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Recommendations for core critical care ultrasound competencies as a part of specialist training in multidisciplinary intensive care: a framework proposed by the European Society of Intensive Care Medicine (ESICM)
Critical care ultrasound (CCUS) is an essential component of intensive care practice. Although existing international guidelines have focused on training principles and determining competency in CCUS, few countries have managed to operationalize this guidance into an accessible, well-structured programme for clinicians training in multidisciplinary intensive care. We seek to update and reaffirm appropriate CCUS scope so that it may be integrated into the international Competency-based Training in Intensive Care Medicine. The resulting recommendations offer the most contemporary and evolved set of core CCUS competencies for an intensive care clinician yet described. Importantly, we discuss the rationale for inclusion but also exclusion of competencies listed.
Background/aim
Critical care ultrasound (CCUS) is an essential component of intensive care practice. The purpose of this consensus document is to determine those CCUS competencies that should be a mandatory part of training in multidisciplinary intensive care.
Methods
A three-round Delphi method followed by face-to-face meeting among 32 CCUS experts nominated by the European Society of Intensive Care Medicine. Agreement of at least 90% of experts was needed in order to enlist a competency as mandatory.
Results
The final list of competencies includes 15 echocardiographic, 5 thoracic, 4 abdominal, deep vein thrombosis diagnosis and central venous access aid.
Conclusion
The resulting recommendations offer the most contemporary and evolved set of core CCUS competencies for an intensive care clinician yet described.
Journal Article
Revolutionary doctors : how Venezuela and Cuba are changing the world's conception of health care
\"Revolutionary Doctors gives readers a first-hand account of Venezuela's innovative and inspiring program of community healthcare, designed to serve--and largely carried out by--the poor themselves. Drawing on long-term participant observations as well as in-depth research, Brouwer tells the story of Venezuela's Integral Community Medicine program, in which doctor-teachers move into the countryside and poor urban areas to recruit and train doctors from among peasants and workers. Such programs were first developed in Cuba, and Cuban medical personnel play a key role in Venezuela today as advisors and organizers. This internationalist model has been a great success--Cuba is a world leader in medicine and medical training--and Brouwer shows how the Venezuelans are now, with the aid of their Cuban counterparts, following suit. But this program is not without its challenges. It has faced much hostility from traditional Venezuelan doctors as well as all the forces antagonistic to the Venezuelan and Cuban revolutions. Despite the obstacles it describes, Revolutionary Doctors demonstrates how a society committed to the well-being of its poorest people can actually put that commitment into practice, by delivering essential healthcare through the direct empowerment of the people it aims to serve\"--Provided by publisher.
Book
Feasibility study of using GPT for history-taking training in medical education: a randomized clinical trial
Backgrounds
Traditional methods of teaching history-taking in medical education are limited by scalability and resource intensity. This study aims to assess the effectiveness of simulated patient interactions based on a custom-designed Generative Pre-trained Transformer (GPT) model, developed using OpenAI’s ChatGPT GPTs platform, in enhancing medical students’ history-taking skills compared to traditional role-playing methods.
Methods
A total of 56 medical students were randomly assigned into two groups: an GPT group using GPT-simulated patients and a control group using traditional role-playing. Pre- and post-training assessments were conducted using a structured clinical examination to measure students’ abilities in history collection, clinical reasoning, communication skills, and professional behavior. Additionally, students’ evaluations of the educational effectiveness, satisfaction, and recommendation likelihood were assessed.
Results
The GPT-simulation group showed significantly higher post-training scores in the structured clinical examination compared to the control group (86.79 ± 5.46,73.64 ± 4.76, respectively,
P
< 0.001). Students in the GPT group exhibited higher enthusiasm for learning, greater self-directed learning motivation, and better communication feedback abilities compared to the control group (
P
< 0.05). Additionally, the student satisfaction survey revealed that the GPT group rated higher on the diversity of diseases encountered, ease of use, and likelihood of recommending the training compared to the control group (
P
< 0.05).
Conclusions
GPT-based history-taking training effectively enhances medical students’ history-taking skills, providing a solid foundation for the application of artificial intelligence (AI) in medical education.
Clinical trial number
NCT06766383.
Journal Article
A novel 3D printed model for educating medical students on limb fractures: a randomized controlled preliminary study
Background
Medical education related to bone fracture must address numerous challenges including complex anatomical characteristics, diverse injury mechanisms, fracture typing, and treatment modalities. Our newly developed 3D printed model comprises components that may be combined or split to simulate various anatomical features, fracture types, and treatment modalities. This study aims to analyze the teaching utility of the new 3D-printed model compared with the traditional solid model.
