BMC Medical Education

IntroductionUganda still survives way below the recommended doctor-patient ratio. This problem could be solved by increasing the number of doctors produced in the country annually. Attempts at this are ongoing, however, this is challenged by the absence of quality assurance programs amidst lack of a universal medical curriculum. With inadequate supervision and limited resources in health facilities, transitioning from students life to clinical practice is perhaps the most challenging time for an intern doctor. We used the domains of competencies provided by the General Medical Council to assess levels of self-perceived competence and its determinants among pre-intern doctors (PRINTs) in Uganda. MethodsAn online cross-sectional study was conducted using a quantitative questionnaire distributed to confirmed pre-interns in Uganda. Self-perceived competence was determined by 4 Likert scale questions and participants were dichotomized into competent and incompetent using a standardized Blooms cutoff criterion. Determinants of self-perceived competence were determined by the ANOVA test. ResultsWe obtained 142 entries. Of these, 68.3% were males; median age was 26 years (range: 22-49). Majority of the participants (78.9%) had no prior medical-related training and only a third (34.5%) had previous work experience. Overall scores were poor and very few participants were confident they attained a satisfactory level of competence through their medical training. Participants reported more competence in basic procedural skills (Mean score: 19.8{+/-}3.2/21), followed by Knowledge (Mean score:12.4{+/-}3.1/15), with surgical (Mean score:11.5{+/-}3.5/18) and Emergency skills (Mean score: 12.5{+/-}4.4/21) scoring least. Participants with previous work experience were more likely to report higher competence scores than their counterparts (91.7 vs 84.9, p=0.039). ConclusionThe study shows that majority of PRINTs feel deficient in knowledge and skills to start clinical practice, with less competence in surgical skills and emergency care. There is need to review the training curricula to ensure adequate clinical exposure experiences for a smooth transition to clinical practice.

IntroductionThis study sought the views of undergraduate medical students on the effectiveness of their modes of instruction in communication skills knowledge and skills acquisition and transfer. Understanding the teaching-learning experiences from the students viewpoint could influence communication skills course facilitators to adopt instructional modes and learning experiences that enhance competency development in communication skills. It could also emphasize the need for curriculum developers to review the medical school curriculum, specifying student-centered and active learning pedagogical practices. MethodsThe descriptive study involved an in-depth semi-structured interview of eight undergraduate medical students from two medical schools in Zambia, who participated in communication skills training, selected through a purposive nonprobability sampling. The study mostly appropriated Tracys phronetic iterative analysis during its thematic analysis of the textual data collected between April and May 2022. ResultsThe participants affirmed the importance of communication skills to their medical training but, decried the dominance of lecture-based delivery, limited interactive sessions, untimely and inadequate feedback from teachers and peers, inefficacy of teaching communication skills as theory, and limited understanding and distraction from online delivery as factors that hindered communication skills teaching-learning. ConclusionAlthough the students expressed communication skills as pivotal to their training and medical practice, their experiences of learning the skills through non-experiential and traditional lecture-based methods did not facilitate the motivation required for mastery and competency, suggesting that facilitators and curriculum planners should reevaluate the teaching-learning modes and process.

IntroductionMorning report (MR) is an educational activity that uses inpatient case-based teaching. Given the rapid changes taking place in medical practice, it is important to assess the residents perspective regarding this teaching method. ObjectiveTo establish the perspective of residents in internal medicine on various aspects of MR and propose a format based on our observations. Study DesignObservational cross-sectional study. Place & Duration of StudyData was collected from groups of residents in the Department of Medicine at the Aga Khan University Hospital, from July 2002 to August 2007. MethodologyAn observational cross-sectional survey on MR was conducted among the residents of the Department of Medicine at Aga Khan University. A 22-item questionnaire was distributed among the residents based on the purpose, format, and contents of the morning report, as well as the most appropriate person to present and conduct it, and how frequently they should be carried out. Analyses were carried out using the statistical software Statistical Package for Social Sciences (SPSS) Results92% of residents believed MR to be an effective teaching activity with 65% of them choosing Improvement in clinical problem-solving ability as the primary purpose of MR followed by improving presentation skills (62%) and conveying medical knowledge to the residents (58%). 79 residents (87%) believed that the junior resident should present the case history. 75 residents (83%) thought that faculty on call at time of patients admission should conduct MR. Residents wanted to discuss diagnostic work-up (90%) and management (89%) of specific interesting cases (79%) in MR. ConclusionMR is an effective educational activity and should be an essential component of any post-graduate residency program within the country and outside.

