BMC Medical Education

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.

BackgroundCompetence-Based Education (CBE) in physiotherapy aims to equip graduates with essential capabilities for safe and effective practice. Frameworks often include domains like clinical reasoning, communication, and professionalism. Despite its alignment with healthcare needs, CBE implementation in higher education remains inconsistent. Many educators still rely on behaviourist paradigms focused on passive learning and binary assessments, which inadequately reflect professional competence. Constructivist and progressive models offer more suitable alternatives yet are underutilized. Objective: This study explores the feasibility of integrating programmatic assessment (PA) to better support capability development and learner-centred education. MethodThis randomized controlled trial will be conducted a University of Applied Sciences across two campuses in Switzerland. Students from Cohort PHY25 enrolled in the BSc Physiotherapy program will be included. Students are assigned to PA in two formats, individual coaching (IG A) and group coaching (IG B), or to a sham PA without any coaching or reflective support (CG). Feasibility will be evaluated through session attendance, completion of all program components, and implementation fidelity. Secondary outcomes include staff readiness, wellbeing, workload, and learning gain. DiscussionThis study explores the feasibility and educational impact of implementing programmatic assessment in undergraduate physiotherapy education. If successful, PA may enhance competence development. Findings will inform curricular redesigns and support the shift toward learner-centred, capability-based assessment strategies in health professions education. Trial registrationRegistry of Efficacy and Effectiveness Studies under the number: #25261.2v1.

ABSTRACT Objective Structured Clinical Examinations (OSCEs) are widely used to assess medical students clinical skills, including non-technical abilities such as communication and empathy. However, the potential influence of individual psychological traits, such as personality dimensions, empathy, and stress-related mindset on OSCE performance remains understudied. This study investigated associations between personality traits, empathy levels, stress mindsets, and performance in OSCEs among medical students. An online questionnaire (including the Big Five Personality Traits Inventory 2, the Jefferson Scale of Physician Empathy (Medical Student version), the Growth Mindset Scale, the Stress Mindset Measure) was provided to all fifth-year medical students enrolled at the Universite Paris Cite for six weeks before undertaking graduation summative OSCEs. Their scores were correlated with OSCE performance using Spearmans correlation and linear regression analyses. A total of 99 questionnaires were included and analysed. None of the psychometric tests we assessed showed a significant correlation with OSCE scores. The strongest predictors of success in OSCEs were higher scores in written examinations, previous OSCE performance, and being female. In non-interactive OSCE stations, conscientiousness was the only significant predictor, with a positive association (p=0.001). Neuroticism was positively associated with performance improvement between OSCE sessions (p=0.042). Personality traits, self-reported empathy, and stress-related mindsets do not predict success in OSCEs as isolated traits. Further research is needed to determine whether it holds true for all kinds of OSCEs. Multidimensional psychometric assessment may be relevant when investigating performance outcomes in OSCEs.

BackgroundThe United Arab Emirates (UAE) is characterised by a diverse educational landscape, where students enter medical school from various high school curricula. Understanding how these varied academic backgrounds influence medical students academic performance is essential. The transition to medical school is a critical phase, with graduation outcomes carrying important implications for both students and institutions. Identifying early predictors of success is crucial to improving student support and academic outcomes in undergraduate medical education. AimThis study aimed to evaluate the predictive value of high school curriculum type on graduation outcomes in an undergraduate medical education program. MethodsA retrospective cohort study was conducted on undergraduate medical students enrolled at Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai Health, Dubai, UAE, from its inception in 2016 through 2024. The data were accessed for this research on 04/06/2024. The study employed machine learning methods, including Bayesian Networks (BN), Neural Networks (NN), and Random Forests (RF), to evaluate the predictive power of high school curriculum type and other academic variables for graduation success. ResultsThe study included 661 undergraduate medical students, predominantly female, 76.7% (n=507). Students represented 11 high school curricula, with the American (48.1%) and British (22.7%) systems being the most common. Among 122 students eligible to graduate, the Bayesian Network model demonstrated the highest predictive accuracy (AUC = 0.94). The cumulative GPA was the most influential predictor. The model correctly identified 269 out of 494 students (54.5%) as likely to graduate. ConclusionThe type of high school curriculum alone is not a strong predictor of graduation success. Academic performance during medical school and providing targeted support for students from diverse educational backgrounds are more robust predictors. Advanced predictive modelling holds promise for educational research and institutional policy development.

