Abstract

Introduction: The COVID-19 pandemic significantly impacted postgraduate medical education (PGME). This led to rapid adaptations to ensure training continuity and to develop competent healthcare professionals.

Methods: This descriptive study focusses on the sustainable innovations made in Indonesia, Malaysia, Singapore, Taiwan and the USA PGME residency training. Draft country sections were written by co-authors with direct, current knowledge of postgraduate training in those settings.

Results: Key lessons emerged from curricular adjustments, digital transformation, operational agility, assessments, and faculty development. Curriculum changes included integrating pandemic-specific content, such as COVID-19 management and public health priorities, into training programs. Singapore’s rapid revision efforts and Indonesia’s compulsory topic introduction are typical examples. Despite movement restrictions and constraints on clinical training, innovative solutions like simulations and telemedicine preserved skill development. Digital transformation played a crucial role, with countries adopting virtual platforms and hybrid simulation models. Technology-driven innovations like augmented reality and teleconsultation expanded training scopes. However, challenges like engagement, transitioning faculty to remote learning systems and unstable internet connectivity remained challenges. Operational agility was demonstrated through cross-institutional collaborations. Assessment formats evolved, with hybrid models and virtual logbooks introduced to maintain educational standards. Accreditation processes were adapted, with flexibility granted in assessment delivery while ensuring quality. Faculty development was accelerated with Singapore leveraging international trends to ensure resilience in local training programs.

Conclusion: The pandemic instigated a paradigm shift from reactive adaptation to proactive transformation in PGME, positioning systems as global exemplars of how medical education can evolve amidst complexity and incorporate necessary changes envisioning long-term strengthening of the systems.

Abstract

Introduction: Medical education is continuously adapting to new challenges. Cinemeducation, the use of films in teaching, provides contextualised learning experiences, yet its role in pharmacology has not been systematically reviewed. This systematic review synthesises the reported applications and outcomes of cinemeducation in pharmacology education.  

Methods: A systematic review (PROSPERO ID: CRD42024568417) was conducted following PRISMA 2020 guidelines. PubMed, Scopus, and Google Scholar were searched for studies published up to June 2024. Eligible studies included healthcare undergraduates where films were used as teaching interventions in pharmacology. Methodological quality was assessed using the QuADS (Quality Assessment with Diverse Studies) tool. Data extracted included study characteristics, teaching approaches, and reported educational outcomes (e.g., test performance, reflections, feedback, and student perceptions).

Results: A total of 77 records were identified; 22 full texts were assessed, and 9 studies met inclusion criteria. Most involved medical undergraduates, using qualitative, longitudinal, or cross-sectional designs. Key details are summarized in Table 1. Reported outcomes included improved post-test scores, better knowledge retention, enhanced engagement, and deeper understanding of pharmacological concepts, ethics, and palliative care. Students also reported greater motivation and confidence in decision-making.

Conclusion: Cinemeducation is an engaging adjunct to conventional pharmacology teaching, supporting cognitive, affective, and ethical learning. However, the lack of control groups and heterogeneous methodologies limit the strength of conclusions. Short, thematically relevant film clips integrated into lectures are recommended to enhance comprehension and engagement.

Keywords:           Cinemeducation, Movies, Pharmacology, Medical Education, Systematic Review

Abstract

Introduction: The culture of respect is a crucial aspect of medical learning environments. It has many positive impacts on learning, inclusivity, healthcare collaboration, and healthcare quality. Since it has not been specifically described in previous studies, this review aimed to describe the nature of respect cultivation in medical education (including its definition, assessment, exemplary actions, actors, impacts, and barriers) and thus identify the potential gaps therein.

Methods: This scoping review adapted Arksey and O’Malley’s steps for scoping reviews. Five databases (PubMed, Medline, Science Direct, Google Scholar, and Wiley) were searched, using combinations of related keywords and Boolean operators. The publication year was limited to within the last 15 years. The data analysis was performed using descriptive charting and thematic analysis.

Results: Out of 3,900 articles searched, 169 were full text screened, and 23 were included for further analysis. Six discussed themes were (1) the definition of respect, (2) assessment methods of respect, (3) exemplary actions of respect, (4) contributing actors of respect, (5) the impacts of respect, and (6) barriers to cultivating respect.

Conclusion: The nature of respect in medical education was described diversely in the studies, which lacked specific assessment instruments. Barriers to cultivating respect were reported on multiple levels (personal, interpersonal, and institutional), thus requiring multilevel-based approaches. Further studies are required to explore the theoretical framework of respect in various medical educational settings and strategic approaches for cultivating respect in each context.