IntroductionThe Hispanic community is the most rapidly growing minority group in the United States, making up 18.1% of the population, with 40% reporting limited English proficiency. To address this need, many health sciences institutions have implemented medical Spanish courses to increase Spanish proficiency among future healthcare providers. Although interactive courses have shown efficacy in teaching field-related terminology, barriers to medical Spanish curriculum implementation persist. Our study investigated the benefit of role-play, an underutilized teaching modality, in a medical Spanish course. Methods19 second year medical students were recruited to participate. Based on their placement test performance, students were assigned to a beginner or intermediate group and met weekly for one-hour sessions over five consecutive weeks. Students assumed the roles of Spanish-speaking patient, English-speaking provider, and interpreter to practice various medical scenarios. Students completed pre- and post-course examinations to assess Spanish proficiency improvement. Statistical significance was determined using a p-value < 0.05. ResultsSeven students, all members of the intermediate group, completed the course. Attendance among this group was 77.4%. When comparing examination scores, there was statistically significant improvement in oral translation of phrases from Spanish to English (p-value= 0.03). DiscussionStatistically significant improvement in oral translation of phrases from Spanish to English was accomplished through a minimal time requirement of one hour per week utilizing role-play. Given the fact that limited time poses a barrier to implementing medical Spanish curricula, our findings highlight the potential benefit of this teaching methodology and call for further evaluation.

BackgroundDespite the implementation of Competency-Based Medical Education (CBME) in India, there is limited data on the perspectives of students regarding prevailing educational methodologies. MethodsAn observational cross-sectional study was conducted to assess the perception and satisfaction of Indian medical students towards current teaching-learning and assessment methods. Data were collected via an electronic questionnaire, stratified by academic year, and analysed using SPSS. Results(N=413) 45% students expressed a neutral response to the curriculum, with greater satisfaction in the clinical years (44.9%) than pre/para-clinical years (30.7%). Lectures were rated neutral by 53%. Tools like clinical demonstration videos (68.8%) and animated videos (56.7%) were favoured over traditional methods. Outpatient and bedside learning were the preferred practical instruction modes (58.9%), though poor departmental coordination was cited as a significant barrier to clinical learning by 42.5%. Students favoured MCQ-based assessments, complemented by viva-cum-practical (78% in clinical years, 68.8% in pre/para-clinical years), while written long essay-type questions were less preferred. ConclusionsStudents prefer interactive, clinically integrated teaching and MCQ-based assessments. However, as of now, preferences of students seem to differ from reality, especially in developing countries like India. Addressing these concerns and feedback from students can guide in-depth discussions for medical education curriculum reforms in resource-limited settings.

IntroductionThe utilization of high fidelity simulations across medical school campuses has grown in recent years as simulation is a useful tool in allowing students to practice real life scenarios in a safe space, as well as providing exposure to rarer cases in medicine. This study evaluated second and third-year medical students recognition and management of a postpartum hemorrhage (PPH) due to a retained placenta in SimMom(R). The objective was to describe the methods and procedures used in PPH simulation to educate these students across two geographically separated medical school campuses. It became apparent that there is a need to standardize medical simulation to maintain the quality of medical education. MethodsA case-scenario simulation with retained tissue had a run-time of 10 minutes. Times were marked when students identified the retained placental tissue was the cause of hemorrhage and when students extracted the fragment. A debrief with faculty followed the scenario regarding performance and education about the "4 Ts"of post-partum hemorrhage differential diagnosis (Tone, Trauma, Tissue, Thrombin), and the students feelings towards the simulation were evaluated with a post simulation survey. ResultsDespite efforts to maintain consistent simulations between the two campuses, there was a significant difference of timing between the two campuses to successful completion of the simulation, as well as in the number of students that did not successfully complete the goals of the simulation. However, the post-simulation survey did show that students on both campuses found value in participating in the simulation. DiscussionThe performance across the two campuses was statistically different, which illustrates a need to standardize simulation education experiences across medical school campuses. However, this protocol was an effective way to educate students and allow students to have hands-on experience in diagnosing and treating a rare but deadly complication of childbirth. This initial study may facilitate expansion on this particular, topic, as well as suggest more simulation education delivery within the medical school curriculum.