Background: Increasing relevance of genetics and molecular biology in medicine necessitates greater genetic literacy among healthcare workers. To assess the literacy level, a validated genetic literacy questionnaire is needed. Therefore, a standardised Indonesian-language genetic literacy questionnaire is essential. Aims: We aimed to translate and validate three genetic literacy questionnaires (PUGGS, iGLAS, and UNC-GKS) for use among Indonesian medical students. We then evaluated genetic literacy levels using one of the validated questionnaires. Methods: The PUGGS, iGLAS, and UNC-GKS questionnaires were translated into Indonesian and then reviewed by an expert panel for translational accuracy and conceptual appropriateness. Back-translation was performed to confirm validity. Initial Indonesian versions of the questionnaires underwent cognitive pre-testing with 12 undergraduate medical students. After refinements, the questionnaires were validated among 34 first- to third-year medical students. The Indonesian version of UNC-GKS questionnaire was then used to assess genetic literacy of 486 medical students comprising 228 preclinical medical students, 187 clerkships, and 71 residents. Results: The Indonesian versions of PUGGS (Cronbach's = 0.819) and UNC-GKS ( = 0.809) demonstrated good reliability, while iGLAS showed poor reliability ( = 0.315). Among the 486 students tested, 56% demonstrated moderate overall genetic literacy, and only 15.2% demonstrated good overall literacy. Basic genetic concepts were relatively well-understood with 54.3% having good literacy. On the contrary, gene variant's effects on health were poorly understood with only 9.7% having good literacy. Inheritance concepts were moderately understood with 24.9% having good literacy. Conclusion: The Indonesian translations of PUGGS and UNC-GKS are reliable tools for assessing genetic literacy among medical students. Using UNC-GKS, we observed predominantly moderate genetic literacy levels. Curriculum improvement to better integrate genetics education is essential to support its clinical applications.

BackgroundChest radiograph interpretation is a foundational skill in physician associate (PA) education, and competence in diagnostic imaging is an accreditation standard. While a larger body of research on radiology education exists in undergraduate medical education, considerable variability in instructional approaches limits clear conclusions regarding the most effective method. Growing evidence supports the use of active learning strategies in radiology instruction. However, little published research specifically addresses radiology education within PA programs. Team-Based Learning (TBL), an active learning approach grounded in social constructivism that emphasizes preparation, collaboration, and application, may be well suited to teaching image interpretation. This study evaluates the effectiveness of TBL compared with traditional lecture-based instruction for chest radiograph interpretation. MethodsA mixed-methods, quasi-experimental cohort comparison using a pre-post design was conducted with two consecutive PA student cohorts at a single institution. One cohort received a 90-minute lecture-based session; another cohort participated in a 90-minute TBL session. Academic performance was assessed using validated pre- and post-tests. Student satisfaction and self-efficacy were evaluated using post-session surveys derived from the Kirkpatrick model and Banduras self-efficacy theory. Independent sample t-tests compared quantitative outcomes, and qualitative responses were analyzed thematically. ResultsBoth cohorts demonstrated improvement in chest radiograph interpretation scores, with no statistically significant differences between groups in post-test performance or score improvement (p = 0.841). Survey results indicated favorable perceptions of both instructional approaches. The TBL cohort reported significantly higher ratings for engagement and peer interaction (p = <0.001). Self-efficacy ratings were higher among TBL participants for selected confidence-related items (p=0.003, p = 0.021, p = <0.001). Qualitative responses on what contributed most to self-efficacy emphasized peer discussion in the TBL group and structured explanations in the lecture group. ConclusionsTBL produced academic performance comparable to lecture-based instruction while supporting greater learner engagement and confidence. These findings support TBL as a feasible instructional approach for chest radiograph interpretation in PA education.

