Tag: nevin manimala

BMC Med Educ. 2025 Oct 2;25(1):1275. doi: 10.1186/s12909-025-08034-5.

ABSTRACT

BACKGROUND: Competency-based education is globally recognized as the standard for preparing midwives to provide high-quality, evidence-based care. In 2024, Rwanda introduced a standardized, competency-based curriculum for midwifery education aligned with the International Confederation of Midwives (ICM) Essential Competencies. However, the successful implementation of this curriculum depends on the capacity of midwifery educators to deliver it effectively. Understanding faculty development needs is essential for supporting this transition.

AIM: To identify the specific faculty development needs of midwifery educators in Rwanda to inform strategies for strengthening their capacity to deliver competency-based education.

METHOD: A cross-sectional mixed-methods study was conducted in December 2024 using an anonymous online survey. The survey was conducted immediately following the curriculum introduction. Midwifery faculty from all eight institutions offering midwifery education in Rwanda were invited to participate. The survey included Likert-scale and open-ended questions to assess training needs across various educational domains. Quantitative data were analysed using descriptive statistics, and qualitative responses were textually analysed. RESULTS : A total of 48 out of 60 midwifery educators responded. The highest reported needs were in curriculum design and module development (79%), scientific writing (79%), management and leadership (79%), and research skills (77%). Capacity needs were also noted in clinical teaching, particularly using simulation (66%), and in the clinical environment (77%). Faculty expressed preferences for faculty development programs using blended learning with predominantly face-to-face components, and they favored intensive, short-term training formats. CONCLUSION: Midwifery faculty in Rwanda expressed strong needs for capacity development across education, leadership, and research domains. These findings highlight the importance of targeted, context-specific faculty development initiatives. Given the shared challenges across low-resource settings, the findings may be transferable to similar contexts aiming to develop faculty development programs aligned with global standards.

PMID:41039596 | DOI:10.1186/s12909-025-08034-5

BMC Med Educ. 2025 Oct 2;25(1):1329. doi: 10.1186/s12909-025-07909-x.

ABSTRACT

BACKGROUND: Practical classes and skills labs, where students learn, practice, and demonstrate key professional and technical skills, are essential in health professional education. As such, attendance at practical classes has historically been mandated and, in some cases, an “attendance hurdle” (i.e., mandatory minimum attendance requirement that students must meet to pass the course) is applied to subjects where practical classes are a core part of the curriculum. We aimed to explore students’ attitudes, beliefs and experiences of attendance hurdles for practical classes.

METHODS: We surveyed students from entry-to-practice programs in Medicine, Dentistry, Oral Health, Optometry, Physiotherapy, Social Work, Nursing, and Speech Pathology who were currently or previously enrolled in a subject/s with attendance hurdles for practical classes. In a single online survey, students answered multiple-choice, ranking, and Likert questions about their attitudes, beliefs, and experiences of attendance hurdles for practical classes. Data were analysed descriptively and with Pearson chi-squared test of association.

RESULTS: Sixty-three percent (n=362) of 575 students who completed the survey wanted to maintain attendance hurdles. In contrast, almost 80% of students stated they would attend 80% or more of classes without attendance hurdles. Many students believed that attendance hurdles could adversely affect some individuals (e.g., due to personal circumstances and sociodemographics), and half believed as adult learners, they should decide whether to attend practical classes. Students valued the in-class tutor feedback and application to clinical practice that practical classes offered. Students suggested that greater flexibility in the timing of practical classes would be more likely than hurdles to improve attendance.

CONCLUSIONS: The advantages of participating in practical classes to develop essential clinical skills are evident to students, and likely motivate them to attend most scheduled classes. Numerous factors can lead to student absences, and mandating attendance may disadvantage some students. Alternatives to attendance policies could include offering scheduling flexibility and student sign-up, accommodating students’ personal and health needs, and aligning classes to student values.

PMID:41039594 | DOI:10.1186/s12909-025-07909-x

Malar J. 2025 Oct 2;24(1):314. doi: 10.1186/s12936-025-05575-4.