BackgroundActive learning is a well-established educational methodology in medical schools worldwide, although its implementation in Brazilian clinical settings is quite challenging. The objective of this study is to review the literature in a systematic manner to find and conduct a reflective analysis of how problem-based learning (PBL) has been applied to clinical teaching in medical schools in Brazil. Material & methodsA systematic literature search was conducted in three databases. A total of 250 papers related to PBL in Brazilian medical schools were identified through the database searches. Four studies were finally selected for the review. ResultsFour fields of medicine were explored on the four selected papers: gynecology/family medicine, medical semiology, psychiatry, and pediatrics. Overall, all the papers reported some level of strategic adaptability of the original PBL methodology to be applied in the Brazilian medical schools curricula and to the peculiar characteristics specific to Brazil. ConclusionPBL application in Brazilian medical schools require some level of alteration from the original format, to better adapt to the characteristics of Brazilian students maturity, health system priorities and the medical labor market.

Despite the benefits of Advance directives, approximately only 1 in 3 U.S adults have documented advance directives. In medical school and residency, learners are often not taught or given very brief information on conducting end-of-life planning conversations with patients. Due to this deficiency, some institutions have conducted advance directive workshops but not many have been both palliative fellow and resident led, though some have been led by a geriatric fellow. Therefore, we approached advance directives with a resident and palliative fellow-led workshop. We aimed to develop and conduct a workshop on advance directives to assess feasibility and effectiveness. We sent a survey to 52 residents prior to two one-hour didactic sessions. For the first session, a small group of residents discussed common terminology and the tools available to help patients complete advanced directives in the outpatient setting. A hospice and palliative care fellow led the second session and focused on patient communication and approach. Our results showed that the workshop was well-received and improved resident confidence in discussing advance directives with patients. In conclusion, a resident and palliative fellow-led advance directive workshop for internal medicine residents was feasible and effective in increasing resident confidence.

BackgroundFamily practices constitute an important learning environment for medical students. However, teaching situations markedly vary between practices, and students frequently find rotations underwhelming. Especially, students active participation in patient care varies profoundly, although it has a significant impact on students interest in primary care careers. To standardize and improve learning situations in practices, we developed the so-called Toolbox Family Medicine (TFM) using the concept of entrustable professional activities. It provides standardized learning content appropriate for students levels and allows teaching adaptable to actual practice conditions. MethodsUsing a controlled trial with a waiting list control arm, we will evaluate the effectiveness of the toolbox on students learning satisfaction. A total of 94 students will be allocated 1:1 to intervention and control practices. The teaching concept Toolbox Family Medicine (TFM) comprises a didactic workshop for supervising physicians and a toolbox with practice-specific tasks for medical students. The primary outcome is students overall satisfaction with their learning progress after the rotation. Secondary outcomes include the kind and number of tasks performed, the entrusted level per task, the feasibility of implementing the toolbox in actual practice settings, and students motivation to pursue a career in primary care. DiscussionWe assume an improvement in learning satisfaction with the intervention. The study will begin with the next practice rotations. Administrative information O_TBL View this table: org.highwire.dtl.DTLVardef@f4c29aorg.highwire.dtl.DTLVardef@1142ab3org.highwire.dtl.DTLVardef@ff5ba8org.highwire.dtl.DTLVardef@da9808org.highwire.dtl.DTLVardef@1337127_HPS_FORMAT_FIGEXP M_TBL C_TBL

