Skip to Content
You are currently on the new version of our website. Access the old version .

International Medical Education, Volume 5, Issue 3

2026 September - 42 articles

Cover Story: Physician and resident burnout are well documented, yet the work-system factors driving it remain poorly understood. Guided by the National Academy of Medicine's systems framework, we used a sequential mixed-methods design—surveys, focus groups, contextual inquiry, and resident-led prioritization, with 119 internal medicine and med-peds residents. We identified 167 workplace breakdowns, with interruptions, excessive workload, time pressure, and work–life integration as high-severity factors. An impact-effort analysis of the 11 resulting priorities identified reducing in-basket workload as the clearest high-impact, low-effort target, with clinic workflows as a related, near-quick-win priority. This study offers a practical framework for engaging residents as partners in developing systems-level solutions to burnout. View this paper
  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list .
  • You may sign up for email alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Reader to open them.

Articles (42)

  • Article
  • Open Access
250 Views
14 Pages

20 September 2026

Scholarly activity and teaching are recognized components of radiology training, but their distribution across residency years is poorly characterized in Italy. We conducted an anonymous cross-sectional online survey of Italian radiology residents be...

  • Article
  • Open Access
319 Views
19 Pages

18 September 2026

Background: Health Informatics (HI) education aims to prepare graduates to contribute to digitally enabled healthcare. However, HI programme evaluations have largely focused on employment and career outcomes, providing limited insight into graduates&...

  • Article
  • Open Access
395 Views
14 Pages

Perception of Artificial Intelligence in Medical Education and Clinical Practice Among Medical Students

  • Souhir Chelly,
  • Saoussen Layouni,
  • Ines Loubiri,
  • Mehdi Mansia and
  • Hela Ghali

18 September 2026

Introduction: Artificial intelligence (AI) is transforming healthcare systems and medical education worldwide. However, data on medical students’ usage patterns, perceptions, and motivation toward AI remain limited in Tunisia. This study aimed...

  • Article
  • Open Access
382 Views
19 Pages

Scientific Competence in Undergraduate Medical Education: Professional Orientations of Physiology Educators

  • Alexander Peter Schwoerer,
  • Christian Albert,
  • Katrin Werwick,
  • Christoffer Krug and ,
  • Holger Buggenhagen,
  • Rüdiger Christian Braun-Dullaeus and
  • Philipp Stieger
  • + 2 authors+ 0 author

17 September 2026

Introduction: Scientific Competence (SC) is a central objective in medical education, but its conceptualization remains insufficiently differentiated, particularly regarding the relationship between evidence use and participation in scientific knowle...

  • Article
  • Open Access
443 Views
18 Pages

Simulation-Based VR Bronchoscopy Training: ADDIE-Driven Development and User Experience Study

  • Ratchagun Koonchayanggoon,
  • Chanut Kunchayangkoon and
  • Teerawat Kamnardsiri

15 September 2026

Background: Fiberoptic bronchoscopy training is constrained by high equipment costs and limited patient availability. This pilot feasibility and usability study describes the development and preliminary evaluation of a Simulation-Based VR Bronchoscop...

  • Review
  • Open Access
2 Citations
827 Views
43 Pages

14 September 2026

Background: Conversational artificial intelligence (AI), including chatbots, large language models, virtual agents, and embodied conversational systems, is increasingly being introduced into healthcare, rehabilitation, education, and professional pra...

(This article belongs to the Special Issue Celebrating IME's First Impact Factor: Global Initiatives, Innovations, and New Directions in Medical Education)
  • Article
  • Open Access
631 Views
11 Pages

Background: General Practice is facing workforce shortages across Europe. In Italy, the estimated shortage was 5575 General Practitioners in 2024, with high retirement rates and persistent difficulties in attracting new physicians to the profession....

  • Article
  • Open Access
324 Views
13 Pages

Impact of MOOC-Based CME on General Practitioners’ Knowledge of Early-Life Nutrition

  • Yoga Devaera,
  • Yulia Ariani,
  • Titis Prawitasari,
  • Diantha Soemantri and ,
  • Desak Gede Budi Krisnamurti and
  • Rizki Marfira
  • + 1 author+ 0 author

General practitioners (GPs) are at the forefront of stunting interventions, but only a few studies have examined their understanding of growth monitoring. Therefore, this study aims to assess the effectiveness of massive open online course (MOOC)-bas...

