The transition from medical student to doctor is demanding. Although research has explored preparedness and wellbeing, disabled doctors’ experiences remain underexamined, risking a homogenised understanding of a process that is likely experienced unevenly across learner groups. We conducted a longitudinal qualitative study using a phenomenological approach, following six disabled final-year medical students through their first year of postgraduate practice in the UK. All six completed interviews before and shortly after starting work, four completed a third interview, and two completed all four interviews. The 18 interviews were analysed using reflexive thematic analysis, with crip theory informing interpretation. We constructed four themes: negotiating legitimacy and belonging, living with the fluctuating pace of clinical practice, access work as ongoing labour, and seeking survivable futures. Belonging rose and fell across placements, access arrangements were repeatedly renegotiated, and fluctuations in pace shaped wellbeing and participants’ sense of professional legitimacy. Difficulties did not follow a consistent trajectory of decline. Rather, participants developed strategies for navigating recurring tensions, often at significant personal cost. By the end of the year, some were orienting career planning toward contexts where practice felt sustainable. Transition for disabled doctors was recurrent and context dependent, with changing placements requiring renewed negotiation of disability legitimacy and access. PGME support should reduce the individualised labour of maintaining adjustments across rotations and address how expectations concerning pace and productivity shape supervision and judgements of competence.
Medical training is associated with a high prevalence of anxiety symptoms that escalate with curricular advancement. Complex thinking has been proposed as a protective cognitive skill; however, its predictive capacity and evolution throughout training remain poorly explored. This study aimed to determine the predictive capacity of complex thinking for anxiety symptoms in medical students and to analyze the variation of this predictive effect by academic year. A cross-sectional study was conducted among 567 medical students at a Mexican public university. Complex thinking and anxiety symptoms were assessed using the COMPLEX-21 scale and the Beck Anxiety Inventory, respectively. One-way ANOVA with Tukey post hoc comparisons, Pearson correlations, stratified linear regression models, and a Year × Complex Thinking interaction model were conducted. In the overall sample, complex thinking was an inverse predictor of anxiety symptoms (B = − 0.249, 95
Developing high-quality Objective Structured Clinical Examination (OSCE) standardized patient (SP) scripts is time and resource-intensive. Large language models such as GPT-4 may improve script writing, however, their educational adequacy and realism compared with expert-written scripts remain uncertain. We compared GPT-4 generated OSCE scripts to expert-written scripts across five educational quality domains: detectability of AI authorship, perceived realism, consistency of role depiction, clinical accuracy, and alignment with learning objectives. A secondary exploratory non-inferiority analysis was also conducted. We developed fifteen OSCE SP scripts using three approaches, expert-written, AI-generated, and AI-generated with human editing, with five scripts per group. Scripts were rated by blinded SPs and physicians. We assessed whether AI-generated scripts were non-inferior to expert-written scripts within 10-percentage-points. Raters could not reliably distinguish either AI-generated script group from expert-authored scripts. For realism, means were 3.90 (SD 0.79) for expert-written, 3.88 (1.02) for AI-generated, and 3.56 (1.07) for AI+human scripts. For clinical accuracy, means were 4.27 (0.70), 4.07 (0.96), and 4.40 (0.63). For alignment with learning objectives, they were 4.27 (0.80), 3.67 (1.11), and 4.27 (0.80). AI+human scripts were rated highest for clinical accuracy and alignment with learning objectives, and expert-written scripts highest for realism and consistency of role depiction. In the exploratory non-inferiority analysis, non-inferiority to expert-written scripts was not demonstrated for either AI-generated set. This pilot study provides preliminary evidence on the comparability of GPT-4-generated and expert-written OSCE scripts, with similar ratings across several educational quality domains, though non-inferiority was not demonstrated. Larger, more rigorous studies are needed to conclusively demonstrate AI generated OSCE scripts are non-inferior when compared to human expert generated OSCE scripts.
Listening Rooms are a qualitative data collection method, wherein two participants have a discussion without a researcher present. The conversation is guided by prompts provided by the researcher. This approach can elicit more candid, honest accounts of experiences than may occur when participants communicate directly with researchers, which can be advantageous in medical science education contexts. This article outlines practical tips for getting the most out of using Listening Rooms in medical science education research, including guidance on deciding whether listening rooms are appropriate for a particular project, advice regarding prompt design, and logistical, safety and wellbeing factors to consider.
