Latest Research in Medical Education - Newsletter #26

Hundreds of abstracts reviewed in the past 2 weeks and here are the greatest hits!

Welcome to our 26th newsletter! As with prior newsletters, I’ve highlighted what I find to be the critical pearls within each abstract and called out my #TOPPICK(s)!

Learning Science:

1. Learning by drawing: understanding the potential of comics-based courses in medical education through a qualitative study #TOPPICK
   In recent years, medical educators have increasingly incorporated comics into their teaching to promote humanism and empathy and to encourage reflective practice. However, it remains unclear how and to what extent comics-based courses effectively address persistent challenges in medical education, such as the need for more engaging, multimodal learning strategies and the cultivation of emotional intelligence alongside clinical competencies. The aim of this study is to investigate the experiences of students who have enrolled in courses on comics and medicine during medical school. Students reported that comics-based courses support key aspects of their medical training that traditional pedagogical approaches may overlook, such as fostering self-reflection, enhancing empathy, and encouraging creative engagement with complex medical narratives.

   

2. Effectiveness of Gagné's 9 Events of Instruction in health professions education: a systematic review and meta-analysis #TOPPICK
   This review assesses the effectiveness of Gagné's 9 Events of Instruction in improving theoretical scores and clinical practice abilities in medical education.

   A total of 11 studies involving 825 participants were included in the meta-analysis, including 5 RCTs and 6 CSs. In the cumulative meta-analysis, compared with the traditional lecture-based learning model, Gagné's 9 Events of Instruction significantly improved learners' Knowledge Examination Score (KES), Practice Score (PS), Learning Compliance (LC, participation), and Teaching Satisfaction (TS, evaluations). The meta-analysis indicated that, compared to traditional medical teaching models, Gagné's 9 Events of Instruction are significantly effective in health professions education and can effectively enhance learners' KES, PS, LC, and TS.
   *Click here to learn more about Gagne’s Events of Instruction!

   

3. Learning endocrine physiology of the female reproductive system through memes
   Technology is an integral part of the learning process of the new generation of students. The use of digital tools in education increases engagement and information retention by the students and also creates a pleasant learning environment. Memes are technological tools widely used in social media that can be used in classrooms to make concepts more visual and humorous. Learning endocrine physiology at university can be challenging, especially the endocrine physiology of the female reproductive system, which involves cyclic changes of female sex hormones and gonadotropic hormones and complex regulation through feedback loops. Thus, we propose using memes as an educational tool for teaching female gonad physiology. In the paper, we provide memes to aid the understanding and stimulate the discussion of every aspect of the endocrine physiology of the female reproductive system.

4. Enhancing group outcomes: the role of individual preparation in collaborative learning
   Individual preparation can enhance the effects of collaborative learning through effective information processing. However, the limitations of prior studies in distinguishing the unique effects of individual preparation from individual learning, as well as their focus on short-term effects within the humanities and social sciences, have hindered its application into education for health professionals. Therefore, the current study examined the distinct effects of individual preparation for collaborative learning in short- and long-term contexts by conducting two experiments. In Experiment 1, the results demonstrated that the participants who prepared individually before collaboration performed better than those who engaged solely in collaborative or individual learning. The results of Experiment 2 indicated that medical and dental students who prepared individually and then collaborated performed better than those who engaged solely in collaborative or individual learning in short- and long-term settings. These findings suggest that individual preparation for collaborative learning can be an effective instructional approach across educational settings, which enhances the academic performance in short- and long-term perspectives especially in education for health professionals.

genAI/LLMs:

1. Evaluating the Ability of Artificial Intelligence to Address Nuanced Cardiology Subspecialty Questions: ChatGPT and CathSAP #TOPPICK
   Recent developments in artificial intelligence (AI), particularly in large language models, have shown promise in various fields, including health care. However, their performance on specialized medical board examinations, such as interventional cardiology assessments, remains relatively unexplored. This study aimed to assess the overall performance of Chat Generative Pre-trained Transformer (ChatGPT) and compare it to that of average test takers. Additionally, the study evaluated the impact of pertinent educational materials on ChatGPT’s responses, both before and after exposure. The primary outcome measures included ChatGPT’s overall percentage score on the CathSAP examination and its performance across various subsections. Initially, ChatGPT achieved an overall score of 54.44% on the CathSAP exam, which improved significantly to 79.16% after exposure to relevant textual content. The improvement was statistically significant (P = .0003). Notably, the improved score was comparable with the average score achieved by typical test takers (as reported by CathSAP). ChatGPT demonstrated proficiency in sections covering basic science, pharmacology, and miscellaneous topics, although it struggled with anatomy, anatomic variants, and anatomic pathology questions.

