BMC Medical Education

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.

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.

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.

M.D.-Ph.D. programs in the United States have traditionally followed a "2-n-2" curricular model, with the graduate phase occurring between the pre-clerkship and clerkship portions of medical training. While well established, this format can limit trainee autonomy in shaping their physician-scientist training trajectories. In response, some programs have introduced a "3-n-1" model, allowing students to complete clerkships before beginning Ph.D. training. Our institution implemented multiple flexible curricula in 2017. Understanding why trainees choose one pathway is important as programs consider implementing more adaptable training structures. To investigate these factors, we surveyed M.D.-Ph.D. students at our institution, which offers multiple flexible curricular alternatives, about contributions to their curricular decisions. Responses supported that trainees weigh considerations across medical education, scientific development, and integrated physician-scientist training domains. Although the traditional pathway was a popular option, most students pursued one of the flexible pathways. Our findings suggest that introducing flexibility in the timing of undergraduate medical education and graduate training can support diverse educational, logistical, and personal priorities while maintaining the rigor of physician-scientist training. Offering multiple pathways empowers trainees to design trajectories that best fit their needs. Continued longitudinal studies are needed to assess the long-term impacts of flexible curricula on physician-scientist career outcomes.

IntroductionIn France, Writing and defending a medical thesis are mandatory components of medical education curriculum to obtain the degree of Doctor of Medicine. The expectations of medical interns in medical gynecology regarding their medical thesis have not been evaluated. MethodsA 10-question form was distributed during the national teaching of the advanced phase of the specialized medical studies (DES) in medical gynecology (corresponding to the 2nd and 3rd year of internship). Responses were collected using the Wooclap* software. ResultsA total of 131 interns participated in the survey out of 170 interns solicited. Approximately two-thirds of the surveyed students had a medical thesis topic at the time of the survey. Among students with a thesis topic, thesis supervisors were most often university practitioners (MCU-PH/PH-U/PU-PH, 37.4%), followed by hospital practitioners (22.8%). The quality of supervision by the thesis supervisor was rated at 6.9/10, and the quality of supervision by the university was rated at 3.3/10. Overall, 53.4% of students wished to leverage their work through scientific publication. Nearly all students (94%) wished for guidance on at least one of the following topics: writing scientific articles (83%), basic statistics (83%), basic data collection (75%), training in the use of Pubmed (68%), Excel (65%), Zotero (63%), project management (53%), Word (15%). ConclusionSupport for medical interns in medical gynecology for their medical thesis could be improved, particularly through modules on scientific publication, bibliography, and office automation.

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.

IntroductionThe predominant method of learning Medicine at its core has remained unchanged for decades. This stagnancy creates a need for making learning more effective, insightful, and quantified. Schema achieves this through e-learning, active feedback, and quantified learning by granulating the medical curriculum into specific subtopics selected based on the crucial knowledge that a competent medical learner must possess, hereafter referred to as yield. This particular study aims to analyze medical students multidimensional competency in solving clinical scenario-based MCQs pertaining to vertically integrated topics derived from the Schema. MethodsA retrospective study was conducted by analyzing the user data of a leading e-learning platform for medical students. For the purposes of this study, twenty such "high-yield" Schema topics were shortlisted as being the most crucial knowledge areas. Students performance in solving a fixed set of SOC-MCQs of these Schema topics was used to gauge their competence. Performance variation over five years (2018-2022) was also analyzed to study the changing patterns in topic-specific performance. ResultsA total of 20 Schema topics were shortlisted, consisting of 128 MCQs. The number of participants solving each Single Option Correct Multiple Choice Question (SOC-MCQ) ranged from 60,080 to 2,06,672. A significant improvement in the Net Delta was observed in 9 topics. Performance in other topics showed either no significant change or a significant downtrend. ConclusionA significant performance uptrend (ND = 128%) was observed in Anaphylaxis, Basic Lifesaving Skills, ST-Elevated Myocardial Infarction, Glasgow Coma Scale, and subdural hemorrhage & Syndromic management of Sexually Transmitted Infections, most of which are either acute or emergency conditions. A significant downtrend in performance was seen in Schema topics such as Asthma management, Hypertension management, Diabetic Ketoacidosis, and Subarachnoid hemorrhage pertaining to chronic conditions. Several hypotheses for these findings can be derived, the validities and collective impacts of which can be explored in more in-depth and broader studies in the future.

