Explore the vast range of titles available.

Background This study aimed to investigate the various models of student representation in curriculum development across medical schools in the United States, based on the participatory governance theory. Recognizing the critical role of student feedback in enhancing medical education, the work sought to assess the diversity of student representation models, identify key elements that contribute to effective student involvement, and evaluate the potential impact on curriculum outcomes. Methods An initial list of 166 allopathic MD schools was curated from the AAMC Medical Schools Admission Requirements website. Schools were selected based on the presence of information about student representation in curriculum design. This selection was refined through a Google search using specific search terms related to student representation, followed by an evaluation based on the amount and relevance of available information on each school’s website. The methodology involved a detailed examination of the websites for selected schools, focusing on the structure and organization of student involvement in curriculum development. Results Of the initial 166 medical schools, 49 (29.7%) had publicly available information on student involvement in curriculum development. These schools were categorized into three main models of student representation: direct representation, feedback-driven, and hybrid models. The analysis revealed significant diversity in how student representation is implemented, with each model exhibiting unique strengths and limitations. Direct representation models were found to facilitate substantive student roles in decision-making, feedback-driven models excelled in rapidly integrating student feedback into curricular adjustments, and hybrid models combined aspects of both to provide a comprehensive approach to student involvement. Conclusions There is no one-size-fits-all model for student representation in medical education. However, the hybrid model shows promise for its balanced approach to integrating student perspectives into curriculum development. Continuous evaluation and refinement of student representation models are essential for ensuring that medical education remains responsive to the needs of students and the evolving landscape of the medical field. This work underscores the importance of student feedback in medical education and advocates for further studies to quantify the impact of different models of student representation on educational outcomes and professional success.

BackgroundDespite the ever-expanding role that the patient experience plays in healthcare, effective strategies proven to increase patient satisfaction ratings remain scarce. At the University of Pittsburgh Medical Center, we identified patient-doctor and patient-nurse communication as an area for intervention to improve suboptimal patient satisfaction among medicine inpatients. We posited that the likely reasons for underperformance in this area were a lack of adequate training in bedside communication skills.DesignWe developed and evaluated a curriculum for medicine residents and nurses focused on clear communication at the bedside. A total of 76 internal medicine residents and 85 medical service nurses participated in 2016. The curriculum utilized didactics, video demonstrations, and role play, and was evaluated using pre- and post-surveys of participants’ health literacy knowledge, attitudes, and confidence. Communication skills were evaluated using pre- and post-direct observation at the bedside with a communication skills checklist. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores were compared 3 months before and after the curriculum to assess changes in patient satisfaction.Key ResultsKnowledge and attitudes improved significantly for both residents and nurses. Residents’ and nurses’ observed clinical communication skills improved significantly in most domains, and there was moderate increase in communication-specific HCAHPS scores.ConclusionA small investment of curricular time devoted to clear communication skills improved residents’ and medical nurses’ knowledge, attitudes, skills, and communication-specific HCAHPS scores. This curriculum, focused on improving bedside communication skills, could be implemented in a variety of settings to improve patient satisfaction and patient experience.

Despite the increasing body of evidence supporting the use of simulation in medicine, a question remains: when should we introduce it into the medical school's curriculum? We present the experience and future perspectives of the MD program in Medicine and Surgery of University of Turin-MedInTo. Since its launch, MedInTo has been dedicated to integrating innovative teaching approaches at the early stages into the medical curriculum. Herewith, we describe a case-based approach for our activities, which includes the utilization of simulation for emergency medical care training for students and the integration of virtual and augmented reality technology. Dedicated surgical training activities using virtual-augmented reality and life-like simulator for students are also described.