2. An Academic Viewpoint (2025) on the Integration of Generative Artificial Intelligence in Medical Education: Transforming Learning and Practices
   Generative artificial intelligence (GAI) has introduced a new era of medical education by offering innovative solutions to critical challenges in teaching, assessment, and clinical training. This expanded review explores the current and potential applications of GAI across multiple domains, including personalized tutoring, enhanced academic administrative efficiency, and improved preparedness for daily learning interactions. Utilizing a narrative review methodology combined with expert analysis, this study involved a structured literature search in January 2025 across PubMed, Scopus, and Google Scholar, followed by iterative brainstorming sessions and expert evaluations to assess the feasibility and impact of various GAI applications. Six domain experts then appraised the feasibility and impact of GAI technologies across educational settings, resulting in 10 identified domains of application: Quality and Administration, Curriculum Development, Teaching and Learning, Assessment and Evaluation, Clinical Training, Academic Guidance, Student Research, Student Affairs, Internship Management, and Student Activities. Overall, by embracing targeted, ethically guided implementations, GAI has the evolving potential to enhance educational quality, improve operational effectiveness, and equip future healthcare professionals with the adaptive skills needed in a patient-centered clinical landscape.

#socialQI/Social Media

1. Using Social Media to Engage and Enroll Underrepresented Populations: Longitudinal Digital Health Research
   Emerging digital health research poses roadblocks to the inclusion of historically marginalized populations in research. Exclusion of underresourced communities in digital health research is a result of multiple factors (eg, limited technology access, decreased digital literacy, language barriers, and historical mistrust of research and research institutions). Alternative methods of access and engagement may aid in achieving long-term sustainability of diversified participation in digital health research, ensuring that developed technologies and research outcomes are effective and equitable. This study aims to (1) characterize socioeconomic and demographic differences in individuals who enrolled and engaged with different remote, digital, and traditional recruitment methods in a digital health pregnancy study and (2) determine whether social media outreach is an efficient way of recruiting and retaining specific underrepresented populations (URPs) in digital health research. Social media recruitment (paid/unpaid) provides access to URPs and facilitates sustained retention similar to other methods, but with varying strengths and weaknesses.

2. Video Clips of the Dietary Approaches to Stop Hypertension Diet on YouTube: A Social Media Content Analysis

   Background: YouTube is among the most highly used internet video sharing platforms worldwide. Objective: The aim in this study was to conduct a social media content analysis of Dietary Approaches to Stop Hypertension (DASH) diet videos on YouTube. Methods: Specific search parameters were input into YouTube, and 101 videos were evaluated for quality and viewer exposure/engagement metrics independently by 3 content experts using the DISCERN instrument, a 16-item instrument designed to assess quality, reliability, and dependability of an online source. Scores were aggregated for analysis. Conclusion: Study findings suggest that videos on DASH diet offered via YouTube could potentially be an inexpensive venue to promote healthful dietary practices and educate clients. Existing YouTube content on DASH diet demonstrates significant variability in quality ratings based on DISCERN. Providers should direct individuals to engage with high-quality educational DASH diet videos on YouTube that are created with qualified health professionals and are shared by reputable institutions.

General Themes:

1. Have We Made Progress? Interprofessional Diversity Within Faculty and Course Directors of Continuous Professional Development Courses Pre- and Post-Joint Accreditation
   This study aimed to quantify the impact of joint accreditation on the prevalence of physician and non-physician continuous professional development (CPD) course directors(CDs) and faculty. CPD CDs and faculty credentials were collected in 2017 (one-year pre-joint accreditation) and 2022 (one-year post-joint accreditation), using electronic and manual data extraction. CPD CDs and faculty were grouped into physician and non-physician cohorts for the quantitative analysis. A significant increase in the number of non-physician CDs was observed from 2017 (11.3%) to 2022 (22.5%). There were significantly more non-physician faculty at non-physician-focused courses (8.7 ± 8.1 faculty compared to 2.6 ± 4.1 at physician-focused conferences, p = 0.003) with a large effect size, Cohen's d = -1.32 [95% CI -1.8, -0.9]. Finally, while physicians had statistically higher faculty scores for all three measurements (p < 0.001), the effect sizes were small (Cohen's d ranging 0.18-0.20). Increased diversity in CDs and faculty was noted when comparing pre- and post-joint accreditation suggesting compliance with joint accreditation standards and the growing emphasis on team-based healthcare.

