Background: Evidence-Based Medical Education guides methodological choices to ensure effectiveness in formative processes. There is evidence that proves the development of transversal skills in undergraduate students of occupational therapy, physiotherapy and speech therapy through the Service-Learning methodology. However, this evidence has not been adequately systematized, which prevents us from clearly finding the skills most promoted through this approach. Therefore, it is essential to explore the development of these skills in students, thus justifying the relevance of this methodology in their training. Method: A scoping review was conducted in four databases (PubMED, ERIC, LILACS and Web of Science), applying the SANRA scale to evaluate the quality of narrative analysis and the CASP protocol for thematic analysis. Results: Of 248 articles found, 23 met the inclusion criteria, of which more than 50% met high quality standards. The most outstanding skills developed through service learning were teamwork, professional role identification, intercultural skills, self-efficacy, critical thinking, and global competencies. Discussion: The findings suggest that, under specific conditions, service learning not only promotes key transversal skills, but also enhances critical competencies for professional performance in the areas of occupational therapy, physiotherapy, and speech therapy. However, challenges persist in the uniform implementation of this methodology, which highlights the importance of protocols that ensure their effectiveness and sustainability. Conclusions: Service-Learning methodology, applied strategically, facilitates the development of essential transversal skills for students in rehabilitation careers. The design of clear implementation protocols that improve its application and maximize its benefits in the educational and professional environment is recommended.
Background: Longitudinal and amalgamative clerkship models enhance medical education through faculty continuity, mentorship, and targeted feedback. A United States allopathic medical school piloted a 16-week longitudinal clerkship (PIONEER), including one half-day of obstetrics and gynecology (OB/GYN) clinic per week. This study assessed the impact of preceptor continuity on student knowledge and procedural experience during the OB/GYN portion of PIONEER. Methods: This cross-sectional study (August 2023-July 2024) surveyed PIONEER students on OB/ GYN knowledge, procedural experience, and preceptor continuity. Students were categorized into "high" or "low" continuity experiences based on Likert responses. Outcomes included changes in knowledge and procedural exposure, with secondary analyses comparing procedural opportunities across the academic year and to the OB/GYN traditional block clerkship. Results: Among 83 respondents (76.1% response rate), 71.1% reported low continuity with OB/GYN preceptors. Knowledge and procedural experience did not differ between continuity groups (all p>0.05). PIONEER students' procedural opportunities remained consistent across the year and exceeded those of traditional clerkship students (e.g., 25.7-fold increase in students performing >10 breast exams; 1.6-fold increase for pelvic exams). Discussion: These exploratory findings suggest that meaningful educational experiences can occur in OB/GYN amalgamative longitudinal clerkships even with variable preceptor continuity. Importantly, PIONEER preserved a core benefit of longitudinal models-greater procedural exposure-while highlighting the need for future research to more comprehensively evaluate the contributions of preceptor, patient, and location continuity to student learning.
While the traditional apprenticeship model in surgical training remains valuable, it often underutilizes the surgeon's potential as a co-creator of solutions to pressing clinical challenges. As surgical device development increasingly emphasizes locally relevant and immediate problem-solving issues, innovation in surgical education is no longer optional but an essential component of modern training. This commentary introduces the Surgeons for Innovation (SuFI) program, a nonprofit collaborative program spearheaded by surgeons, researchers, and engineering teams. Designed as a structured yet adaptable model, SuFI integrates innovation training directly into surgical education in India. The program fosters collaboration among surgeons, researchers, and engineers to co-develop effective, and scalable medical devices of relevance to the local and global users. Its framework is built on four pillars: (1) design conceptualization (2) access to incubators (3) regulatory approvals and (4) a repository of problem statements. Through this approach, SuFI will successfully guide surgeon-engineer teams from problem identification to prototype development, patenting, and market launch of effective, patient-centered devices inspired by real surgical needs. By positioning surgeons as co-creators rather than passive end-users, SuFI strengthens the national innovation ecosystem and aligns with calls to institutionalize innovation within medical curricula. This model offers a potential blueprint for advancing surgical education, particularly in resource-constrained settings.
