Taiwan's declining fertility rate is reshaping the pediatric care landscape. The demands of child health care encompass acute and critical care, chronic disease management, complex diagnostic conditions, as well as developmental and mental health support. In response, the Ministry of Health and Welfare's Program for Excellence in Child Health Care and the Project of Holistic Physicians for Young Children represent a strategic transition toward proactive, community-anchored child health stewardship. By integrating preventive services, developmental surveillance, case management, and cross-sector coordination, these initiatives strengthen early detection and timely intervention while redefining pediatricians as key actors within the social safety net. Embedding prevention-oriented competencies into undergraduate medical education and pediatric subspecialty training will further empower pediatricians to influence population-level child health outcomes. This forward-looking transformation positions pediatrics to sustain high-value impact amid demographic headwinds, ensuring equitable and continuous health support for every child.
Purpose: Medical education is characterized by complex content and high cognitive demands, which often challenge learners. motivation and engagement. With advances in educational technology, interactive teaching approaches have gained increasing attention for their potential to enhance learning experiences. This study aimed to investigate the effects of integrating an Interactive Response System (IRS) into a medical education course on learners. learning motivation, technology acceptance, and learning satisfaction. Methods: A single-group posttest design was employed. Participants were 23 healthcare professionals specializing in respiratory therapy who attended a professional training course on the clinical application of high-frequency ventilators. During the 50-minute instructional session, IRS-supported interactive teaching was implemented to facilitate real-time interaction and feedback. Data were collected using validated questionnaires measuring learning motivation, perceived usefulness (technology acceptance), and learning satisfaction. Descriptive statistics and Wilcoxon signed-rank tests were conducted to examine post-intervention outcomes, while Mann.Whitney U tests were used to explore differences across gender and work experience. Results: The results indicated that participants. post-intervention scores for learning motivation, perceived usefulness, and learning satisfaction were all significantly higher than the corresponding scale midpoints (p < 0.01). No significant differences were found across gender or work experience for any of the measured variables. Conclusion: These findings suggest that IRS-supported interactive teaching can influence learning motivation, technology acceptance, and learning satisfaction in medical education. Although this study design cannot draw causal conclusions, it underscores the educational value and inclusivity of IRS-based teaching methods and supports their adoption as a pedagogical strategy for professional medical training. Keywords: interactive response system; medical education; learning motivation; technology acceptance; learning satisfaction
Background: Balint groups have been widely implemented to support medical training in many countries. However, no empirical study has yet been conducted in Taiwan to evaluate their effectiveness. Methods: An introductory presentation on Balint groups was held at a medical center in southern Taiwan, followed by a survey assessing attendees' perceptions and attitudes toward Balint work. Subsequently, a six-session Balint group was offered to healthcare professionals who volunteered to participate. All participants completed the 25-item Resilience Scale before and after the intervention. Thematic analysis was employed to analyze qualitative data. Results: A total of 44 healthcare professionals attended the introductory presentation. Among them, half expressed willingness to participate in a Balint group (n = 22). A significant difference was found across job titles (p < .001), with all physicians (n = 10, 100%) indicating willingness to participate. Among the participants who joined the six-session group (n = 7), Improvements were observed in the total Resilience Scale score (pre-group: 112.71 ± 10.23; post-group: 130.29 ± 19.00; p = .018) and in the subscales of Meaningfulness (pre: 33.14 ± 3.29; post: 39.71 ± 4.68; p = .026) and Equanimity (pre: 22.43 ± 4.20; post: 28.29 ± 7.57; p = .018). Three overarching themes were identified: (1) emotional vulnerability and shared humanity, (2) professional identity, (3) meaning-making. Conclusion: Balint groups appear acceptable to at least a portion of healthcare professionals in Taiwan. Participation in the group was associated with higher resilience scores and was generally evaluated positively. Further research is warranted.
