Tag: pubmed

BMC Med Educ. 2025 Oct 2;25(1):1301. doi: 10.1186/s12909-025-07920-2.

ABSTRACT

BACKGROUND: Academic institutions play an important role not only in increasing the health workforce, but also ensuring faculty are equipped to meet the rising demand on trainees to enter the workforce. Located in Kigali, Rwanda, Africa Health Sciences University (AHSU) is a newly established institution training the next generation of health professionals across medicine, nursing, midwifery, and other health domains. This study explores faculty and staff perceptions of their current skills in teaching and research and identifies ways to further strengthen faculty development initiatives.

METHODS: This cross-sectional, survey-based study was conducted from August 11 to September 30, 2024, across AHSU’s three main residency clinical teaching sites. Participants included doctors, nurses, midwives, and administrators involved in educational activities. Data was collected via an anonymous questionnaire, with sections on participant demographics, job profile allocations, teaching and research skills, and faculty development preferences. Data was analyzed via descriptive statistics. Mean scores and standard deviations were calculated across Likert scale questions to evaluate central tendencies and participant response variability. The Kruskal-Wallis test was also employed for associations, with a statistical significance of p < 0.05.

FINDINGS: 230 participants completed the survey, including nurses and midwives (62.61%), medical doctors (31.74%), and administration (5.65%). Teaching skills were perceived to be stronger overall than research skills, with an average of 3.46 and 2.95 out of 4 respectively. Improving teaching and scholarship, and personal interest were the most cited motivations to engaging in faculty development programs. The perceived importance of faculty development showed significant associations with role, highest level of education, and faculty rank.

CONCLUSION: Strengthening faculty development in clinical academic settings has the potential to improve the overall academic environment across health sciences universities and their teaching sites. Health sciences universities should consider ways to recognize, develop, and support both their clinical and non-clinical staff engaged in academic activities. This can be done through institutional support systems, improved academic recognition frameworks, and the promotion of innovative teaching and learning methods.

PMID:41039527 | DOI:10.1186/s12909-025-07920-2

BMC Med Educ. 2025 Oct 2;25(1):1336. doi: 10.1186/s12909-025-07939-5.

ABSTRACT

INTRODUCTION: Generational change is impacting medical education and driving the adaptation and reform of teaching and clinical practice to successfully educate the next generation of physicians. Aim of the study was to establish undergraduates’ needs by analyzing the strengths and weaknesses of their soft skills from the start of medicine school. METHOD: We conducted a cross-sectional study to evaluate the personalities and soft skills of first-, third-, and sixth-year undergraduates in medical school. Of the eligible participants (N = 333), 127 of them (38.1%) were evaluated for their soft skills. The assessment was based on psychological and behavioral assessments.

RESULTS: Results showed the strong need of the young to understand themselves and know how to improve their personal growth during academic study. Mediation statistical analyses showed significant direct and indirect effects of the factors (year level in medical school) and mediators (conscientiousness/extroversion and openness) on the soft skills indexes. Conscientiousness was a predictive factor for all soft skills examined: self-determination (β = 0.54), resilience (β = 0.48), empathy (β = 0.36), assertiveness (β = 0.24), social support (β = 0.18), and teamwork (β = 0.30). Openness was correlated and predictive for empathy (β = 0.19). The model of the multilayered construct of medical competence represents a fruitful framework and using the lens of Self-Determination theory, medical undergraduates could be engaged and buffered against the stressors of patient care. DISCUSSION: In this scenario, the interaction with medical leaders is relevant, clinical trainers and medical undergraduates should model the professional learning; escalated clinical skills should build advanced knowledge in medicine.

PMID:41039516 | DOI:10.1186/s12909-025-07939-5

BMC Med Educ. 2025 Oct 2;25(1):1334. doi: 10.1186/s12909-025-07906-0.

ABSTRACT

BACKGROUND: The COVID-19 pandemic had severely disrupted the education system in a variety of settings, particularly medical and dental teaching institutes. Restricting the teaching system to virtual mode and the treatment aspect to emergency-only care was of great challenge, in order to prevent the spread of COVID-19. During the pandemic, distance learning had become necessary to ensure that education continues.