IntroductionPhysician assistant (PA) programs face persistent challenges in recruiting and retaining clinical preceptors due to time constraints, administrative burden, lack of compensation, and limited training. Additional pressures, such as health care consolidation, program expansion, clinician burnout, and financial implications of paid clinical sites, further strain preceptorship capacity. This study examines motivators and barriers influencing clinicians willingness to precept PA students. MethodsThis mixed-methods study used snowball sampling to recruit current, former, and non-precepting PAs across North Carolina. Participants completed surveys with Likert-scale and open-ended items adapted from the 2011 National Survey of Physician Assistants. Four virtual focus groups, selected from survey respondents, underwent semi-structured interviews informed by Self-Determination Theory (SDT). Quantitative data were analyzed using descriptive statistics and ordinal logistic regression; qualitative data underwent thematic analysis with deductive SDT coding and inductive refinement. Triangulation integrated findings. ResultsRespondents (N = 158) represented diverse clinical experience. Top motivators included student quality (66%), program support (53%), and financial compensation (51%). Key barriers were student quality (61.29%), burnout (53.23%), and lack of compensation (46.77%). From the focused group discussion, four themes emerged: Student Quality, Financial Compensation, Non-Financial Incentives, and Administrative Support. Student preparedness acted as both motivator and barrier; compensation concerns focused on fairness. DiscussionPreceptorship relies on relational and professional factors, student quality, recognition, and institutional alignment, rather than financial incentives alone. System inefficiencies, inadequate preparation, and misaligned compensation hinder engagement. Improving student readiness, enhancing institutional support, and implementing transparent, layered incentives may strengthen recruitment and retention.

BackgroundVision loss represents a significant public health concern according to the World Health Organisation, with increasing global age-standardised prevalence rates. Visual impairments are disproportionately distributed, occurring eight times more frequently in Sub-Saharan Africa and Southeast Asia compared to high-income regions. The Interprofessional Education (IPE) approach, utilizing the Arclight package as an implementation vehicle, offers promising potential for collaborative early detection and management of eye conditions in resource-constrained environments. This research aimed to implement validated Interprofessional Eye Health Education(IPEHE) in Rwanda, assess fundamental eye health knowledge and skills acquisition, evaluate medium to long-term learning retention, and explore IPEs role in developing these competencies. MethodsThe study employed a mixed-methods approach combining a Randomised Controlled Trial (RCT) with qualitative assessment at the University of Rwanda. Researchers invited 443 final-year students from diverse healthcare programs including nursing, pharmacy, midwifery, medicine, and ophthalmic clinical officers. With statistical power set at 0.80 and alpha error probability at 0.05, the design aimed to detect pre-post training score differences of 10% or greater. The calculated sample size of 54 participants per group was expanded to 280 total participants (180 intervention, 100 control) to accommodate potential attrition. ResultsIn the intervention group, 161 students (89.4%) attended the training, and 113 (70.2%) participated in the 10-month follow-up assessment (POST2). Of the control group, 90 participants (90%) attended assessments at 10 months post-intervention (POST2). Knowledge scores in the intervention group increased by 58.9% (SD=20.8, Z=10.82 p<0.001) immediately post-training, while skills improved by 49.7% (SD=14, Z=-8.382, P<0.001). At the 10-month follow-up, these gains remained significantly above baseline levels. Intervention participants significantly outperformed the control group at follow-up in both knowledge, with a 54.1% difference (SE= 2.0, df (201) = 27.3, P<0.001), and skills, with a 44% difference (SE=1.1, t(155)=38.7, p<0.001). Qualitative data from the intervention group indicated an appreciation for interprofessional collaboration, holistic patient care approaches, and the practical skills acquired. ConclusionThe IPEHE intervention significantly enhanced collaborative eye health knowledge and skills among Rwandan healthcare students, with demonstrated retention up to 10 months post-intervention. These findings suggest that pre-qualification interprofessional education effectively produces collaborative practice-ready professionals capable of addressing eye health challenges in resource-limited settings.