Competency-based education (CBE) is gaining prominence in post-secondary education due to its effectiveness in optimizing workforce readiness. However, assessing competence and workforce readiness presents a significant challenge. Entrustable professional activities (EPAs) offer an effective solution by translating competencies into observable, measurable, and entrustable tasks. While EPAs have been widely adopted in medical education, their application in non-clinical educational contexts remains minimal. This scoping review aims to map the diffusion of EPAs beyond medicine and assess their scalability to undergraduate non-clinical minor pathways, which are ideal piloting sites for EPA-based assessment frameworks. Guided by Rogers Diffusion of Innovations theory, this review will identify the barriers and facilitators influencing the adoption of EPAs in non-clinical educational contexts. Following Arksey and OMalleys framework, this review will progress through five stages: identifying the research question, identifying relevant studies, study selection, charting the data, and reporting results. Searches will be conducted across Ovid MEDLINE, CINAHL, Scopus, ERIC, and grey literature. The research question is: "How have EPAs been developed and implemented outside of medical education, and what factors influence their adoption in non-clinical training programs?" The search will include articles describing the development or implementation of EPAs outside medicine and will exclude irrelevant studies. Titles and abstracts will be reviewed first, followed by a full-text examination of relevant articles. Data will be extracted, organized, and summarized to highlight key findings. Two reviewers will ensure quality during screening and data extraction. Findings from this scoping review will inform the rationale for scaling EPAs to non-clinical training programs and offer insights to guide the adaptation, development, and implementation of EPA-based assessment frameworks in undergraduate non-clinical minor pathways, addressing pressing challenges in CBE and creating a replicable model for future program development. Findings from this scoping review will be submitted for publication in a scientific journal.

TITLEPerceived Clinical Readiness of Senior Medical Students as Outcomes 0f Online Clerkship in the Philippines: New Normal in Medical Education INTRODUCTIONCOVID-19 formed new challenges to the medical institutions; it resulted in the transition from the usual face-to-face classes and direct clerkship training within the hospital to a new remote learning with online lectures and virtual clinical experience. Given the new online interactive setting, problems were raised given the limited patient care and interaction as well as restricted bedside teaching opportunities and its impact on how medical students can acquire and hone their clinical skills. OBJECTIVETo determine the perceived clinical readiness of the medical clerks in the new normal setting in the Philippines. METHODOLOGYConvenience sampling was used to gather respondents who were asked to answer an online survey questionnaire. The questions pertained to: academic training profile, clinical skills, patient management, communication, understanding clinical guidelines, and personal development. After analyzing the data, the scales of readiness from these subjects were gathered. RESULTSThe medical clerks in the Philippines perceived that they were ready with regards to understanding clinical guidelines, communication, personal development, and patient management. They were moderately ready in the different clinical skills in the departments of Family and Community Medicine, Internal Medicine, Pediatrics, Surgery and Obstetrics and Gynecology with some specific skills in Surgery and Obstetrics and Gynecology being perceived as less ready than the rest. CONCLUSIONThe impact of the pandemic has disrupted the students confidence and readiness. This shows that online clerkship in this time of pandemic may have provided learning to a certain degree but it is not enough to replace what face-to-face training could offer.

IntroductionIn Brazil, practices of medical students have been interrupted due to COVID-19 to meet emergency demands. AimTo describe a strategy for a controlled return to the presential practices for medical students. MethodsWe developed a standardized protocol to be applied before and during the return of the practical classes in medical students of Universidade Federal Fluminense, in the follow months after COVID-19 pandemic beginning. The protocol was comprised in three parts: Remote training on COVID-19 prevention; Face-to-face training focused in COVID-19 prevention, handwashing and personal protective equipment use; Investigation of students COVID-19 status before starting practical activities and weekly monitoring for COVID-19 during seven weeks. The training was done by medical teachers in small groups for medical students of the last lective semester. ResultsThe classes were interrupted on March 12, 2020 and returned in August 10, 2020. Seventy-one students were trained and followed. The mean age was 26.6 years (26.7 {+/-}0.835) and 54% were female. Forty-nine (69%) students over 71 had a private health insurance, 60 (84.5%) shared a house/apartment with one or more person and 12(16.9%) reported a previous comorbidity. Eighteen (25.4%) over 71 reported previous symptoms of COVID-19, being positive in two students. During the follow-up, fourteen (19.7%) over 71 students were placed in quarantine due to signals/symptoms compatible with COVID-19 or contact with symptomatic case. Only two cases (2.8%) were confirmed and occurred in Brazilian epidemiological week 37. ConclusionThe protocol was successful in minimizing COVID-19 acquisition during practical classes of medical students.

