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This action research examines the transition from audio- to video-based tasks in the final Medical Hungarian exam for international medical students, aiming to better align assessment with real-life language needs and enhance student motivation. Conducted at a Hungarian medical university with 61 second-year students, the study uses a mixed-methods approach. Quantitative data from a questionnaire and qualitative insights from focus group interviews reveal students' experiences with the video-based exam tasks and preparatory materials. The results indicate a positive reception of the Practice Test Book and the new video exam format, with visual cues like body language aiding in comprehension and engagement. Students found that the video-based tasks closely mirrored clinical interactions, strengthening the relevance of language skills in professional contexts. Preparatory materials, including lead-in exercises, were well-received by students and seen as effective in improving readiness for the exam. The study suggests that the shift from audio- to video-based assessment can bridge classroom learning with real-world application, potentially serving as a model for other non-traditional study abroad settings in Languages Other Than English (LOTEs), especially as purely audio-based communication has become less prevalent in today's world. [ABSTRACT FROM AUTHOR]

Abstract Background Depression and anxiety are common psychological issues among international medical students in universities, which have serious negative impacts on their learning and life. The present study aimed to evaluate the efficacy of positive emotional writing in alleviating symptoms of anxiety and depression, as well as enhancing subjective well-being among this population. Method This study was conducted at an international college of a comprehensive university in central China. A total of ninety-two participants who met the inclusion criteria were recruited to participate in a single-blind randomized controlled trial, in which participants were not aware that there was an experimental group and a control group. Participants in control received daily psychological care weekly for 8 weeks (n = 46). Correspondingly, participants in experimental group received the positive emotional writing intervention on the basis of daily psychological care. Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and General Well-being Scale (GWB) were used to evaluate the effect of the intervention. Data from 89 students who completed the entire study (experimental group, n = 44; control group, n = 45) were analyzed. Results After the intervention, the scores of SDS and SAS in the experimental group significantly decreased, while the subjective well-being score significantly increased. Although the SAS score of the control group after intervention was significantly lower than before, the decrease in SDS and SAS scores, as well as the increase in GWB score, were significantly greater in the experimental group than in the control group. Conclusion The findings suggest that positive emotional writing can effectively reduce the depression and anxiety of international medical students, and significantly enhance their subjective well-being, providing ideas for management to solve the psychological problems of international medical students. Trial registration number ChiCTR2400087815. Registered at Chinese Clinical Trial Registry.

Abstract Background Feedback and psychological safety are well-established concepts within medical education, vital for student learning and progress. However, the concepts remain unexplored in the context of international students. This area deserves attention given the unique challenges faced by the overseas medical students due to cultural differences. The present study examines international students’ experiences of psychological safety in feedback interactions in a Scottish undergraduate medical programme. Methods A focused ethnographic approach was adopted to explore international students’ experiences and perceptions of psychological safety in their feedback experiences. Data were collected in the form of field observations and semi-structured interviews, involving both student and faculty participants. Approximately 13hrs of fieldwork and a total of 11 interviews were conducted. These were analysed using a combination of inductive and deductive thematic analysis. Results Data analysis identified four key themes: feedback delivery, educator attributes, cultural factors and longitudinal educational relationships. Both staff and student participants highlighted how environmental factors such as room design and group size functioned as enablers or barriers to psychological safety in feedback episodes. Additionally, students appreciated tutors who expressed vulnerability and demonstrated awareness of their cultural backgrounds. Students described significant differences between the feedback approaches in the host (UK) institute and that in their home country. Longitudinal associations fostered trust and familiarity with peers and tutors, enhancing students’ receptivity to learning and feedback. Conclusion This present study highlights cultural differences in feedback practices across countries and their impact on psychological safety among international students. It stresses the importance of integrating overseas students by considering group dynamics, environment and diverse student needs. Staff awareness of cultural variability, openness to tutor vulnerability and fostering long-term educational relationships can greatly enhance psychological safety in learning and teaching activities. These insights are relevant amidst the growing globalisation of medical education and the mobility of students across borders, advocating for tailored integration to optimise their learning experience and achievement.

Effective patient communication is vital in medical training. At a Hungarian Medical university, international students in the English-medium program are required to study Hungarian for two years to prepare for clinical rotations in Hungarian hospitals. The final language assessment traditionally included an audio-based listening exam, but both students and teachers raised concerns about its difficulty and its lack of relevance to real-life clinical interactions and the students' actual language needs. A needs analysis was conducted with 52 second-year international medical students through focus-group interviews after they took the exam to address these issues. Based on the feedback, a video-based exam format was developed and piloted. The new format incorporated visual cues such as gestures and facial expressions, better reflecting face-to-face patient communication. A total of 38 third-year students who had previously taken the audio-based version of the exam participated in the pilot, with focus-group interviews conducted to directly compare the two formats. The majority of the students found the video-based exam more engaging and relevant to their clinical experience. The findings suggest that the video-based exam better prepares students for real-life medical communication and provides a more meaningful assessment experience, bridging the gap between language learning and clinical practice. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety are common psychological issues among international medical students in universities, which have serious negative impacts on their learning and life. The present study aimed to evaluate the efficacy of positive emotional writing in alleviating symptoms of anxiety and depression, as well as enhancing subjective well-being among this population. Method: This study was conducted at an international college of a comprehensive university in central China. A total of ninety-two participants who met the inclusion criteria were recruited to participate in a single-blind randomized controlled trial, in which participants were not aware that there was an experimental group and a control group. Participants in control received daily psychological care weekly for 8 weeks (n = 46). Correspondingly, participants in experimental group received the positive emotional writing intervention on the basis of daily psychological care. Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and General Well-being Scale (GWB) were used to evaluate the effect of the intervention. Data from 89 students who completed the entire study (experimental group, n = 44; control group, n = 45) were analyzed. Results: After the intervention, the scores of SDS and SAS in the experimental group significantly decreased, while the subjective well-being score significantly increased. Although the SAS score of the control group after intervention was significantly lower than before, the decrease in SDS and SAS scores, as well as the increase in GWB score, were significantly greater in the experimental group than in the control group. Conclusion: The findings suggest that positive emotional writing can effectively reduce the depression and anxiety of international medical students, and significantly enhance their subjective well-being, providing ideas for management to solve the psychological problems of international medical students. Trial registration number: ChiCTR2400087815. Registered at Chinese Clinical Trial Registry. [ABSTRACT FROM AUTHOR]

Background: Feedback and psychological safety are well-established concepts within medical education, vital for student learning and progress. However, the concepts remain unexplored in the context of international students. This area deserves attention given the unique challenges faced by the overseas medical students due to cultural differences. The present study examines international students' experiences of psychological safety in feedback interactions in a Scottish undergraduate medical programme. Methods: A focused ethnographic approach was adopted to explore international students' experiences and perceptions of psychological safety in their feedback experiences. Data were collected in the form of field observations and semi-structured interviews, involving both student and faculty participants. Approximately 13hrs of fieldwork and a total of 11 interviews were conducted. These were analysed using a combination of inductive and deductive thematic analysis. Results: Data analysis identified four key themes: feedback delivery, educator attributes, cultural factors and longitudinal educational relationships. Both staff and student participants highlighted how environmental factors such as room design and group size functioned as enablers or barriers to psychological safety in feedback episodes. Additionally, students appreciated tutors who expressed vulnerability and demonstrated awareness of their cultural backgrounds. Students described significant differences between the feedback approaches in the host (UK) institute and that in their home country. Longitudinal associations fostered trust and familiarity with peers and tutors, enhancing students' receptivity to learning and feedback. Conclusion: This present study highlights cultural differences in feedback practices across countries and their impact on psychological safety among international students. It stresses the importance of integrating overseas students by considering group dynamics, environment and diverse student needs. Staff awareness of cultural variability, openness to tutor vulnerability and fostering long-term educational relationships can greatly enhance psychological safety in learning and teaching activities. These insights are relevant amidst the growing globalisation of medical education and the mobility of students across borders, advocating for tailored integration to optimise their learning experience and achievement. [ABSTRACT FROM AUTHOR]