Background Conventionally, infertility has been regarded as primarily a female issue, leading to misconceptions, stigma, and underrepresentation of male infertility in healthcare discussions. This study assessed the knowledge, attitude and perception of Undergraduates towards male infertility in Osun State University. Methods A descriptive cross-sectional design was employed to select 300 undergraduates via multistage sampling. Qualitative data were collected using a focus group discussion guide covering the knowledge, attitude and perception, while quantitative data were collected using a self-administered questionnaire covering socio-demographic characteristics, knowledge, attitude and perception towards male infertility. Qualitative analysis was performed using NVivo software, while IBM SPSS Statistics version 27 was used for the quantitative analysis, with thematic analysis and chi-square tests to determine the association between variables (significance at p < 0.05). Results Respondents were predominantly females (64.0%) with a mean age of 20.99 {+/-} 2.31 years. Overall knowledge was low (47.7%), while more than half had a negative attitude (52.3%). Significant predictors of attitude include faculty (0.049), level (p=0.031), and formal education on male infertility (p=0.007). Conclusion Students demonstrated a poor understanding of male infertility, and their attitudes remain influenced by cultural norms surrounding marriage, masculinity, and gender roles. Hence, the need to foster open dialogues, promote gender-inclusive narratives, and strengthen healthcare support systems.

BackgroundHigh workload among healthcare workers has increasingly been correlated with poor patient outcomes, inefficient operational and financial outcomes, and burnout. Despite growing literature exploring causes of attending physician workload, there is limited understanding of trainee-specific measures. ObjectiveWe aimed to characterize elements contributing to trainee workload and perceived challenges and satisfiers to the trainee workday as a foundation for better understanding and measuring trainee work experience. MethodsInternal Medicine and Medicine-Pediatrics residents at an academic medical center were invited to participate in focus groups discussing contributors to inpatient workload and work experience between March and April 2024. A qualitative content analysis identified key metrics of trainee workload and work experience, which were then consolidated into overarching domains. A structured, multi-round rating process ranked the perceived relevance of each metric. ResultsTwenty residents participated across six focus groups. Analysis of focus groups yielded 297 workload metrics across 28 unique domains. Seventeen domains had metrics identified as highly relevant (median 6-7; IQR < 1) including autonomy, communication, disruptions, task switching, documentation, emotional burden, patient factors, professional fulfillment, rounding, teaming, and work-life balance. ConclusionsResident physicians highlighted complex interactions between clinical factors, work design, and psychosocial dynamics that contribute to their sense of workload. This creates opportunities to develop unique measures of workload to understand the trainee experience better. Further studies are needed to capture the generalizability of these findings and the relationship between these workload domains and patient, organizational, and trainee outcomes with the aim of implementing evidence-based work design.

IntroductionTherapeutic communication is the basis of nursing care yet it has been considered so stressful by student nurses with only 3.5% of nursing students in Kampala Uganda exhibiting optimum therapeutic communication competence. This has been attributed to inadequate training. Faculty must explore means to impart these skills in nursing students. This study implemented and evaluated an educational intervention module on therapeutic communication skills for nurses for incorporation into their teaching learning activities. MethodsA one-group pre-post quasi-experimental study was conducted with 41 diploma extension nursing students, selected via census sampling. Data were collected using self-administered structured questionnaires (content validity = 0.98; Cronbachs = 0.96), on students knowledge and perceived confidence in performing therapeutic communication. Observation checklists were used to evaluate students ability to establish nurse-patient relationships and deliver bad news in the skills lab, both before and after the intervention. ResultsThere was a significant improvement of knowledge scores from 4 (IQR: 3, 5) to 8.0 (IQR: 7.0, 9.0), (P value <0.001); perceived confidence in practicing therapeutic communication scores from 144.0 (IQR: 136.0, 153.0) to 164.0 (IQR: 155.0, 174.0) (P value <0.001); ability to initiate a nurse-patient relationship from 12.0 (IQR: 10.0, 14.0) to 17.0 (15.0, 18.0) (P value <0.001); and the ability to break bad news to the patient/caretaker from 9.0 (IQR: 7.0, 12.0) to 16.0 (14.0, 18.0) (P value <0.001) after the intervention. All scores improved in all categories of sex, program and semester of study for all participants apart from participants in the first semester of study. ConclusionThis study offers preliminary evidence that the educational intervention improves nursing students therapeutic communication skills. Further longitudinal research is needed to assess the sustained effectiveness of the module, the teaching methods used, and patients perspectives on students TC competence.

