Introduction: Sickle Cell Disease (SCD) is a common inherited haemoglobinopathy with significant oral and systemic implications. Despite its prevalence in multi-ethnic populations in the UK, there is limited evidence on clinicians’ awareness and understanding of the condition. This study aimed to compare the knowledge of doctors and dentists regarding SCD, including awareness of at-risk populations, disease features, and clinical management. Methods: A questionnaire assessing knowledge and attitudes toward SCD was distributed to clinicians at Kingston Hospital (KH) and King’s College Hospital NHS Foundation Trust (KCH). Data were collected between August 2023 and January 2024 using convenience sampling in divisional meetings, clinics, and via email. Responses were analysed descriptively using percentages and frequencies, with cross-tabulation performed to compare doctors’ and dentists’ knowledge. Results: A total of 100 clinicians participated (64 doctors, 36 dentists). While 81% correctly identified African/African-Caribbean patients as at risk, few recognised other affected groups such as Middle Eastern (6%) or South Asian (10%) populations. Only one participant (1%) identified all correct at-risk ethnicities. Sixty-two percent correctly identified the Hb SS genotype as Sickle Cell Anaemia, with doctors performing better than dentists (78% vs 48%). Two-thirds (66%) recognised that sickle cell trait is clinically benign, with dentists demonstrating higher accuracy (74% vs 57%). Knowledge of clinical features was limited: only 34% correctly identified that iron deficiency anaemia is not a feature of SCD. Conclusion: This study highlights variability and gaps in knowledge of SCD among doctors and dentists, particularly regarding at-risk demographics and disease features. Improving education, clinical guidance, and cultural awareness is essential to ensure appropriate screening, timely diagnosis, and effective management of patients with SCD.
Single best answer (SBA) questions dominate UK medical licensing assessments, valued for their standardisation, reliability, and psychometric rigour. Yet the inclusion of demographic descriptors, particularly race and ethnicity, raises ethical and methodological challenges. Evidence indicates that presenting race or ethnicity in the opening sentence of an SBA stem may trigger cognitive biases, reinforce stereotypes, and introduce construct-irrelevant variance, potentially compromising fairness and validity. This perspective critically examines the use of race and ethnicity in UK licensing SBAs, emphasising that such descriptors should be included only when clinically relevant and embedded within the clinical observation or context rather than as initial identifiers. We propose a framework to guide item writers, aligning with international best practice and psychometric principles, to ensure ethical, unbiased assessment. By implementing these recommendations, the UK Medical Licensing Assessment can enhance construct validity, reduce bias, and promote equity, setting a precedent for ethically sound and psychometrically robust medical examinations.
Introduction: This study aims to investigate the primary concerns of medical students and their support needs, focusing on academic, career, and psychological challenges. The research questions address how these concerns vary by academic year and gender and seek to identify students’ preferences for counseling and support types. Methods: A cross-sectional survey was conducted with 135 medical students from first to sixth year. Data on concerns, academic year and gender differences, and counseling preferences were collected and analyzed using frequency analysis, t-tests, ANOVA, and correlation analysis. Results: The study found that career choice and academic performance were the most significant concerns. Female students reported more emotional and study-related challenges than male students. A strong correlation was observed between academic performance, study motivation, and emotional issues, with career and major concerns intensifying in higher years. Students preferred face-to-face counseling once or twice per year, favoring professional counselors or clinical faculty advisors. Conclusion: The findings highlight the need for tailored support programs to address diverse student concerns, emphasizing the importance of strengthening academic, career, and psychological support systems in medical schools.
Introduction: Extended Reality (XR) combines the physical world with a computer-generated one, across a reality-virtuality continuum. There is good evidence that XR can promote learning, with reasonable evidence for improving healthcare learner knowledge, moderate evidence for changing healthcare learner attitudes, and less good evidence for improving healthcare learner performance, including performance of clinical skills. The General Medical Council mandates competence in 23 procedural skills and additional wider clinical skills for UK medical undergraduates. Methods: We undertook a rapid review to identify XR solutions which may improve clinical skills performance. Results: Four databases were searched for relevant articles, yielding 7167 records, of which 41 studies were included in the review. Data were extracted on study population, intervention, comparator, and outcome. 22 studies were included in the narrative synthesis. Conclusions: Recommendations were made for pilot implementation of XR solutions in UK undergraduate clinical skills curricula, and the next steps required to assess their impact.
