Based on the cell theory of life that was first formulated by Theodor Schwann in the first half of the 19th century (Schwann, 1838), histology encompasses a structural description of cells, tissues, and organs and links these structural attributes to their biological function. This is especially important for aspiring health care providers as many human disorders are cellular in nature. A detailed understanding of cellular differentiation, structure, and function is a key foundational element of the biomedical basic sciences and for disease diagnosis and treatment.Traditionally, histology or microanatomy has been taught in two distinct steps or components: (1) a didactic transfer of basic knowledge, either in a lecture or a self-learning format and (2) a skill-building laboratory component that helps students acquire the ability to scientifically
Background Microaggressions are one form of gender bias contributing to gender disparities and mistreatment, but their prevalence during virtual residency interviews has not been explored. Objective To explore applicants' recall of experiencing gender microaggressions during virtual residency interviews and whether these experiences affected programs' rank position on applicants' rank lists. Methods Fourth-year medical students at a single institution who participated in the 2021 Match were surveyed after submitting their rank lists. Students were surveyed categorically on (1) their recall of the frequency they experienced 17 gender microaggressions during interviews, and (2) how these affected reported ranking of programs on their rank lists. Results Sixty-one percent (103 of 170) of eligible students responded to the survey. Seventy-two percent (36 of 50) of women experienced at least one microaggression compared to 30% (9 of 30) of men. The largest difference was in the experience of environmental microaggressions, which are demeaning cues communicated individually or institutionally, delivered visually, or that refer to climate (P<.001). Women experienced more microaggressions than men in nonsurgical (P=.003) and surgical specialties excluding obstetrics and gynecology (P=.009). When microaggressions were experienced at 1 to 2 programs, 36% of applicants (26 of 73) reported significantly lowering program ranking, compared to 5% (1 of 19) when microaggressions occurred at more than 5 programs (P=.038). Conclusions Women applicants experience more microaggressions than men do during nonsurgical and male-dominated surgical specialty residency interviews. Respondents who recalled experiencing microaggressions at fewer programs were more likely to report significantly lowering the rank of those programs compared to those who experienced them at more programs.
Background Interns must recognize urgent clinical situations and know when to seek assistance. However, assessing this skill is challenging. Objective We explored whether graduating medical students could determine urgency of medical cross-cover scenarios and what factors were associated with this ability. Methods Sixty senior medical students enrolled in an internal medicine residency preparation course, and 28 experts were invited to take an assessment using 4 clinical vignette handoffs, each with 5 to 6 cross-cover scenarios. Respondents were asked whether they would evaluate the patient at bedside and notify their supervising resident. They were asked to rate their comfort managing the scenario, rate the urgency (1=low, 2=moderate, 3=high), and take a medical knowledge quiz. Student performance was categorized based on stratification of clinical urgency—those who underestimated (fourth quartile), accurately estimated (second and third quartile), and overestimated (first quartile) urgency. We examined differences between groups in medical knowledge, action, and confidence using analysis of variance and post-hoc Tukey Honestly Significant Difference test. Results Fifty-eight students (96.7%) and 22 experts (78.6%) participated. Clear differentiation emerged between students' ability to estimate urgency on the 3-point urgency scale (lowest quartile: 2.15±0.11; mid-quartiles: 2.38±0.07; upper quartile: 2.61±0.10, respectively). Students who underestimated urgency were less likely to notify their supervising resident (P=.001) and less likely to evaluate a patient at bedside (P=.01). There was no difference in quiz score or comfort level. Conclusions Incoming interns vary in their abilities to recognize urgent scenarios, independent of medical knowledge and confidence.
In an ever‐changing medical curricular environment, time dedicated for anatomical education has become more and more curtailed. This happened at the University of Michigan Medical School when the period of preclinical medical education was reduced from two years to one year starting with the academic year 2016–17. Histology instruction remained integrated in organ system courses, but all faculty‐guided laboratory sessions were completely removed, reducing histology teaching to a lecture‐only format and requiring students to study virtual histological slides from a course website on their own time. In accordance with the shortened instructional time, the number of histology examination questions was reduced more than twofold. We investigated changes in students’ histology examination results, surveyed their motivation to learn histology, and assessed their use of histology educational material and opportunities before and after these curricular changes were implemented. Students’ motivation to learn histology and their evaluation of histology lectures slightly increased in the new curriculum. However, they devoted less study time to learning histology and used the course website and supplementary learning material less than students in the old curriculum. Students’ cumulative histology examination scores over the entire M1 year were significantly lower in the new curriculum and the number of students with overall scores under 75%, which is considered a failing performance, increased more than fifteenfold. Aside from the shorter instruction time, the decision to not provide histology performance subscores to students may also have contributed to this decrease in academic performance. In addition, we suspect that a decentralization of curricular organization, leaving decisions to individual organ system course directors about the integration and time dedicated for longitudinal histology instruction, may have played a role in decreasing consistent histology education in the new curriculum. This study received a non‐regulated status from the University of Michigan IRB (HUM00162947).
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