ObjectivePalliative care is recognized as an essential component of humanitarian health response, yet its delivery in field operations remains limited. This study assessed perceived importance, readiness to deliver, training needs, and operational barriers among Red Cross and Red Crescent Health Emergency Response Unit (ERU) delegates. MethodsA cross-sectional, web-based survey (LimeSurvey) was conducted among health professionals with ERU deployment experience between 1 October and 31 December 2024. The questionnaire captured demographics, background, preparedness, barriers, and training preferences. Descriptive statistics summarized categorical variables, and free-text responses underwent content analysis by two reviewers. Quantitative and qualitative strands were analyzed separately and integrated in interpretation. FindingsOf 173 responses, 114 met inclusion criteria (including 11 partial [&ge;]50% complete). Half (50.9%) had over ten years of humanitarian experience. Most (71%) considered palliative care extremely important, yet only 49.1% reported providing it, usually limited to pain relief; 25.4% reported none. Barriers included insufficient time or resources (56.1%), lack of training (49.1%), absent policies (48.2%), cultural barriers (47.4%), limited knowledge (36.8%), and restricted opioid access (28.1%). Among prescribers, 85.1% felt comfortable prescribing opioids, but stockouts (54.2%) and regulations (44.9%) constrained use. Most delegates (75.4%) had delivered bad news without structured communication training. 83% reported no palliative care training, though 91.4% endorsed dedicated, blended learning combining online and practical components. ConclusionERU delegates view palliative care as essential yet under-implemented. Integrating core competencies, standard protocols, and medicine access pathways--supported by competency-based training--could strengthen humanitarian readiness and align with WHO Emergency Medical Team standards.

ImportanceThe United States is facing a projected shortage of 40,000 primary care physicians by 2034. Student-run clinics (SRCs) are widely regarded as service-learning environments that may encourage students to enter a primary care specialty, but prior studies have yielded conflicting results and are limited to non-generalizable, single site analyses. ObjectiveTo compare likelihood of practice in a primary care specialty between students who did and did not participate in an SRC via pooled meta-analysis of U.S.-based studies. Study SelectionStudies were first identified through a comprehensive library of U.S.-based SRC literature. The inclusion criteria were publications on SRCs in the United States with MD/DO students, from all time until March 1, 2024. Exclusion criteria were: full text not available; published abstract/textbook/dissertation/thesis; not in English. Two authors independently screened the database for publications on SRC participation and practice in primary care specialties. To identify relevant literature after March 1, 2024, the authors performed iterative snowball sampling of the bibliographies of included studies and their Google Scholar "cited by" lists until saturation. Finally, we included original data from the single largest study on this topic. Data Extraction and SynthesisWe evaluated study quality using the NIH Study Quality Appraisal Tool. We used a random-effects model to account for heterogeneity. Main Outcomes and MeasuresThe primary outcome was the relative likelihood (risk ratio) of pursuing a primary care specialty among SRC volunteers versus non-volunteers. We used a funnel plot and sensitivity analysis to assess for bias. ResultsSeven studies met inclusion criteria with a cumulative sample size of 7,468 students. SRC volunteers pursued primary care at 102% to 160% the rate of non-volunteers. The pooled risk ratio was 1.25 (95% CI: 1.09-1.44). Funnel plot and multiple sensitivity analyses did not suggest publication bias or undue influence from included studies. Conclusions and RelevanceSRC participation is associated with a statistically-significant 25% increased likelihood of practicing in a primary care specialty. These findings may inform national and institutional strategies to support service-learning and address the national primary care workforce shortage. KEY POINTSO_ST_ABSQuestionC_ST_ABSIs participation in a student-run clinic during medical school associated with increased likelihood of practicing in a primary care specialty? FindingsDespite conflicting results in the literature among small and single-site studies, in this meta-analysis of 7,468 medical students, participation in a student-run clinic was associated with a statistically significant 25% increased likelihood of practicing in a primary care specialty. MeaningStudent-run clinics may be a potential strategy for strengthening the pipeline into primary care and reducing the projected shortage of 40,000 primary care physicians.