To evaluate student perceptions, self-reported utility, and iterative modifications of “Matchy-Matchy” (MM), an interactive card-alignment activity in Team-based Learning (TBL) across pre-clerkship cohorts. Between 2023 and 2025, MM was implemented in pharmacology modules. M2 iterations included baseline implementation (Fall 2023), an exploratory step incorporating an AI chatbot (Fall 2024), and a refined version replacing the chatbot with case-tailored NBME-style clicker questions (Fall 2025). M1 (Spring 2025/2026) and M2 (Fall 2024) MM utility perceptions were compared via a 4-item survey. Open-ended M2 comments (N = 76, 2023–2025) were classified as Positive, Negative, or Neutral/Mixed by five raters (three faculty, one student, one unaffiliated; Fleiss’ kappa = 0.591). M2 students (Fall 2024), surveyed within one month of USMLE Step-1, endorsed MM utility aspects such as “reinforcing connections between terms” (34
Reflective writing assessment in medical education is labor-intensive and raises data privacy concerns that preclude cloud-based AI solutions. We conducted a feasibility study using a locally-hosted, open-weight large language model (LLM) deployed on institutional servers to assess medical students’ reflective writing. The model evaluated 10 de-identified student narratives using two published rubrics across three independent passes, generating rubric-aligned scores and formative feedback. Scores were consistent across passes and rubrics with no statistically significant differences. Expert faculty rated LLM-generated feedback as meeting most quality criteria (mean 5.48/7). These findings support feasibility of a privacy-preserving, locally-hosted LLM for scalable reflective writing assessment.
Lifelong learning is a core expectation in medical education yet approaches to cultivating and assessing it are often fragmented. The goal of this study was to develop a practical, theory-informed model of lifelong learning that could (a) unify messaging across our academic success programs (b) to guide diverse applications, including online self-assessment inventories, integration into workshops, development of learning resources, individual coaching sessions, and targeted support interventions (c) help students strengthen their lifelong learning skills, enhance study strategies, and support continuous development, and (d) be applicable to all learners, whether engaged in proactive growth or receiving reactive academic support. We used the MEASURE framework to guide the design of the 7Ps Framework (Plan, Prepare, Participate, Process, Practice, Perform, Pause) and a complementary self-reflection inventory. An exploratory factor analysis (EFA) of 26 items (N = 191) revealed a seven-factor structure, accounting for 68.32
Carol Dweck’s Growth Mindset Theory (GMT) has gained increasing attention in health professions education (HPE), yet its development has not been comprehensively mapped. This first bibliometric review analyzed 142 HPE articles identified through a Scopus search and Bibliometrix analysis. Publications increased substantially after 2016, with rapid growth following 2020. Commonly associated concepts included resilience, competency-based education, motivation, and self-regulation. The United States produced the most publications and citations, and medicine, nursing, and pharmacy were the most represented professions. Although GMT scholarship in HPE is expanding, greater collaboration and more robust research designs are needed to strengthen the evidence base.
The critical analysis and diagnostic decision-making skills are essential for developing competent physicians. This study aimed to investigate the educational effectiveness of an AI-assisted World Café model within the Clinical Comprehensive Reasoning and Ability Training course. A single-group pretest-posttest quasi-experimental design was employed. Participants comprised 55 third-year clinical medicine students at Kunming Medical University. The instructional design integrated the World Café discussion method, Case-Based Learning, and AI-assisted tools. Students received explicit training in standardized prompt engineering to facilitate structured and critically reflective interactions with AI. Multiple source data were collected using perception questionnaires, clinical knowledge tests, and a double scoring protocol involving both AI analysis and blinded human instructor evaluation. Following the course intervention, students’ acceptance of AI-assisted learning increased. In the evaluation of case discussion records and PowerPoint slides, AI-generated scores exhibited consistency with human instructor scores across multiple assessment dimensions. Although improvements in clinical knowledge test scores and perceptions of AI output quality did not reach statistical significance, the observed positive trends suggest potential for longer‑term educational gains that merit investigation in future studies. These findings suggest that the AI-assisted World Café model is feasible and effective in fostering students’ acceptance of AI technologies and supporting formative assessment in clinical reasoning training. The model offers a practical framework for integrating AI into medical education pedagogies, with particular value in enhancing collaborative learning processes and preparing students for informed human-AI collaboration in future clinical practice.