Introduction: The transition from academic education to clinical practice is a critical challenge for new occupational therapy (OT) graduates. While most Western countries have adopted master's or doctoral entry-level into the profession, bachelor's-level OT training remains the mainstream in Asia. This raises questions about whether such programs adequately prepare graduates for today's complex clinical environments. This study examined the preparedness of OT graduates under bachelor-level training by exploring the alignment between educational experiences and workplace expectations from the perspectives of multiple stakeholders. Methods: A total of 547 respondents, including recent graduates, clinical educators, practicing occupational therapists, and heads of occupational therapy divisions, participated in an online anonymous survey. The study explored essential knowledge and skills for OT practice, internship effectiveness, and the adequacy of support and mentorship for new graduates. Results: While core competencies were broadly recognized, stakeholders identified gaps in several clinical skills such as advocacy, interdisciplinary collaboration, transition service and contextual adaptation of interventions. Recent graduates reported inadequate preparation in assistive technology, transition services, and communication across disciplines. These gaps were most prominent in areas that require adaptive decision-making and resource integration. Conclusions: Bachelor-level OT education in Taiwan lays a solid foundation but requires enhanced integration of competency-based training, interdisciplinary collaboration, and real-world applications. Insights from this study may inform educational reform across similar systems in Asia and support international dialogue on OT workforce development.
Background: Despite increasing emphasis in medical education, LGBTQ clinical sensitivity and care competencies remain insufficient. This study developed a structured Standardized Patient (SP) training model replacing traditional lecturing. It aims to alleviate role boundary blurring and psychological stress SPs face with highly sensitive topics while enhancing their professional comprehension. Objectives: To develop and evaluate a structured SP training model that integrates psychological safety mechanisms to mitigate role confusion and stress in handling gender diversity topics, while enhancing SPs' professional role interpretation and cultural sensitivity. Method: The course was implemented through systematic integration of the ``Introspection, Empathy, Deconstruction'' three-phase model: (1) self-trait reflection using card-guided activities to help SPs recognize boundaries between personal values and roles, establishing psychological defense mechanisms to reduce cognitive dissonance; (2) image-guided scenario discussions leveraging visual media to create a ``psychological buffer space,'' allowing SPs to observe and understand transgender patients' medical experiences without immediate performance pressure, thereby gaining emotional adjustment space and safety; and (3) professional knowledge deepening through de-roling, emphasizing structured reflective de-roling strategies to support SPs in restoring psychological balance when engaging with highly sensitive topics. Results: Preliminary data showed positive self-evaluations, with role interpretation scoring 4.88 and clinical needs understanding scoring 4.79 (out of 5). Discussions highlighted the need to address SPs' emotional burden under instructional care responsibilities. Conclusion: Initial findings indicate this structured training model holds potential for alleviating learners' emotional loads, serving as a practical reference for advancing gender-affirming medical education and training on highly sensitive topics.
Competency-based medical education (CBME) has reshaped physician training, yet system-level implementation in allied health professions is rarely described. In this Perspective, we examine Taiwan's decade-long national reform of medical radiation technologist (MRT) education led by the Taiwan Association of Medical Radiation Technologists (TAMRT) and distill lessons for system-level CBME. Beginning in 2012, TAMRT adapted the Accreditation Council for Graduate Medical Education (ACGME) core competencies and introduced workplace-based assessments across diagnostic radiography, radiation therapy, and nuclear medicine. Early national accreditation cycles revealed persistent variability in assessment quality and highlighted the limitations of time-based advancement. TAMRT therefore shifted from adding isolated tools to building an integrated progression system. Using Van Melle's core components of CBME as a scaffold, TAMRT implemented a ``CBME trilogy'': (1) specialty milestones (107/115/125 across the three specialties) and 14 entrustable professional activities; (2) a structured national faculty development and certification program; and (3) a nationwide electronic platform supporting programmatic assessment and visualization of competency trajectories. In 2024, TAMRT launched a second-generation MRT Professional Advancement System aligned with a Dreyfus-informed, five-level framework. This case illustrates how coordinating competency frameworks, faculty capacity, and data infrastructure can enable system-level CBME in allied health professions and may provide actionable design levers for broader medical education reform.