Values are an essential aspect of day-to-day life, both in healthcare and in society as a whole. Values affect both the smaller decisions we make and our overall goals. Because of this, it is important for physicians to be prepared to help patients identify individual values, which begins with needing to be able to identify their own personal values. One way to prepare students to do this is through the lens of narrative medicine, a discipline which uses the skills of close reading and reflective writing as techniques for enhancing clinical skills and patient care. An introductory workshop on reflective writing and value identification was offered to first- and second-year medical students. The workshop was capped at twelve participants to ensure a small group environment. Participants were provided with a brief presentation on value identification, followed by a guided reflection time. Students were presented with a passage from a physician memoir, followed by three reflective writing prompts. After the reflective writing portion, participants shared their writing and discussed the value of community while in healthcare training and how reflective writing groups help reduce burnout and create better connection between peers. Workshop members also highlighted the ways in which these skills could apply to their future practice in a variety of different fields (including primary care, surgical, and further specialized). In fact, 92% of participants marked "Strongly Agree" for the statements: "This workshop was relevant to my future as a physician." and "An understanding of personal values will help me to be a better future physician." The combined metrics of the optional end of workshop survey as well as the remarks made during group discussion lead to the conclusion that small reflective writing groups focused around a specific topic offer a valuable communication and relationship intervention in medical education.

Embedding an experiential research curriculum into medical programs is still not widely adopted. This study investigated, using convergent mixed methods design, the journey of medical students in relation to a research module. The students perception of the experience was qualitatively explored using thematic analysis. The students performance data were quantitatively analyzed using multi-repeated ANOVA. The exploration generated four themes: 1-Attend-Acquire, 2-Accumulate-Assimilate, 3-Apply-Appreciate, and 4-Articulate-Affect. Quantitatively, two distinct clusters of mean Grade Point Average were revealed (p<0.01). Joint display analysis enabled integrating the qualitative and quantitative findings, generating the 8A-Model. The students start appreciating the experience upon conducting their research.

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.

IntroductionEvaluating skills requires developing relevant grading tools that could potentially be used for self-assessments. The goal of our study was to assess the relevance of a self-assessment (SA) grid used for a skin suture exercise as compared to an evaluation carried out at the same time by an expert (EE), while also identifying any factors likely to influence it. Materials and methodsBetween 2018 and 2022, an assessment grid for a skin suture exercise was used during skills assessment sessions with first-year trainee surgeons. The students were given a self-assessment grid to fill out at the same time. The results of the SA and the EE in this grid were analyzed and compared, then set against the anxiety scores of the trainees based on the STAI Y-A. A comparative analysis of trainees with a tendency to over- or underestimate themselves was carried out to identify the factors that could contribute to them misjudging their skills. FindingsThe data for 70 trainee doctors was analyzed. The mean of the difference in score between the SA and the EE was 2 points lower for SA than EE (p < 0.001). The mean score for the STAI Y-A was 36.2 +/- 8.9 and the learners anxiety had no effect on the EE but did affect the SA. When learners showed low self-confidence, they underestimated themselves, but examiners also had a tendency to give them lower grades. In multivariate analysis, the less experience a learner had, the more they tended to overestimate their abilities. ConclusionAnxiety and self-confidence affect self-assessment, but external assessment does not seem to be affected by the learners stress levels. Formative self-reflection based on the use of SA grids should be introduced during medical studies so as to adjust the level of technical skill perceived by trainees and to make simulation-based training more effective.