It is the year 2050, and the world of medicine has undergone significant changes. With the advent of advanced technology and medical breakthroughs, medical schools have become even more competitive. Medical students are now required to have an exceptional academic record, outstanding research experience, and a perfect social media presence. However, with the rise of social media, a new phenomenon has emerged, one that has been plaguing medical students for years - imposter syndrome. [ABSTRACT FROM AUTHOR]

Between 2018–2021, eight European medical schools took part in a study to develop a medical knowledge Online Adaptive International Progress Test. Here we discuss participants' self-perception to evaluate the acceptability of adaptive vs non-adaptive testing. Study participants, students from across Europe at all stages of undergraduate medical education with varying levels of prior experience with progress testing, sat remotely invigilated tests using the online QuizOne® platform. Participants completed online feedback questionnaires on their experiences and perceptions of adaptive and non-adaptive tests. Overall satisfaction with the organisation and delivery of remote online tests was high regardless of previous experience with progress testing, differences in stages, programmes, and to some degree language. In statements probing the appropriateness of the level and the length of testing, differences were observed between adaptive and non-adaptive tests. There was a high level of agreement that the adaptive test was a good measure of personal knowledge and increased participants' motivation for study. Students' self-perception of the assessment is an important factor in evaluation of acceptability of the exam and its further development. In our study, the adaptive test algorithm adjusted the level of difficulty for the individual student in real-time, leading to positive perceptions of the length of the test and promoting students' engagement. The assessment increases student motivation for learning and in turn, has the potential to improve their performance. [ABSTRACT FROM AUTHOR]

Medical students face numerous challenges due to demanding academic and environmental requirements set by educational institutions, society, and families. International medical students, in addition, grapple with further hurdles related to their acculturation in a foreign country, including isolation from their family and friends, language and cultural barriers, and individual factors. Although a body of knowledge addresses stressors typical for international medical students in other countries, insufficient attention has been given to this issue in Malaysia, which has recently emerged as an educational hub and a favored destination for young people aspiring to study medicine. It is vital to consider the academic, cultural, and religious aspects of the countries international students come from in the context of their potential acculturative dynamics in the host country. This paper explores factors contributing to stress among international medical students in Malaysia and examines common coping mechanisms relevant to this unique student population. The role of social, institutional, and professional support, religion, language, and personal development has been highlighted. Emphasizing the need for further research to inform tailored interventions aimed at alleviating stress among international medical students and enhancing the educational environment in Malaysian medical schools is crucial. [ABSTRACT FROM AUTHOR]

Phenomenon: China hosts a large number of international medical students from low-income countries, and some fail examinations in the early stage of the Bachelor of Medicine and Bachelor of Surgery (MBBS) program. Little is known about how failing international medical students cope to recover their academic performance. It would be beneficial to investigate the coping strategies they use to help them recover their academic performance and progress. Approach: Semi-structured interviews were conducted with 21 international medical students at two universities in China from September 2020 to January 2021. These students had passed make-up exams or re-sits and progressed academically. A thematic analysis approach was used to identify major themes in the interview data. Findings: After failing initial exams or re-sits, students were found to adopt seven coping strategies to help them pass future examinations and recover their academic performance: (i) increased help-seeking behaviors, (ii) improved learning motivation and attitudes, (iii) improved learning strategies, (iv) improved exam preparation, (v) utilization of library resources, (vi) enhanced time management, and (vii) enhanced English language skills. Of the seven strategies, seeking help from friends, peers, seniors, and teachers was the strategy reported most frequently. Insights: The results of this study provide insights into the coping strategies that international undergraduate medical students adopt to recover from poor academic performance in Chinese universities. Host institutions should recognize the resilience and agency of such students to make positive changes. Furthermore, institutional efforts should be made to develop contextualized intervention plans that stimulate students' learning motivation and encourage them to adopt self-help strategies by incorporating useful resources (e.g., help from peers, seniors, and teachers). Enrollment should integrate specific English language proficiency criteria, and interviews and entrance exams should be conducted. For some failing students, it may be necessary to provide academic remediation. [ABSTRACT FROM AUTHOR]

Effective patient communication is vital in medical training. At a Hungarian Medical university, international students in the English-medium program are required to study Hungarian for two years to prepare for clinical rotations in Hungarian hospitals. The final language assessment traditionally included an audio-based listening exam, but both students and teachers raised concerns about its difficulty and its lack of relevance to real-life clinical interactions and the students’ actual language needs. A needs analysis was conducted with 52 second-year international medical students through focus-group interviews after they took the exam to address these issues. Based on the feedback, a video-based exam format was developed and piloted. The new format incorporated visual cues such as gestures and facial expressions, better reflecting face-to-face patient communication. A total of 38 third-year students who had previously taken the audio-based version of the exam participated in the pilot, with focus-group interviews conducted to directly compare the two formats. The majority of the students found the video-based exam more engaging and relevant to their clinical experience. The findings suggest that the video-based exam better prepares students for real-life medical communication and provides a more meaningful assessment experience, bridging the gap between language learning and clinical practice.

Background Academic success is extremely important for international medical students enrolled in Chinese universities, as it affects their performance in their licence exams and future work opportunities. However, insufficient research has been conducted on university academic staff’s awareness of teaching-related factors that affect their students’ academic success. Methods A purposive sampling approach was taken in the study to recruit academics teaching in medical universities in China. The selection of informants was based on the subject they taught and their gender, experience of teaching international medical students, educational background and career stage. Semi-structured interviews were conducted with academics ( N = 36) between November 2020 and January 2021 at two medical universities in China. Each interview lasted between 30 and 70 minutes and was audiotaped, transcribed verbatim and thematically analysed. Results The teaching factors that academics perceived to have an important influence on the success of students were (i) pedagogy and content alignment; (ii) language barriers; (iii) resource management and the learning environment; and (iv) educator attributes and guidance. Conclusions University faculties and departments involved in teaching international medical students should ensure that their academic staff are supported in their ongoing professional development and provided with resources to enhance their teaching quality. The four factors (and their sub-factors) listed above should be prioritised in such staff training.