BackgroundThe global decline in the number of physician-scientists, despite an increase in practicing physicians, underscores a critical need for integrating research training into medical education. Addressing this issue, we established an international research exchange program aimed to enhance scientific literacy, foster transferable skills, and align curricula with European standards through collaborative research experiences. MethodologyThe program enabled reciprocal student mobility, involving eleven medical undergraduates who conducted month-long basic science research projects. Participants also completed comprehensive pre-training in scientific communication, safety protocols, and ethics, and were required to participate in local public engagement events. Feedback from participants, which we present here, was collected via three anonymous, voluntary questionnaires: pre-program, post-program and post-1-year follow-up, which we provide here to support similar initiatives. ResultsDespite challenges and delays due to the COVID-19 pandemic, the program met its objectives, demonstrating adaptability and effective resource management. Feedback revealed significant improvements in participants confidence in research methodologies, critical appraisal of scientific literature, and motivation for future research involvement. ConclusionThis project highlights the potential of structured international exchange programs, particularly among smaller institutions, to address gaps in medical education, enhance scientific training and opportunities in translational research for undergraduates, and cultivate the next generation of physician-scientists.

ObjectiveTo evaluate experiences of labor and delivery (L&D) staff with a Values Clarification and Attitude Transformation (VCAT) workshop on abortion perspectives and professional responsibilities prior to expanding abortion services to L&D. MethodsWe conducted VCAT workshops about abortion with 192 perinatal healthcare personnel at a single urban, community-based, tertiary care center in California. The workshops used a virtual adaptation of the Four Corners exercise, a previously published VCAT method that prompts participants to reflect on and represent diverse abortion viewpoints. Post-workshop, 25 participants, including nurses, physicians and midwives completed semi-structured interviews about their experience with the workshop. Transcripts were coded and thematically analyzed using a framework approach. ResultsFour major themes emerged: (1) VCAT promoted personal reflection and perspective taking, where participants described how representing others views deepened their understanding of their own beliefs, fostered empathy, and challenged assumptions about colleagues. 2) VCAT prompted reconsideration of professional roles and the role of L&D in abortion care with some viewing L&D as a space incompatible with abortion care and others seeing opportunity to expand inclusive, compassionate care. (3) Professional and personal contexts shaped participants engagement with the workshop with factors like compassion fatigue from many years of service in a hospital with many social needs and personal abortion experiences influencing how participants processed the workshop. (4) Respect for autonomy and commitment to patient care emerged as core, shared values, even among those with differing personal beliefs. ConclusionsVCAT workshops provided a structured opportunity for L&D staff to reflect on the complex personal and professional dimensions of abortion care. The process helped participants explore value tensions, clarify their professional roles, and identify shared ethical commitments to patient care. These findings suggest VCAT may be a valuable tool for preparing multidisciplinary perinatal teams to navigate institutional abortion care expansion with empathy, professionalism and cohesion.

BackgroundAdvanced Practice Providers (APPs) in emergency and urgent care settings experience high burnout rates, yet limited research examines cognitive factors influencing professional fulfillment. The Empowerment Dynamic framework suggests outcome-oriented thinking may protect against burnout compared to problem-oriented patterns. ObjectiveTo examine relationships between cognitive mindset orientation, professional fulfillment, and burnout among APPs while providing preliminary validation of a novel cognitive assessment instrument. MethodsCross-sectional survey of licensed APPs working in emergency departments and urgent care facilities across two health systems (July-October 2025). Professional fulfillment and burnout were measured using the Stanford Professional Fulfillment Index; cognitive orientation was assessed using a newly developed 22-item instrument. ResultsAmong 98 respondents (19.5% response rate), mean professional fulfillment was 5.8 and mean burnout was 4.5; 40.8% met burnout criteria. Professional fulfillment and burnout were inversely correlated (r = -0.62; P < .001). Problem orientation correlated positively with burnout (r = 0.56) and negatively with fulfillment (r = -0.36), while outcome orientation showed opposite patterns (burnout: r = -0.57; fulfillment: r = 0.44). In multivariable models, outcome orientation remained independently associated with lower burnout ({beta} = -1.51; P = .003) and higher fulfillment ({beta} = 1.73; P = .002). ConclusionsCognitive mindset orientation is associated with burnout and professional fulfillment among APPs. The novel assessment instrument demonstrates acceptable psychometric properties. Future longitudinal studies are needed to establish causality and evaluate cognitive interventions for burnout prevention.

