Journal of Advances in Medical Education & Professionalism

Editorial

How to Teach Generation Z Students: Reflections from Medical Educators

MITRA AMINI; RITA REZAEE; JAVAD KOJURI

Volume 13, Issue 4 , October 2025, Pages 257-258

https://doi.org/10.30476/jamp.2025.108312.2245

Abstract

Generation Z (Gen Z) or iGen describes individuals born between 1995 and 2012. They are the first generation raised entirely in the digital world. They have always had the technology, ... Read More

Review article

A Systematic Review and Meta-Analysis on the Impact of Peer-Made MCQ Question-Bank Usage on Summative Assessments in Medical Education

ROBERT HWANG; MAX PALEY; DAVID BULL; OSAMA OMRANI; DIEGO VERGARA-JALANDONI; GERALD EGBURY

Volume 13, Issue 4 , October 2025, Pages 259-269

https://doi.org/10.30476/jamp.2025.104780.2084

Abstract

Introduction: This systematic review and meta-analysis investigated the impact of utilising peer-generated multiplechoice question (MCQ) banks on the summative performance of undergraduate ... Read More Introduction: This systematic review and meta-analysis investigated the impact of utilising peer-generated multiplechoice question (MCQ) banks on the summative performance of undergraduate students studying medicine and allied subjects. Answering and writing peer-made MCQ questions are hypothesised to enhance learning through achievement of thedomains of Bloom’s taxonomy and thus summative examination performance.Methods: A random-effects meta-analysis of correlation coefficients was conducted on six studies (n = 1,571) published between 2011 and 2021, drawn from MEDLINE, Scopus, Web of Science, PubMed, CENTRAL, and ERIC. The studies included undergraduate medical students from four countries. The risk of bias was assessed using the ROBINS-I tool.Results: A weak positive correlation was found between answering peer-made MCQs and summative performance (Spearman’s ρ = 0.22, 95% CI: 0.15 to 0.29, p < 0.0001), with a prediction interval of 0.00 to 0.42, indicating that in future studies, the effect of answering peer-made questions is likely beneficial or, at worst, neutral. A similar weak positive correlation was observed for writing peer-made MCQs (Spearman’s ρ = 0.21, 95% CI: 0.09 to 0.32, p < 0.0004), though the prediction interval (-0.27 to 0.61) cannot exclude negative correlation between writing questions and summative performance in future studies. The findings suggest that answering and creating peer-generated MCQs positively influence exam performance. The modest correlations likelyreflect confounding factors, such as prior academic performance and socio-economic background. This complicates isolating the impact of MCQ banks and may understate their true impact.Conclusion: This study advocates for the integration of peergenerated MCQ banks into medical curricula, highlighting their potential as a cost-effective method to improve summativeperformance. Future research should focus on large-scale observational studies to better quantify these effects as well as controlling for confounding factors. The study underscores the value of peer engagement in learning and the utility of peer-made MCQ banks as educational tools.

Review article

The Role of AI in Shaping Medical Education: Insights from an Umbrella Review of Review Studies

FATEME JAFARI; AHMAD KEYKHA; ATEFEH TAHERIANKALATI; AVA TAGHAVI MONFARED

Volume 13, Issue 4 , October 2025, Pages 270-293

https://doi.org/10.30476/jamp.2025.105625.2116

Abstract

Introduction: Artificial intelligence (AI) has become integral to various fields, including medical education. This study explores AI applications in medical education through a review ... Read More

Original Article

Understanding Surgeon Professionalism in Indonesia: A Qualitative Study in a Multicultural and Resource-Limited Context

DANIEL ARDIAN SOESELO; RETNO ASTI WERDHANI; TOAR JEAN MAURICE LALISANG; AGUS PURWADIANTO; WIRSMA ARIF HARAHAP; RENNIE YOLANDA; THEDDEUS OCTAVIANUS HARI PRASETYONO; DIANTHA SOEMANTRI; ARDI FINDYARTINI