Background Academic success is extremely important for international medical students enrolled in Chinese universities, as it affects their performance in their licence exams and future work opportunities. However, insufficient research has been conducted on university academic staff’s awareness of teaching-related factors that affect their students’ academic success. Methods A purposive sampling approach was taken in the study to recruit academics teaching in medical universities in China. The selection of informants was based on the subject they taught and their gender, experience of teaching international medical students, educational background and career stage. Semi-structured interviews were conducted with academics (N = 36) between November 2020 and January 2021 at two medical universities in China. Each interview lasted between 30 and 70 minutes and was audiotaped, transcribed verbatim and thematically analysed. Results The teaching factors that academics perceived to have an important influence on the success of students were (i) pedagogy and content alignment; (ii) language barriers; (iii) resource management and the learning environment; and (iv) educator attributes and guidance. Conclusions University faculties and departments involved in teaching international medical students should ensure that their academic staff are supported in their ongoing professional development and provided with resources to enhance their teaching quality. The four factors (and their sub-factors) listed above should be prioritised in such staff training.

Abstract Background The two most prevalent mental health conditions are anxiety and depression and they often coexist (comorbidity) in an individual aggravating the person’s psychological or medical conditions. College students suffered from anxiety and depressive symptoms during the COVID-19 pandemic, according to numerous studies. The lack of information on the comorbidity of anxiety and depression (CAD) among international medical students, however, makes it difficult to develop effective policies or strategies to support these students. Objective The present research seeks to investigate the incidence of CAD among international medical students in China and to identify the variables that may be useful in predicting CAD. Method A cross-sectional study was conducted at China Medical University in Shenyang, China, for international medical students during November 2020. A total of 519 international students provided information on their demographics, stress related to the COVID-19 pandemic, generalized anxiety disorder assessment (GAD-7), patient health questionnaire-9 (PHQ-9), simplified coping style questionnaire (SCSQ), perceived stress scale (PSS-10), the multidimensional scale of perceived social support (MSPSS), revised life orientation test (LOT-R), and resilience scale-14 (RS-14). To investigate the potential predictors of CAD, a chi-square test, a nonparametric test, and multinomial logistic regression analyses were carried out as appropriate. Results The incidence of anxiety, depression, and CAD in the current study was 5.8%, 8.9%, and 22.7%, respectively. The predictors for students having symptoms of anxiety were observed to be the negative coping style (β = 0.662, OR = 1.938, CI:1.07–3.694) and perceived stress (β = 0.167, OR = 1.181, CI:1.076–1.297); the predictors for students having symptoms of depression were observed to be the COVID-19 pandemic-related stress (β = 0.323,OR = 1.382,CI:1.211–1.577), negative coping style (β = 0.693,OR = 2.000, CI:1.21–3.568), and perceived stress (β = 0.135,OR = 1.145,CI:1.050–1.248); whereas the predictors for students with CAD were observed to be staying up late (Yes VS No) (β = 1.028,OR = 2.794,CI:1.227–6.364), current place of residence (Other continents VS China) (β = -1.413, OR = 0.243,CI:0.065–0.910), COVID-19 pandemic-related stress (β = 0.371,OR = 1.450,CI:1.284–1.636), negative coping style (β = 1.092,OR = 2.979,CI:1.706–5.203), and perceived stress (β = 0.339,OR = 1.403,CI:1.289–1.527). Conclusion Single anxiety and depressive symptoms were moderately prevalent among international medical students in China. However, CAD turned out to be the most prevalent mental health issue due to its relatively higher incidence. Negative coping style and perceived stress were the communal predictors of the three categories, whereas stress related to the COVID-19 pandemic was linked to both depression and CAD, and staying up late and in residential places were specific predictors for CAD. Study results suggest that COVID-19 pandemic-related stress was related to students’ CAD and depressive symptoms, and specific intervention measures with stress reduction, proper coping strategy, and a good lifestyle might be useful in improving the international students’ mental health status.

Abstract Background Over the past few decades, the number of international students has increased dramatically. These students have to adjust to unfamiliar social, cultural, and educational environments. The concept of acculturation has been applied in multiple studies on various health outcomes. This study investigated the relationship between acculturation and self-rated health (SRH) among international medical students. Methods A cross-sectional study was conducted among international medical students at the University of Szeged, Hungary between April and October 2021. A total of 326 participants filled out questionnaires about sociodemographic characteristics, acculturation, and SRH. The modified Stephenson multigroup acculturation scale (SMAS) was used to assess the acculturation status; the scale defined acculturation as the degree of dominant society immersion (DSI, 12 items) and ethnic society immersion (ESI, 16 items). To measure SRH, participants were asked to rate their current general health and mental health. The data were analyzed by using descriptive statistics and the multiple logistic regression model. Results 32.5% of the students reported having poor general and 49.7% poor mental health. We have found that acculturation was associated with SRH in multivariable logistic regression models controlling for sociodemographic characteristic. Bidimensional acculturation, such as ESI and DSI significantly influenced SRH as the likelihood of poor general health decreased (OR = 0.50; 95% CI = 0.31–0.81, P = 0.005), when the ESI was higher, whereas the likelihood of poor mental health decreased (OR = 0.52; 95% CI = 0.35–0.79, P = 0.002) if students had a greater DSI. Conclusion Both types of immersion can affect the students’ SRH. If the student could integrate better into their own ethnic group, their general health was better, and if they could strongly integrate into the Hungarian society, their mental health was more favorable. Acculturation measures should be promoted by academics and public health professionals in order to better understand their role in the behaviors, health outcomes, and health care use of medical international students. These findings will help professionals shape culturally sensitive prevention and counselling strategies for international student populations.

Background: The two most prevalent mental health conditions are anxiety and depression and they often coexist (comorbidity) in an individual aggravating the person's psychological or medical conditions. College students suffered from anxiety and depressive symptoms during the COVID-19 pandemic, according to numerous studies. The lack of information on the comorbidity of anxiety and depression (CAD) among international medical students, however, makes it difficult to develop effective policies or strategies to support these students. Objective: The present research seeks to investigate the incidence of CAD among international medical students in China and to identify the variables that may be useful in predicting CAD. Method: A cross-sectional study was conducted at China Medical University in Shenyang, China, for international medical students during November 2020. A total of 519 international students provided information on their demographics, stress related to the COVID-19 pandemic, generalized anxiety disorder assessment (GAD-7), patient health questionnaire-9 (PHQ-9), simplified coping style questionnaire (SCSQ), perceived stress scale (PSS-10), the multidimensional scale of perceived social support (MSPSS), revised life orientation test (LOT-R), and resilience scale-14 (RS-14). To investigate the potential predictors of CAD, a chi-square test, a nonparametric test, and multinomial logistic regression analyses were carried out as appropriate. Results: The incidence of anxiety, depression, and CAD in the current study was 5.8%, 8.9%, and 22.7%, respectively. The predictors for students having symptoms of anxiety were observed to be the negative coping style (β = 0.662, OR = 1.938, CI:1.07–3.694) and perceived stress (β = 0.167, OR = 1.181, CI:1.076–1.297); the predictors for students having symptoms of depression were observed to be the COVID-19 pandemic-related stress (β = 0.323,OR = 1.382,CI:1.211–1.577), negative coping style (β = 0.693,OR = 2.000, CI:1.21–3.568), and perceived stress (β = 0.135,OR = 1.145,CI:1.050–1.248); whereas the predictors for students with CAD were observed to be staying up late (Yes VS No) (β = 1.028,OR = 2.794,CI:1.227–6.364), current place of residence (Other continents VS China) (β = -1.413, OR = 0.243,CI:0.065–0.910), COVID-19 pandemic-related stress (β = 0.371,OR = 1.450,CI:1.284–1.636), negative coping style (β = 1.092,OR = 2.979,CI:1.706–5.203), and perceived stress (β = 0.339,OR = 1.403,CI:1.289–1.527). Conclusion: Single anxiety and depressive symptoms were moderately prevalent among international medical students in China. However, CAD turned out to be the most prevalent mental health issue due to its relatively higher incidence. Negative coping style and perceived stress were the communal predictors of the three categories, whereas stress related to the COVID-19 pandemic was linked to both depression and CAD, and staying up late and in residential places were specific predictors for CAD. Study results suggest that COVID-19 pandemic-related stress was related to students' CAD and depressive symptoms, and specific intervention measures with stress reduction, proper coping strategy, and a good lifestyle might be useful in improving the international students' mental health status. [ABSTRACT FROM AUTHOR]