Postgraduate medical training often lacks clearly defined, assessable outcomes. Entrustable professional activities (EPAs) have emerged as a promising framework for competency-based training, aiming to improve transparency, accountability, and efficiency in specialist education. This systematic review investigates the current development status of EPA-based curricula in orthopedic and neurosurgical spinal surgery and highlights their potential to address educational challenges in this high-stakes field. A systematic review was conducted combining database studies (PubMed and Embase) and gray literature screening through professional societies' websites and direct inquiries. Two reviewers independently screened, extracted, and synthesized the data. Given the anticipated heterogeneity among the included studies, a narrative synthesis was performed, while a quantitative synthesis was not feasible. No formal risk-of-bias assessment was conducted; however, potential sources of bias related to language, scope, and publication period were acknowledged and discussed. Out of 15,768 initial records, only 4 relevant papers were identified. The EPAs in these studies were developed primarily through expert consensus methods such as modified Delphi or nominal group techniques. Additionally, among the 10 professional societies analyzed, only the AO Foundation (AO Spine) and the Royal College of Physicians and Surgeons of Canada provided explicit EPA frameworks for spinal surgery, contributing together to 26 EPAs. The limited number and heterogeneity of sources underscore the exploratory nature of this review and the current lack of standardized, spine-specific EPA curricula. EPA-based curricula in spinal surgery remain largely undeveloped. While conceptual frameworks exist, their implementation into structured residency programs is still in its infancy. This review provides a foundational overview of the existing EPAs and methodological approaches, offering a reference point for future curriculum development. Collaborative initiatives among professional societies are strongly encouraged to define, validate, and implement specialty-specific EPAs for spinal surgery, fostering competency-based education and improving training outcomes.

Resident physicians are at higher risk for depression, anxiety, and burnout when compared with same-age peers, resulting in substantive personal and professional consequences. Training programs across the country have acknowledged the gravity of this situation and many have implemented programs and curricula that address wellness and resilience, yet the benefits of such initiatives are still largely unknown. While the development of wellness programming is well intentioned, it is often incongruent with the residency training environment. The mixed messaging that occurs when wellness programs are implemented in environments that do not support self-care may unintentionally cause resident distress. Indeed, outside of the time dedicated to wellness curricula, residents are often rewarded for self-sacrifice. In this commentary, we describe how the complexities of the medical system and culture contribute to mixed messaging and we explore the potential impact on residents. We offer recommendations to strengthen wellness programs through efforts to promote structural change in the training environment.

ObjectivesThis study investigates students’ adoption of LeiKA, a new extracurricular longitudinal general practice (GP) teaching project. LeiKA aims to attract a broad range of students, not only those who are already planning to become GPs. This study compares participants’ and non-participants’ characteristics, career preferences and job-related value orientations to assess the programme’s initial potential to increase the number of students subsequently entering GP careers. Additionally, students’ motives for taking part in the programme were explored.DesignWe analysed administrative data and data from a cross-sectional questionnaire survey for the first three cohorts. LeiKA participants were compared with non-participants regarding baseline characteristics, career intentions and attitudes associated with GP careers. There was also a qualitative analysis of the reasons for taking part.SettingFaculty of Medicine, University of Leipzig, Germany.ParticipantsFirst-semester medical students in the years 2016–2018.ResultsIn the first 3 years, 86 of 90 LeiKA slots were taken, 9.0% (n=86/960) of those eligible to apply. LeiKA participants were a mean of 0.6 years older (LeiKA: 21.5 vs whole cohort: 20.9 years, p<0.001) and slightly more interested in long-term doctor–patient relationships (3.6 vs 3.3, scale from 1 ‘unimportant’ to 5 ‘very important’, p=0.018), but did not differ regarding other characteristics and attitudes. Although more participants definitely favoured a GP career (13.1% vs 4.9%, p=0.001), it was a possible option for most students in both groups (78.6% vs 74.0%). Early acquisition of skills and patient contact were the main motives for taking part, stated by 60.7% and 41.7% of the participants, respectively.ConclusionsThe extracurricular programme was taken up by a broad range of students, indicating its potential to attract more students to become GPs. The reasons for taking part that we identified may guide the planning of other similar projects.

BackgroundHealth disparities exist in HIV risk in the USA among the lesbian-gay-bisexual-transgender-queer (LGBTQ) community. There is also scarce literature on curricula for HIV prevention and pre-exposure prophylaxis (PrEP) for trainees.AimTo create a curriculum to train residents to perform inclusive sexual history taking and HIV prevention care. The curriculum covers sexual history, LGBTQ health, sexually transmitted infections, and HIV risk assessment and risk reduction counseling including use of PrEP.SettingA dedicated PrEP Clinic was created within an Academic Medical Center Outpatient HIV Clinic. Patients were primarily LGBTQ identified, but also included HIV sero-discordant couples, cisgender individuals, heterosexual invididuals, and those with experience of homelessness, sex work, and substance abuse.ParticipantsThirty-four internal medicine residents completed the course between November 2017 and May 2018.Program DescriptionThe curriculum was delivered as Just in Time Teaching (JiTT) via online virtual patient cases followed by directly observed clinical care at a large urban PrEP clinic.Program Evaluation and ResultsThe effectiveness of the curriculum was assessed through paired pre/post-self-assessment surveys (n = 19), additional post-surveys on the online modules (n = 22), and interviews (n = 9). Many respondents reported no prior training or inadequate prior training in the course content. As a result of the course, participants reported statistically significant increased confidence and comfort in all seven HIV prevention topic areas, with the greatest gains in safe sex counseling for LGBTQ patients and in discussing PrEP (mean changes of 1.21, 1.58 on 5-point Likert scale, respectively, p < 0.0001). Six of nine interviewees post-course had applied what they learned to patient care; five indicated their learning would benefit patients.DiscussionAn HIV prevention curriculum focused on cultural humility in care can improve trainee’s skills in HIV risk reduction counseling, including PrEP, among all patients including those identifying as LGBTQ.