Volume 13, Issue 4 , October 2025, Pages 294-302

https://doi.org/10.30476/jamp.2025.105730.2126

Abstract

Introduction: Surgeons’ professionalism is vital for ensuring safe surgical care, particularly in Indonesia, where cultural and systemic factors present unique challenges to healthcare ... Read More Introduction: Surgeons’ professionalism is vital for ensuring safe surgical care, particularly in Indonesia, where cultural and systemic factors present unique challenges to healthcare delivery.Professionalism affects surgical outcomes, patient safety, and interprofessional collaboration directly. This study represents the first national-level exploration of surgical professionalism, involving culturally diverse participants from various regions. To explore how healthcare professionals and patients perceive surgeon professionalism in Indonesia, emphasizing cultural and systemic influences.Methods: This qualitative study employed a phenomenological approach to capture the lived experiences and perspectives of informants regarding surgeons’ professionalism. This study was conducted at public, private, and military healthcare institutions in Indonesia, including type B, C,and D hospitals, as well as specialty hospitals. A total of 27 participants, including surgeons, anesthesiologists, pediatricians, internists, operating room nurses, ward nurses, hospital management, and patient representatives, were recruited through snowball sampling to ensurediverse perspectives. In-depth interviews were conducted to elicit the participants’ perceptions of surgeons’ professionalism in their healthcare context. Reflexivity and triangulation methods were applied to ensure validity and minimize bias. The study identified key themes and subthemesof professionalism as perceived by participants, highlighting non-technical aspects of surgeon professionalism in Indonesia.Results: Four non-technical themes of surgeon professionalism were identified: fulfilling roles and responsibilities, upholding integrity, having good communication skills, and engaging in multidisciplinary collaboration. These aspects were influenced by cultural values and systemic challenges, including disparities in healthcare resources.Conclusions: Surgeons’ professionalism in Indonesia is shaped by cultural and structural factors distinct from global standards. The findings provide insights for culturally sensitive interventions that enhance professionalism and surgical care quality in Indonesia. Addressing these unique dynamics is essential for improving patient safety, healthcare outcomes, and professional relationships.

Original Article

Evaluating the Clinical Learning Environment for Competency-based Postgraduate Education in a Low-Middle Income Country: Trainee Perceptions using PHEEM Inventory

QAMAR RIAZ; MUHAMMAD RIZWAN KHAN; SADIA MASOO

Volume 13, Issue 4 , October 2025, Pages 303-310

https://doi.org/10.30476/jamp.2025.105990.2140

Abstract

Introduction: The clinical learning environment (CLE) is an important element of competency-based postgraduate medical education (CBME). Trainee perceptions of their CLE serve as a ... Read More

Original Article

Bridging the Gaps: Allied Health Practitioners, Clinical Educators, and Peers Perspectives on Resident Performance Assessments

BAU DILAM ARDYANSYAH; MASRIAN MASRIAN; ZAKIAH ZAKIAH; ANDI RATIH RADIAH ISKANDAR; SITI ADANI AYUNDI; DWI SARTIKA; TENRI PADA RUSTHAM

Volume 13, Issue 4 , October 2025, Pages 311-321

https://doi.org/10.30476/jamp.2025.106145.2148

Abstract

Introduction: Teaching hospitals integrate healthcare, education, and research but face challenges in assessing residents as learners and healthcare providers. Conventional supervisor-led ... Read More

Original Article

Defining Entrustable Professional Activities for Hematology Residency Program in a Low-Resource Setting: A Modified Delphi Study

JAVERIA REHMAN; MUHAMMAD SHARIQ SHAIKH; MUHAMMAD HASAN; SANA BROHI; BUSHRA MOIZ

Volume 13, Issue 4 , October 2025, Pages 322-333

https://doi.org/10.30476/jamp.2025.106370.2155

Abstract

Introduction: The concept of Entrustable Professional Activities (EPAs) is central to competency-based medical education, which enables the assessment and guidance of learners in clinical ... Read More

Original Article

The Cognitive Error Styles of Midwifery Students in Clinical Decision-Making: A Directed Qualitative Content Analysis Study

HADIS SOURINEJAD; ELHAM ADIB MOGHADDAM; SAYED AHMAD REZA RAEISI DEHKORDI; ZIBA RAISI DEHKORDI

Volume 13, Issue 4 , October 2025, Pages 334-343

https://doi.org/10.30476/jamp.2025.107111.2191

Abstract

Introduction: Cognitive error styles refer to faulty patterns of thinking that can negatively influence individuals’ decision-making and behavior. Among midwifery students, identifying ... Read More

Original Article

The Impact of Digital Storytelling on Learning Outcomes and Student Satisfaction in Psychology Education for Nursing and Midwifery Students: A Quasi-Experimental Study