Background: Academic success of international medical students enrolled in Chinese universities is of great significance, because it directly influences their performance in the license exam and in obtaining a job. Insufficient research has been conducted on academics’ awareness of factors related to teaching that affect their students’ academic success. Methods: Semi-structured interviews were conducted with academics ( N=36) from November 2020 to January 2021 at two medical universities in China. Each interview, lasting between 30 to 70-min, was audiotaped, transcribed verbatim and analyzed using thematic analysis. Results: The important teaching factors that academics perceived to influence the success of students are: (i) style of pedagogy, (ii) addressing students’ language difficulties and differences, (iii) teaching resources management, (iv) attributes of the academics, (v) supervision and guidance by the academics, (vi) rapport between the academic and student, (vii) linking teaching content to license exams, (viii) classroom discipline management, and (ix) assessment style. Conclusions: University faculties and departments that are involved in teaching international medical students need to ensure that academic staff are provided with ongoing professional development and resources to enhance teaching quality. The nine areas identified above should provide priority topics for such staff training.

Abstract Background International medical students are frequently confronted with intercultural, psychosocial, and language barriers and often receive lower marks in written, oral, and clinical-practical examinations than fellow local students. Training communication competence in procedural skills, such as blood sampling, is further challenge in this particular group of medical students. This pre-post comparative intervention study aimed to investigate the effects of training communication skills during the performance of procedural skills (taking blood samples from a silicone model) in international and local students as part of their clinical practical medical training. Methods Study participants performed blood sampling on an arm prosthesis model (part-task trainer) before and after the communication skills training, focusing on accompanying communication with a simulation patient sitting next to the arm model. The pre- and post-evaluation video was assessed by two independent evaluators using a binary checklist, the Integrated Procedural Performance Instrument (IPPI) and global assessments of clinical professionalism in terms of procedural and communication performance. Linear models with mixed effects were used. Group differences regarding global competence levels were analysed with χ2-tests. Results International medical students did not perform as well as their local counterparts in the pre- and post-examinations. Both groups improved their performance significantly, whereby the international students improved more than their local counterparts in terms of their communication performance, assessed via binary checklist. Clinical professionalism evaluated via global assessments of procedural and communication performance highlights the intervention’s impact insofar as no international student was assessed as clinically not competent after the training. Conclusions Our results suggest that already a low-dose intervention can lead to improved communication skills in medical students performing procedural tasks and significantly increase their confidence in patient interaction.

The COVID‐19 pandemic has greatly impacted the education of international students. The authors taught a molecular biology course using the DingTalk platform for international medical students (IMS) in the autumn semester of 2020. We assessed the effect of this online teaching based on an online questionnaire and by analysis of the final examination scores. Our findings demonstrate that the DingTalk platform is a free, effective and convenient online teaching tool for international students. The students' feedback showed that most of them were satisfied with this live teaching with DingTalk. They considered who viewed that the questions used in the live classroom setting were helpful for their learning. There is nonetheless still scope to improve this online teaching mode for international students, such as providing more pre‐recorded teaching videos for offline application and use of a virtual simulation experimental molecular biology course. We hope that our findings regarding the experience of IMS with this teaching mode will be of value to other academic faculty. Online teaching for international medical students [ABSTRACT FROM AUTHOR]

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Abstract Background The COVID-19 pandemic posed a huge challenge to the education systems worldwide, forcing many countries to provisionally close educational institutions and deliver courses fully online. The aim of this study was to explore the quality of the online education in China for international medical and nursing students from low- and middle-income countries (LMICs) as well as the factors that influenced their satisfaction with online education during the COVID-19 pandemic. Methods Questionnaires were developed and administered to 316 international medical and nursing students and 120 teachers at a university in China. The Chi-square test was used to detect the influence of participants’ personal characteristics on their satisfaction with online education. The Kruskal–Wallis rank-sum test was employed to identify the negative and positive factors influencing the online education satisfaction. A binary logistic regression model was performed for multiple-factor analysis to determine the association of the different categories of influential factors—crisis-, learner-, instructor-, and course-related categories, with the online education satisfaction. Results Overall, 230 students (response rate 72.8%) and 95 teachers (response rate 79.2%) completed the survey. It was found that 36.5% of students and 61.1% of teachers were satisfied with the online education. Teachers’ professional title, students’ year of study, continent of origin and location of current residence significantly influenced the online education satisfaction. The most influential barrier for students was the severity of the COVID-19 situation and for teachers it was the sense of distance. The most influential facilitating factor for students was a well-accomplished course assignment and for teachers it was the successful administration of the online courses. Conclusions Several key factors have been identified that affected the attitudes of international health science students from LMICs and their teachers towards online education in China during the COVID-19 pandemic. To improve the online education outcome, medical schools are advised to promote the facilitating factors and cope with the barriers, by providing support for students and teaching faculties to deal with the anxiety caused by the pandemic, caring for the state of mind of in-China students away from home, maintaining the engagement of out-China students studying from afar and enhancing collaborations with overseas institutions to create practice opportunities at students’ local places.

Background: Applications of artificial intelligence (AI) in medicine are expanding every year. AI education is crucial to its appropriate use in healthcare; however, most US medical schools lack a dedicated AI curriculum. These resources are sparse for international medical graduates (IMGs). Using the Artificial Intelligence in Radiology Education (AIRE) curriculum, we assessed the radiology AI course's effectiveness in increasing the AI competency of IMGs., Approach: AIRE curriculum features nine free YouTube lectures on AI in radiology. Participants watched lectures remotely on fundamental AI terms, methods, clinical applications and special topics. They completed a pre- and post-course e-survey and assessment. The survey assessed participants' prior AI experience, subjective knowledge and opinions on the need for AI in medical education. The assessment determined participants' knowledge of AI. Pre- and post-course assessment scores were compared using a Student's t-test to determine if the course increased participant knowledge of AI terms and applications., Evaluation: Three hundred fifty-seven students from 28 countries enrolled in the course; 175 completed the course within the study period. Nearly all participants reported insufficient AI exposure in their radiology training (91.3%). Participants' knowledge of fundamental AI terms and methods increased after completion of the course, with an average pre-course assessment score of 6.5/15 and a post-course assessment score of 9.4/15 (p < 0.0001)., Implications: AIRE curriculum's effectiveness demonstrates that a remote education course is a viable model to bring accessible fundamental AI education to international medical students. Remote education curricula in medical AI can help mitigate disparities in AI education for lower resource medical programmes., (© 2025 Association for the Study of Medical Education and John Wiley & Sons Ltd.)