Background: Since the implementation of Competency-Based Medical Education (CBME) for undergraduate medical education in India, stakeholders have expressed diverse perspectives. While many appreciated its structured framework and emphasis on competency development, others voiced concerns about implementation challenges, assessment strategies, and overall institutional readiness. Objective: The present qualitative meta-synthesis explored the converging and diverging factors influencing the implementation of CBME. Methods: Using a systematic search strategy, we selected seven qualitative and mixed-methods studies published between 2019 and 2025 from PubMed, Scopus, and Google Scholar. The integration of qualitative findings across studies was guided by Critical Interpretative Synthesis. A total of 130 descriptive codes were developed and categorized under six curricular components: competencies, curriculum content, teaching-learning methods, assessment, curriculum governance, and student support and faculty development. Results: Key challenges included difficulties in framing competency objectives, overlapping content in foundation courses, limited faculty training in self-directed learning and assessments, inadequate support for simulation-based teaching, and misalignment between student priorities and curricular goals. Notable enablers included small-group teaching, simulation-based sessions, well-organized timetables, motivated faculty, and constructive student engagement. However, systemic issues such as infrastructure constraints, inadequate staff, their training in new methodologies, and poor interdepartmental coordination hindered full-scale implementation. Conclusion: The study explored the collective dissonance experienced by stakeholders across various curricular components. Effective implementation of CBME would require committed faculty, adaptive leadership, and a context-sensitive regulatory framework that enables innovation and local relevance. This synthesis offers insights for educators, curriculum planners, and policymakers to refine CBME design and foster improvements in medical education in India.
Background: Student evaluation are a critical tool for improving medical education, yet low response rates limit their utility. While QR codes have been used in various educational contexts, their role in promoting continuous student engagement with curriculum evaluation, particularly in the preclinical setting, remains underexplored. Methods: We conducted a cohort comparison study to evaluate whether placing QR codes and hyperlinks on lecture slides could increase student participation in routine course evaluations. The intervention group, Class of 2027 (the class graduating in 2027, enrolled in 2023), received this access enhancement during the latter half of the academic year, while Class of 2026 (class graduating in 2026, enrolled in 2022) served as a historical control. Weekly evaluation response rates and number of written comments per lecture were compared between groups using independent t-tests, and effect sizes were calculated with Cohen’s d. Results: Baseline comparison showed no significant differences between groups. During the intervention period, the QR code group demonstrated significantly higher response rates (12% vs. 7%) and more written comments per lecture (4.3 vs. 1.6) compared to the historical control, with p < 0.001 for both. Effect sizes were large (Cohen’s d = 1.78 and 1.90, respectively). Discussion: This is the first published study to demonstrate that QR codes integrated into preclinical lectures can meaningfully increase both the response rates and amount of written feedback. The intervention’s simplicity, scalability, and effectiveness suggest it is a promising strategy for improving feedback from students in medical education.
Background: Evaluating diversity, equity, and inclusion (DEI) in health education is crucial to ensure an inclusive and effective learning environment. In this pilot study, we aimed to create and validate the first tool, the Diversity, Equity, and Inclusion Index (DEII), to assess DEI within health education lectures. We hypothesized that the DEII would demonstrate strong face and content validity as well as acceptable to excellent interrater reliability. Methods: This pilot cross-sectional study was conducted from January 2022 to December 2023. We developed the Diversity, Equity, and Inclusion Index (DEII) and assessed its face and content validity. The study followed the COSMIN taxonomy guidelines. Interrater reliability was calculated using intraclass correlation coefficients from DEII scores of 50 YouTube lectures. Setting: The study was conducted at several academic medical centers in the United States of America, encompassing diverse health education settings. Participants: 10 expert-DEI reviewers as well as 10 non-expert DEI reviewers who represented the major sections of health professions including physicians, nurses, researchers, social workers, respiratory therapists, and physical therapists, as well as multiple institutions assessed face and contentvalidity. Expert reviewers were defined based on specific criteria, including board certification, leadership positions in DEI, authorship of peer-reviewed DEI publications, national presentations on DEI topics, and implementation of DEI initiatives. Non-expert faculty were selected based on their involvement in health education but without specific DEI expertise. Participants were recruited through a convenience sample approach. All approached participants agreed to take part in the study. To assess interrater reliability, three researchers scored 50 health education lectures on YouTube whose audiences ranged from respiratory therapists, nurses, physicians, physician associates and those training to be each. Results: Interrater reliability analysis demonstrated that 16 out of 17 items met the threshold for acceptable reliability (ICC ≥ 0.50). Specifically, 7 items exhibited excellent reliability (ICC ≥ 0.90), 5 demonstrated good reliability (0.70 ≤ ICC < 0.90), and 4 showed moderate reliability (0.50 ≤ ICC < 0.70). At the domain level, three of the four domains achieved acceptable reliability (ICC ≥ 0.70), with one domain reaching the threshold for excellent reliability (ICC ≥ 0.90). Discussion: In this pilot study, the DEII is a reliable and valid tool for assessing diversity, equity, and inclusion in health education lectures. Its implementation may enhance the inclusivity of health education, ultimately leading to better-preparedhealthcare professionals and improved patient outcomes. Further research is needed to refine the tool and explore its impact on educational practices and outcomes.