Introduction: Faculty development enhances teaching, professional growth, and educational scholarship, yet opportunities for collaborative educational scholarship with students remain limited. The Interprofessional Scholars’ Collaboration in Teaching and Learning (iSCTL) addresses this gap by fostering collaboration among health professions educators and learners to tackle complex challenges and develop interdisciplinary skills. Despite its promise, such programs are underutilized and rarely evaluated. This study assessed iSCTL’s outcomes to demonstrate its impact on health professions education. Methods: A mixed-methods approach was used to evaluate three years of iSCTL participants. Pre- and post-program surveys measured mastery of program objectives, while follow-up surveys and interviews conducted one-year post-participation explored sustained impact. Quantitative analysis included descriptive statistics, Cronbach’s Alpha for reliability, and Wilcoxon signed-rank tests. Qualitative data underwent thematic analysis. Results: Participants demonstrated significant improvements in mastery of iSCTL objectives (P < 0.001), supported by strong internal consistency (Cronbach’s Alpha > 0.7). Three themes emerged: program impact, barriers and facilitators to learning, and recommendations for improvement. Follow-up findings revealed that 62% implemented their projects, and 90% reported enhanced research, teaching, and career growth. Participants credited mentorship, hands-on learning, and networking as key to their success. Conclusion: iSCTL enhanced interdisciplinary collaboration, career development, and scholarly teaching. Findings emphasize integrating the scholarship of teaching and learning into training and offer guidance for optimizing program design to maximize impact.
This paper proposes a “play triad” of curiosity, divergent thinking and a freedom to fail which fosters a healthy learning environment for successful medical education. Traditional medical education has focused on individual mastery and rote memorization, but a shift towards small group learning centering on adaptability, collaboration, and clinical application of knowledge is needed. The success of this communal learning is fostered through the elements of play, a curiosity-driven exploration of hidden potential. Curiosity is the importance of moving from knowing right answers to slowing down and grappling with the why behind the answers we hold true. Divergent thinking builds on the complexity of medical education and being willing to value creative exploration and multiple perspectives. Finally, freedom to fail is the awareness that “wrong answers” are often our greatest teachers. By framing learning around the elements of play, educators can cultivate a growth mindset, creativity, and critical thinking, enabling students to navigate the uncertainties and challenges of the medical profession.
Introduction: There are challenges associated with the availability of Educational and named Clinical Supervisors (CS) for Postgraduate Doctors in Training (PGDiTs). This is likely to increase with NHS England’s (re)distribution and expansion of Training Programmes. Although supervision responsibility is common for Consultants and SAS (specialist, associate specialist) Doctors, PGDiTs are not afforded the opportunity of experience and practice. This pilot is part of a strategy to widen the pool of available future supervisors. Methods: Selected PGDiTs with appropriate training were matched to act as CS to FY2 Doctors in the December 2023 to April 2024 rotation across 3 trusts in the Southwest. Evaluation of the pilot involved: emailed questions, online surveys and structured WhatsApp Voice Note Interviews with thematic analysis. Results: 91% of FY2s and 100% of PGDiT CS would recommend taking part in this programme to colleagues. Thematic analysis demonstrated that FY2s valued the closer mentoring presence that the PGDiT CS provided and preferred this dual supervision to the traditional model. Registrars reported professional and personal development, including specific supervision skills that positively influenced their preparedness to take on supervision in the future. Conclusion: There is minimal risk to FY2s of taking part in such a programme. For the PGDiT CSs there are many benefits to taking part and not only does it better prepare them for conducting supervision but they may take on these responsibilities earlier which will expand supervisory capacity. These results have supported the integration of this programme within the Foundation Training Programme in England.