The present study explores current state of play of international medical student population in Ukraine. Their number in national medical universities has been constantly rising since 2006. Ukraine is a country of international medical students’ destination for higher medical or pharmaceutical education. Ukraine is not only one of the biggest suppliers of international students to the European Union in European Higher Education Area, but it is also a host country for international students primarily from Asia and Africa. The survey aimed at studying international medical students’ current needs and perspectives was conducted at Bogomolets National Medical University in 2019. The university is chosen as it is situated in the capital city. Sample was composed of 60 first-year international medical students, chosen at a random. It allowed students to provide feedback on their country of origin, educational background, preferences, satisfaction in quality of educational service in a host country, ways of financing the study and future career plans. Among the reasons of international students’ choice of Ukraine as a place for study are their preference of the country, high quality education, friends’ advice and geographical location. The research results show that international medical students consider Ukraine not only as high quality medical education provider but as perspective country for postgraduate employment. The research results allow us to hypothesise that the current needs and perspectives of international medical students at one medical university are likely to be typical for other national medical universities and for Ukraine in whole. It is concluded, that increasing international students’ population requires regular monitoring and special researches by universities and government. These measures will make benefits in international university strategy and national educational policy coordination

Background: The rapid spread of Coronavirus Disease-19 (COVID-19) infection has been the most important public health crisis across the globe since the end of 2019. Anxiety and depression are the most common mental health problems among people during the pandemic, and many studies have reported anxiety and depressive symptoms in college students. However, information on the mental health status of international medical students during this critical period of time has been scarce, which hinders the efforts in making proper policy or strategies to help these students. The present study aims to explore the prevalence of anxiety and depressive symptoms in international medical students in China and to find out the factors that have potential predictive value for anxiety and depressive symptoms.Method: A cross-sectional study was carried out for international medical students during November 2020 at China Medical University in Shenyang, China. Five hundred and nineteen international students were interviewed with questionnaires containing demographic variables, Stressors in school, Generalized Anxiety Disorder Assessment (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Simplified Coping Style Questionnaire (SCSQ), Perceived Stress Scale (PSS-10), the Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R) and Resilience Scale-14 (RS-14). Univariate logistic regression and stepwise multiple logistic regression analyses were conducted where appropriate to explore the predictive factors of anxiety symptoms and depressive symptoms.Results: The prevalence of anxiety symptoms and depressive symptoms in the sample population was 28.5% (148/519) and 31.6% (164/519), respectively. Stressors in school (β = 0.176, OR = 1.192, CI: 1.102–1.289), negative coping style (β = 0.639, OR = 1.894, CI: 1.287–2.788) and perceived stress (β = 0.230, OR = 1.258, CI: 1.184–1.337) were found to be the predictors of anxiety symptoms among the international medical students; while gender (β = −0.594, OR = 0.552, CI: 0.315–0.968), stay up late (β = 0.828, OR = 2.288, CI: 1.182–4.431), current place of residence (β = 1.082, OR = 2.951, CI: 1.256–6.931), stressors in the school (β = 0.303, OR = 1.354, CI: 1.266–1.496), negative coping style (β = 0.866, OR = 2.377, CI: 1.516–3.725), perceived stress (β = 0.233, OR = 1.262, CI: 1.180–1.351) were found to be predictors of depressive symptoms.Conclusion: The prevalence of anxiety symptoms and depressive symptoms was moderate among international medical students in China. The communal predictors of anxiety and depressive symptoms were stressors in school, negative coping style and perceived stress; while demographic factors such as gender (male), stay up late at night and current place of residence were found associated with depressive symptoms. These results suggest that proper stress management and specific interventions are needed to help students maintain their mental health during the COVID-19 pandemic period.

Background: The rapid spread of Coronavirus Disease-19 (COVID-19) infection has been the most important public health crisis across the globe since the end of 2019. Anxiety and depression are the most common mental health problems among people during the pandemic, and many studies have reported anxiety and depressive symptoms in college students. However, information on the mental health status of international medical students during this critical period of time has been scarce, which hinders the efforts in making proper policy or strategies to help these students. The present study aims to explore the prevalence of anxiety and depressive symptoms in international medical students in China and to find out the factors that have potential predictive value for anxiety and depressive symptoms. Method: A cross-sectional study was carried out for international medical students during November 2020 at China Medical University in Shenyang, China. Five hundred and nineteen international students were interviewed with questionnaires containing demographic variables, Stressors in school, Generalized Anxiety Disorder Assessment (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Simplified Coping Style Questionnaire (SCSQ), Perceived Stress Scale (PSS-10), the Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R) and Resilience Scale-14 (RS-14). Univariate logistic regression and stepwise multiple logistic regression analyses were conducted where appropriate to explore the predictive factors of anxiety symptoms and depressive symptoms. Results: The prevalence of anxiety symptoms and depressive symptoms in the sample population was 28.5% (148/519) and 31.6% (164/519), respectively. Stressors in school (β = 0.176, OR = 1.192, CI: 1.102–1.289), negative coping style (β = 0.639, OR = 1.894, CI: 1.287–2.788) and perceived stress (β = 0.230, OR = 1.258, CI: 1.184–1.337) were found to be the predictors of anxiety symptoms among the international medical students; while gender (β = −0.594, OR = 0.552, CI: 0.315–0.968), stay up late (β = 0.828, OR = 2.288, CI: 1.182–4.431), current place of residence (β = 1.082, OR = 2.951, CI: 1.256–6.931), stressors in the school (β = 0.303, OR = 1.354, CI: 1.266–1.496), negative coping style (β = 0.866, OR = 2.377, CI: 1.516–3.725), perceived stress (β = 0.233, OR = 1.262, CI: 1.180–1.351) were found to be predictors of depressive symptoms. Conclusion: The prevalence of anxiety symptoms and depressive symptoms was moderate among international medical students in China. The communal predictors of anxiety and depressive symptoms were stressors in school, negative coping style and perceived stress; while demographic factors such as gender (male), stay up late at night and current place of residence were found associated with depressive symptoms. These results suggest that proper stress management and specific interventions are needed to help students maintain their mental health during the COVID-19 pandemic period. [ABSTRACT FROM AUTHOR]

Background: International medical students are frequently confronted with intercultural, psychosocial, and language barriers and often receive lower marks in written, oral, and clinical-practical examinations than fellow local students. Training communication competence in procedural skills, such as blood sampling, is further challenge in this particular group of medical students. This pre-post comparative intervention study aimed to investigate the effects of training communication skills during the performance of procedural skills (taking blood samples from a silicone model) in international and local students as part of their clinical practical medical training. Methods: Study participants performed blood sampling on an arm prosthesis model (part-task trainer) before and after the communication skills training, focusing on accompanying communication with a simulation patient sitting next to the arm model. The pre- and post-evaluation video was assessed by two independent evaluators using a binary checklist, the Integrated Procedural Performance Instrument (IPPI) and global assessments of clinical professionalism in terms of procedural and communication performance. Linear models with mixed effects were used. Group differences regarding global competence levels were analysed with χ2-tests. Results: International medical students did not perform as well as their local counterparts in the pre- and post-examinations. Both groups improved their performance significantly, whereby the international students improved more than their local counterparts in terms of their communication performance, assessed via binary checklist. Clinical professionalism evaluated via global assessments of procedural and communication performance highlights the intervention's impact insofar as no international student was assessed as clinically not competent after the training. Conclusions: Our results suggest that already a low-dose intervention can lead to improved communication skills in medical students performing procedural tasks and significantly increase their confidence in patient interaction. [ABSTRACT FROM AUTHOR]

