through systemic change; working with governments, institutions and other stakeholders; and the implications, ethics and stewardship of shared data. The authors examine each of these areas and propose specific steps that evolving healthcare systems can take to prioritise human relationships and optimise technology to support those relationships. We acknowledge that our gaze is somewhat tinted, reflecting our work in healthcare and the global north. Yet our aim is universal: to celebrate human connections and the art of caring in a digital age.

Learning about the abandonment of moral principles of healthcare professionals and scientists, their societies and academic institutions, to a murderous ideology yields fundamental concerns and global implications for present and future healthcare professionals’ education and practice. Medicine’s worst-case scenario raises deeply disturbing yet essential questions in the here and now: Could the Holocaust, one of the greatest evils ever perpetrated on humankind, have occurred without the complicity of physicians, their societies, and the scientific profession community? How did healers become killers? Can it happen again? We reflect here on those queries through the lens of the Second International Scholars Workshop on Medicine during the Holocaust and Beyond held in the Galilee, Israel on May 7–11, 2017 and derive contemporary global lessons for the healthcare professions. Following a brief historical background, implications of the history of medicine in the Holocaust are drawn including 1) awareness that the combination of hierarchy, obedience, and power constitutes a risk factor for abuse of power in medicine and 2) learning and teaching about medicine in the Holocaust and beyond is a powerful platform for supporting professional identity formation. As such, this history ideally can help “equip” learners with a moral compass for navigating the future of medical practice and inherent ethical challenges such as prejudice, assisted reproduction, resource allocation, obtaining valid informed consent, end of life care, and challenges of genomics and technology expansion. Curriculum modules are available and studies on impact on students’ attitudes and behavior are emerging. The conference culminated with the launch of the Galilee Declaration, composed and signed by an international, inter-professional community of historians, healthcare professions educators, and ethicists. The Declaration included herein ( http://english.wgalil.ac.il/category/Declaration ) calls for curricula on history of healthcare professions in the Holocaust and its implications to be included in all healthcare professions education.

Background A near-peer instructors (NPI) program was designed for 1st year medical students who successfully finished the Anatomy course, in order to develop their didactic ability and teaching skills, mostly for cadaver dissection. Methods Graduates of the training program were administered a voluntary survey at the end of the program, annually. Best graduates of the training program were offered a NPI position in the next academic year. They were evaluated by the first-year students, at the end of the Anatomy block. Results In a debriefing questionnaire at the end of the NPI training, on the five-point Likert scale (1 = lowest to 5 = highest), the overall rating ranged from 3.63 in 2013 to 3.71 in 2015. Learning prosection and anatomy demonstration skills scored on average from 4.30 to 4.36, respectively. The NPIs were then evaluated by first-year students at the end of the next year’s Anatomy block. On the Likert scale, the average score of NPIs ranged from 4.10 in 2014 to 4.75 in 2016, on the par with the general satisfaction score for the professional preclinical teachers during the same period (which ranged from 3.80 to 4.26). Conclusions It is suggested that students as near-peer instructors can make a valuable contribution to the teaching faculty, especially in a new medical school.