ABSTRACT

BACKGROUND: Malaria in pregnancy (MiP) is responsible for several maternal and neonatal complications. Despite the renewed dedication towards elimination and eradication, it is still endemic in Ghana. Although previous studies have examined MiP from clinical or epidemiological standpoints, gaps remain in understanding the interactions between determinants of transmission. This study examined the synergistic association between environmental, sociocultural, and socioeconomic determinants of MiP.

METHODS: A cross-sectional study was conducted among 456 pregnant women in the Pru East Municipality from April to August 2024. Data were collected using serological screening and a structured, closed-ended questionnaire and were analysed with STATA 17 and IBM SPSS AMOS 29. Descriptive statistics, chi-square tests, logistic regression, confirmatory factor analysis (CFA) and structural equation modelling (SEM) were employed as part of statistical analyses. CFA and SEM were employed to validate multidimensional latent constructs and assess their interdependent and synergistic association within a single analytical framework. A significant level was set at (p < 0.05) at a 95% confidence interval (CI).

RESULTS: Overall, the prevalence of MiP was 21.5% (95% CI 17.7-25.3), with Plasmodium falciparum (14.7%) being the most prevalent species. A co-infection by Plasmodium falciparum and Plasmodium malariae was also found at 3.5%. High Plasmodium parasitaemia was observed in 6.4% of infected women. Moreover, all factor loadings for the three determinants showed significance (p < 0.001) and a high internal consistency. The SEM also yielded good fitness (NFI 0.998, GFI 0.994, AGFI 0.996, CFI 0.984, RMSEA 0.048). Key environmental (proximity to stagnant water, refuse sites, Volta Lake, livestock shelters), sociocultural (spiritual attribution, illness confusion, plant repellents, outdoor sleeping), and socioeconomic (rural residence, delayed ANC initiation, limited media exposure, LLIN use, IPTp-SP uptake, health insurance) factors were strongly associated with MiP. Importantly, the structural model showed that these three domains were moderately to strongly correlated, confirming their synergistic influence on MiP.

CONCLUSION: Malaria control strategies should go beyond biomedical interventions to incorporate community-based environmental management, sociocultural engagement, and socioeconomic empowerment. Such a multidimensional approach is essential to achieving sustainable reductions in malaria burden among vulnerable populations and improving health outcomes.

PMID:41039589 | DOI:10.1186/s12936-025-05575-4

BMC Med Educ. 2025 Oct 2;25(1):1321. doi: 10.1186/s12909-025-07922-0.

ABSTRACT

BACKGROUND: Embryology is often a challenging subject for medical students, leading to decreased engagement and learning difficulties. Gamification has gained attention as an innovative teaching method to enhance motivation and improve educational outcomes. This study examined the impact of gamified embryology education on medical students’ reactions, learning achievements, and behaviors.

METHODS: A quasi-experimental study was conducted with 281 medical students at Jahrom University of Medical Sciences, Iran, from 2020 to 2022. Students in 2020-2021 received conventional instruction through online lectures and electronic content, while those in 2021-2022 were taught using the same routine methods supplemented by a gamification-based platform. Data collection tools included the 18-item Game User Experience Satisfaction Scale (GUESS), the 21-item Technology Acceptance Model (TAM) questionnaire, and a researcher-designed Quality of Online Learning Questionnaire (Q-OLQ). Final exam scores in embryology were compared between the groups. Statistical analysis was performed using SPSS version 21, employing descriptive statistics and Independent Samples t-tests to assess differences in academic performance.

RESULTS: All questionnaire components scored above the threshold, indicating positive responses. The highest satisfaction scores were found in Enjoyment (3.98 ± 1.02) and Visual Aesthetics (3.92 ± 1.04). For technology acceptance, Perceived Usefulness (4.06 ± 0.88), Concentration (3.96 ± 0.83), and Attitude towards Using (3.95 ± 0.90) were rated highly. Regarding online learning quality, Quality of Online Resources (3.95 ± 0.97) and Perceived Importance of Online Resources (3.90 ± 0.99) received the top scores. Importantly, students who experienced gamification alongside routine teaching scored significantly higher on final exams (p < 0.001).

