[The Development and Application of Virtual Patient in Clinical Training: The New Horizon for Nursing Education].

Clinical problem-solving training that involves hands-on practice with patients is regarded as an important yet challenging aspect of medical education. A majority of schools around the world have suspended face-to-face classes because of the COVID-19 pandemic. Although remote digital classes represent a widely adopted alternative approach to education, the format of these classes is poorly suited to clinical learning and examination.

Difference in demographics and motivation to study medicine with respect to medical students' channel of admission: A national study.

Introduction: Medical schools employ various tools to select suitable medical students (MS). This study investigated whether MS who were admitted through multiple mini-interviews (MMI) and MS who were admitted through Taiwan's Joint College Entrance Written Test (JCEWT) differed in their characteristics.

Methods And Subjects: First-year MS from seven medical schools completed a semi-structured questionnaire that inquired into their channel of admission (MMI or JCEWT), gender, location (metropolitan or rural), high school type (public or private), parents' socioeconomic status (SES), and motivations to study medicine.

Effects of anxiety on dental students' noncognitive performance in their first objective structured clinical examination.

Patient-dentist discourse is a core nonoperational competency in dental education. The skills of querying patients and responding to questions are noncognitive attributes, and their evaluation by the standardized patient objective structured clinical examination (OSCE) is particularly necessary. However, it is not clear whether students' test anxiety affects these attributes.

Analyzing the effectiveness of teaching and factors in clinical decision-making.

Objective: The aim of this study is to prepare junior physicians, clinical education should focus on the teaching of clinical decision-making. This research is designed to explore teaching of clinical decision-making and to analyze the benefits of an "Analogy guide clinical decision-making" as a learning intervention for junior doctors.

Materials And Methods: This study had a "quasi-experimental design" and was conducted in a medical center in eastern Taiwan.

Twelve tips for the construction of ethical dilemma case-based assessment.

Ethical dilemma case-based examination (ethics Script Concordance Test, eSCT) is a written examination that can be delivered to a large group of examinees for the purpose of measuring high-level thinking. As it accommodates for diverse responses from experts, ethics SCT allows partial credits. The framework of ethics SCT includes a vignette with an ethical dilemma and a leading question, which asks the examinee to "agree" or "disagree", plus the shifts of prior decision by adding new information.

Sleep apnea and the risk of chronic kidney disease: a nationwide population-based cohort study.

Study Objectives: Sleep apnea (SA) is characterized by apnea during sleep and is associated with cardiovascular diseases and an increase in all-cause mortality. Chronic kidney disease (CKD) is a global health problem that has placed a substantial burden on healthcare resources. However, the relationship between SA and the incidence of CKD is not clear.

Hospital-based school for children with chronic illness in Taiwan.

Background/purpose: To provide educational support and avoid unwanted damage that may impede learning for children with chronic illness, the learning environment should be friendly and safe. There is a need to establish schools inside hospitals, however, which may be neglected in a highly efficient health care system. A study was conducted to identify hospital-based schools for sick children in Taiwan, and to explore the barriers for implementation.

Is problem-based learning an ideal format for developing ethical decision skills?

Ethical decision making is a complex process, which involves the interaction of knowledge, skills, and attitude. To enhance the teaching and learning on ethics reasoning, multiple teaching strategies have to be applied. A medical ethical reasoning (MER) model served as a framework of the development of ethics reasoning and their suggested instructional strategies.

Career satisfaction, commitment, and well-being among Taiwanese pediatricians.

Background: Currently, the pediatrician shortage in Taiwan has raised concerns about pediatricians' workloads and wellbeing. This study aimed to understand in-hospital pediatricians' perceptions toward career satisfaction and their wellbeing.

Methods: A questionnaire exploring pediatricians' life management, commitment to work, and work satisfaction was distributed to all the pediatricians (including attending physicians and residents) in 79 certified training institutions in Taiwan.

Power of the policy: how the announcement of high-stakes clinical examination altered OSCE implementation at institutional level.

Background: The Objective Structured Clinical Examination (OSCE) has been widely applied as a high-stakes examination for assessing physicians' clinical competency. In 1992, OSCE was first introduced in Taiwan, and the authorities announced that passing the OSCE would be a prerequisite for step-2 medical licensure examination in 2013. This study aimed to investigate the impacts of the announced national OSCE policy on implementation of OSCE at the institutional level.

EGCG inhibits transforming growth factor-β-mediated epithelial-to-mesenchymal transition via the inhibition of Smad2 and Erk1/2 signaling pathways in nonsmall cell lung cancer cells.