MARJAN NOORSHADI; MEHRI YAVARI; HOURA ASHRAFIFARD; SHIMA SADAT ZARIF NAHAD

Volume 13, Issue 4 , October 2025, Pages 344-352

https://doi.org/10.30476/jamp.2025.104978.2095

Abstract

Introduction: The importance of retaining content in the longterm memory of medical students is well-documented. Given the narrative structure of medical disciplines, digital storytelling ... Read More Introduction: The importance of retaining content in the longterm memory of medical students is well-documented. Given the narrative structure of medical disciplines, digital storytelling is an effective educational tool. This study investigates the effect of digital storytelling on the learning and satisfaction of nursing and midwifery students.Methods: This quasi-experimental study included 20 thirdsemester midwifery students (intervention group, digital storytelling) and 50 first-semester nursing students (control group, traditional lectures), all enrolled in an undergraduate psychology course. Both groups participated in five initial lecturebased sessions. Thereafter, the intervention group received six weekly digital storytelling sessions, each featuring a 3–8 minute narrative followed by instructor-led discussions, while the control group continued with standard lectures and question–and–answer sessions. Learning outcomes were measured using pre- and posttests, and student satisfaction was assessed using a validated questionnaire. Statistical analyses were performed, adjusting forbaseline scores and demographic confounders. Results: The digital storytelling group showed significantly higher post-test scores in learning outcomes (75.21±17.75 vs. 54.97±23.40, p=0.001) and satisfaction (38.15±6.45 vs. 31.22±4.59, p=0.0003) compared to the traditional lecture group. The potential effect of baseline values, as well as non-homogeneous demographic variables across groups, was removed using non-parametric ANCOVA. The result confirmed that gender had no confounding effects on either learning outcomes or satisfaction. Additionally, the differences between the two groups in terms of learning and satisfaction remained significant (p<0.001).Conclusion: Digital storytelling offers a meaningful and learnercentered approach that extends beyond content delivery. By fostering active engagement and deeper cognitive involvement,it transforms traditional instruction into a more personalized and reflective learning experience. This approach is recommended in healthcare education to improve instructional effectiveness andstudent satisfaction.

Commentary

Organizational Professionalism: Role of Medical Council in Public Trust in the Profession

FARIBA ASGHARI

Volume 13, Issue 4 , October 2025, Pages 353-358

https://doi.org/10.30476/jamp.2025.105902.2133

Abstract

As an ideology for managing healthcare relying on internal professional oversight, medical professionalism entrusts the responsibility of regulation to the members of the profession ... Read More

ChatGPT and Medical Research: A Meta-Synthesis of Opportunities and Challenges

Volume 12, Issue 3 , July 2024, , Pages 135-147

https://doi.org/10.30476/jamp.2024.101068.1910

Abstract

Introduction: The utility of ChatGPT in research is ambiguous, serving as both a boon and bane and presenting challenges and opportunities. Accordingly, this study aimed to delineate ... Read More Introduction: The utility of ChatGPT in research is ambiguous, serving as both a boon and bane and presenting challenges and opportunities. Accordingly, this study aimed to delineate themerits and demerits of ChatGPT within the realm of research.Methods: A meta-synthesis methodology involving a seven-step process was adopted to pursue the research objectives. Data were collected from comprehensive studies across specialized research databases, such as Science Direct, Springer, Eric, Emerald, Sage Journals, Wiley Online Library, PubMed, and Google Scholar, within the time frame spanning from 2022 to 2023. A total of 57 articles were meticulously chosen for analysis through judgmental sampling. Subsequently, key concepts were distilled from these articles and categorized using the thematic analysis approach while considering Karl Llewellyn’s octagonal model from 1963.Results: The outcomes underwent scrutiny employing the thematic analysis strategy devised by Wolcott. The results about the capabilities and constraints of ChatGPT encompass eight dimensions, including formulating the research problem, reviewing relevant literature, selecting an appropriate research design, defining the population and choosing the sample, collecting data, analyzing data, interpreting data, and discussing and drawing conclusions. The credibility of these dimensions was substantiated through adherence to the criteria established by Lincoln and Guba.Conclusion: ChatGPT manifests myriad potentialities and constraints within the research purview based on the results. In light of the expeditious progression of artificial intelligence acrossmultifarious domains, integrating this technological paradigm in research becomes an inexorable imperative, and excluding its use in research is untenable. Thus, policymakers and higher education strategists should devise policies that harness ChatGPT’s potential in research endeavors, engendering many opportunities.