CONCLUSIONS: The findings indicate that gamification effectively enhances student engagement and learning outcomes in medical education, suggesting its valuable role as a complementary teaching strategy.

PMID:41039562 | DOI:10.1186/s12909-025-07922-0

BMC Med Educ. 2025 Oct 2;25(1):1308. doi: 10.1186/s12909-025-07896-z.

ABSTRACT

BACKGROUND: Large Language Models (LLMs) are artificial intelligence (AI) systems that simulate human language processing through deep learning techniques and neural networks. They are increasingly utilized for clinical decision support, student training, and enhancing educational processes. However, the reliability of AI models, especially in answering various types of questions, remains a point of debate. Standard multiple-choice questions (MCQs) involve selecting one correct answer from five options, whereas combination-type MCQs (C-MCQs) identify all correct statements among several alternatives. This study aims to evaluate and compare the performance of various LLMs in answering MCQs and C-MCQs in endodontics.

METHODS: A total of 151 endodontic questions were identified through a comprehensive review of publicly available Dentistry Specialty Exams in Turkey conducted since 2012. The questions were presented to eight LLMs (ChatGPT-4o, ChatGPT-4, Gemini 1.5 Flash, Gemini 1.5 Pro, Gemini 2.0 Flash, Copilot, Deepseek-V3, and Qwen2.5-Max) in Turkish. Accuracy rates for both MCQs and C-MCQs were statistically analyzed using SPSS v23 (p < 0.05).

RESULTS: ChatGPT-4o achieved the highest overall accuracy rate (81.5%), while Gemini 1.5 Flash had the lowest (57%). In standard MCQs, ChatGPT-4o significantly outperformed the other models (p < 0.001), but in C-MCQs, no significant difference was observed between the models (p = 0.179). Across all models, accuracy rates for C-MCQs were significantly lower than for MCQs (p < 0.05). Deepseek-V3 maintained a more balanced performance across question types than the other models.

CONCLUSIONS: LLMs show promising potential as educational tools in endodontics. However, their accuracy varies by question type and model. They can support student learning and clinical decision-making but cannot yet be considered a fully reliable standalone source in endodontics.

PMID:41039560 | DOI:10.1186/s12909-025-07896-z

BMC Med Educ. 2025 Oct 2;25(1):1344. doi: 10.1186/s12909-025-07980-4.

ABSTRACT

BACKGROUND: Vital signs measurement is a fundamental nursing responsibility that requires cognitive and psychomotor competence. In alignment with the ethical principle of nonmaleficence, it is important to provide learning environments where students can practice and make mistakes without causing harm. This study aims to examine the effect of a 3D game-based simulation application developed for vital signs on students’ academic achievement, learning satisfaction and self-confidence levels.

METHODS: A randomized controlled experimental design was employed with 73 nursing students, assigned to either the intervention group (n = 37) or the control group (n = 36). The intervention group used a game-based simulation developed with 3D animation technology, while the control group received traditional instruction. Data were collected using the Student Introductory Characteristics Form, Academic Achievement Test of Vital Signs Measurement Skills, and the Student Satisfaction and Self-Confidence in Learning Scale. Statistical analyses were conducted using SPSS version 25, with significance set at p < 0.05.

RESULTS: The results indicated that students’ current learning satisfaction subscale scores were high in the traditional teaching group and that there was a statistically significant difference between the groups (p = 0.047). There was no statistically significant difference between the groups in terms of academic achievement (p = 0.932) and self-confidence levels in learning (p = 0.375). However, both groups had high mean scores in academic achievement, satisfaction with current learning, and self-confidence in learning.

CONCLUSIONS: The game simulation method supported by 3D animation may be insufficient for significantly improving nursing students’ academic performance, satisfaction with the learning process, and self-confidence in learning. Therefore, it is recommended that such technology-supported methods be used in blended learning environments alongside traditional teaching methods in nursing education.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT07009275; retrospectively registered.

PMID:41039559 | DOI:10.1186/s12909-025-07980-4

Scand J Trauma Resusc Emerg Med. 2025 Oct 2;33(1):159. doi: 10.1186/s13049-025-01475-3.