Introduction: Many medical students begin with a passion for serving urban communities, but few pursue such careers, exacerbating urban health disparities. This study evaluated the effectiveness of the Urban Health Pathway (UHP) established in 2015 at Case Western Reserve University School of Medicine to address the problem. The UHP aims to provide medical students with urban health experiences, including didactics, hands-on rotations, and mentorship. Methods: From 2015 to 2022, 44 students graduated from UHP. Of those, 15 alumni completed a follow-up survey in 2023, and 24 students submitted detailed self-reflective portfolios at graduation. The longitudinal impact of the UHP was assessed using programmatic data, portfolios, and a follow-up survey. Descriptive statistics and thematic analysis were employed. Results: The UHP significantly influences students’ career aspirations, fostering a strong commitment to working with medically vulnerable populations. Graduates highly valued the mentorship offered by the pathway and reported UHP as instrumental in shaping career choices and reinforcing their dedication to under-resourced urban communities. Discussions: The UHP provides essential support for students interested in serving under-resourced populations. Implementing similar programs in other medical schools could help meet the growing need for urban healthcare providers, ultimately reducing health disparities in these communities.
Introduction: Effective study strategies are essential for success in medical education, particularly during the pre-clinical years. This study explored the use and perceived effectiveness of physical and digital learning resources among Year 1 and Year 2 medical students at the University of Buckingham. Methodology: An electronic survey was distributed, gathering both qualitative and quantitative data on resource usage patterns. A total of 21 students responded, with 52% in Year 1 and 48% in Year 2. Participants reported their highest educational qualification and rated the frequency and manner (active, passive, neither) in which they used various digital and physical resources. Results: Chi-squared statistical analysis revealed several significant findings related to the frequency of use of various resources and their association with perceived learning effectiveness. Among digital resources, the university’s Moodle VLE (χ2 = 35.29, p = 0.000001) and online teaching videos (χ2 = 13.57, p = 0.019) were significantly associated with effective learning. While flashcards (χ2 = 15.29, p = 0.09) and question banks (χ2 = 10.14, p = 0.071) showed a positive trend, these did not reach statistical significance (p > 0.05). Among physical resources, written notes (χ2 = 5.57, p = 0.035) and group work (χ2 = 5.57, p = 0.040) were both significantly associated with improved learning outcomes. Interestingly, support from family members (χ2 = 11.29, p = 0.046) also showed a statistically significant association, suggesting the value of peer-teaching strategies. In contrast, passive use of physical resources literature (χ2 = 8.43, p = 0.134) and online textbooks (χ2 = 5.00, p = 0.416) appeared to have minimal impact on perceived learning effectiveness. Discussion: While the study suggests that students tend to favour online resources to support their learning, limitations such as a small sample size and reliance on self-reported data highlight the need for further research to confirm this. Conclusion: This study offers insight into the resource preferences of pre-clinical medical students, advocating for active engagement with both digital and traditional tools to promote academic success and professional development.
Introduction: Restorative justice is increasingly recognized as a promising approach to address harm, mistreatment, and inequity in medical education. This scoping review explores how restorative justice is currently integrated into undergraduate medical education, with attention to formal curricula, educational interventions, and institutional culture. It aims to identify key strategies, conceptual frameworks, barriers, and reported outcomes related to restorative practices in medical training. Methods: A structured search was conducted across five databases for peer-reviewed literature published between 2000 and 2024. Studies were included if they focused on undergraduate medical education and described or evaluated restorative justice concepts. Data were synthesized thematically into five domains: curricular delivery, conceptual framing, outcomes, implementation barriers, and connections to related frameworks. Results: Sixteen studies were included in the final analysis. Restorative justice was implemented through formal and hidden curricula, often using restorative circles, community dialogues, and consensus-based approaches. Reported benefits included improved collaboration, trust, and equity; however, barriers such as hierarchical norms, lack of training, and insufficient evaluation were widespread. Conceptual links to just culture, trauma-informed education, and moral repair reinforced the relevance of restorative approaches to broader institutional reform. Conclusion: Restorative justice in medical education represents a valuable yet underutilized framework for healing harm and promoting equity. Future efforts must address structural and cultural barriers, invest in educator training, and develop robust methods to evaluate long-term impact.
This research aimed to find out why people with learning disabilities (LDs) choose to teach healthcare students, how this impacts them and why they may choose to return to teaching. The literature surrounding the experiences of people with LDs in teaching is scarce hence providing a need for further research into this topic. The methodology of this research was phenomenology as it has the potential to offer unique insights into human experience. The methods of this project were individual semi-structured interviews. Thematic analysis was conducted on the interview transcripts and identified themes such as: enjoyment of teaching, positive and negative communication experiences, helping students, personal development/gain, and remuneration for teaching. Overall, the results demonstrated many reasons why people with LDs teach healthcare students, as well as areas they found enjoyable. Positive experiences were discussed as well as areas where the experience could be improved. The themes found demonstrate the importance of communication skills and how they can impact people with LDs, both when executed well and when improvement is needed. To disseminate findings inclusively, an easy-read document has been created, and is included in this paper so that those involved in the study can appreciate the findings of this research and understand the importance of their involvement in this paper.