Addressing the complex and evolving needs of individuals with autism requires more than incremental improvement; it demands a rethinkingof how care systems are designed, delivered, and evaluated, and how we educate the health workforce. While existing clinical guidelines and resources provide valuable foundations, they often remain fragmented and may not fully reflect the diversity of the populations they serve. This paper presents a critical analysis of existing global autism care frameworks, highlighting gaps that particularly impact underserved populations, especially in low-and middle-income settings. While many guidelines emphasize early diagnosis and evidence-based therapies, they frequently overlook essential areas such as trauma-informed care, sexual health, caregiver support, transitions across the lifespan, and more. This paper offers a fresh, equity-driven perspective and proposes actionable, context-sensitive strategies to reimagine autism care. For mental health and social care professionals and trainees, including primary care providers and other healthcare practitioners, as well as those supporting individuals with autism in public health and social care settings, this paper highlights key challenges and outlines practical solutions. A full set of detailed recommendations is presented in our comprehensive report.
Background: To advance social accountability in our medical school admissions, this study aims to examine how sociodemographic profiles of students admitted to undergraduate medicine at the University of Ottawa compare to those of the Ottawa regional community. Methods: Weconducted a cohort study of our 2023 first-year MD students. We used data from the Ontario Medical Student Applicant Service and the Ottawa Neighbourhood Study to descriptively compare nine sociodemographic factors. Results: Of 183 students, our cohort demonstrated greater diversity in non-official first languages, second and third-generation status, and non-White racial identities. However, Black students (4.4% vs. 6.3%) were underrepresented, and Indigenous students (4.4% vs. 3.2%) were likely underrepresented given the known underreporting of Indigenous identity in census data. Students from the highest-earning households (32.8% vs. 13.2%), and with parents working in education (30.1% vs 16.5%) or health (15.8% vs 7.5%) professions were overrepresented. Conclusions: This study demonstrates student underrepresentation for some sociodemographic factors and serves as an approach for other medical schools to consider admissions representation using local data.
Medical education is undergoing significant transformations to better align with evolving healthcare needs. In 2015, the Pontificia Universidad Católica de Chile implemented a major curricular reform in its School of Medicine, shifting from a traditional 7-year program to an integrated, competency-based 6-year curriculum. This study aimed to assess the academic outcomes, clinical competencies, and differences in student well-being between both curricula. Methods: We conducted a prospective, longitudinal, comparative study of two cohorts: the last cohort under the traditional curriculum and the first cohort under the new curriculum. Three measurements were carried out along the study program: at the beginning, at the middle and at the last year of the program. Academic performance, professionalism, and clinical competencies were evaluated using standardized written tests, OSCEs and the National Medical Exam (EUNACOM). In addition, we compared the courses grades and attrition statistics along the studies. At these three points, students also answered a range of self-reporting instruments regarding distress, burnout, wellbeing, mindfulness, empathy and the educational environment. Results: Both cohorts achieved similar average grades and EUNACOM scores. The new curriculum cohort had a significantly lower course failure rate (7.6% vs 13%, p<0.01) and better outcomes in professionalism and communication. Final OSCE scores were slightly higher in Obstetrics/Gynecology and Family Medicine. Despite these improvements, both cohorts showed high and increasing levels of stress, burnout, and declining empathy, particularly in the final years. While the elevated levels of stress and anxiety observed among medical students are extensively documented in the literature, the COVID-19 pandemic may have exerted an additional influence on these outcomes. Conclusion: The new curriculum maintained academic performance while enhancing professionalism and reducing failure rates and training time. However, persistent mental health challenges underscore the need for stronger and more effective support systems. These findings reveal the value of competency-based education while highlighting the importance of holistic curricular evaluation.
Background: Teledentistry facilitates treatment planning, patient monitoring and education in dentistry by enhancing the access to and outcomes in oral health. This study aimed to assess the undergraduate students' use and acceptance of teledentistry services using a tool based on the UTAUT model. Methods: The implementation of teledentistry into the curriculum of 241 undergraduate students receiving training for teleconsultation was evaluated. The students' behavioral intention to adopt teledentistry was measured with questions based on the Unified Theory of Acceptance and Use of Technology (UTAUT) constructs, such as performance expectancy, effort expectancy, social influence facilitating conditions, and trust. Results: A total of 105 students completed the UTAUT model questionnaire. The valid hypotheses considered the following constructs: performance expectancy (H1), social influence (H3) and trust (H5) showed positive impacts, whereas effort expectancy (H2) had a non-significant negative influence and facilitating conditions (H4) had no significance. Therefore, performance expectancy, social influence and trust had an impact on the students' behavioral intention to use teledentistry. Discussion: The constructs performance expectancy, social influence and trust impacted the behavioral intention of undergraduate students in using teledentistry, meaning that these factors must be considered during the implementation of this telehealth service.