Assessment format shapes how medical students study. While multiple-choice questions (MCQ) are widely used, they may incentivize pattern recognition and memorization. We developed and implemented a novel open-ended assessment format, the Diagnostic Reasoning (DxR) exam, designed to mirror the step-by-step, iterative nature of clinical decision-making. Our goal was to verify content delivery validity and to study the effects of employing a hybrid assessment approach (MCQ and DxR) across multiple courses on students’ study strategies. End-of-course DxR and MCQ exams were administered concurrently at the end of four second-year organ systems courses for the Classes of 2021–2024. Four independent expert raters reviewed each exam to generate item and scale level content validity indices. Students were surveyed about study resources and strategies used, and frequency of re-organizing study around presenting complaints and differential diagnoses rather than disease states for each assessment format. Content validity analysis revealed strong alignment between content and intended construct for the DxR exam (S-CVI = 0.93). DxR exam preparation favored institution-developed resources, while MCQ preparation emphasized board-oriented materials, particularly question banks and review texts (P < .001, Cramér’s V = 0.26). Study strategies also differed significantly (P < .001, Cramér’s V = 0.19) with MCQ preparation favoring individual study, while DxR preparation included self-created cases, content reorganization, and group study. Learners were 2.4 times more likely to report organizing study material by clinical presentation rather than disease state when studying for DxR exams (P < .001). DxR exams demonstrate high content validity. Students report more frequent use of study strategies more closely aligned with institutional learning objectives and the development of clinical reasoning skills when studying for DxR exams than when studying for MCQ exams. Incorporating complementary assessment formats may align curricular objectives with both licensing preparation and diagnostic reasoning skill development.
Undergraduate medical students often have limited confidence when approaching neurology and neuroimaging, a challenge commonly described as neurophobia. Non-contrast CT brain interpretation is visually and cognitively demanding, yet students often encounter scans in acute care placements. This monograph proposes the 4S Framework—Symmetry, Shade, Sulci and Structures—as a simple visual scaffold for introductory CT brain teaching. The framework translates image review into four sequential questions and is accompanied here by teaching examples, session plans, assessment suggestions, pitfalls and safeguards. It is intended as educational scaffolding rather than a substitute for formal radiological interpretation.
Health professions education (HPE) increasingly operates amid recurrent disruption: technological change, resource constraint, accreditation reform and unstable clinical learning environments. Antifragility — the property of systems that improve because of stressors — offers a tempting vocabulary. This Monograph argues that its value depends on the level of analysis. Applied to individuals, antifragility risks becoming another attribute demanded of those already absorbing systemic strain. Applied to systems, it asks whether institutions learn from disruption or transfer its costs downwards. The article distinguishes antifragility from neighbouring concepts, proposes five conditions for ethically defensible design, and identifies indicators for detecting burden transfer.
Medical and nursing students often feel insufficiently prepared to care for individuals with intellectual disabilities. Simulation-based education represents an innovative approach by enabling direct contact in a safe learning environment with patient-centred feedback. This study evaluates the effectiveness of a simulation-based intervention involving real expert patients with mild to moderate intellectual disabilities on students’ relational and communication practices, immediately after the intervention and at six-week follow-up. Students’ satisfaction was also assessed. A quasi-experimental study was conducted with 115 medical and nursing students assigned to either an experimental or waitlist control group. The experimental group participated in a simulation session involving an expert patient with intellectual disability. Measures of attitudes, empathy, and representations and practices in inclusive health were collected pre- and post-intervention. The experimental group also completed a satisfaction questionnaire and a 6-week follow-up survey. Fifty-eight students participated in the intervention and 57 formed the control group. Among the experimental group, 43 completed the follow-up. Compared with the control group, the intervention group showed significant improvements in affective and behavioural attitudes, representations and practices in inclusive health, and empathy towards intellectual disability. These effects were maintained at six weeks except for empathy. Students also reported increased comfort and confidence. Satisfaction with the intervention was high, and students highlighted the value of involving individuals with intellectual disabilities in the simulation. Simulation-based education involving expert patients improves students’ self-reported attitudes toward individuals with intellectual disabilities, empathy, and inclusive healthcare practices. It represents a promising approach to promote more inclusive and patient-centred healthcare.
To improve the transition to residency, the Coalition for Physician Accountability recently recommended a post-Match, learner-driven educational handover. Few studies have analyzed students’ perspectives on the content of handovers, especially the inclusion of personal values or self-care goals. We surveyed graduating medical students at our institution on their perspectives about the content in an educational handover to residency programs. A subset agreed with sending goals, personal values, and learning style to program directors. Students expressed concerns with sending feedback or grades and the potential to perpetuate prior perceptions.