OBJECTIVE: The present study aimed to analyse dental students’ perceptions of the transition of education from traditional to distance learning.

METHODS: This was a cross-sectional study consisting of a 25-statement online questionnaire, which was validated (Item- Content Validity Index (I-CVI: 0.87-0.89), reliability confirmed (Cronbach’s alpha = 0.82). The questionnaire was anonymously administered to students studying dentistry at the Manipal Academy of Higher Education, Manipal, India. The data collected were analysed statistically.

RESULTS: A total of 713 out of 800 undergraduate dental students participated in the survey, resulting in an 89.12% response rate. Approximately 74% students did not feel that it was easier to concentrate in online classes than in offline lectures, and 60.9% of the students felt that they could not learn the theoretical aspects adequately. Almost three-fourths of the students (73.9%) felt that lockdowns and distance education severely affected the quality of their dental education. Most of the students (86.4%) felt that a lack of patient exposure would affect their future dental practice. With respect to learning preferences, the majority of the students preferred a combination of traditional methods and online learning.

CONCLUSION: The COVID-19 pandemic taught not only the use of technology in education but also future learning strategies. In today’s technologically adept world, e-learning is a convenient and effective method for teaching undergraduate dental students. Dental education is evolving consistently to accommodate rapid changes in the education system. However, it should be used as an auxiliary approach in the clinical setting since it cannot replace the conventional face-to-face approach.

PMID:41039511 | DOI:10.1186/s12909-025-07906-0

Head Face Med. 2025 Oct 2;21(1):65. doi: 10.1186/s13005-025-00539-0.

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of endoscopic navigation-guided 3D printing combined with absorbable materials for individualized minimally invasive reconstruction of orbital blowout fractures, comparing outcomes to preformed titanium mesh controls to validate clinical value in achieving anatomical reduction, improving visual function, and reducing complications.

METHODS: This retrospective study enrolled 87 patients receiving absorbable implants (Trial Group) and 19 patients treated with preformed titanium mesh (Control Group). Preoperative CT scans were processed using Mimics 21.0 and Geomagic Studio 12.0 for 3D reconstruction, generating patient-specific guides and 3D-printed orbital models based on mirror-imaged healthy orbits. In the Trial Group, absorbable plates were thermo-molded using surgical guides and implanted; controls underwent titanium mesh trimming followed by screw fixation. Statistical analyses employed SPSS 26.0 with Python-automated covariate control: propensity score weighting (PSW) balanced baseline covariates (gender, age, fracture extent; SMD < 0.1 confirmed balance). Longitudinal continuous data (exophthalmos difference, logMAR BCVA) were analyzed via generalized estimating equations (GEE) modeling time-group interactions, while ordinal outcomes (diplopia severity, ocular motility restriction) used weighted ordinal logistic regression to compute marginal effects. All analyses controlled for timepoint interactions with statistical significance defined at α = 0.05.

RESULTS: The absorbable material group demonstrated superior diplopia resolution (residual rate: 9.2% vs. 31.6%, P = 0.018) with significant long-term recovery interaction (β = 1.59, P = 0.039). Both groups showed significant time-dependent improvements in ocular motility and exophthalmos (P < 0.001), though intergroup differences were non-significant. Trial group BCVA improved an additional 42% at 6 months (interaction β = 0.05, P = 0.028). No implant-related complications (infection/displacement) occurred in the absorbable group.

CONCLUSION: Endoscopic navigation-guided 3D printing with absorbable materials enables precise, individualized orbital reconstruction, significantly improving diplopia and visual acuity with superior safety, strongly supporting clinical adoption.

PMID:41039504 | DOI:10.1186/s13005-025-00539-0

Genome Med. 2025 Oct 2;17(1):108. doi: 10.1186/s13073-025-01552-3.

ABSTRACT

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by diverse presentations and a strong genetic component. Environmental factors, such as prematurity, have also been linked to increased liability for ASD, though the interaction between genetic predisposition and prematurity remains unclear. This study aims to investigate the impact of genetic liability and preterm birth on ASD conditions.