Keywords:           Respect, Professionalism, Learning Environment, Culture, Medical Education

Abstract

Introduction: University students may be influenced by intimate relationships (IR) and extracurricular activities (EA), which can impact academic performance (AP). This study assessed the effects of IR and EA on the AP of medical undergraduates.

Methods: A cross-sectional study was conducted among 253 medical undergraduates at the University of Peradeniya, Sri Lanka. Data was collected using an online self-administered questionnaire. AP was evaluated using the cumulative grade point average (cGPA) from the previous semester.

Results: Of the 253 participants, 110 (43.5%) were involved in IR and 143 (56.5%) were single; 56.9% were female. Among participants in relationships, 44.5% had partners within the same faculty. There was no significant association between involving in an IR and AP (p=0.651), regardless of the other variables of IR. Most participants (51.8%) believed EA had no impact on AP, and analysis showed no significant association between EA and AP (p=0.394). Economic status of participants was positively associated with their AP (p=0.015). The prevalence of IPV in IR was 18.2% (7.9% of the total sample), with psychological type being the most prominent. Out of those in relationships, 18.2% reported experiencing IPV, of whom 75.0% were male and 25.0% were female, possibly due to underreporting by females. However, there was no significant association between experiencing IPV and AP (p=0.534).

Conclusions: Although involvement in IR and EA did not significantly affect AP, the presence of IPV highlights the need for targeted interventions. Males were more likely to report IPV than females, emphasising the importance of support programs.

Keywords:           Academic Performance, Demographic Data, Intimate Relationships, Extracurricular Activities, Medical Education, Medical Undergraduates

Abstract

Introduction: The growing use of social media among students offers educators in dental education enhanced opportunities for student-teacher interaction and improved access to learning materials. This study aims to examine the patterns of social media usage for learning purposes among undergraduate dental students at Universiti Sains Malaysia.

Methods: A cross-sectional questionnaire-based study was conducted involving 222 undergraduate dental students from all academic years, excluding those without social media accounts or who declined participation. A validated questionnaire was distributed online via Google Forms and WhatsApp, collecting data on socio-demographics, smartphone ownership and internet access, preferred social media platforms, and the use of social media for academic purposes.

Results: All 222 respondents completed the survey. The majority (65.8%) were iPhone users, and 95.0% reported access to internet data via Wi-Fi or 4G networks. Almost all participants used social media to connect with friends (99.1%), while 10.4% used it for business. Instagram (99.1%), WhatsApp (97.7%), and YouTube (91.9%) were the most commonly used platforms, with WhatsApp being the most frequently used (86.0%). Gender showed a significant association with academic use, particularly for inquiries and consultations, with female students engaging more than males. No significant differences were found across academic years. Google (91.0%) and YouTube (84.2%) were the preferred platforms for academic content.

Conclusion: Social media presents valuable opportunities to support dental education by enhancing learning engagement and communication. However, as the study focuses on a single institution, broader research involving multiple dental schools is recommended to achieve more generalisable findings.

Keywords:           Dental Education, Dental Undergraduate, Learning, Malaysia, Social Media

Abstract

Introduction: The ACGME-I Singapore Otorhinolaryngology residency programme started in 2011. Our first Exit MCQ Examinations were held at the start of the fifth year of residency, in 2015. Its questions are developed by the American Boards and modified by Singapore’s regulatory bodies to ensure relevance to local clinical practice. In contrast, Otorhinolaryngology residents in both Singapore and the USA take the same Otorhinolaryngology Training Examination (OTE) annually. Otorhinolaryngology residents in Singapore sit for the OTE in their first to fourth years of the five-year residency programme.

Multiple specialities have described a positive association between in-training examination and final board MCQ examination pass rates. Our study aims to demonstrate that that OTE scores may serve as predictors of performance in our local Exit MCQ Examination.

Methods: A retrospective review was performed of all 24 Otorhinolaryngology residents who entered and took the Exit MCQ Examination at a single institution’s residency programme between 2016 to 2023.

Results: 75% (18/24) passed the Exit MCQ Examination in their first sitting. Univariate logistic regression analyses showed lower OTE stanines in the fourth year of residency was significantly associated with failing the Exit MCQ Examination. Youden’s index showed attaining an OTE stanine <4 in the fourth year of residency training was most associated with failing the Exit MCQ Examination.