BackgroundParticipating in research during medical school is supported by institutional programs and may influence subsequent professional development. ObjectiveWe aimed to describe the current status and heterogeneity of scholarly research programs for medical students in the United States, including expectations, support, and key structural features. MethodsWe conducted a cross-sectional web audit of official webpages for all accredited US MD- and DO-granting medical schools (search performed September 2024 to January 2025). Extracted variables included participation requirements, mentorship, timing and duration (overall and dedicated research time), expected scholarly outputs, funding sources, stipend information, and stated program goals. We compared Carnegie tier R1 (Very high research activity) versus other institutions, QS Top-50 versus other institutions, and MD versus DO schools using {chi}2/Fisher exact tests for 2x2 tables and exact trend or Freeman-Halton tests for multicategory variables. ResultsPrograms were identified for all 202 institutions. Funding was explicitly mentioned by 61.9% (125/202) of programs, 27.0% (51/189) were compulsory, 98.9% (188/190) reported faculty mentorship, and 91.0% (171/188) were exclusive for medical students. Program duration, dedicated time, expected outcomes, stipend reporting, funding sources, and stated goals varied widely. Carnegie R1 institutions had longer duration (P=.002) and tended to report external funding more often than other institutions (25/104, 24.0% vs 9/98, 9.2%; OR 3.13, 95% CI 1.38-7.10; P=.008). QS Top-50 institutions were more likely to require compulsory participation than other institutions (11/19, 57.9% vs 40/170, 23.5%; OR 4.47, 95% CI 1.68-11.87; P=.003). No significant differences were observed between MD and DO programs across most measured characteristics. ConclusionsScholarly research programs for medical students are ubiquitous across US medical schools but heterogeneous in structure, expectations, and support. Research-intensive and top-ranked institutions may have more external funding and sometimes may put together longer and compulsory programs Further evaluation of student experiences and outcomes is warranted.

BackgroundClinical research coordinators play a crucial role in ensuring the scientific rigor, regulatory compliance, and operational integrity of clinical trials. However, in Africa, they often lack access to structured, competency-based training, especially in operational, regulatory, and trial management domains. This study evaluated the effectiveness of a comprehensive training intervention designed to standardize and enhance core competencies of clinical trial coordinators. MethodsWe conducted a prospective pre-post interventional study among cohorts of clinical research professionals completing a 10-week, internationally-accredited, Moodle-based clinical trial operations training program aligned with the Joint Task Force Core Competency Framework, covering 10 lessons and 25 domains. Self-reported competence was evaluated at baseline and post-training. Data analyses included paired t-tests for aggregate scores, McNemars exact test for domain-level proportions, multivariable logistic regression for predictors of improvement, and Cohens d for effect size. ResultsAmong the 166 participants enrolled from 19 African countries and completed the pre-training survey, 152 who completed the program and post-training survey were included. The training significantly increased the mean aggregate competence from 12.24{+/-}7.85 (out of a maximum of 25) to 23.35{+/-}2.73 (mean difference: 11.11; 95% CI 9.86-12.36; p<0.001; Cohens d=1.41). Score variance decreased, with the median score increasing from 12.0 (IQR: 6.0-19.0) to 24.5 (IQR: 23.0-25.0). All 25 domains improved (p<0.001), with the largest gains in complex, low-baseline domains: managing external partners (+59.2%), project management (+58.6%), financial management (+55.3%), and trial close-out (+57.2%). (+57.2%). Ethical principles and informed consent that had high baseline competence reached near-universal levels at 99.3% and 98.7%, respectively. No differences were observed by country or gender (p>0.05). ConclusionStructured, competency-based training strengthens clinical trial coordinators capabilities, particularly in technical and administrative domains that are often overlooked. Accredited, framework-aligned clinical trial training programs promote consistent trial quality, strengthen research capacity, and sustain excellence in clinical trial delivery. WHAT IS ALREADY KNOWN ON THIS TOPIC- Clinical research coordinators play a crucial role in ensuring the scientific rigor, regulatory compliance, and operational integrity of clinical trials WHAT THIS STUDY ADDS- The study evaluated the effectiveness of a comprehensive training intervention designed to standardize and enhance core competencies of clinical trial coordinators in Africa, where they often lack access to structured, competency-based training HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY- This study should encourage the design and delivery of internationally-accredited, Moodle-based clinical trial operations training programs in Africa that enhance clinical trial competency.