BackgroundPoint-of-care ultrasound (POCUS) utilization across specialties continues to grow, making it a valuable skill for medical students. Early exposure to ultrasound may enhance students clinical reasoning, anatomical understanding, and integration of POCUS into the physical exam. This study evaluates the impact of a student-organized, physician-taught POCUS elective course on pre-clinical medical students competence in foundational ultrasound skills. MethodsFifteen students were enrolled in the course. Students attended four weekly 90-minute sessions focused on a unique organ system. Students took a 19-question test before and after the course to assess overall learning. Five-question quizzes were conducted before and after each session to evaluate immediate learning. Fishers exact test was used to compare correct vs. incorrect quiz answers before and after each session. ResultsOverall knowledge of POCUS, determined by the 19-question quiz, improved from 61.5% to 76.8% (p = 0.01). FAST and cardiac ultrasound quiz scores improved from 54.2% to 91.4% (p < 0.01) and 57.7% to 85.7% (p < 0.01), respectively. The pre- and post-quiz score for the abdominal ultrasound exam remained the same at 80.0% (p = 1). The gynecologic ultrasound exam score improved from 45.0% to 66.7% (p = 0.3). ConclusionsThis elective course significantly increased pre-clinical medical students knowledge of ultrasound. No statistically significant difference was noted for the abdominal or gynecologic sessions.

BackgroundA minority of Pulmonary and Critical Care Medicine (PCCM) graduates pursue careers in academic medicine. Although compensation is only a portion of the career decision, job negotiations remain shrouded in ambiguity and inconsistency. Additionally, while role-level salary tables exist through the Association of American Medical Colleges (AAMC), to our knowledge there is no resource that includes important non-salary information such as start-up packages, full-time equivalent (FTE) breakdown, and bonus ranges. ObjectiveWe sought to describe key components of first PCCM academic job offers for both physician scientists and clinician educators, including salary, start-up packages, non-clinical FTE, and bonuses. MethodsAn electronic survey was distributed via a snowball method between May - June 2025. PCCM graduates between 2020-2025 who accepted a job in academic medicine were included. Mann-Whitney Wilcoxon tests were used for ordinal comparisons. Qualitative analysis of free text responses was performed with a social cognitive career theory framework. ResultsThere were 60 respondents who provided information about 103 job offers, with 50% (14/28) of physician-scientists and 66% (21/32) of clinician-educators reporting more than one job offer. Physician-scientists received lower salary offers compared to clinician-educators (respective median ranges: $150,000-$199,999 vs $250,000-$299,999, p<0.001). 35.7% physician-scientists (10/28) received a career development award prior to negotiation, which was associated with a higher start-up package offer (p<0.05). For all clinician-educator jobs (n=59), 42.4% had non-clinical FTE in the initial offer. Many respondents commented on the lack of negotiating power. ConclusionPCCM physician-scientists and clinician-educators experience wide variability in their initial job offers. Recognizing differences is essential to improve transparency in job negotiations in academic medicine.