ABSTRACT

BACKGROUND: Large Language Models (LLMs), such as GPT-4o, are increasingly investigated for clinical decision support in emergency medicine. However, their real-world performance in disposition prediction remains insufficiently studied. This study evaluated the diagnostic accuracy of GPT-4o in predicting ED disposition-discharge, ward admission, or ICU admission-in complex emergency respiratory cases requiring pulmonology consultation and chest CT, representing a selective high-acuity subgroup of ED patients.

METHODS: We conducted a retrospective observational study in a tertiary ED between November 2024 and February 2025. We retrospectively included ED patients with complex respiratory presentations who underwent pulmonology consultation and chest CT, representing a selective high-acuity subgroup rather than the general ED respiratory population. GPT-4o was prompted to predict the most appropriate ED disposition using three progressively enriched input models: Model 1 (age, sex, oxygen saturation, home oxygen therapy, and venous blood gas parameters); Model 2 (Model 1 plus laboratory data); and Model 3 (Model 2 plus chest CT findings). Model performance was assessed using accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and F1 score.

RESULTS: Among the 221 patients included, 69.2% were admitted to the ward, 9.0% to the intensive care unit (ICU), and 21.7% were discharged. For hospital admission prediction, Model 3 demonstrated the highest sensitivity (91.9%) and overall accuracy (76.5%), but the lowest specificity (20.8%). In contrast, for discharge prediction, Model 3 achieved the highest specificity (91.9%) but the lowest sensitivity (20.8%). Numerical improvements were observed across models, but none reached statistical significance (all p > 0.22). Model 1 therefore performed comparably to Models 2-3 while being less complex. Among patients who were discharged despite GPT-4o predicting admission, the 14-day ED re-presentation rates were 23.8% (5/21) for Model 1, 30.0% (9/30) for Model 2, and 28.9% (11/38) for Model 3.

CONCLUSION: GPT-4o demonstrated high sensitivity in identifying ED patients requiring hospital admission, particularly those needing intensive care, when provided with progressively enriched clinical input. However, its low sensitivity for discharge prediction resulted in frequent overtriage, limiting its utility for autonomous decision-making. This proof-of-concept study demonstrates GPT-4o’s capacity to stratify disposition decisions in complex respiratory cases under varying levels of limited input data. However, these findings should be interpreted in light of key limitations, including the selective high-acuity cohort and the absence of vital signs, and require prospective validation before clinical implementation.

PMID:41039558 | DOI:10.1186/s13049-025-01475-3

BMC Med Educ. 2025 Oct 2;25(1):1303. doi: 10.1186/s12909-025-07899-w.

ABSTRACT

BACKGROUND: Ultrasound-guided vascular access (USGVA) is an essential clinical skill, but novice learners often face difficulties in interpreting ultrasound images and achieving spatial alignment during procedures. To address this challenge, we hypothesized that using a reversed screen orientation could facilitate the learning process. Reversed screen orientation refers to an ultrasound image flipped in the transverse plane, producing a top-to-bottom mirror image by activating the “reverse” function on the ultrasound (US) device. We assumed that this configuration might help align the visual trajectory of the needle with the user’s hand movements, potentially easing spatial perception during the early stages of learning.

METODS: The study was conducted in the Anatomy Laboratory of Ordu University Medical Faculty with 60 final-year medical students with no prior US experience. Participants were randomly divided into two groups (A and B), who performed femoral vein needle punctures on cadavers under US guidance with standard (Group A) and reverse (Group B) screen. Each group used both screen orientations across two attempts. Before the procedure, students received theoretical training. Data collected included demographic information, needle visibility, procedure duration, success rates, and complications. Statistical analyses were performed using Statistical Package for the Social Sciences (SPSS), and significance was set at p < 0.05.

RESULTS: The results showed no significant differences in age or sex distribution between groups. In the first attempt, 83.3% of participants with posterior wall penetration were in Group A (standard screen orientation). Needle visualibity score was higher in Group B (reversed screen orientation). The perceived ease of the procedure showed a significant difference in favor of Group B in the second attempt. Overall, while the success rates and time taken were similar between groups, Group B exhibited improved needle visualization and fewer complications related to posterior wall penetration.