BackgroundLarge language models (LLMs) are increasingly embedded in medical education and clinical care settings, yet limited empirical data describe medical students in Canadas use and perceptions of these tools. We aimed to characterize student engagement including LLMs used, frequency, purposes, trust, accuracy, perceived impacts, and attitudes toward educational and clinical integration. MethodsWe conducted a national survey of medical students in Canada distributed between November and December 2025. We summarized responses using descriptive statistics and compared results between students in preclerkship versus clerkship using Fishers exact test. ResultsAmong 286 respondents from 10 medical schools, 96.50% reported using at least one LLM. The most commonly used LLMs were ChatGPT (93.36%) and OpenEvidence (57.69%). Daily/weekly use was most frequent for coursework assistance (60.22%) and clinical questions (57.14%). Most respondents reported positive impacts on efficiency (81.62%), learning (77.01%), and academic performance (59.49%). Students commonly reported encountering inaccurate information (90.18%). Formal instruction on LLM use was uncommon (10.95%), though 67.67% of students agreed medical schools should integrate formal instruction on LLMs. Only 21.43% of respondents felt adequately educated on data privacy regulations applicable to these tools. ConclusionsLLM use among surveyed medical students in Canada was nearly universal and perceived favourably. However, students reported exposure to inaccurate outputs and substantial gaps in formal training and privacy literacy. These findings support the development of structured curricular guidance on appropriate application of these tools, including information verification practices and ethical, privacy-aware engagement.

IntroductionRural and geographically isolated communities in the Philippines continue to face chronic shortages of healthcare professionals, particularly among younger generations who often prefer urban or overseas employment. Despite long-standing national deployment programs, many rural health units (RHUs) and barangay health stations (BHSs) still struggle to attract and retain competent staff. Understanding the organizational characteristics that support young professionals is essential for strengthening rural workforce sustainability in these settings. This study explored how rural health organizations in the Philippines adapt to generational expectations and support the next generation of healthcare workers in geographically isolated and disadvantaged areas (GIDAs). MethodsA qualitative descriptive design was employed. Fourteen healthcare workers--physicians, nurses, midwives, nutritionists, barangay health workers, and administrative staff--were purposively selected from three GIDA municipalities in the Philippines. Semi-structured interviews were conducted in RHUs and BHSs, audio-recorded with consent, transcribed verbatim, anonymized, and analyzed using qualitative content analysis. Meaning units were coded and grouped into categories and themes through iterative team discussions to enhance credibility and confirmability. ResultsFive organizational characteristics emerged as essential for supporting young rural healthcare workers. Community-integrated mentorship enabled hands-on learning in barangay settings and strengthened cultural competence. Flexible and supportive work environments fostered teamwork, emotional safety, and shared responsibility. Clear pathways for professional growth--including access to training and opportunities for expanded roles and leadership--enhanced motivation and long-term commitment. Culturally grounded patient engagement improved community trust and the perceived relevance of health interventions. Finally, organizational adaptability to generational values, such as structured feedback, digital communication, and attention to work-life balance, was critical for retaining younger staff. ConclusionRural health organizations that provide mentorship, supportive work environments, meaningful opportunities for professional growth, culturally grounded care, and generationally responsive practices are better positioned to attract and retain young healthcare professionals in GIDAs. These findings offer practical guidance for local government units, the Department of Health, and academic institutions in designing policies and programs that strengthen rural health workforce development in the Philippines.