Background: Bedside teaching (BST) is a crucial component of the clinical skills training program for medical students, where patients are used as educational examples. Understanding patients’ attitudes toward BST is essential for making informed choices and enhancing quality. Objectives: The present study aimed to investigate the attitudes of hospitalized patients toward various aspects of BST. Methods: A cross-sectional study was coanducted involving 250 patients admitted to Shahid Beheshti Hospital in Kashan, Iran. Patients’ attitudes toward BST and influencing factors were assessed using a translated and validated version of the Marwan Questionnaire. Results: The highest level of dissatisfaction was observed with diagnostic or therapeutic procedures performed without the supervising professor (19.4%), while the lowest dissatisfaction was with students reviewing medical records (5.1%). Women expressed significantly more dissatisfaction than men regarding examinations conducted without a teacher and diagnostic and therapeutic procedures, both with and without a teacher present. Conversely, men were more opposed to students’ presence in outpatient clinics (23.8% vs. 5.4%, P < 0.001) and during surgeries (12.7% vs. 4.5%, P = 0.04) compared to women. Conclusions: Overall, patients generally accept the presence of students, irrespective of gender, and the presence of a supervising professor enhances patients’ willingness to participate in BST.
Background: Pharmacy education in Taiwan has shifted from a four-year Bachelor of Science (B.S.) degree to a six-year Doctor of Pharmacy (Pharm.D.) degree emphasizing patient-centered competencies. This study evaluated the self-efficacy of pharmacy students at different stages of the programs. Methods: A repeated cross-sectional survey was conducted from 2017 to 2019 at a university in Taiwan. Third- to sixth-year Pharm.D. and fourth-year B.S. students completed a validated 53-item self-efficacy scale comprising five domains. Data were analyzed using ANOVA, repeated-measures ANOVA, and Kruskal–Wallis one-way analysis to evaluate differences in students' self-efficacy scores across academic years and between different programs. Results: Among the 355 respondents (93% response rate), self-efficacy showed a consistent increasing trend from third-year Pharm.D. to sixth-year Pharm.D. in all domains. The 2019 Pharm.D. cohort showed significant gains from the fourth to sixth year in professionalism (3.57, 3.92, and 4.00), pharmaceutical care (3.51, 3.92, and 4.06), systems-based practice (3.12, 3.75, and 3.81), and practice-based learning (3.84, 4.05, and 4.21). Sixth-year Pharm.D. candidates reported the highest self-efficacy in practice-based learning and improvement, and the lowest in systems-based practice. Compared with fourth-year B.S. graduates, sixth-year Pharm.D. students scored higher in pharmaceutical care. Conclusion: Self-efficacy in professional competencies showed a steady upward trend across the Pharm.D. program. This pattern was observed alongside progressive curricular exposure and practice experiences. However, relatively low confidence in systems-based practice and unchanged self-efficacy in communication skills suggest areas for curriculum enhancement.
Background: AI's expansion in medicine sharpens the tension between diagnostic science and the art of healing. AI is a complex sociotechnical system. Its integration in medicine is accelerating, yet reactive and tool-driven, which offers both opportunities and risks. AI will potentially worsen depersonalization and burnout. Objectives: The aim is to develop the guiding principles of AI to strengthen the art healing in medical education. Innovations: Healer's Mindset, inspired by Gardner's Five Minds, reframes Respectful and Ethical minds as three pillars: critical validation, a humanistic core, and discerning augmentation. These principles can help AI restore medicine's essence: fostering inquiry, faculty as facilitators, meaningful assessments, and dignified governance. Conclusion: AI provides the ``gift of time'' to give clinicians more time for compassionate patient care. Healer's Mindset is promising to protect humanity central in medicine, to ensure the art and science of medicine inseparable in the Human-AI era.