Conclusion: OTE scores may be a better predictor of Exit MCQ performance in the fourth year of residency. Optimal OTE score targets for each year of residency were established.

Keywords:           Health Profession Education, Board Examinations, Assessments, Otorhinolaryngology, Residency, ACGME

Abstract

Introduction: This study evaluates military medicine education at the Defence Services Medical Academy (DSMA) in Myanmar, focusing on curriculum structure, practical training quality, and alignment with evolving military and civilian healthcare needs. Despite a comprehensive approach, identified gaps in practical training (e.g., trauma care, CBRN management) and curriculum continuity hinder student preparedness for modern military medicine.

Methods: This qualitative study used Focused Group Discussions (FGDs) with 24 participants (12 students, 12 faculty) to explore themes like time constraints, practical training, curriculum integration, and modern technology integration. Data were analysed using MAXQDA 24 to identify key themes related to the curriculum’s content and effectiveness.

Results: Findings indicate that while the military medicine module of DSMA covers a broad range of topics, practical training remains inadequate, especially in critical areas such as trauma care, CBRN management, and digital health technologies. Furthermore, curriculum continuity issues, marked by disconnected annual topics, impede clear progression. The study recommends revising the module to include modern warfare medicine, expanding hands-on training, and incorporating mobile learning platforms. It also suggests increasing simulation-based training, restructuring the module to enhance its practical application, and establishing a dedicated military medicine department.

Conclusion: The study identifies critical gaps in DSMA’s curriculum, particularly in practical training (e.g., trauma, CBRN) and coherence. These must be addressed to better prepare students for the challenges of modern military and civilian healthcare. Proposed improvements will ensure DSMA graduates are equipped to handle contemporary healthcare demands, reinforcing the academy’s role as a leader in military medical education.

Keywords:           Military Medicine, Curriculum Development, Practical Training, Outcome-Based Education, Tactical Combat Casualty Care, Qualitative Analysis

Abstract

Introduction: English is the main medium of medical education in many institutions worldwide. However, several terms in the medical lexicon carry colonial, cultural, or linguistic origins that may be outdated or confusing for students from non-English-speaking backgrounds. This study explores culturally exclusive and outdated metaphorical terms in medicine and debates their continued usage.

Methods: A two-stage protocol was followed. First, textbooks and teaching material from the pre-clinical phase of the medical curriculum at the authors’ institution were screened for metaphorical medical terms with outdated concepts or Anglo-European cultural elements. Next, the definitions and origins of each term were explored using open-source etymological resources and peer-reviewed literature from PubMed and Google Scholar. Terms were then thematically grouped and narratively analysed.

Results: Twenty Anglo-European references were identified and categorised into sub-themes: Western food (e.g., “port-wine stain,” “maple syrup urine disease”), fiction (e.g., “Alice-in-Wonderland syndrome”), religion (e.g., “Hand of Benediction”), and foreign languages (e.g., “café-au-lait spots,” “tache noire”). These may be unrelatable to students from diverse cultural or religious backgrounds. In addition, ten obsolete societal references were noted (e.g., “Washerwoman’s hands,” “rugger jersey spine,” “Indian file pattern”), which are no longer part of common knowledge.

Conclusion: While such terms aided understanding for Anglo-European learners, they may now burden today’s diverse student population. Medical educators should reassess their continued use to ensure clarity and equity in global medical education. This review, based on single institutional findings, provides a foundation for broader, multi-institutional studies to explore the prevalence and impact of these terms across curricula.

Keywords:           Medical Terminology, Equity in Medical Education, Colonialism in Medicine, Obsolete Medical Terms, Global Medical Education

Abstract

Introduction: Absenteeism during clinical rotations among medical students is on the rise, adversely affecting both patient care and the development of essential clinical skills. Factors such as inadequate learning resources, exhaustion, and disengagement contribute to this trend, which must be addressed to safeguard the quality of medical training and future healthcare quality. This study aimed to identify the underlying causes of absenteeism among undergraduate medical students and to propose strategies to improve attendance and learning outcomes.

Methods: A cross-sectional study was conducted on third, fourth, and final-year students of primary medical qualification at Rashid Latif Medical College, Lahore, Punjab, Pakistan, from June 2024 to July 2024. A validated, self-structured questionnaire was distributed during clinical rotations. Data were analysed using SPSS version 25. Frequencies and percentages were calculated to summarise attendance patterns and perceived barriers. Pearson’s correlation was used to examine associations between absenteeism factors—personal health, family obligations, academic workload, perceived relevance of rotations and academic year, with statistical significance set at p ≤ 0.05.