METHODS: We analyzed phenotype and genetic data from two large ASD cohorts, the Simons Foundation Powering Autism Research for Knowledge (SPARK) and Simons Simplex Collection (SSC), encompassing 78,559 individuals for phenotype analysis, 12,519 individuals with genome sequencing data, and 8104 individuals with exome sequencing data. Statistical significance of differences in clinical measures was evaluated between individuals with different ASD and preterm status. We assessed the rare variants burden using generalized estimating equations (GEE) models and polygenic load using the ASD-associated polygenic risk score (PRS). Furthermore, we developed a machine learning model to predict ASD in preterm children using phenotype and genetic features available at birth.

RESULTS: Individuals with both preterm birth and ASD exhibit more severe phenotypic outcomes despite similar levels of genetic liability for ASD across the term and preterm groups. Notably, preterm-ASD individuals showed an elevated rate of de novo variants identified in exome sequencing (GEE model, p = 0.005) in comparison to non-ASD-preterm group. Additionally, a GEE model showed that a higher ASD PRS, preterm birth, and male sex were positively associated with a higher predicted probability for ASD in SPARK, reaching a probability close to 90%. Lastly, we developed a machine learning model using phenotype and genetic features available at birth with limited predictive power (AUROC = 0.65).

CONCLUSIONS: Preterm birth may exacerbate multimorbidity present in ASD, which was not due to ASD-associated genetic variants. However, increased ASD-associated rare variants may elevate the likelihood of a preterm child being diagnosed with ASD. Additionally, a polygenic load of ASD-associated variants had an additive role with preterm birth in the predicted probability for ASD, especially for boys. Future integration of genetic and phenotypic data in larger preterm or population-based cohorts will be crucial for advancing early ASD identification in preterm subgroup.

PMID:41039503 | DOI:10.1186/s13073-025-01552-3

BMC Med Educ. 2025 Oct 2;25(1):1300. doi: 10.1186/s12909-025-07911-3.

ABSTRACT

BACKGROUND: Simulation-based learning (SBL) is a structured educational method that enables learners to practice clinical, technical, and decision-making skills in a safe, immersive, and controlled environment. It has become a cornerstone of modern medical education.

OBJECTIVE: This study aimed to assess the effect of SBL on the academic performance of medical students at the pediatrics end of the clerkship examination.

METHODS: We analyzed the academic performance of 2,251 fifth-year medical students over 12 academic years, from September 2012 to June 2024, at the end of the pediatric clerkship. The period includes six years before and six years after the integration of simulation-based learning into the pediatric curriculum.

RESULTS: The performance of the students in the three components of the end of the clerkship examination, written, clinical, and continuous assessment, after the utilization of SBL was much better than their performance in the era before the SBL. The difference was statistically significant (p < 0.001).

CONCLUSION: The study highlights the positive impact of incorporating SBL into pediatric education for medical students in Bahrain. These findings support the wider integration of simulation as a teaching strategy across various clinical specialties in medicine and other sciences worldwide. They also highlight its potential to progressively complement and, in some cases, partially replace traditional classroom-based instruction.

PMID:41039502 | DOI:10.1186/s12909-025-07911-3

BMC Med Educ. 2025 Oct 2;25(1):1311. doi: 10.1186/s12909-025-07778-4.

ABSTRACT

INTRODUCTION: Surgical training effectiveness varies significantly worldwide. Understanding the key determinants of trainee confidence and career preference across diverse healthcare systems is crucial for optimizing educational strategies. This study examines surgical training experiences from trainees and surgeons across Kenya, Mali, and China that shape confidence and career preference identifying common associated challenges and potential solutions.

METHODS: An anonymous 38-item questionnaire incorporating multiple response formats was distributed online to surgical trainees and professionals across Kenya, China, and Mali (n = 274) between December 2023 and March 2024. The survey assessed demographics, training duration, working patterns, operative experience, assessment methods, perceived pre-operative mastery, and confidence/preference regarding surgery. Data were analysed using descriptive statistics, univariate tests, binary logistic regression (for confidence), and mixed-effects logistic regression (for preference, accounting for country). This study adheres to CHERRIES guidelines.