DISCUSSION: The findings indicate that reversed screen orientation may facilitate learning and enhance procedural outcomes in USGVA. This orientation aligns better with the spatial perception of needle movement, potentially improving hand-eye coordination. The study supports the integration of reversed screen techniques in US training to improve skill acquisition and reduce complication rates in vascular access procedures. However, limitations include the study being conducted at a single center and using only one cadaver, which may affect the generalizability of results. Future research should explore long-term effects and further validate these findings in diverse clinical settings.

PMID:41039551 | DOI:10.1186/s12909-025-07899-w

BMC Med Educ. 2025 Oct 2;25(1):1302. doi: 10.1186/s12909-025-07895-0.

ABSTRACT

BACKGROUND: In today’s rapidly changing world, soft skills are essential in both academic and professional settings, as they facilitate effective interaction, clear communication, and adaptation to diverse labour markets. This study aimed to determine the relationship between the self-esteem and assertiveness of undergraduate students and the communication perceived by patients seen in the dental clinic of a Peruvian university.

METHODS: A cross-sectional study was conducted with a sample of 198 students and 198 patients. The validated questionnaires, “Rosenberg Self-Esteem Scale” and the “Rathus Assertiveness Schedule”, were used for the students. Further, the CAT Questionnaire, Communication Assessment Tool, was used for patients. Sociodemographic characteristics were recorded for both groups. Descriptive statistics were used to describe the scores of assertiveness, self-esteem, and communication variables. For inferential analysis, the relationships among self-esteem, assertiveness, and communication were assessed via Spearman’s Rho test. Comparisons with sociodemographic variables were performed via the Mann-Whitney U, Kruskal-Wallis, and Pearson chi-square tests. Poisson regression models with robust variance were applied.

RESULTS: Self-esteem, assertiveness, and communication had means ± standard deviations of 30.53 ± 5.74, -2.43 ± 22.12, and 63.69 ± 7.28, respectively. A significant relationship was found between self-esteem and assertiveness (p < 0.001, Rho = 0.598), but no significant relationships were observed for self-esteem and assertiveness with communication (p > 0.05).

CONCLUSIONS: No relationship was observed between the self-esteem and assertiveness of undergraduate students and the communication perceived by patients.

PMID:41039549 | DOI:10.1186/s12909-025-07895-0

BMC Med. 2025 Oct 2;23(1):532. doi: 10.1186/s12916-025-04311-8.

ABSTRACT

BACKGROUND: MicroRNAs (miRNAs) are short, single-stranded RNAs that function as post-transcriptional regulators of gene expression. Although circulating miRNAs have been linked to carcinogenesis, they have not yet been systematically investigated in relation to risk of colorectal cancer (CRC).

METHODS: We used Mendelian randomization (MR) and colocalization analyses to investigate the association of genetically predicted plasma miRNA concentrations (2083 miRNAs in 710 individuals) with risk of CRC (58,221 cases and 67,694 controls). For miRNAs associated with CRC risk, we also investigated their association with circulating plasma proteins (4907 proteins in 35,559 participants), bidirectionally, using MR. We performed pathway enrichment analysis (PEA) to explore downstream molecular pathways.

RESULTS: Associations of five miRNAs with CRC were found in MR and supported in colocalization analyses. Specifically, miR-146a-5p, miR-21-5p, and miR-4707-3p were positively, and miR-1908-5p and miR-6810-3p were inversely associated with CRC risk. Several protein associations were found for these miRNAs (range of proteins with P < 0.05: 78-796; 211 with FDR < 5%), and 11 pathways were identified in PEA, including regulation of Erb-B2 receptor tyrosine kinase 4 (miR-6810-3p) and insulin-like growth factor pathways (miR-1908-5p).

CONCLUSIONS: Our results support a potential implication of miR-146a-5p, miR-21-5p, miR-4707-3p, miR-1908-5p, and miR-6810-3p to CRC risk. However, their downstream effects should be elucidated before they can be utilized as preventive targets.

PMID:41039543 | DOI:10.1186/s12916-025-04311-8