Results: Out of 450 surveys, 270 students responded: 31% third year, 27% fourth year, and 43% final year students. Faculty-related barriers included poor feedback (3.2), ineffective communication (3.2), lack of preparation (3.3), and unprofessional attitude (3.3). Personal obstacles included personal health (3.2), lack of learning resources (3.4), and family obligations (3.3). Additionally, 41% of the students believed that non-exam-specific rotations were irrelevant.

Conclusion: Faculty dissatisfaction, peer pressure and downplaying non-exam specific rotations cause clinical rotation absenteeism. Systemic reforms and enhanced faculty engagement are essential to improve students’ professional development and clinical engagement.

Keywords:           Medical Education, Absenteeism, Faculty, Clinical Rotations

Abstract

Introduction: Self-efficacy significantly impacts academic performance and clinical competence in healthcare education. Students need to develop confidence and adaptability to handle unpredictable situations in high-pressure fields like anaesthesia nursing. While global studies emphasise self-efficacy’s role in clinical training, research on Vietnamese nursing students is limited. This study aimed to evaluate the clinical self-efficacy beliefs of anaesthesia nursing students to understand their confidence levels and identify factors influencing this.

Methods: A cross-sectional descriptive study was conducted from February to June 2024, with Stratified sampling of 205 third- and fourth-year anaesthesia nursing students at the University of Medicine and Pharmacy in Ho Chi Minh City. The Self-Efficacy in Clinical Performance (SECP) scale was used to evaluate students’ self-efficacy, and the Critical Thinking Disposition Inventory for Medical College Students (CTDI-M) measured critical thinking disposition.

Results: The overall clinical self-efficacy score for students was 105.4±12.87. A statistically significant positive correlation was found between self-efficacy and critical thinking disposition among students (r_s = 0.37, p < 0.001). Furthermore, a significant linear regression analysis indicated that critical thinking disposition (coefficient = 8.6, p < 0.001), attitudes regarding the characteristics of anaesthesia nursing students (coefficient = 0.9, p < 0.001), and academic year (coefficient = 6.1, p < 0.001) are significant predictors of clinical self-efficacy.

Conclusion: Integrating the promotion of critical thinking, addressing specific attitudes, and considering students’ academic progression into clinical training programmes is essential. This has important implications for developing training programmes that enhance essential skills and better prepare students for their professional careers.

Keywords:           Anaesthesia Nursing Students, Clinical Self-Efficacy, Critical Thinking Disposition, Clinical Practice

Abstract

Introduction: Medical students often face psychological distress affecting their academic performance and well-being. While coping and resilience may buffer this stress, their roles in academic outcomes across different training stages are poorly understood. This study explored how distress, coping, resilience, and learning perception relate to academic performance across semesters.

Methods: A cross-sectional study of 677 pre-clinical medical students was conducted in 2024 across Semesters 1, 3, 5, and 7. Standardised instruments measured psychological distress, burnout, resilience, coping, and perceptions of the learning environment. Data were analysed using ANCOVA to compare constructs across semesters. Principal Component Analysis (PCA) and Structural Equation Modeling (SEM) assessed the direct and indirect pathways linking distress to Grade Point Average (GPA).

Results: Psychological distress and burnout increased during mid-training while resilience traits such as perseverance and help-seeking consistently decreased. Coping styles remained stable. PCA identified three latent constructs: distress, coping, and resilience. SEM revealed that distress negatively predicted GPA both directly (β = –0.186, p < .001) and indirectly via resilience (β = 0.052, p = .003). Coping was positively associated with resilience (β = 0.412, p < .001), but its effect on GPA was marginal. A multi-group SEM confirmed a consistent relationship across academic semesters.

Conclusion: Although the effects were small, psychological distress significantly influenced academic performance, partially mediated by resilience. While coping remained stable, resilience declined and did not recover, highlighting the need for support. Interventions to enhance coping may bolster resilience and improve academic outcomes.

Keywords:           Medical Students, Resilience, Coping Strategies, Academic Performance, Psychological Distress

Abstract

Introduction: The necessity for evaluating the effectiveness of medical education departments (DME) arises from the rapid technological advancements, frequent updates in healthcare paradigms and increasing societal demands. Such evaluations are crucial to understand how DMEs influence the future healthcare workforce and the quality of healthcare delivery. This research aims to explore the functions, procedures, and potential areas for innovation and improvement within DMEs.