Background and objectives: For decades, there have been many opinion and perspective publications advocating to include One Health in medical curricula. However, it is also known that there are numerous barriers for doing so including a lack of expertise and difficulty of transdisciplinary collaborations, both of which are essential for the development of One Health curricular content. This study comprehensively reviews peer-reviewed publications on One Health curricula in undergraduate medical education, with a focus on the curricular content in terms of scope and substance, implementation strategies, and outcome assessments. Methods: A comprehensive PubMed search was conducted to identify articles that addressed the integration of One Health into undergraduate medical curricula. Eligible articles were screened and categorized based on their primary focus: (1) scope and substance of One Health topic coverage, (2) incorporation of transdisciplinary collaboration, (3) teaching and learning strategies, and (4) outcome evaluation or assessment. Results: A total of 3,445 publications in peer-reviewed journals over a span of 40 years (1983 to 2023) were screened, and only three met the inclusion criteria for detailed analysis. Most publications focused on conceptual advocacy or general descriptions of educational processes, with few offering concrete curricular materials or educational outcome evaluations. Conclusion: This review highlights a hidden gap in peer-reviewed, published literature: a scarcity of tangible, peer-reviewed examples of One Health curricular materials developed and evaluated for undergraduate medical education. Therefore, to support the integration of One Health into physician training across institutions, we urge One Health educators and journal editors to prioritize the dissemination of practical course materials, implementation guides, and evidence-based outcome data. This is essential to prepare future physicians to address complex global health challenges through a One Health lens.
Aim: To identify the level of preparedness of Post Graduate Year 1 (PGY1) doctors for clinical practice in New Zealand. Methods: A survey was sent to PGY1 doctors in 2022 and 2023 six weeks after commencing clinical practice asking them to rate (using a 5-point scale) how prepared they felt starting as a doctor across a range of skills. The respondents were also asked to rank the top three skills in which they wished they had more knowledge when they started, and to provide free text responses with regard to factors that proved challenging during their transition into clinical practice. Results: There were 128 complete survey responses in 2022 and 113 in 2023. Sixty five percent were female, 33% male, and 1% other. Almost all respondents felt prepared for examining patients, understanding common clinical conditions, taking a history, and communicating effectively and sensitively with patients. Approximately half of all respondents reported being prepared for prescribing safely and calculating medication dosages, 37% for participating in an arrest or resuscitation, and 30% felt prepared for looking after sick and deteriorating patients. When asked to rank the top three skills in which they wished they had more knowledge, 77% of respondents ranked looking after sick and deteriorating patients within their top three. Conclusions: Most PGY1 doctors felt well prepared for a range of clinical skills at the commencement of clinical practice. However, there were a number of critical patient management skills that are expected and required of PGY1 doctors for which many respondents felt unprepared. The skills taught in the undergraduate programme should accurately reflect the skill mix required by PGY1 doctors for the practise of medicine in New Zealand.
Introduction: The COVID-19 pandemic and similar calamities can prevent learners from attending offline classes. Simulation is a valuable alternative in such a situation. Aim: To compare learner perceptions and efficacy between simulated patients (SPs) and bedside clinics (BSCs) as a teaching-learning method for the clinical skill training of orthopedic residents. Methods: Our study was an exploratory study conducted at a tertiary care teaching institution in 2021. We randomly divided 21 residents into the BSC group (Group A) and the SP group (Group B). These participants underwent training in five essential clinical skills. We assessed the learners’ perceptions with a Likert scale and focus group discussion. The Likert scale covers seven important domains: liking, understanding, confidence in performance, memorization, interest, willingness to recommend to other faculty, and the need for alternative teaching methods. Furthermore, we effectively compared the efficacy of both approaches by analyzing scores obtained from the MCQ and OSCE examinations. Results: Among the 23 invited participants, 21 participated (participation rate of 91.3%). There were 55 responses (A) and 50 from the group (B). The Likert scale scores for all the cases were not significantly different between the two groups for understanding and confidently performing the concept (P value < 0.05). Learners’ perceptions were similar between the two groups in most domains regarding neurological cases (p value <0.05). The perception was similar in domains such as interest and confidence for ortho cases. We assessed learner perceptions by conducting focus group discussions. There was no significant difference in the final scores obtained on the MCQ and OSCE. Discussion: We can use SP as an alternative to BSC for training in orthopedic clinical skills. SPs are as effective as BSCs. Both methods have no uniformity in terms of learners’ perceptions of different domains.