RESULTS: Analysis of 274 respondents revealed notable variations in professional composition and working patterns across countries. Only 28.8% reported confidence in performing gastrointestinal surgery independently after training. Multivariate analysis demonstrated that making a specialty decision (OR = 2.00, p = 0.035), experience as primary surgeon (OR = 3.07, p = 0.009), assessment during training (OR = 2.86, p = 0.011), and pre-operative mastery (OR = 3.43, p < 0.001) were key predictors of surgical confidence. Country-specific factors included professional status in Kenya, pre-operative mastery in China, and practical examinations in Mali. Regarding interest in surgery as a career, weekly participation in operations (OR = 1.94, p = 0.031), understanding procedures beforehand (OR = 2.13, p = 0.013), and effective team communication (OR = 2.15, p = 0.030) were significant factors.

CONCLUSION: This multinational survey reveals that surgical training effectiveness is primarily determined by quality factors (pre-operative preparation, hands-on experience, and formal assessment) rather than training duration. Implementation of structured learning approaches emphasizing these elements could substantially improve surgical education, regardless of resource availability or regional differences.

PMID:41039490 | DOI:10.1186/s12909-025-07778-4

JAMA Otolaryngol Head Neck Surg. 2025 Oct 2. doi: 10.1001/jamaoto.2025.2849. Online ahead of print.

ABSTRACT

IMPORTANCE: Patients with vestibular schwannoma (VS) commonly present with neurological symptoms such as hearing loss, tinnitus, and dizziness. However, factors associated with dizziness at presentation are not well understood.

OBJECTIVE: To evaluate the baseline features of adults diagnosed with VS associated with subjective dizziness using a validated instrument.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study included adults with radiologically diagnosed VS who completed vestibular testing at Washington University (St Louis, Missouri) between June 2004 and January 2025. Baseline dizziness was measured using the Dizziness Handicap Inventory (DHI).

EXPOSURES: Anxiety associated with a VS diagnosis.

MAIN OUTCOMES AND MEASURES: The primary outcome was severity of dizziness based on DHI score.

RESULTS: A total of 109 patients were included; the mean (SD) age was 61 (14) years, 57 (52%) were female, and 52 (48%) were male. The mean (SD) DHI score was 27 (24) points. Participants with a history of anxiety had a DHI score that was 13.7 points (95% CI, 4.2-23.2 points) higher than those with no such history. For every additional point in severity of anxiety measured using the Generalized Anxiety Disorder-7 (GAD-7) scale, DHI score increased 2.6 points (95% CI, 2.0-3.3 points). After controlling for covariates, for every 1-point increase in GAD-7, DHI score increased by a mean of 1.9 points (95% CI, 1.3-2.6 points). On average, patients with a history of anxiety had a DHI score 10.6 points (95% CI, 2.4-18.7 points) higher than those with no such history.

CONCLUSIONS AND RELEVANCE: This retrospective cohort study suggests a psychological association between anxiety and dizziness might exist among patients with VS that has not previously been explored. Further studies examining this association are needed in this patient population.

PMID:41037309 | DOI:10.1001/jamaoto.2025.2849

JAMA Netw Open. 2025 Oct 1;8(10):e2534968. doi: 10.1001/jamanetworkopen.2025.34968.

ABSTRACT

IMPORTANCE: Patients with metastatic castration-resistant prostate cancer (mCRPC) harboring BRCA1/2 alterations are eligible to receive poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors as single agents or in combination with an androgen receptor pathway inhibitor after these agents showed survival improvement in their landmark clinical trials. However, data are limited regarding the uptake of PARP inhibitors in these patients.

OBJECTIVE: To investigate the use of PARP inhibitors in patients with mCRPC harboring BRCA1/2 alterations.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used the deidentified Flatiron-Health electronic health record-derived database of US community and academic practices to extract patient-level data. The data cutoff date was May 31, 2024. Patients with mCRPC with evidence of harboring BRCA1/2 alterations and alive after August 15, 2020 (ie, 3 months after the approval of the first PARP inhibitor, rucaparib, in mCRPC) were included. Statistical analysis was performed from September 2024 to May 2025.

EXPOSURES: Age, race and ethnicity, insurance status, and practice type at the time of mCRPC diagnosis.

MAIN OUTCOMES AND MEASURES: The receipt of PARP inhibitors. Multivariable logistic regression was conducted to assess the association between the exposures and the main outcome.