Reflection writing practices among MBBS students are limited and the challenges with respect to students have not been explored in Indian context. This quasi-experimental study was conducted among MBBS students based on ADDIE Framework through convenience sampling.Reflective writing skills were evaluated using a pre-validated rubric scale before and after a workshop and a performance review with feedback was given in-person to the students in the subsequent weeks. About 66% of the participants preferred to reflect immediately after the class and 34% of them strongly agreed that mastering the reflective writing skills will develop thought process, critical analysis skills and eventually make them a better physician. About 99% reported that they used the inputs of the workshop and performance review for writing reflection. This study demonstrates the importance of constructive feedback and workshop in the effective reflective writing skills of medical students.
COVID-19 exposed a fragile public health apparatus: nearly half of U.S. state and local health professionals departed between 2017 and 2021, and many who remained faced harassment, burnout, and politicization of their work. Against this backdrop, doctoral programs in community and public health continue to privilege theory and publication, leaving graduates ill-equipped for the data-driven, highly visible, and cross-sector roles that contemporary crises demand. It further highlights student anxiety over uncertain career stability and the exodus of experienced mentors. This commentary synthesizes workforce surveys, qualitative accounts of threatened officials, and curricular audits to demonstrate the widening gulf between training and practice. It argues that doctoral education must shift from insular scholarship to practice-anchored leadership and proposes four interlocking reforms: (1) integrate competencies in leadership, informatics, health equity, policy translation, and crisis communication into core coursework; (2) mandate extended, mentored placements across governmental, nonprofit, and industry settings to cultivate applied proficiency; (3) build career and mentorship infrastructures that normalize trajectories beyond academia and support professional identity formation; and (4) embed resilience, media literacy, and public-engagement training to prepare graduates for politicized environments. By reframing doctoral study as preparation for service as well as inquiry, universities can cultivate leaders who convert evidence into action, navigate ideological headwinds, and restore public trust. The pandemic served as a stress test; the next emergency will judge whether doctoral education has learned. An outward-looking, practice-oriented, and people-centered curriculum is therefore not optional, but imperative.
Background: There are gender disparities for women in medicine, with poorer health outcomes and decreased representation in the physician workforce. While many solutions have been proposed, the unconscious bias that perpetuates these disparities is hard to change. In this study, we examined the impact of an educational intervention focused on the history of women’s rights in the United States, on students’ knowledge, perceptions, and attitudes towards women’s rights. The educational intervention was designed using critical theory to improve student knowledge of the social and historical contexts that have led to gender disparities, promoting critical reflection of beliefs in an attempt to modify student attitudes towards women’s rights. We hypothesized that men and women would respond differently to this educational intervention, based on their prior knowledge, experiences, and beliefs. Methods: The knowledge and attitudes of 159 allopathic medicalstudents were measured between 2023–2024 using a pre- and post-survey to assess the impact of participating in a modified jigsaw educational intervention on gender bias. Results: Students identifying as women had more formal education or experiences with women’s reproductive rights compared to students identifying as men. On average, students showed improved knowledge, answering 4.94 questions correctly on the pre-survey compared to 8.65 questions on the post-survey (p <0.001); however, women began with a higher knowledge level than men. Finally, student attitudes, as measured by agreement with statements, also changed post-intervention, and written statements indicated students’ desire to advocate for women. Discussion: This study shows that a single educational intervention can impact students’ short-term knowledge and attitudes toward women’s rights, which is the first step towards creating agency in students to mitigate thegender biases seen in medicine.