IntroductionMedical education has always been considered an essential component for improving the knowledg and performance of physicians and medical assistants. However, this education must be carried out continuously t update the knowledge of physicians and improve their performance. Various strategies are used to achieve this goal, the most important of which are CME, CPD, and CBME strategies. This study aimed to investigate the effect of using these strategies on improving the performance of physicians in the world using a systematic review method. MethodsThis study was conducted using a systematic review method on the effect of educational strategies o improving the performance of physicians in the world. Accordingly, all relevant articles published between 195 and 2024 were extracted and reviewed through a search in the scientific databases PubMed/Medline, Web of Science, ProQuest, and Scopus. The quality of the articles was assessed using the CONSORT checklist an Newcastle-Ottawa Scale. Resultstwenty articles conducted between 1993 and 2024 were included in the systematic review process. According to the findings, providing continuing education based on CME, CPD, CBME, and knowledge translatio strategies positively affected the knowledge, skills, and performance of physicians and medical assistants i providing health services. This can be used to train medical students and practicing physicians on an ongoing basis. ConclusionMedical education using CME, CPD, and CBME strategies can improve physicians knowledge and performance, and subsequently increase job satisfaction, self-efficacy, communication skills, medical knowledge, performance, and skill. However, individual, structural, and content limitations that can prevent success in learnin and training programs should be considered and addressed.

BackgroundIn Peru, the Universidad Nacional Mayor de San Marcos involved teachers and students in the creation of management cases in the Rural Urban Marginal Health Service (SERUMS). However, their perception of the implementation of this methodology is not known. ObjectiveTo evaluate the perception of students and teachers on the implementation of a case-creation methodology in the Health Management course at UNMSM. MethodsMixed methods design. Questionnaires (quantitative phase) and focus groups (qualitative phase) were used to explore the perceptions of students and teachers on the implementation of a case-creation methodology in the Health Management course at UNMSM during 2019. ResultsOf the 182 surveyed students, 61% found the created cases interesting and 63% stated that the methodology encourages the use of critical thinking. Qualitatively, the possibility to learn about real SERUMS cases and work collaboratively to find innovative solutions was highlighted. However, several mentioned that this led to an academic overload and emphasized a lack of information on the topic. Teachers mentioned that the methodology promoted learning in management, though they recognized challenges in its implementation due to the limited experience and training of teachers and students. ConclusionsThe case-creation methodology is perceived as an innovative and beneficial and educational strategy for teaching managerial aspects in SERUMS. However, an adequate process of training, planning, and organization is suggested for its effective implementation.

BackgroundThe right problem for graduate medical education (GME) program directors is whether diversity in their GME programs is as good as diversity in feeder entities to their GME programs. Generally, the feeder entities to GME residency programs are their affiliated medical schools. However, the specific feeder entities to GME residency programs are the unfiltered applicants pool who apply to these programs through Electronic Residency Application Service(R) (ERAS(R)). ObjectivesTo analyze associations in diversity among the GME applicants, the GME interviewees and the GME residents within an internal medicine residency program assuming that unfiltered applicants pool is the specific feeder entity to the analyzed GME program. MethodsWe analyzed associations in age-group, gender, ethnicity and race diversity among the GME applicants, the GME interviewees and the GME residents within an internal medicine residency program for ERAS(R) 2018-2020 seasons to decipher Cramers V as association coefficients ("diversity scores"). ResultsThe only significant finding was that among Not Hispanic or Latino ethnicity applications, race of ERAS(R) applicants had a very weak association with them being called for interviews or them becoming residents during ERAS(R) 2019 season as well as during the entire three-season-period (2018-2020). ConclusionRace of Not Hispanic or Latino ethnicity ERAS(R) applicants had a very weak association with them being called for interviews or them becoming residents at the analyzed internal medicine residency program.