IntroductionIn response to the lack of research engagement among medical undergraduates, ASPIRE at Seth GSMC and KEM Hospital introduced an innovative mentorship program during their academic fest, Confluence. This program counters the typical challenges faced by students, such as mentorship access and practical experience, by providing structured, comprehensive training in research methodologies. MethodologyIn the study, four custom-developed and validated questionnaires assessed biomedical research knowledge, attitudes, skills, and post-session feedback among participants of the National Level Peer-Based Research Mentorship Programme (NLPRMP) in India. The prospective evaluation study included mentees from the 2021 and 2022 cohorts, using a rigorous selection process for team formation based on research interests and experience. The program curriculum, revised in 2022 based on feedback, encompassed key research methodology topics and concluded with a protocol presentation competition. Data analysis involved pre and post-programme questionnaires, using statistical tools to evaluate shifts in participants research perspectives and capabilities. ResultsThe study, involving 64 medical students in a mentorship program, demonstrated significant improvements in various areas post-mentorship. Knowledge scores increased notably, attitudes towards medical research became more positive, motivation for engaging in medical research grew, and there were enhancements in research-related skills. Additionally, students perception of research as a career option and their views on integrating research into the medical curriculum improved substantially, underlining the mentorship programs profound impact on their academic and professional development. ConclusionExponere, the National Level Peer-Based Research Mentorship Programme at Seth GSMC and KEM Hospital significantly enhanced research engagement among medical undergraduates. It effectively improved their knowledge, attitudes, and skills in biomedical research, fostering a greater inclination towards research as a career path. This innovative approach, addressing the previously identified gaps in early research exposure and practical experience, underscores the programs pivotal role in shaping the future of evidence-based medical practice.

PurposeStructural obstacles in healthcare related to social, economic, and political factors contribute to inequities in patient care. Combined didactic and experiential learning may be more effective to teach medical students how to address implicit bias and microaggression in the clinical setting. MethodsRising third year medical students at New York Medical College participated in a student-led implicit bias and microaggression training program, including experiential learning through standardized patient (SP) encounters and self-reflection via student-led debrief sessions. The SP encounters simulated instances of xenophobia and perceived language barriers in a hospital setting, in which students were expected to address microaggressions in real time utilizing the VITALS (Validate, Inquire, Take time, Assume the best, Leave opportunities, Speak up for others) framework. Results200 students participated in the program. Survey responses on attitudes regarding implicit bias and microaggressions were collected prior to participating in the program (T1), after the VITALS video presentation (T2), and after the SP encounter and debrief sessions (T3). Students felt more likely to interrupt a microaggression from T1 to T3. ConclusionsOur implicit bias training, equipped students with the tools and practice needed to interrupt microaggressions in the clinical setting. Practice PointsO_LICombined didactic and experiential learning may be more effective than didactics alone for teaching medical students how to address implicit bias and microaggression in the clinical setting. C_LIO_LIStudents overestimated their comfort level to interrupt a microaggression after watching the training video alone, underscoring the importance of experiential learning. C_LIO_LIStudents valued the opportunity to practice interrupting microaggressions in a safe space with the SPs. C_LIO_LIThe SP encounter positively impacted students likelihood to interrupt a microaggression in the future. C_LIO_LIStudents felt more comfortable interrupting a microaggression from a peer than from a person in power. C_LI

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.

IntroductionInterprofessional collaborative practice (IPC) is deemed essential to address the quadruple aims of improving healthcare. There is also emerging interest in the role IPC among healthcare faculty in their educational and research roles educators. Various facilitators and barriers of IPC at the individual and team levels have been identified. However, organizations and systems are often strong drivers for professional practice and limited attention has been placed on the strategies needed for organizations to support IPC. This study explored the perspectives of faculty and other professions regarding organizational facilitators and barriers to IPC, as well as strategies to support IPC within their own professional contexts. MethodsDocument analysis was performed on papers from a course entitled "Interprofessional Collaboration in Practice", a requirement of a Doctor of Health Sciences in Clinical and Academic Leadership program. The papers were written as part of a culminating project exploring opportunities to enhance IPC within students own professional contexts. Students used reflections of their own professional experiences, informed by the literature and other course content, as well as informal interviews with other professionals in their workplace, to explore facilitators, and barriers to IPC. Inductive content analysis was performed by two members of the research team. Final results and selective quotes were reviewed by the full research team. ResultsTwenty papers written by students of various professional backgrounds, professional roles, and organizational types were included. Four dominant themes were identified that reflected facilitators and barriers to IPC that existed within students organizations. These four aspects of organizations appear to be both essential and inter-related, and include organizational systems, strategic priorities, culture, and institutional leaders. ConclusionOrganizations and their senior leaders play a critical role in developing collaborative organizations where employees from various professions effectively work together to accomplish organizational goals. In addition to the current practice of preparing individual healthcare professionals for IPC, attention to organizations and their leaders is essential. Faculty and other professionals have particularly valuable perspectives in understanding how IPC can be advanced in healthcare organizations and should be the focus of future professional development initiatives and additional research related to IPC. Trial registrationnot applicable