Transforming growth factor-β (TGF-β)-mediated epithelial mesenchymal transition (EMT) of human lung cancer cells may contribute to lung cancer metastasis. It has been reported that EGCG can inhibit tumorigenesis and cancer cell growth in lung cancer; however, the effect of EGCG on EMT in nonsmall cell lung cancer (NSCLC) cells has not been investigated. In this study, we found that NSCLC cells A549 and H1299 were converted to the fibroblastic phenotype in response to TGF-β.

Predicting the demand of physician workforce: an international model based on "crowd behaviors".

Background: Appropriateness of physician workforce greatly influences the quality of healthcare. When facing the crisis of physician shortages, the correction of manpower always takes an extended time period, and both the public and health personnel suffer. To calculate an appropriate number of Physician Density (PD) for a specific country, this study was designed to create a PD prediction model, based on health-related data from many countries.

A medical ethical reasoning model and its contributions to medical education.

Objectives: Ethical reasoning in medicine is not well understood and medical educators often find it difficult to justify what and how they teach and assess in medical ethics. To facilitate the development of moral values and professional conduct, a model of ethical reasoning was created. The purposes of this paper are to describe the ethical reasoning model and to indicate how it can be used to foster moral and ethical behaviours.

Assessing ethical problem solving by reasoning rather than decision making.

Context: The assessment of ethical problem solving in medicine has been controversial and challenging. The purposes of this study were: (i) to create a new instrument to measure doctors' decisions on and reasoning approach towards resolving ethical problems; (ii) to evaluate the scores generated by the new instrument for their reliability and validity, and (iii) to compare doctors' ethical reasoning abilities between countries and among medical students, residents and experts.

Methods: This study used 15 clinical vignettes and the think-aloud method to identify the processes and components involved in ethical problem solving.

Screening young children with a first febrile urinary tract infection for high-grade vesicoureteral reflux with renal ultrasound scanning and technetium-99m-labeled dimercaptosuccinic acid scanning.

Objective: To evaluate the predictive value of renal ultrasound scanning and 99m-Technetium-dimercaptosuccinic acid (DMSA) scintigraphy for high-grade vesicoureteral reflux (VUR) in young children with a first urinary tract infection (UTI).

Study Design: The medical records of children who had been examined with renal ultrasound scanning, DMSA scanning, and voiding cystourethrography (VCUG) were reviewed. The findings of renal ultrasound scanning, DMSA scanning, and their predictive values were evaluated.

Paecilomyces lilacinus peritonitis complicating peritoneal dialysis cured by oral voriconazole and terbinafine combination therapy.

Fungal peritonitis (FP) is a serious complication in patients on continuous ambulatory peritoneal dialysis (CAPD). We report a case of CAPD-related FP caused by Paecilomyces lilacinus in a 15-year-old uraemic boy. The infection was successfully treated by combination therapy consisting of oral voriconazole and terbinafine, which has not been previously reported in the treatment of FP.

The use of medical cognition in medical curriculum reform in Taiwan.

Medical cognition studies have generated a great deal of knowledge that can be used to improve the quality of medical education. This review summarizes medical cognition research, the trends in medical education, and how the results of cognitive research can be applied to medical curriculum reform in Taiwan. The current trend in medical education is to develop a student-centered, outcome-oriented curriculum that integrates basic and clinical science, introduces students to patients at an early stage, reduces redundancy, and promotes active learning.

Current trends in developing medical students' critical thinking abilities.

Health care is fallible and prone to diagnostic and management errors. The major categories of diagnostic errors include: (1) no-fault errors--the disease is present but not detected; (2) system errors--a diagnosis is delayed or missed because of the imperfection in the health care system; and (3) cognitive errors--a misdiagnosis from faulty data collection or interpretation, flawed reasoning, or incomplete knowledge. Approximately one third of patient problems are mismanaged because of diagnostic errors.

Clinical differentiation of acute pyelonephritis from lower urinary tract infection in children.

Background And Purpose: To evaluate clinical variables for diagnosing childhood acute pyelonephritis (APN) when technetium-99m dimercaptosuccinic acid (DMSA) scintigraphy is not available.

Methods: We retrospectively reviewed the records of 590 children with febrile UTI seen from January 1999 to February 2004. On the basis of DMSA scintigraphy performed within 7 days after admission, they were divided into APN (n = 237) or non-APN (n = 353) groups.

Students' perception on medical professionalism: the psychometric perspective.

Background: The main purpose of this study was to identify and understand the structure of latent traits underlying the concept of medical professionalism of Taiwanese students.

Methods: A 32 item questionnaire assessing medical professionalism derived from the definition by the American Board Internal Medicine (ABIM) was distributed to 133 year seven medical students. A five-point rating scale of importance was used to identify the extent of their values or beliefs in each item.