BackgroundAt the school of medicine of the University of Burundi, we have faced the challenge of lack of dissection facilities and cadaveric resources, and hence, we tried to use evidence-based alternative teaching methods to meet the student needs and enhance learning outcomes in anatomy. The aim of this study was to collect students perceptions regarding this innovative teaching method of anatomy and share our experience to professionals working in similar environments. MethodsWe have designed a multimodal approach where first year medical students were first exposed to the topics during lectures and practical sessions were held afterwards in small groups using four materials including: YouTube dissection videos, 3d plastic models, anatomy drawings and the 3D4Medical virtual anatomy app. A Likert scale questionnaire including questions regarding the perceived achievement of learning objectives, 3d understanding of the structures and engagement with the content was distributed to them. Moreover, we have performed paired samples contingency tables and McNemar tests to check the statistical significance of the results in comparing the different didactic methods. ResultsThe majority of the students had positive perceptions regarding the multimodal approach. They preferred the combination of lectures and practicals rather than these didactic methods used separately (p<0.001). Furthermore, regarding the tools used in the practical sessions, the combination of the tools was also significantly preferred (p<0.001). The virtual anatomy app was significantly superior to the YouTube dissection videos in perceived achievement of 3d understanding (p=0.018). Moreover, the students agreed that being taught anatomy by surgeons has helped in bringing in more context that is useful to transfer the learnt knowledge into real life situations (p<0.001). ConclusionEfficient teaching of anatomy without cadaveric materials can be achieved by combining multiple didactic tools that promote active learning and enhance 3d understanding of the material.

BackgroundThere has been a rapid increase in the number of cases of COVID-19 in Latin America, Africa and Asia, in many countries that have an insufficient number of physicians and other health care personnel, and the need for the inclusion of medical students as part of the health teams is a very important issue. It has been recommended that medical students work as volunteers, have appropriate training, do not undertake any activity beyond their level of competence, have continuous supervision and adequate personal protective equipment. However, motivation of medical students must be evaluated in order to make volunteering a more evidence-based initiative. The aim of our study was to evaluate motivation of medical students to be part of the heath team tohelp in the COVID-19 pandemic. Methods and FindingsWe developed a questionnaire specifically to evaluate medical students perceptions about participating in care of patients with suspected infection due to coronavirus during the COVID-19 pandemic. The questionnaire had two parts: a) individual characteristics, year and geographic location of medical school; b) twenty-eight statements responded on a 5-point Likert scale (totally agree, agree, neither agree nor disagree, disagree and totally disagree). To develop the questionnaire, we performed consensus meetings of a group of faculty and medical students. The questionnaire was sent to student organizations of 257 medical schools in Brazil and answered by 10,433 students. We used multinomial logistic regression models to analyse the data. Statements with greater odds ratios for participation of medical students in COVID-19 pandemic were related to sense of purpose or duty ("It is the duty of the medical student to put himself at the service of the population in the pandemic"), altruism ("I am willing to take risks by participating in practical in the context of pandemic"), perception of good performance and professional identity ("I will be a better health professional for having experienced the pandemic"). Males had higher odds ratios than females (1.36 [95% CI: 1.24 - 1.49] to 1.68 [95% CI: 1.47 - 1.91]). ConclusionsMedical students are motivated by sense of purpose or duty, altruism, perception of good performance and values of professionalism more than their interest in learning. These results have implications in the developing of programs of volunteering and in the design of health force policies in the present pandemic and in future health emergencies.

BackgroundCBL involves students working within groups to solve clinical and non-clinical cases which enables the development of communication and team-working skills and promotes a deeper understanding of relevant clinical knowledge. CBL sessions are traditionally supported by an in-person facilitator in face to face settings. The recent COVID-19 pandemic has necessitated moves to online learning in many areas, one of which is CBL, providing good reason to consider the role of the facilitator in CBL and digital opportunities to augment facilitation. AimsTo understand the role of facilitation within CBL teaching (in face to face and online settings) and the impact that different approaches to facilitation can have on outcomes including student experience and engagement. MethodsA scoping review will be conducted of four main academic and medical databases: MedLine, Scopus, Excerpta Medica Database (EMBASE) and Education Research Complete (ERC) using a search strategy built around Undergraduate medical students (Population), Approaches to facilitation (Concept) and Case-based learning (Context). Articles will be selected according to pre-determined inclusion and exclusion criteria, with scope for the selection criteria to further develop. Charting from included full text articles will encompass research approach, approach to facilitation and findings about facilitation. A constructivist conceptual framework will be used to guide the synthesis. ConclusionsOverall, it is hoped that this review will be able to inform the role of facilitation within CBL sessions and the potential impact that this has on attainment, engagement and satisfaction of students, as well as their development of skills such as: teamworking, communication and problem solving.