Background: The integration of artificial intelligence, particularly generative AI (GenAI), in learning is transforming medical education from undergraduate to subspecialty levels, promising enhanced diagnostic accuracy, personalized learning, and real-time feedback. However, concerns persist regarding reliability, accuracy, and ethical implications, including the potential for "hallucinations" and an erosion of students´ critical thinking skills. The evolving regulatory landscape also highlights challenges in ensuring safety, fairness, and accountability as GenAI systems gain autonomy in clinical decision-making. This narrative literature review examines the current landscape of GenAI applications in medical education within China and Indonesia, aiming to identify trends, gaps, and strategies for developing GenAI competencies among future healthcare professionals. Methods: A systematic search of PubMed, MedLine, Google Scholar, Scopus, and Chinese CNKI databases, along with targeted hand searches, identified 12 empirical studies published between January 2022 and December 2024. Studies were categorized based on Kirkpatrick’s evaluation levels. Results: We found that GenAI has been used across various medical topics and learning activities, including scientific presentations, small-group discussions, and simulations. Benefits included increased confidence in GenAI use, improved student engagement, and enhanced practical skill development. Conversely, challenges included sporadic adoption, lack of training, concerns about misinformation, technical limitations (e.g., accuracy in non-English contexts), and the high cost of implementation. Most evaluated outcomes were at Kirkpatrick's Level 1 (satisfaction) and Level 2 (knowledge/skills), with a notable absence of Level 3 (behavioral changes) or Level 4 (healthcare outcomes), suggesting the field is in early evaluative stages. Discussion and Conclusion: Our review recommends comprehensive training for faculty and students, curriculum integration, and robust evaluation systems to address accuracy and ethical concerns. Future research should focus on longer-term impacts on behavioral changes and patient outcomes, utilizing multi-methodological approaches and fostering interdisciplinary collaboration. This will ensure GenAI effectively complements, rather than replaces, human expertise in preparing competent and ethical healthcare professionals.
Background: Medical students in Brazil experience high rates of mental health problems (MHPs). However, the current prevalence rates inthis population remain unknown. Therefore, the authors aimed to estimate the prevalence of MHPs among medical students in Brazil. Methods: In this systematic review and meta-analysis, PubMed, Embase, Scopus, LILACS, and PsycINFO were searched for cross-sectional studies published in peer-reviewed journals that reported the prevalence of MHPs in a medical student sample in Brazil and utilized validated instruments translated to Portuguese. A DerSimonian-Laird random-effects model was used to calculate the pooled prevalence of each different MHP, for males and females, and for studies conducted before and after the pandemic outbreak. Registered in PROSPERO, number: CRD42024499416. Results: Ultimately, 126 studies were included, aggregating data from 47,513 medical trainees. The pooled prevalence was36.3% (95% CI 31.2–41.6) for depressive symptoms, 41.2% (33.8–48.8) for anxiety symptoms, 38.7% (32.3–45.3) for common mental disorders, 65.6% (58.5–72.4) for poor sleep quality, among other MHPs. Female students showed higher prevalence rates than males, except for alcohol abuse. For depression, pre-Covid-onset studies yielded a pooled prevalence of 34.8% (29.1-40.7) compared to 43.4% (31.0-56.3) in post-Covid-onset studies (p=0.22). Conclusions: These findings underscore the need for greater emphasis on mental health care and support during medical training in Brazil.
Background: Leadership development is an important part of strengthening Human Resources for Health (HRH) and navigating the complex, dynamic, and interdependent nature of health systems in low- and middle-income countries (LMICs). These health systems are frequently characterized by uncertainty, resource limitations, and fragmented service delivery, necessitating contextually grounded and adaptive leadership on all levels. Despite this, conventional public health staff training programs in LMICs often overlook leadership competencies and fail to incorporate learner-centric, affective, and experiential learning methods. The objective of this review was to synthesise evidence from leadership development initiatives implemented in LMICs to identify common success factors, gaps, and contextual adaptations, and to propose a strategic framework for strengthening leadership capacity among human resources for health (HRH) especially for LMICs. Methods: This study employed a qualitative thematic synthesis of nine leadership development initiatives implemented across LMICs between 2000 and 2022. Initiatives were selected based on defined inclusion criteria: targeting HRH, reporting contextual adaptation, and including participatory or applied pedagogies. Braun and Clarke’s six-step framework for thematic analysis was applied to extract and synthesize key findings from the selected case studies. Results: Four major crosscutting themes emerged from the synthesis: (1) contextual relevance and local ownership; (2) adaptive and participatory pedagogies; (3) multilevel stakeholder engagement; and (4) progressive skill development and reflective practice. Based on these findings, we propose a comprehensive strategic approach to leadership development that integrates adult learning theories, blended instructional designs, and adaptive training ecosystems. Emphasis is placed on co-design with stakeholders, including policymakers, healthcare providers, academic institutions, and communities, to ensure relevance and sustainability. Discussion: Aligning global standards with local contexts, this approach positions leadership development as a central driver for the strengthening of health systems. The paper offers practicalrecommendations for health system leaders, training institutions, and global health policymakers committed to building resilient and inclusive HRH leadership in LMICs. Drawing on thematic insights from nine leadership initiatives, the study emphasizes the importance of participatoryteaching-learning methods, stakeholder engagement, and adaptive training ecosystems.