IntroductionSpecial Study Module is a mandatory research project implemented in some medical curriculum. For the successful application of evidence-based practice, physicians must understand research methodology before the appraisal of relevant evidence. The objective of this paper is to provide a brief overview of the effectiveness of student research modules in enhancing research understanding. MethodsSecond-year students of undergraduate medical programs were included in this study. At the beginning and after completion of literature review type research projects, the same student cohort completed a questionnaire comprising sections on perceived competency, attitude, and knowledge on research skills. Data from 163 participants who completed both pre and post-survey were analyzed. ResultsPaired t-test revealed significant differences in self-perceived knowledge, attitude, and assessed knowledge of the subjects before and after completing the research modules. Multivariate analysis also displayed a significant increase in self-perceived and assessed knowledge by carrying out the project. No significant association was exhibited by gender and ethnicity. ConclusionsIn summary, the research module improved students understanding of research methodology as well as the structure of scientific communication. Further studies to assess the effect of various types of research modules in different study populations are warranted.

IntroductionObjective Structured Clinical Examinations (OSCEs) are critical tools in medical education, designed to evaluate clinical competence by engaging students in tasks such as patient history-taking and physical examinations across multiple stations. Examiners assess student performance using structured rubrics to ensure objective evaluation. The COVID-19 pandemic spurred the adoption of technology in OSCEs, introducing virtual formats to maintain social distancing. While these advancements showcased the need for more interactive and realistic simulations, AI-driven tools like ChatGPT offer potential solutions. With its advanced conversational capabilities, ChatGPT can simulate patient interactions and provide real-time feedback, supporting active learning, experiential engagement, and cognitive management. Rooted in established learning theories, ChatGPT represents a promising avenue to enhance OSCEs by improving the evaluation of clinical competence and enriching training experiences. MethodThis pilot study engaged 20 faculty members who design and evaluate OSCE scenarios for medical students. Participants utilized ChatGPT in three simulated clinical cases that mirrored traditional OSCE formats. Following the simulations, feedback was collected via a survey to evaluate ChatGPTs effectiveness and usability. ResultsThe study found that participants appreciated AI as a standardized patient for its responsiveness, clarity, and ability to enhance clinical reasoning while reducing intimidation. However, key challenges included the lack of non-verbal communication, limited empathy, and an inability to perform physical examinations. Technical issues and inconsistent responses also affected the experience. While 20% of participants expressed interest in using AI in future OSCEs, they recommended a hybrid model combining AI with real standardized patients. This approach would leverage AIs strengths while ensuring essential communication, empathy, and practical skills are effectively developed in clinical education. ConclusionTraining ChatGPT to simulate diverse patient scenarios within OSCEs represents a significant innovation in medical education. By offering realistic simulations and precise feedback, ChatGPT has the potential to enhance both assessment accuracy and student preparedness for real-world clinical settings.

Introduction: Postgraduate clinical training is crucial for developing professional competence, communication skills, and effective teamwork. Although resident physician selection is crucial, little is known about how Japanese residency programs select residents and whether selection practices are associated with difficulties during training. Methods: We conducted a nationwide cross-sectional survey of residency programs participating in Japan's 2023 General Medicine In-Training Examination (GM-ITE). Program directors completed a questionnaire assessing selection methods, interview content, quality-assurance measures, and resident difficulties, defined as at least one postgraduate year 1 or 2 resident physician receiving disciplinary action or a severe warning. Free-text responses were coded using the Situation, Task, Action, and Result framework. Associations between selection methods and resident difficulties were examined using adjusted logistic regression models controlling for hospital type and number of GM-ITE examinees. Results: Of 151 participating physician-selection programs, 150 provided valid responses. Interviews were used by 90.1% of programs and were identified as the most important selection component by 87.3%. Thirty-five programs (23.3%) reported difficulties with resident physicians, involving professionalism and workplace conduct including rule, ethics, or boundary violations, work avoidance or unavailability, and inappropriate communication. Use of applicants' pre-clinical-clerkship computer-based test scores as a selection criterion was associated with resident difficulties (adjusted OR, 4.60; 95% CI, 1.50-14.11; P = 0.008; FDR-adjusted P = 0.048). No significant associations were observed for essays, academic tests, medical school grades, or personality assessment. Program-level GM-ITE total and domain scores did not differ significantly between programs with and without reported resident physician difficulties. Discussion: Resident physician selection in Japan is highly interview-centered; reported difficulties were more often related to professionalism and workplace conduct than to knowledge deficits. Although these exploratory findings are program-level, they highlight the importance of strengthening the quality assurance processes in resident selection systems, particularly for assessing professionalism-related attributes in applicants.