Analyzing the Trends and Drivers Influencing Future Leadership in Medical Education in Iran

Volume 13, Issue 2 , April 2025, , Pages 134-148

https://doi.org/10.30476/jamp.2025.103897.2029

Abstract

Introduction: A key challenge for policymakers in medical education lies in grasping the future landscape of leadership. Without insights into emerging trends, they may face unforeseen ... Read More Introduction: A key challenge for policymakers in medical education lies in grasping the future landscape of leadership. Without insights into emerging trends, they may face unforeseen issues, leading to expensive and inefficient decision-making. This study aimed at analyzing the trends and drivers influencing future leadership in medical education in Iran.Methods: In this research, we employed a descriptiveexploratory approach This study consists of systematic reviews and interviews that have been analyzed using Structural Equation Modeling with the help of MicMac software (version 6.1.2, 2003/2004: 3IE/EPITA, France). We conducted a systematic review according to PRISMA. A literature search was performed using databases including Medline, Web of Science, ProQuest Dissertation & Theses, Scopus Embase, and Persian studies from SID, and Magiran. The inclusion criteria for the study were the articles which needed to contain one or more listed keywords, were published in a scientific journal, were written in English or Persian, were published between 2004 and 2024, had the full text available, and focused on educational leadership in medical schools. Additionally, interviews were conducted with 14 Iranian experts to pinpoint influential components. To be included, experts possessed relevant education in medical education, health policy, or higher education management; occupied an executive or managerial position in higher health education or health policy; had more than 15 years of work experience, and were willing to participate in the study. Afterward, the codes were presented in a focus group discussion of experts to define how extracted drivers would affect leadership in medical education in Iran.Results: We identified 6081 articles in the initial literature search; 17 met inclusion criteria for final review. The study identified 37 drivers in medical education management and leadership. Thesedrivers were categorized into four types: effective drivers (3), impressionable drivers (3), autonomous drivers (16), and bimodal drivers (15). Among these, the components of meritocracyin selecting managers and international relations within the education sector had the most significant impact.Conclusion: By understanding and planning around these influential and susceptible components, managers, and policymakers can gain foresight. This foresight can enhance the effectiveness of current decisions and activities, enabling a more desirable future. This can be achieved by systematically improving decision-making processes, revising procedures, and developing appropriate strategies in medical education leadership.

Investigating the Effect of Online Gamification on Electrocardiogram Interpretation and Self-Directed Learning in Nursing Students

Volume 12, Issue 3 , July 2024, , Pages 199-207

https://doi.org/10.30476/jamp.2024.101396.1925

Abstract

Introduction: Knowing and interpreting the Electrocardiogram correctly and taking care based on it is one of the most important ways to save the patient’s life. Therefore, this ... Read More Introduction: Knowing and interpreting the Electrocardiogram correctly and taking care based on it is one of the most important ways to save the patient’s life. Therefore, this study aimed toinvestigate the effect of online gamification on the ability to interpret Electrocardiograms and Self-Directed Learning in nursing students.Methods: The present study was carried out quasi-experimentally on 44 nursing students (22 participants for each group) in the fifth semester in Ilam city in 2023 using a convenience sampling method by four permutations balanced block randomization to control and intervention groups. During four sessions in four weeks, the participants in the intervention group receivedElectrocardiogram interpretation as training on the Storyline platform and playing games in the Socrative software. The control group received the same content in the form of education from the same lecturer. ECG Interpretation Learning Test, Self-Directed Learning, Mini-Mental Status Examination, and demographic questionnaires were filled out before the intervention (pre-test).Then, Electrocardiogram Interpretation Learning Test and Self-Directed Learning questionnaires were completed two weeks after the end of the intervention (post-test), and the data were analyzed in the standard error of 0.05 using Shapiro-Wilk, independent t-test, paired t-test, chi-square, and multiple linear regression tests in SPSS V.16.Results: The mean and standard deviation of the participants’age was 21.35±1.02, and 59% of the samples were male. Before the intervention, no significant difference was observed between the two groups, but after the intervention, the mean and standard deviation of the ECG interpretation scores in the intervention group increased significantly (14.1±2.94) compared to the control group (8.8±1.36) (P=0.007). Also, Self-Directed Learning in the intervention group (168±10.42) compared to the control group (125±4.3) showed a statistically significant difference (P=0.003).Conclusion: Using online gamification as a new educational method in nursing students improves the ability to interpret Electrocardiograms and Self-Directed Learning. It is suggested that this method should be used to teach lessons that are more useful and important at the hospital.