Introduction: Cultural competence curricula (CCC) in medical schools are imperative for preparing future physicians to improve quality of care for the variety of patients they will encounter. The objective of this review was to determine whether historically invisible health disparities in the United States have been adequately represented in the evolving array of CCC content.Methods: This scoping review analyzed 77 papers published between 1989-2023 describing LCME-mandated CCC in U.S. medical schools. Data was categorized by curricular inclusion of seven Identity Groups and nine Cultural Concepts.Results: Findings reveal that racial/ethnic groups dominated the content, appearing in 77% of programs, while LGBT+, disability, religious, socioeconomic, gender, and local groups were represented in fewer than 50% of curricula. After 2012, the percentage of programs including social concepts such as systemic bias, individual bias, and social determinants of health increased by at least 20%.Conclusions: The underrepresentation of LGBT+, disability, religious, socioeconomic, gender, and local groups relative to racial/ethnic groups suggests programs prioritized teaching concepts applied to race/ethnicity and focused less on other cultural groups. After 2012, the substantial increase in included social concepts without change in the distribution of included cultural groups suggests programs maintained representation of identity groups while attempting to address systemic issues for groups already represented in CCC content. Incorporating intersectionality through a “dimensions of identities” approach may allow students to extend systemic concepts to the less visible groups in need of conversation about their disparities.
Background: This article introduces Wardley Mapping, a visual tool with a long-standing history in business and technology sectors, as a valuable and novel approach for medical trainees navigating the complex and evolving healthcare landscape. Wardley Mapping offers unique methods to visualise and analyse complex systems, aligning well with the multifaceted nature of training and career development. How we Did It: The article illustrates its application through a comparative example of planning a medical school elective. We outline the key components of Wardley Maps, describing the process of creation, present the benefits, limitations, and challenges of applying this tool in the medical education context. Learning Points: We describe key lessons for implementing and refining Wardley Mapping in medical education. Conclusions: Wardley Mapping offers comprehensive visualisation of career components, enabling evolution tracking, facilitating informed decision-making, and offering a holistic perspective. Exciting opportunities for future research include integration into medical curricula and its long-term impact on career outcomes.
Introduction: Early exposure to medical research is essential for healthcare professionals, to shape their careers and enhancing patient care. However, students face significant obstacles, such as lack of prior knowledge and mentorship. Malta’s healthcare students lack hands-on research teaching. Methods: To address this gap in knowledge, a tailored elective virtual research course was designed using the analysis, design, development, implementation and evaluation (ADDIE) framework. Titled “An Introduction to Health Research: From Idea to Publication,” the course comprised eight weekly lectures covering theoretical and practical aspects of research. Teaching consisted of didactic teaching and problem-based learning tasks. Conducted via the University of Malta’s DegreePlus program, it allowed hands-on group work and active participation through online conferencing platforms. All students enrolled in the course completed pre- and post-course surveys, to assess whether the course affected students’ perception towards research. Results: Most (57.14%, CI95%: 32.55 – 78.66) were in pre-clinical years, predominantly female (78.57%, CI95%: 51.68 – 93.16). 85.71% (CI95%: 58.81 – 97.24) lacked research experience or publishing opportunities. Main barriers included lack of opportunity (50.00%), time (21.40%), and training (28.60%). Post-course, significant improvements (p < 0.05) were observed in research knowledge and confidence in conducting research. Qualitative analysis revealed that respondents expressed feelings of “empowerment through education” and appreciation for the “effective course design and delivery” of the course. Conclusion: Engaging medical students in research during training is crucial despite challenges like limited opportunities and foundational skills. A virtual research course has significantly improved students’ confidence, knowledge, and skills in conducting research, showcasing its potential to enhance research training globally and advance healthcare delivery.