Background: An educational partnership between The University of Queensland (UQ) in Australia and Ochsner Health in the United States developed the UQ-Ochsner medical program that trains American citizens to practice medicine in the United States. This program provides the opportunity to explore and compare the personal characteristics of UQ-Ochsner students with their domestic (Australian citizen) and international classmates not enrolled in the Ochsner program. Findings may offer some insights into the types of students who choose to study medicine across multiple countries. Methods: We used a quantitative cross-sectional design for our study. A first-year cohort of domestic, international, and UQOchsner students completed a survey comprising demographic questions and measures of temperament and character personality, resilience, and calling to medicine. Univariate statistics were used to compare groups for all variables. Results: Thewhole sample response ratewas 72.1% (375/520). Domestic students represented the greatest proportion of students <25 years, and UQ-Ochsner students represented the greatest proportion of students of -26 years. Gender did not differ significantly between groups. The majority first degree for all students was science, although 23% of UQ-Ochsner students reported arts/law/humanities degrees. In comparison to all other students (domestic and international combined), UQ-Ochsner students scored significantly lower in levels of harm avoidance (P=0.039) and higher in self-directedness and self-transcendence, resilience, and calling with medium to strong effect sizes (d>0.3). Conclusion: UQ-Ochsner students have a personality profile similar to their classmates but with levels of certain traits-higher self-directedness and lower harm avoidance-that in combination contribute to higher resilience and a strong sense of calling to medicine. Being slightly older may allow for more development of self-directedness, but low harm avoidance suggests an innate degree of confidence in and acceptance of risk to achieving goals. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic posed a huge challenge to the education systems worldwide, forcing many countries to provisionally close educational institutions and deliver courses fully online. The aim of this study was to explore the quality of the online education in China for international medical and nursing students from low- and middle-income countries (LMICs) as well as the factors that influenced their satisfaction with online education during the COVID-19 pandemic.Methods: Questionnaires were developed and administered to 316 international medical and nursing students and 120 teachers at a university in China. The Chi-square test was used to detect the influence of participants' personal characteristics on their satisfaction with online education. The Kruskal-Wallis rank-sum test was employed to identify the negative and positive factors influencing the online education satisfaction. A binary logistic regression model was performed for multiple-factor analysis to determine the association of the different categories of influential factors-crisis-, learner-, instructor-, and course-related categories, with the online education satisfaction.Results: Overall, 230 students (response rate 72.8%) and 95 teachers (response rate 79.2%) completed the survey. It was found that 36.5% of students and 61.1% of teachers were satisfied with the online education. Teachers' professional title, students' year of study, continent of origin and location of current residence significantly influenced the online education satisfaction. The most influential barrier for students was the severity of the COVID-19 situation and for teachers it was the sense of distance. The most influential facilitating factor for students was a well-accomplished course assignment and for teachers it was the successful administration of the online courses.Conclusions: Several key factors have been identified that affected the attitudes of international health science students from LMICs and their teachers towards online education in China during the COVID-19 pandemic. To improve the online education outcome, medical schools are advised to promote the facilitating factors and cope with the barriers, by providing support for students and teaching faculties to deal with the anxiety caused by the pandemic, caring for the state of mind of in-China students away from home, maintaining the engagement of out-China students studying from afar and enhancing collaborations with overseas institutions to create practice opportunities at students' local places. [ABSTRACT FROM AUTHOR]

The increase in the number of international students at medical universities in Ukraine has made great demands for the quality of instruction in the first three years of study when adaptation of these students takes place. The aim of the paper is to analyse international students’ perceptions of teaching Microbiology, Virology and Immunology (MBVI) at Bogomolets National Medical University and outline the recommendations. A mixed research method was applied; the questionnaire with close-ended and open-ended questions grouped in nine sets was developed. Anonymous survey was conducted with the students (N=104) after completing the MBVI course with English as a medium of instruction. The survey has indicated general satisfaction of the respondents with the course. Insufficient proficiency in English often affects the quality of learning, and a low level of the Ukrainian or Russian language skills create difficulties in their communication and effective integration to the Ukrainian cultural environment. The survey results have shown the positive attitude of the respondents to the lectures with the requirement to have more interactive communication between the lecturer and students as well as have identified the difficulties concerning practical classes and self-study. The recommendations on how to improve academic performance of international medical students have been given. The focus is on increasing and maintaining language skills, consideration of ethnic and psychological features of students from different countries and implementing interactive teaching methods so that effective interaction in the learning environment could be achieved.

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Abstract Background Particularly at the beginning of their studies, international medical students face a number of language-related, social and intercultural challenges. Thus, they perform poorer than their local counterparts in written and oral examinations as well as in Objective Structured Clinical Examinations (OSCEs) in the fields of internal medicine and surgery. It is still unknown how international students perform in an OSCE in the field of psychosocial medicine compared to their local fellow students. Methods All students (N = 1033) taking the OSCE in the field of psychosocial medicine and an accompanying written examination in their eighth or ninth semester between 2012 and 2015 were included in the analysis. The OSCE consisted of four different stations, in which students had to perform and manage a patient encounter with simulated patients suffering from 1) post-traumatic stress disorder, 2) schizophrenia, 3) borderline personality disorder and 4) either suicidal tendency or dementia. Students were evaluated by trained lecturers using global checklists assessing specific professional domains, namely building a relationship with the patient, conversational skills, anamnesis, as well as psychopathological findings and decision-making. Results International medical students scored significantly poorer than their local peers (p

The new project "International Medical Students" within the German Medical Students' Association (bvmd) aims at connecting local support programs for international medical students as well as the representation of their interests within the bvmd. Within the frame of this project, the first symposium "International Medical Students – Support Programs in Practical Application" took place from the 12 to the 14 of May 2017 at the Hannover Medical School (MHH). Through partaking in different workshops, 31 participants discussed the framework conditions of local work (i.e. curricula, tutorials, social offers, cooperation between faculty members and student body, legal aspects), common problems (i.e. addressing the target group, funding of support programs) and possible solutions (i.e. targeted advertisement, application for public funds). This report constitutes a summary of the results of these discussions. The feedback from the participants on the need for such a regular exchange and the format of the symposium was positive. However, there were requests for further thematic specification. Based on this feedback the next symposium is planned for 2018.

Introduction: This project report describes the development, pilot phase, evaluation and implementation of a preparatory course week for incoming Erasmus medical students at the LernKlinik Leipzig, the Skills and Simulation Centre of the Medical Faculty, University of Leipzig.Project description: The aim of this project is to prepare Erasmus students for their year abroad using peer-assisted teaching as the method of choice. Major intended outcomes were support of language and clinical practical skill competency development, as well as enhancement of integration among international and German-speaking peer tutors. The methodological framework of Ross and Cameron was used in planning the Erasmus-Week. For planning the 2012 pilot project, a survey among Erasmus students of the academic year 2011/12 was performed. All succeeding cohorts were asked to participate in pre- and post-surveys which were analyzed quantitatively and qualitatively.Results: Between 2012 and 2017, n=173 European medical students spent their Erasmus year in Leipzig. Of these, n=148 (86%) participated in the Erasmus-Week. The country of origin of most Erasmus students was Rumania (20,3%). Among the most positively received aspects of the Erasmus-Week, the active use of German for medical purposes and the use of peer-teaching as the method of choice to learn and repeat basic medical examination skills were mentioned. Students emphasized their wish for being able to participate in further course offers.Conclusions: Offering a preparatory course week for incoming Erasmus students focusing on language and clinical practical skills training using peer-teaching as the method of choice may facilitate the integration of Erasmus students into their foreign medical curriculum. Further studies are underway to elucidate if these experiences influence later professional careers and choice of employment.

