Qayumi Karim, Masoumian Hosseini Seyedeh Toktam, Masoumian Hosseini Mohsen, Nejat Asadullah, Salih Mohibullah, Azimi Mammodullah, Forqani Sharif, Akbar Banaras, Farooq Ghulam, Shafaq Najibullah, Rustampoor Hussain, Oryakhil Nasrin, Rahmani Masoud, Noora Masood, Jallah Mohammad Nasir, Naebkhil Asmatullah, Zhwak Zubaida Anwari, Aziz Sohaila, Omar Farid Ahmad, Rahimi Ahmad Mustafa, Mansuri Parwin, Yaftali Sumaira, Sadiq Nilofar, Payman Jahed, Arifzai Amanullah, Azimee Mohammed Azim, Waqef Somaya, Wisbauer Stefan, Guzmán-Laguna Joffre, Ferreres Alberto
Department of Surgery, University of British Columbia, Vancouver, Canada.
Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
EClinicalMedicine. 2024 Sep 25;76:102854. doi: 10.1016/j.eclinm.2024.102854. eCollection 2024 Oct.
The WHO projects a global shortage of 4.3 million physicians by 2030, with the largest deficits in developing and conflict-affected regions. Our aim is to train competent physicians rapidly and affordably through remote education programs.
We developed an online medical training curriculum with four levels, focusing on different aspects of human body systems using a competency-based, student-centered approach. This study evaluates the first three levels; level four (internship) is outside this scope. The 105 medical students from eight Afghan universities were randomly assigned to nine groups. The curriculum includes Entrustable Professional Activities (EPA) for the cardiovascular system: level 1 covers basic medical sciences, level 2 pathology and basic clinical skills, and level 3 full clinical competencies. EPAs were delivered asynchronously online via Lecturio, CyberPatient, and Zoom. The 30-day intervention included 4 h of weekly online classes for formative assessment, collaborative learning, and evaluation, supervised by medical faculty members. Virtual pre- and post-intervention evaluations used multiple-choice questions and objective structured clinical examination (OSCE). We also conducted a satisfaction survey and open interview forum. Data triangulation from observations, surveys, and interviews validated curriculum effectiveness. The benchmarking method assessed cost-effectiveness.
Pre- and post-intervention analysis showed a significant increase in clinical competencies and knowledge acquisition (P < 0.0001). The CyberPatient intervention improved clinical competency quality (P < 0.0001) and shortened decision-making time (P < 0.001). Cost analysis revealed that a virtual medical university would be 95% more cost-effective than traditional medical education.
Integrating virtual technology with modern curriculum concepts in pre-internship years can effectively address healthcare training gaps and enhance education quality for healthcare workers at a low cost.
Provided by CanHealth International. A UBC spin-off not-for-profit organization.
世界卫生组织预计，到2030年全球将短缺430万名医生，发展中地区和受冲突影响地区的短缺情况最为严重。我们的目标是通过远程教育项目快速且经济高效地培养合格医生。
我们开发了一个四级在线医学培训课程，采用基于能力、以学生为中心的方法，专注于人体系统的不同方面。本研究评估前三个级别；第四级（实习）不在本研究范围内。来自阿富汗八所大学的105名医学生被随机分为九组。该课程包括心血管系统的可托付专业活动（EPA）：第一级涵盖基础医学科学，第二级涵盖病理学和基础临床技能，第三级涵盖全面的临床能力。EPA通过Lecturio、CyberPatient和Zoom以异步方式在线授课。为期30天的干预包括每周4小时的在线课程，用于形成性评估、协作学习和评估，由医学教员监督。虚拟干预前后评估使用多项选择题和客观结构化临床考试（OSCE）。我们还进行了满意度调查和开放式访谈论坛。来自观察、调查和访谈的数据三角验证了课程的有效性。基准方法评估了成本效益。
干预前后分析显示临床能力和知识获取有显著提高（P < 0.0001）。CyberPatient干预提高了临床能力质量（P < 0.0001）并缩短了决策时间（P < 0.001）。成本分析表明，虚拟医科大学的成本效益比传统医学教育高95%。
在实习前阶段将虚拟技术与现代课程理念相结合，可以有效解决医疗培训差距，并以低成本提高医护人员的教育质量。
由CanHealth International提供。这是英属哥伦比亚大学的一家衍生非营利组织。