RESULTS: Of 24 105 patients with metastatic prostate cancer, 443 male patients (median [IQR] age, 72 [65-79] years) had mCRPC with BRCA1/2 alterations and were eligible and included in our analysis. Of these patients, 227 (51.2%) received a PARP inhibitor, whereas 216 (48.8%) did not. Compared with patients covered by a commercial health plan, those covered by Medicare were significantly more likely to receive a PARP inhibitor (odds ratio, 1.91; 95% CI, 1.02-3.66; P = .047). The odds of receiving a PARP inhibitor were not significantly higher in patients treated in community practice compared with those treated in academic centers (odds ratio, 1.64; 95% CI, 1.00-2.70; P = .05).

CONCLUSIONS AND RELEVANCE: This retrospective cohort study of patients with mCRPC and evidence of BRCA1/2 alterations found that approximately half of patients did not receive PARP inhibitors despite evidence of survival improvement in this population. These findings highlight the need to increase awareness of the survival data and access to life-prolonging therapies in patients with mCRPC.

PMID:41037269 | DOI:10.1001/jamanetworkopen.2025.34968

JAMA Netw Open. 2025 Oct 1;8(10):e2535004. doi: 10.1001/jamanetworkopen.2025.35004.

ABSTRACT

IMPORTANCE: Understanding secular patterns in body composition and cardiometabolic risk factors (CMRFs) is essential for identifying early-life determinants of cardiovascular health, guiding public health policies, and developing early prevention strategies.

OBJECTIVE: To examine secular patterns in the prevalence of underweight, overweight, obesity, and CMRFs among schoolchildren in Spain from 1992 to 2022.

DESIGN, SETTING, AND PARTICIPANTS: Repeated cross-sectional study analyzing data from 7 time points over a 30-year period in public primary schools from the Cuenca province in Spain. Participants were children aged 8 to 11 years (fourth to fifth grade) from 7 cohorts studied in 1992, 1996, 1998, 2004, 2010, 2018, and 2022. Data were analyzed from April 2024 to May 2025.

MAIN OUTCOMES AND MEASURES: Prevalence of weight status (underweight, normal weight, overweight, and obesity), lipid parameters, glycemic markers, and resting systolic blood pressure (SBP) and diastolic blood pressure (DBP).

RESULTS: In a total of 4280 participants (mean [SD] age, 9.6 [0.7] years; 2137 [50.0%] girls), patterns in the prevalence of weight status show that increases in obesity appear to have slowed down and plateaued since 2018 (13.4%; 95% CI, 11.5% to 15.5% in 2010; 8.1%; 95% CI, 6.0% to 10.5% in 2018; 10.4% 95% CI, 8.1% to 13.2% in 2022; P < .001). A statistically significant decrease in mean (SD) total cholesterol (184.6 [27.4] to 160.3 [27.4] mg/dL) and low-density lipoprotein cholesterol (113.6 [24.0] to 90.1 [24.0] mg/dL) was observed, which was reflected in a reduction in non-high-density lipoprotein cholesterol (HDL-C) (125.3 [26.2] to 99.8 [26.1] mg/dL) from 1992 to 2022. Mean (SD) serum HDL-C appear to have peaked from 1998 to 2004 (66.2 [13.3] vs 66.9 [13.3] mg/dL, respectively), and its levels have decreased since then (60.5 [13.4] mg/dL in 2022; P < .001). Mean (SD) resting blood pressure showed a substantial decrease over the study period (SBP: 113.5 [9.6] to 101.0 [9.7] mm Hg and DBP: 70.4 [7.2] to 60.7 [7.3] mm Hg; P < .001). However, mean (SD) insulin levels show a significant rise from 2004 to 2022 (6.3 [5.3] to 8.7 [5.2] μIU/mL; P < .001).

CONCLUSIONS AND RELEVANCE: This repeated cross-sectional study provides a picture of the evolution of CMRFs in children over the last 30 years, showing that, in Spain, despite the concerning prevalences of excess weight, lipid parameters and blood pressure have improved over the studied period.

PMID:41037267 | DOI:10.1001/jamanetworkopen.2025.35004