The purpose of the fourth year of medical school remains controversial. Competing demands during this transitional phase cause confusion for students and educators. In 2014, the Association of American Medical Colleges (AAMC) released 13 Core Entrustable Professional Activities for Entering Residency (CEPAERs). A committee comprising members of the Clerkship Directors in Internal Medicine and the Association of Program Directors in Internal Medicine applied these principles to preparing students for internal medicine residencies. The authors propose a curricular framework based on five CEPAERs that were felt to be most relevant to residency preparation, informed by prior stakeholder surveys. The critical areas outlined include entering orders, forming and answering clinical questions, conducting patient care handovers, collaborating interprofessionally, and recognizing patients requiring urgent care and initiating that care. For each CEPAER, the authors offer suggestions about instruction and assessment of competency. The fourth year of medical school can be rewarding for students, while adequately preparing them to begin residency, by addressing important elements defined in the core entrustable activities. Thus prepared, new residents can function safely and competently in supervised postgraduate settings.

Background: The opioid epidemic is a growing problem in the USA. Use of medication-assisted treatment (MAT) has been effective in treating patients with opioid use disorders (OUD) and maintaining sobriety; however, there is a significant shortage of physicians formally trained in MAT. Objective: Wayne State University School of Medicine integrated the 8-hour MAT waiver training into its Internal Medicine clerkship curriculum. The objectives of integrating this into the curriculum were to (1) introduce opioid use education during students' Internal Medicine clerkship and (2) assess whether the curriculum prepares students to feel more comfortable evaluating and treating patients with OUD. Design: MAT training specifically for medical students was provided free online by the Providers Clinical Support System (PCSS). All students on the Internal Medicine clerkship were required to complete the training. A 7-question pre-survey and post-survey assessed students' comfort in evaluating and treating OUD. Significant changes were assessed with a paired McNemar Bowker Test. Results: Medical students (n = 141) completed the pre-survey and post-survey. After the MAT training, students' perspective of their clinical knowledge about OUD, familiarity with MAT, and likelihood to utilize MAT for their patients significantly differed, with increased proportions of medical students in agreement across 6 of 7 pre-post survey items (p <.0001). Conclusions: Online MAT waiver training is a low-cost (free) way to introduce MAT education into the undergraduate clinical curriculum. Upon completing of the training, medical students self-reported improvements in their knowledge and attitudes about OUD and the different treatment options. Our hope is that MAT waiver training will allow for graduation of medical students who are ready to care for patients with OUD during residency and as practitioners upon completion of their residency.

BackgroundDeclining mortality has led to a rising number of persons living with HIV (PLWH) and concerns about a future shortage of HIV practitioners.AimTo develop an HIV Primary Care Track for internal medicine residents.SettingAcademic hospital and community health center with a history of caring for PLWH and lesbian, gay, bisexual, and transgender (LGBT) patients.ParticipantsInternal medicine residents.Program DescriptionWe enrolled four residents annually in a 3-year track with the goal of having each provide continuity care to at least 20 PLWH. The curriculum included small group learning sessions, outpatient electives, a global health opportunity, and the development of a scholarly project.Program EvaluationAll residents successfully accrued 20 or more PLWH as continuity patients. Senior residents passed the American Academy of HIV Medicine certification exam, and 75 % of graduates took positions in primary care involving PLWH. Clinical performance of residents in HIV care quality measures was comparable to those reported in published cohorts.DiscussionWe developed and implemented a novel track to train medical residents in the care of PLWH and LGBT patients. Our results suggest that a designated residency track can serve as a model for training the next generation of HIV practitioners.