Background and objective: Problem-based learning (PBL) strategies such as case studies and role-playing are increasingly adopted in medical education to promote critical thinking, communication, and teamwork. However, comparative evidence regarding their effectiveness in medical biochemistry remains limited. This study aims to evaluate and compare the impact of case studies and role-playing on learning outcomes, engagement and skill development among first year MBBS students. Material and methods: An educational randomized controlled trial (RCT) with a within-subjects crossover design was conducted in the Department of Biochemistry involving forty-five first-year MBBS students. Participants were randomly assigned to receive case studies and role-playing in a counterbalanced sequence. Learning outcomes were assessed using pre- and post- tests, a structured feedback questionnaire and qualitative reflections. Data were analysed using appropriate parametric and non-parametric tests, along with adjusted analysis using ANCOVA to account for baseline performance. Results: All participants completed both methods, with no significant difference in baseline knowledge between arms (P=0.12). Both case studies and role-playing produced significant pre- to post- test improvements (P<0.001). Unadjusted analyses showed higher learning gains with role-playing, but pre-crossover ANCOVA demonstrated comparable effectiveness after baseline adjustment. Exploratory pooled analysis suggested a moderate cumulative advantage for role-playing. Student feedback indicated higher engagement and perceived skill development with role-playing, while both methods were viewed as relevant and educationally valuable. Conclusion: Both case studies and role-playing were effective PBL strategies for improving understanding and application of medical biochemistry concepts. Although student feedback and unadjusted analyses indicated higher engagement with role-playing, adjusted analysis at initial exposure showed comparable effectiveness between the two methods. Role-playing supported interactive learning and AETCOM -related skills, while case studies strengthened structured analytical reasoning. A combined approach may therefore offer a balanced and comprehensive PBL framework in medical education.

BackgroundLive lectures are commonly used in medical education, yet many students prefer video lectures instead. As different learning modalities may affect knowledge, it was necessary to explore medical students perspectives about the two learning modalities in Pakistan. ObjectivesThis study aimed to explore and compare the medical students perspectives regarding live lectures and video lectures. MethodsThis cross-sectional study used an online questionnaire. This was distributed to medical students via internet platforms after institutional approval. Data were analyzed with SPSS version 23 using descriptive statistics. Results585 students, from 11 medical colleges across six cities of Pakistan, were enrolled. 64.4% (n=377) of the students were females, while 34.0% (n=199) were males. The first years comprised 32.7% (n=191), second years, 29.2% (n=171), and third years, 38.1% (n=223) of the total. The commonest reason for attending live lectures was they are compulsory. The commonest reason for not attending was poor teaching quality. 5.0% (n=29) of 585 students reported live lectures and 51.8% (n=290 of 560) found video lectures to be very helpful in concept clarification. 85.1% (n=258) of 303 students found video lectures more effective for learning. For 45.4% (n=254) of students, video lectures improved their grades a lot; more students used video lectures for exam preparation over the years. 50.6% (n=296) of students wanted video lectures to be compulsory, compared with 28.5% (n=167) for live lectures. The main improvement in live lectures was not using slides. ConclusionMedical students in Pakistan prefer video lectures over live lectures for learning and exam preparation. More students wanted video lectures to be compulsory in medical education. Several improvements have been suggested for live lectures. O_TEXTBOXSummary box Section 1: What is already known on this topic? O_LIMedical students prefer video-based learning over attending live lectures. C_LIO_LIThe choice of learning modality (video lectures versus live lectures) may affect knowledge and examination scores. C_LIO_LIStudies have not compared the effectiveness of commercial video lectures (created by any individual, not necessarily affiliated with a medical college, board examination preparation company, or independent person) to live lectures. C_LI Section 2: What this study adds? O_LIMedical students prefer video lectures to live lectures in basic sciences medical education and most want video lectures to be compulsory in medical education. C_LIO_LIMedical students find video lectures more effective in concept clarification and use them more often in exam preparation and believe video lectures improve their grades. C_LIO_LIMedical students do not want (PowerPoint) slides to be used in live lectures. C_LI C_TEXTBOX