Introduction: In addition to linguistic and cultural difficulties, problems with social integration are frequently found among international medical students. In contrast, the social interaction among German medical students is considered as non-problematic. Personal networks are considered as positively influencing factors for the learning environment of students as well as their academic performance and personal wellbeing. However, while general findings on the development and maintenance of personal networks among medical students are available, there is insufficient data on students with different nationality or cultural backgrounds. Therefore, we compared the perception of international and German medical students on the development and maintenance of personal networks and examined possible influencing factors.Methodology: Following the principles of theoretical sampling in qualitative research, we recruited 17 international and 10 German preclinical medical students. The survey was conducted with semi-structured interviews, which focused on the participants’ experiences with the development and maintenance of personal networks in medical school. The coding and analysis of the interview transcripts was based on the principles of grounded theory.Results: We show that German participants rated the network development in medical school much more positively than the international participants. This difference was influenced by: a different perception of affiliation to the group of medical students, a low academic benefit from contacts with international students, the socio-cultural framework of medical school as well as the individual strategies of international medical students in dealing with integration. Conclusion: Our study extends existing insights into the development and maintenance of the social environment in medical school by understanding the perception of a subgroup of medical students. A better understanding of these social processes enables an effective evaluation of support and teaching for the subgroup of international medical students in Germany.

An increasing number of medical schools offer support services for international students. Their frequent focus on linguistic and academic support often reflects a rather deficit-oriented perception of international medical students. Therefore, this comment advocates a stronger focus on the integration into the local medical student communities. This happens both against the background of the expected academic benefits and the added value of intercultural learning at medical schools.

Background: It has been documented that international students face diverse challenges due to language and cultural barriers. International medical students suffer from personal distress, a lack of support and perform poorer than local fellow-students in clinical examinations. It has been documented that international medical students benefit from peer-led tutorials in their first year. We investigated the effectiveness of a tutorial offered for international medical students in their second year.Methods: A peer-guided examination preparation course with interactive elements for second year international medical students was designed, learning objectives were defined. Two evaluations were undertaken: In a quantitative assessment, students were asked to fill out five multiple-choice-questions at the beginning of every session of the tutorial (pre-test) as well as to participate in a post-test at the end of the semester in which all former multiple-choice-questions were re-used. Using a qualitative approach, participants were asked for their thoughts and comments in a semi-structured interview at the end of the semester.Results: International students (N=12) showed significantly better results in the post- than in the pre-test (t(11)=–8.48, p

Background: Over the past few decades, the number of international students has increased dramatically. These students have to adjust to unfamiliar social, cultural, and educational environments. The concept of acculturation has been applied in multiple studies on various health outcomes. This study investigated the relationship between acculturation and self-rated health (SRH) among international medical students.Methods: A cross-sectional study was conducted among international medical students at the University of Szeged, Hungary between April and October 2021. A total of 326 participants filled out questionnaires about sociodemographic characteristics, acculturation, and SRH. The modified Stephenson multigroup acculturation scale (SMAS) was used to assess the acculturation status; the scale defined acculturation as the degree of dominant society immersion (DSI, 12 items) and ethnic society immersion (ESI, 16 items). To measure SRH, participants were asked to rate their current general health and mental health. The data were analyzed by using descriptive statistics and the multiple logistic regression model.Results: 32.5% of the students reported having poor general and 49.7% poor mental health. We have found that acculturation was associated with SRH in multivariable logistic regression models controlling for sociodemographic characteristic. Bidimensional acculturation, such as ESI and DSI significantly influenced SRH as the likelihood of poor general health decreased (OR = 0.50; 95% CI = 0.31-0.81, P = 0.005), when the ESI was higher, whereas the likelihood of poor mental health decreased (OR = 0.52; 95% CI = 0.35-0.79, P = 0.002) if students had a greater DSI.Conclusion: Both types of immersion can affect the students' SRH. If the student could integrate better into their own ethnic group, their general health was better, and if they could strongly integrate into the Hungarian society, their mental health was more favorable. Acculturation measures should be promoted by academics and public health professionals in order to better understand their role in the behaviors, health outcomes, and health care use of medical international students. These findings will help professionals shape culturally sensitive prevention and counselling strategies for international student populations. [ABSTRACT FROM AUTHOR]

Background: Particularly at the beginning of their studies, international medical students face a number of language-related, social and intercultural challenges. Thus, they perform poorer than their local counterparts in written and oral examinations as well as in Objective Structured Clinical Examinations (OSCEs) in the fields of internal medicine and surgery. It is still unknown how international students perform in an OSCE in the field of psychosocial medicine compared to their local fellow students. Methods: All students (N = 1033) taking the OSCE in the field of psychosocial medicine and an accompanying written examination in their eighth or ninth semester between 2012 and 2015 were included in the analysis. The OSCE consisted of four different stations, in which students had to perform and manage a patient encounter with simulated patients suffering from 1) post-traumatic stress disorder, 2) schizophrenia, 3) borderline personality disorder and 4) either suicidal tendency or dementia. Students were evaluated by trained lecturers using global checklists assessing specific professional domains, namely building a relationship with the patient, conversational skills, anamnesis, as well as psychopathological findings and decision-making. Results: International medical students scored significantly poorer than their local peers (p < .001; η² = .042). Within the specific professional domains assessed, they showed poorer scores, with differences in conversational skills showing the highest effect (p < .001; η² = .053). No differences emerged within the multiple-choice examination (p = .127). Conclusion: International students showed poorer results in clinical-practical exams in the field of psychosocial medicine, with conversational skills yielding the poorest scores. However, regarding factual and practical knowledge examined via a multiple-choice test, no differences emerged between international and local students. These findings have decisive implications for relationship building in the doctor-patient relationship [ABSTRACT FROM AUTHOR]

A biochemistry course is a fundamental but important subject in medical education in China. In recent years, the number of international medical students has increased. Curriculum reform in biochemistry teaching is needed because of the knowledge limitations of students, a close linkage of biochemical content with clinics, the shortcomings of lecture-centered teaching, and the requirements for early clinical practice training and competence. In this study, we analyzed a novel curriculum reform, 'Hybrid-PBL,' which combined problem-based learning (PBL) with biochemistry lectures and was implemented for biochemical teaching at Dalian Medical University (DMU) in China. The change in curriculum affected 189 international medical students. This study selected two PBL cases concerning the basic biochemical issues of carbohydrate metabolism and liver biochemistry for the analysis, and ten examples of learning issues for each case were reported by the international students. A questionnaire was utilized to evaluate students' perceptions of the Hybrid-PBL, and examination scores were analyzed to assess the curriculum reform in biochemistry teaching. A statistical analysis revealed that the Hybrid-PBL curriculum was well accepted by the international students as an effective supplement to lecture-centered teaching programs. The students obtained more abilities, higher examination scores, and an improved understanding of biomedical information from the Hybrid-PBL program than from conventional teaching methods. Our study was an innovative trial that applied a PBL curriculum to the specific discipline of biochemistry and may provide a potential and promising new teaching method that can be widely utilized. © 2017 by The International Union of Biochemistry and Molecular Biology, 45(4):336-342, 2017. [ABSTRACT FROM AUTHOR]