Background: This study introduces a reflective learning approach that combines ethical dilemmas with axiological analysis to explore how students' value hierarchies shape their professional identity formation. Moving beyond traditional frameworks such as Principlism, this approach invites learners to examine the tensions between personal and professional values, encouraging critical reflection on how their decisions relate to multiple identities and evolving professional commitments. Methods: Two open-ended ethical dilemmas were distributed via an anonymous online survey using Qualtrics. This method was intentionally chosen to elicit narrative responses from a large cohort of students while providing space for candid reflection on complex, value-laden situations. Responses were analyzed using axiological analysis in NVivo (Version 14, QSR International), focusing on identifying and interpreting conflicting values in students' written reflections. Results: The findings show that both scenarios deepened engagement with ethical dilemmas by prompting students to examine and prioritize competing values. Scenario 1 revealed tensions between professional obligations to patients and personal or family commitments, while Scenario 2 highlighted conflicts involving legal and institutional requirements, patient-centred care, and professional integrity. Students demonstrated value-based reasoning by negotiating these tensions through contextual judgment and effective communication, supporting self-reflection and professional identity development beyond rule-based decision-making. Conclusion: This study expands traditional case-based ethics learning by offering a structured, scalable method for engaging learners in value-oriented reflection. It highlights the utility of combining ethical scenarios with axiological analysis to enhance understanding of professional challenges while offering educators insight into how learners' values shape identity formation.
Background and Objective: The goal of this study was to evaluate the impact of flipped classroom teaching and virtual reality (VR) on fourth-year dental students' comprehension of procedures and concepts in local anesthesia courses. Methods: The School of Dentistry at Chung Shan Medical University created a VR simulation that guided students through an inferior alveolar nerve block anesthesia procedure using HTC Vive headsets. Following traditional classroom lectures, students of the academic year 2022 participated in VR simulations and one-on-one practice, which was supplemented by instructional videos. Performance was assessed using a checklist, and feedback was collected via questionnaires. Results: Eighty-two students participated receiving an average score of 90.49. The tasks with the highest error rates were ``holding the syringe correctly,'' ``installing the dental cartridge,'' and ``using sterilization forceps correctly.'' Feedback indicated that although students found the resources useful in reducing clinical anxiety, students debated the VR's utility for acquiring tactile clinical skills, while strongly agreeing that it was effective for establishing a conceptual framework of the anesthesia steps. Conclusions: The flipped classroom and VR teaching methods are useful for developing a conceptual understanding of anesthesia procedures, but they have limited direct application in clinical practice. It is recommended that students have more hands-on practice opportunities to help them improve their clinical skills.
Objectives: This study aimed to examine the psychometric properties of the traditional Chinese version of the Attitudes to Patient Safety Questionnaire (APSQ-T) in a Taiwanese population (Study 1) and investigate dental students' perceptions of patient safety, identify their educational needs, and correlate these aspects to improve the curriculum (Study 2). Methods: Study 1 conducted a cross-sectional study using convenience sampling at a medical university in Taiwan. A total of 223 participants from the fields of dentistry, oral hygiene, nursing, and medicine were recruited to complete an anonymous survey for the validation of the APSQ-T. In Study 2, data collected from dental students were further analyzed to explore their attitudes and needs regarding patient safety. Results: In Study 1, the APSQ-T demonstrated good reliability and validity. After cultural adaptation, it can be administered to students across all healthcare professions, including dentistry. In Study 2, a total of 135 valid questionnaires from dental students were analyzed, with a response rate of 65.5%. The participants showed relatively conservative attitudes on ``Disclosure responsibility'' and ``Error reporting confidence,'' while showing high agreement with ``Working hours as error cause'' and ``Situational awareness.'' Among the clinical group, females perceived less training than males. Moreover, the clinical group reported a significantly higher percentage of medical error-related experiences than the pre-clinical group. Most respondents expressed a desire for further education on patient safety issues. Conclusions: In future curricular developments, dental students' attitudes and needs regarding medical errors and patient safety should be considered to promote an open clinical culture.