Study of Deep Learning in Medical Education: Opportunities, Achievements and Future Challenges

Volume 12, Issue 3 , July 2024, , Pages 148-162

https://doi.org/10.30476/jamp.2024.99740.1853

Abstract

Introduction: In this era of progress, interest has developed regarding advancing deep learning (DL) in medicine. However, there has been reluctance to use deep learning, particularly ... Read More Introduction: In this era of progress, interest has developed regarding advancing deep learning (DL) in medicine. However, there has been reluctance to use deep learning, particularly among medical educators. The limitations of previous research were examined in this study, along with the extent to which DL can be used in medical education and its potential impact on educational quality. We were interested in discussing DL’s prospects, and determining whether we could benefit from it in medical education.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was used to manage this review procedure. Six databases were searched carefully to obtain relevant studies. Our search identified 981 articles from the database based on our standards. After filtering the duplicated articles, 11 studies were included in the systematic review.Results: The results showed that DL applications attracted researchers’ attention in the medical and education technology owing to their effectiveness to provide the personalized assistanceand feedback. Furthermore, the majority of research concentrated on teaching medical students how to utilize DL applications in the classroom, and all of them tried to improve medical students’proficiency with DL instruments in practical applications. Deep learning components in medical learning environments have two segments—in the educational settings like speech recognitionor Video content analysis for affecting students’ learning, and in the medical settings, applying deep learning from diagnosis to prevention. An integration of them can work better in medicaleducation.Conclusion: Medical education uses DL to improve the students’ education. DL is a powerful instrument which has become more famous in terms of superb outcomes. Besides, using DL in medical education is likely to continue as a hotly debated area of research and a well-known classroom strategy.

Integrating Artificial Intelligence in Medical Education: A Meta-Synthesis of Potentials and Pitfalls of ChatGPT

Volume 13, Issue 3 , July 2025, , Pages 155-172

https://doi.org/10.30476/jamp.2024.104617.2071

Abstract

Introduction: ChatGPT serves as a double-edged sword in education, offering either constructive information or potential challenges. Its impact ranges from being a transformative tool ... Read More Introduction: ChatGPT serves as a double-edged sword in education, offering either constructive information or potential challenges. Its impact ranges from being a transformative tool to a disruptive force, making it difficult to evaluate its educational efficacy comprehensively. In light of this complexity, the primary aim of this research was to investigate the opportunities and challenges associated with the integration of ChatGPT into the domain of medical education.Methods: The study utilized the Interaction Equivalency Theorem as its conceptual framework to guide the investigation. To achieve the research objectives, a meta-synthesis of the literature wasconducted to systematically integrate the findings of selected studies. Data collection involved comprehensive searches across specialized academic databases, including Science Direct, Springer, ERIC, Emerald, SAGE, Wiley Online Library, PubMed, and Google Scholar, focusing on publications from 2022 to 2024. 88 articles were meticulously selected based on their relevanceto the research topic. The data were then subjected to thematic analysis, facilitating the extraction of key insights and patterns to address the study objectives.Results: The findings were organized into four primary subthemes highlighting the opportunities presented by ChatGPT in medical education. These sub-themes encompassed benefits for educators, learners, curriculum development, and the learning process. Similarly, the challenges related to the integration of ChatGPT were categorized into four primary sub-themes: addressing the difficulties experienced by educators, learners, curriculum development, and the learning process. Together, these challenges were further delineated into 11 secondary sub-themes,offering a comprehensive analysis of the complexities involved.Conclusion: The findings suggest that improving educational efficiency, assisting with self-development, enhancing communication skills, creating and expanding curriculum, and improving the learning environment are opportunities for utilizing ChatGPT. The study outcomes also reveal that lack of technological knowledge, negative attitudes, reduction in education quality, diminishing students’ capabilities, reducing learning quality, flaws in learning development, difficulties in designing educational content, and bias in learning evaluation are challenges of applying ChatGPT in medical education.