Introduction: Much of regional Australia continues to face challenges in recruitment and retention of medical practitioners, despite the apparently successful rural medical education initiatives funded by the Commonwealth Government. International feepaying (IFP) medical students are a significant component of Australian medical education, contributing additional income and more diverse learning environments for universities. Their contribution to the Australian medical workforce is harder to determine. After obtaining registration, IFP graduates may apply to remain in Australia as skilled migrants. Since 1999 there has been a 325% increase in the number of international medical students in Australia, with approximately 73% of IFP graduates remaining in Australia for at least some postgraduate training. Recognising the potential contribution of IFP students to the Tasmanian medical workforce, the authors sought better understanding of the career intentions and work locations of IFP graduates from the medical program in Tasmania, Australia, through two studies. Firstly, a quantitative study was conducted of the locations of all IFP graduates from the Tasmanian medical program, and then a qualitative study exploring graduating students' intentions and factors that contribute to their decisions about work location choices. Methods: This was a cohort study of IFP students who graduated from the University of Tasmania School of Medicine over the period 2000--2015. Work locations for 2016 were mapped to a Modified Monash rurality classification. Semi-structured interviews were held with 15 final year IFP medical students, exploring career intentions and location preferences. Results: There were 261 IFP graduates, 54.4% male. The most common country of origin was Malaysia (55.2%). In 2016, 189 (72.4 %) were working in Australia, 42 (16.1%) in Tasmania and 126 (66.7%) in areas categorised as Modified Monash 1. Recent graduates in postgraduate year 1/2 (71.3%) were more likely to be working in Tasmania but most left for specialty training. All 15 interview participants intended to remain in Australia for at least their intern year, although at enrolment only six had planned to remain. Factors influencing workplace location decisions were (1) 'professional': greater appeal of Australian medical workplaces, intention to pursue a speciality, and to complete this at an Australian metropolitan hospital; (2) 'social': proximity to family/partner or opportunity to meet a prospective partner, family obligations, positive rural experiences; and (3) 'location': direct travel access to family. Conclusions: IFP graduates from the Tasmanian medical program make an important contribution to the Australian mainland metropolitan medical workforce, but play only a small role in workforce development for both Tasmania and the broader Australian rural and remote context. Most IFPs do not choose to work rurally. Rurally focused medical programs need to consider how they place IFP students to meet both the learning and career needs of IFP students and the goal of the rural medical programs in developing a rural workforce. [ABSTRACT FROM AUTHOR]

Little is known about challenges and transition that medical students from different cultural backgrounds face with regard to complementary medicine (CM). This paper explores such students’ experiences and perspectives of socio-cultural and academic difference with regard to CM and experiences of intercultural relations. Using a constructivist grounded theory approach, 30 in-depth qualitative interviews were conducted with medical students across 10 Australian medical schools. The data were rigorously analysed through a systematic process of coding, categorisation and theoretical development. The findings indicate that students adapted considerably to the host culture. Students with Western backgrounds integrated better socio-culturally and academically compared to students with non-Western backgrounds. Although nationality represented cultural identity, students’ construction of cultural difference was informed by their perception of diverging value systems within the specific educational environment. These values were, in turn, reflected in students’ reported behaviours, attitudes, and levels of engagement in socio-cultural and academic aspects of university life. Adaptation employed by students was evidenced largely due to their conflicting sense of responsibility towards familial culture regarding CM and focus on fitting in. While students’ tendency to gravitate towards cultural peers was evident, most students adapted to their host environment regarding CM to fit into normal intercultural encounters during medical school. In conclusion, students’ intercultural contact with regard to CM was both complex and problematic. At a time of significant diversification within the higher education student body, this paper highlights the role medical education institutions can play in fostering intercultural and academic guidance and support. [ABSTRACT FROM AUTHOR]

Significant numbers of international undergraduate medical students in English-medium universities find aspects of clinical communication skills challenging. The aim of this study was therefore to investigate the effectiveness of a course in English for medical purposes (EMP) to assist students to develop knowledge and skill in this area. The study also compared the perspectives of a language educator and a medical educator as assessors of role-play performance. Data were gathered from pre- and post-course tests of written knowledge and simulated medical interviews. Results from both test types indicated that students had made progress in their knowledge and ability to ask questions and respond appropriately. However, they had yet to develop skill in the more sophisticated aspects of interviewing such as maintaining rapport throughout the interview, using appropriate screening questions, and following a clear interview structure. Overall, the assessment judgements from the language and medical perspectives were in agreement; however, differences in the knowledge bases and interests of the two assessors led to some divergence. The study provides evidence of gains in knowledge and proficiency following a short ESP course of instruction, and of the value of the ESP teacher perspective in direct role-play assessments. Further studies are needed to corroborate these findings. [ABSTRACT FROM AUTHOR]

Introduction: Medical students with a non-German background face several challenges during their studies. Besides support given by foreign student offices further specific projects for international students have been developed and are offered by medical faculties. However, so far, neither a systematic survey of the faculties’ perceived problems nor of the offered support exists.Method: All study deaneries of medical faculties in Germany were contacted between April and October 2013 and asked for their participation in a telephone interview. Interview partners were asked about 1.) The percentage of non-German students at the medical faculty; 2.) The perceived difficulties and problems of foreign students; 3.) The offers for non-German students; and 4.) The specification of further possibilities of support. Given information was noted, frequencies counted and results interpreted via frequency analysis.Results: Only 39% of the medical faculties could give detailed information about the percentage of non-German students. They reported an average share of 3.9% of students with an EU migration background and 4.9% with a non-EU background. Most frequently cited offers are student conducted tutorials, language courses and tandem-programs. The most frequently reported problem by far is the perceived lack of language skills of foreign students at the beginning of their studies. Suggested solutions are mainly the development of tutorials and the improvement of German medical terminology.Discussion: Offers of support provided by medical faculties for foreign students vary greatly in type and extent. Support offered is seen to be insufficient in coping with the needs of the international students in many cases. Hence, a better coverage of international students as well as further research efforts to the specific needs and the effectiveness of applied interventions seem to be essential.

[english] Introduction: Medical students with a migration background face several specific problems during their studies. International surveys show first indications that this group of students performs worse in written, oral or practical exams. However, so far, nothing is known about the performance of international students in written pre-clinical tests as well as in pre-clinical State Examinations for German-speaking countries.Method: A descriptive, retrospective analysis of the exam performances of medical students in the pre-clinical part of their studies was conducted at the Faculty of Medicine of Heidelberg in for the year 2012. Performance in written tests of the final exams in the second (N=276), third (N=292) and fourth semester (N=285) were compared between German students, students from EU countries and students from non-EU countries. Same comparison was drawn for the performance in the oral exam of the First State Examination in the period from 2009 - 2012 (N=1137).Results: German students performed significantly better than students with a non-EU migration background both in all written exams and in the oral State Examination (all p