Methods: A qualitative study was conducted at Liaquat College of Medicine and Dentistry’s Department of Medical Education, involving two focus groups of seven faculty members each. Participants included both junior and senior faculty. One session was held in person and the online one via Zoom. This was followed by inductive reflexive Thematic analysis.

Results: The study identified several strengths within the Liaquat College of Medicine and Dentistry DME, including robust faculty development programmes and strong student support services. However, areas of concern were highlighted such as research infrastructure and interdisciplinary connections. While faculty members expressed their satisfaction with the provided academic support services, they have reported the need for improving available research resources and faculty development programmes.

Conclusion: The study underscores the significant role of DMEs in medical education and suggests fostering joint research projects, encouraging faculty development, and enhancing student support services. Implementing these recommendations is crucial for advancing medical education and maintaining high standards of excellence. Continuous examination and implementation of these suggestions will ensure that DMEs can adapt to and meet the challenges of an ever-evolving healthcare landscape.

Keywords:           Medical Education Department, Qualitative Study, Action Research, Focus Group

Abstract

Introduction: Student motivation in teaching-learning is pivotal in promoting overall well-being, enhancing performance, and nurturing skilled professionals. Knowledge about student motivation allows educators to broaden their understanding, and this study investigates the levels of student motivation at different phases of their medical education.

Methods: A quantitative study explored medical students’ academic motivation using the validated Academic Motivation Scale AMS-C 28, with a rating on a 7-point Likert Scale. IBM-SPSS was used to analyse the data.

Results: A total of 105 students participated in the study. The results indicated that students exhibited higher levels of intrinsic motivation compared to extrinsic motivation. The mean score for intrinsic motivation (M=5.13, SD=0.91) surpassed that of extrinsic motivation (M=4.63, SD=1.00). Regarding the association between academic year and student motivation, second-year and fourth-year medical students exhibited the highest intrinsic motivation (M=5.36, SD=0.8) and (M=5.36, SD=0.68), respectively, and second-year medical students showed the highest extrinsic motivation (M=4.87, SD=0.96) compared to other academic years, but this difference was statistically not significant.

Conclusion: The findings exhibited higher levels of intrinsic motivation, indicating active involvement in learning activities and deriving satisfaction from the course. The MBBS students in the second year displayed more intrinsic motivation, influenced by the challenging nature of successfully completing the first year, which is historically associated with a high failure rate.

Keywords:           Motivation, Medical Student, Academic Motivation Scale

Abstract

Introduction: Team-Based Learning (TBL), grounded in constructivist learning theory, promotes active engagement among learners. This study aimed to explore postgraduate residents’ perceptions and attitudes toward learning about periodontal-endodontic lesions using TBL as an educational method.

Methods: A total of 8 Periodontic residents and 11 Endodontic residents received pre-reading articles related to periodontal-endodontic lesions. On the day of the workshop, they were divided into four mixed-specialty groups. They completed individual and group readiness assurance tests, followed by facilitated discussions on three simulated clinical cases. Feedback was collected through an online anonymous survey that included 32 Team-Based Learning Student Assessment Instrument (TBL-SAI) items, eight on programme content, four on skills contributions, seven on faculty, and four on learning outcomes, all scored on a 5-point Likert scale (1-strongly disagree to 5-strongly agree) and analysed with descriptive and Cronbach’s alpha analysis.

Results: Fifteen of 19 residents attended the workshop. TBL-SAI scores (max 40) reflected strong accountability, with overall mean scores around 29 across both Periodontic and Endodontic residents. Learning preference scores (max 80) averaged approximately 50, and student satisfaction scores (max 40) were similarly positive, averaging just under 30. Programme content, learning outcomes, and faculty performance received high ratings, with mean scores above 4 out of 5. Internal consistency was strong across all subscales (Cronbach’s alpha: 0.69–0.99). Qualitative feedback highlighted the value of clinical case applications in enhancing engagement and understanding.

Conclusion: Residents reported positive perceptions of Team-Based Learning, noting high engagement, accountability, and satisfaction. The findings support its effectiveness as a valuable instructional approach in postgraduate dental education.

Keywords:           Dental Education, Endodontics, Periodontics, Residency, Team-Based Learning

LLMs are a powerful new tool, and like any other technology introduced into healthcare, clinicians must carefully consider the risks, and use LLMs in a way that leverages and augments clinical knowledge and skill, rather than outsourcing tasks to LLMs in an uncritical way.