2. Barriers and facilitators to the cultivation of communities of practice for faculty development in medical education: A scoping review
   Communities of practice (CoPs) have been promoted as a strategy to foster the professional development of faculty. In recent years, there have been a rising number of publications in the field of medical education that report on the impact of CoPs in faculty development (FD), as well as the factors that influence their cultivation. The objective of this scoping review was to comprehensively map the reported barriers and facilitators to cultivating CoPs for FD in medical education. The main barriers and facilitators were related to: the sufficiency of structural, cultural and resource support; the availability and fit of required stakeholders; relevance to member needs; planning; member attraction and engagement; and reflection and evaluation of the CoP. This review highlights the key patterns and gaps in the emerging publications on CoP cultivation for FD in medical education, from their formation to their sustainability. There remain key unresolved problems and gaps in the evidence concerning how to create long-term participation successfully to sustain CoPs for FD in medical education.

3. Canadian Rheumatology Association Guidance for Developing & Endorsing Quality Measures to Support Learning Health Systems
   Objective: To review methods for developing and endorsing Quality Measures (QMs) to inform a national quality measurement framework for rheumatology care in Canada. Methods: We conducted a rapid environmental scan of measure development organizations from Canada, the United Kingdom, the United States and Australia. Major phases in the development of QMs were abstracted. The results were reviewed and synthesized with members of the Canadian Rheumatology Association's Digital Measurement Subcommittee through iterative review across 3 virtual meetings. The guidance was approved at the committee and the CRA board level. Results: Five key steps in the measure development cycle are proposed including: conceptualization and prioritization, measure specification development, testing and validation, implementation and reporting, continuous evaluation and maintenance. Conclusion: This paper establishes a comprehensive and relevant framework for the development and/or endorsement of QMs in Canadian rheumatology care. This framework will permit streamlining of future quality improvement efforts at the national level.

4. Four distinct models of learning health systems: Strength through diversity
   The concept of a learning health system (LHS) was established nearly 20 years ago as a unifying commitment to speed the generation and use of evidence primarily by leveraging rapid advances in data and technologies, resulting in optimized care for each patient. In the ensuing decades, vanguard adopters of the LHS who have sought to move the LHS from conceptual to operational have done so in ways that fit with and reflect their organizational structure, mission, and culture-as well as their personal values and experiences. They have also extended the focus from health care to include individual and population health more broadly. This commentary describes four distinctive models that have evolved as learning health system activities have matured. Viewing this diversity as a strength, the features, commonalities, and unique differences of these models are described.

5. Creating a culture of coaching: examining clinical teachers' coaching behaviors through a behavior change lens
   Despite the integral role that clinical teachers' coaching behaviors play in shaping residents' learning experiences, these behaviors are not always enacted. To better understand the behavioral determinants of coaching, the objectives of this study were to (a) identify barriers and facilitators of engaging in coaching behaviors using behavior change theories (Behavior Change Wheel, BCW; Theoretical Domains Framework, TDF), and (b) propose relevant interventions and policy changes to facilitate the engagement in coaching behaviors. Participants' perceptions of coaching behaviors were captured in six themes pertaining to clinical teachers' capability (a self-directed journey; a balancing act), opportunity (the show must go on; setting the stage), and motivation (call me coach; an audience for coaching). Although clinical teachers had the necessary coaching knowledge and skills, social and environmental constraints limited the practical implementation of these behaviors. This work supports applying behavior change theories in medical education research.

6. The Value of Learning Collaboratives: Experiences From Several Residency Networks
   The 2023 ACGME guidelines highlight learning collaboratives as the "optimal way to facilitate [family medicine residency] programs' ability to attain their educational and community aims." As a result, many residency programs are seeking to develop, expand, or sustain learning collaboratives. This study aims to provide practical advice, examples, and encouragement for residency programs interested in creating or participating in a learning collaborative, based on lessons learned from the representatives' collective experiences. A purposive sampling of five learning collaboratives at various stages of development and growth was conducted to capture a representative range of models. Data were collected through participatory engagement and refined through iterative rounds of member checking. Despite differences in form and structure, learning collaboratives share commonalities in the support they provide their participants. They encounter common barriers and rely on similar strategies for success.

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