Methods
This prospective study included 112 students randomly assigned to fracture-related education with a conventional model or the newly developed 3D-printed model. All students received 40 min of lecture, 20 min for femoral neck and 20 min for tibiofibular fractures, and a post-class quiz (10 min each) immediately followed. Scores on tests of fracture-related knowledge and user satisfaction were measured pre and post education for comparison.
Results
The 3D printing group had an advantage in retention of anatomic knowledge, fracture typing and choice of treatment for the femoral neck fracture (
P
< 0.05). For the tibiofibular fracture the 3D printing group had an advantage in retention of anatomic knowledge and fracture complications (
P
< 0.05).Scores on the questionnaire survey also showed increased satisfaction in the 3D-printed model group(
P
< 0.05).
Conclusions
The proposed 3D-printed model can enhance the teaching effect significantly and has potential for widespread use in medical student education.
Journal Article
Lessons from problem-based learning
\"Problem-based learning (PBL) has excited interest among educators around the world for several decades. Among the most notable applications of PBL is the approach taken at the Faculty of Health, Medicine and Life Sciences (FHML) at Maastricht University, the Netherlands. Starting in 1974 as a medical school, the faculty embarked on the innovative pathway of problem-based learning, trying to establish a medical training program which applied recent insights of education which would be better adapted to the needs of the modem physician. The medical school, currently part of the FHML, can be considered as an 'established' school, where original innovations and educational changes have become part of a routine. The first book to bring this wealth of information together, \"Lessons from Problem-based Learning\" documents those findings and shares the experiences of those involved, to encourage further debate and refinement of problem-based learning in specific applications elsewhere and in general educational discussion and thought. Each chapter provides a description of why and what has been done in the Maastricht program, followed by reflection on the benefits and issues that have arisen for these developments. The final section of the book examines the application of PBL in the future, and how it is likely to develop further\"--Provided by publisher.
Book
Simulated patient methodology
Simulated Patient Methodology is a timely book, aimed at health professional educators and Simulated Patient (SP) practitioners. It connects theory and evidence with practice to ensure maximum benefit for those involved in SP programmes, in order to inform practice and promote innovation. The book provides a unique, contemporary, global overview of SP practice, for all health sciences educators.
Simulated Patient Methodology:
• Provides a cross-disciplinary overview of the field
• Considers practical issues such as recruiting and training simulated patients, and the financial planning of SP programmes
• Features case studies, illustrating theory in practice, drawn from across health professions and countries, to ensure relevance to localised contexts
Written by world leaders in the field, this invaluable resource summarises the theoretical and practical basis of all human-based simulation methodologies.
eBook
Barriers and solutions to online learning in medical education – an integrative review
Background
The aim of this study is to review the literature on known barriers and solutions that face educators when developing and implementing online learning programs for medical students and postgraduate trainees.
Methods
An integrative review was conducted over a three-month period by an inter-institutional research team. The search included ScienceDirect, Scopus, BioMedical, PubMed, Medline (EBSCO & Ovid), ERIC, LISA, EBSCO, Google Scholar, ProQuest A&I, ProQuest UK & Ireland, UL Institutional Repository (IR), UCDIR and the All Aboard Report. Search terms included online learning, medical educators, development, barriers, solutions and digital literacy. The search was carried out by two reviewers. Titles and abstracts were screened independently and reviewed with inclusion/exclusion criteria. A consensus was drawn on which articles were included. Data appraisal was performed using the Critical Appraisal Skills Programme (CASP) Qualitative Research Checklist and NHMRC Appraisal Evidence Matrix. Data extraction was completed using the Cochrane Data Extraction Form and a modified extraction tool.
Results
Of the 3101 abstracts identified from the search, ten full-text papers met the inclusion criteria. Data extraction was completed on seven papers of high methodological quality and on three lower quality papers. Findings suggest that the key barriers which affect the development and implementation of online learning in medical education include time constraints, poor technical skills, inadequate infrastructure, absence of institutional strategies and support and negative attitudes of all involved. Solutions to these include improved educator skills, incentives and reward for the time involved with development and delivery of online content, improved institutional strategies and support and positive attitude amongst all those involved in the development and delivery of online content.
Conclusion
This review has identified barriers and solutions amongst medical educators to the implementation of online learning in medical education. Results can be used to inform institutional and educator practice in the development of further online learning.
Journal Article