Medical students face high academic and psychological demands, making them especially vulnerable to stress. Ongoing stress without effective coping can harm their mental health and academic performance. Guided by the Transactional Model of Stress and Coping, this study aimed to assess perceived stress levels among Jordanian medical students, identify related sociodemographic factors, and examine the coping strategies they use to manage stress. A cross-sectional study was conducted among 622 medical students recruited through a stratified convenience sampling approach from public and private Jordanian universities. Data were collected using the Medical Student Stressor Questionnaire (MSSQ) and the Brief COPE inventory. Eight incomplete questionnaires were excluded before analysis using a complete-case approach. Descriptive and inferential statistics, including t-tests, ANOVA, and Pearson correlation, were performed using IBM SPSS v.22 to determine relationships between stress domains, coping strategies, and sociodemographic variables. Moderate to high stress levels were reported across all MSSQ domains. Female students, those older than their academic year, students with lower GPAs, physically inactive students, and those reporting lower perceived social support had significantly higher stress levels (p < 0.05). Problem-focused and emotion-focused coping were more common among females and students with higher perceived social support, while avoidant coping was associated with female sex, having a lower GPA, perceived social support, and being older than one’s academic year. Avoidant coping demonstrated the strongest positive correlations with all stress domains, suggesting that greater reliance on maladaptive coping strategies is associated with higher perceived psychological distress. Stress is common among Jordanian medical students and is strongly affected by demographic, academic, and lifestyle factors. Avoidant coping is tied to higher stress, while problem-focused and emotion-focused coping strategies seem more effective. These findings support the integration of structured student wellness initiatives, resilience training, mentorship programmes, and accessible mental health services within undergraduate medical education to promote healthier coping behaviours and improve student well-being.
Professionalism is central to medical education yet remains not universally agreed upon, which threatens trust, equity, and clinical care. Ambiguous standards complicate how professionalism is understood, particularly amid workforce diversification, burnout, COVID-19, and social justice movements. This article reviews how concepts of professionalism have shifted over time, from an assumed moral character to a set of teachable, context-dependent skills emphasizing social awareness, cultural humility, and clinician wellbeing. The authors propose a collaborative, evolving framework for defining and teaching professionalism, grounded in core values—integrity, respect, empathy, accountability, lifelong learning, and commitment to patient care—to keep expectations aligned with changing healthcare environments.
Hack4Health is an adaptable hackathon model for experiential digital health learning. Medical students are paired with computer science and engineering peers to identify health-system problems, co-design prototypes, and pitch implementation-focused solutions. The format provides medical learners structured exposure to digital health development and integration—competencies increasingly expected of future physicians.
Employer-supported volunteering, including volunteer time-off (VTO), has been associated with positive work-related outcomes and may mitigate burnout. This report describes a five-year VTO initiative for faculty and staff at Baylor College of Medicine’s School of Health Professions. Leadership implemented targeted strategies to increase VTO participation and evaluated outcomes using time-off records and a post-program survey. VTO participation increased from 4
The exponential expansion of medical knowledge intensifies cognitive load in undergraduate medical education, challenging learning efficiency and long-term retention. While digital learning tools have been widely explored in high-income settings, their role in contexts marked by structural inequalities in access and educational resources remains less understood. In Brazil, disparities in digital infrastructure and access to formal educational support systems create a distinct learning environment in which widely available platforms such as Instagram may represent a scalable and low-cost microlearning strategy. In this study, we evaluated the integration of Instagram into histology teaching within a Brazilian medical school using the Kirkpatrick model. The 2021 cohort of first-year medical students experienced two instructional approaches: traditional instruction during the abdominal histology module and a hybrid approach incorporating Instagram-based microlearning during the pelvic histology module. Student performance was assessed through practical and theoretical examinations, and engagement was measured through structured questionnaires. A multi-cohort comparison revealed that students exposed to Instagram in 2021 achieved significantly higher practical and final grades in pelvic histology compared to cohorts from 2019 to 2022, in which Instagram was not used. Students also reported high levels of satisfaction, citing accessibility, flexibility, and reinforcement of learning as key benefits, despite recognizing the potential for distraction. These findings suggest that, in resource-limited educational settings, social media platforms such as Instagram can serve as effective adjuncts, enhancing engagement and supporting knowledge retention. Importantly, this study highlights the context-dependent value of digital microlearning strategies, particularly in middle-income countries where scalable and accessible educational innovations are critically needed.