  • Article
  • Open Access
584 Views
12 Pages

Academic Performance, Admission Pathways, and Educational Disruption as Predictors of Professional Licensure Success: Evidence from Physical Therapy Education

  • Onchuma Mueangson,
  • Parinya Vongvaivanichakul,
  • Nantanatch Chaiyamaneerat,
  • Haswanee Purong and ,
  • Amissaanis Doloh and
  • Nusree Hayisa-I
  • + 1 author+ 0 author

This study investigated academic and environmental predictors of national licensing examination success among physical therapy graduates in Thailand, examining overall academic achievement, domain-specific competencies (Code 01: Law/Ethics/Administra...

  • Article
  • Open Access
1 Citations
892 Views
17 Pages

Generative artificial intelligence has been rapidly adopted by university students, yet there is limited evidence describing how and why medical students use it, particularly in regional settings. This cross-sectional study examined the use of genera...

  • Article
  • Open Access
583 Views
18 Pages

Understanding Medical Students’ Perceptions of Evolutionary Medicine and Evolution: A Cross-Sectional Analysis of Acceptance, Knowledge, and Barriers in Egypt

  • Mohamed Ibrahim Mohamed,
  • Nada Ashraf Al-Shafey,
  • Omar El-Kholy,
  • Youssef ElSourady and ,
  • Azza Baraka and
  • Marwa Schumann
  • + 1 author+ 0 author

Evolutionary medicine (EM) applies evolutionary principles to explain disease mechanisms and improve clinical practice, yet it remains underrepresented in medical education, particularly in non-Western settings. This study investigated Egyptian medic...

  • Article
  • Open Access
264 Views
14 Pages

Background/Objectives: Mentoring may support professional development in medicine, but experiences and perceived programme availability may differ across career stages. We aimed to describe previous mentoring participation, perceived availability, sa...

  • Article
  • Open Access
574 Views
16 Pages

Empathy Levels Among Medical Students at a Romanian University: A Cross-Sectional Study Using the Jefferson Scale of Empathy

  • Carla-Antonia Peterdeak,
  • Tiberiu-Andrei Constantin,
  • Anișoara Pop,
  • Adela Nechifor-Boilă and ,
  • Irina Bianca Kosovski,
  • Maria Baldea,
  • Martin Manole,
  • Bogdan Pastor,
  • Alexandru-Constantin Ioniță and
  • Iuliu Gabriel Cocuz
  • + 10 authors+ 5 authors

Background/Objectives: Empathy is a fundamental component of patient-centered care and plays a critical role in the physician–patient relationship. This study aimed to evaluate empathy levels among undergraduate medical students at a medical un...

  • Article
  • Open Access
538 Views
16 Pages

Large language model-enabled virtual patients may expand access to clinical skills practice by supporting explicitly defined practice tasks. This program evaluation examined medical students’ awareness, use, and perceptions of the McMaster Virt...

  • Article
  • Open Access
1 Citations
701 Views
17 Pages

Background and Objectives: Digital tools are now embedded in anesthesia and intensive care, but access to them, and in particular to digital educational resources, is distributed unevenly across professional groups. This study describes how nurses, r...

  • Article
  • Open Access
328 Views
15 Pages

An Exploratory Pilot Evaluation of a Blended Virtual Reality and Mannequin-Based Educational Program for Teaching the Initial Management of Postpartum Hemorrhage to Midwifery Students

  • Yumika Tachikawa,
  • Kenya Kamimura,
  • Tomoko Sumiyoshi,
  • Mayumi Nishikata and ,
  • Mayumi Ishida,
  • Chiho Morita,
  • Sayaka Kojima and
  • Mieko Uchiyama
  • + 3 authors+ 0 author

Background/Objectives: Opportunities for pre-service midwifery students to manage postpartum hemorrhage (PPH), a high-risk, infrequent emergency, are limited. Virtual reality (VR) can provide contextual decision-making practice, whereas mannequin tra...

  • Article
  • Open Access
683 Views
12 Pages

Modeling Reliability and Validity Across OSCE Station Numbers in Final MBBS Exam

  • Alok Kumar,
  • Kandamaran Krishnamurthy,
  • Shastri Motilal,
  • Michael H Campbell and ,
  • Joanne Paul-Charles,
  • Maritza Fernandes,
  • Kenneth Connell,
  • Euclid Morris,
  • Maisha Emmanuel and
  • Md Anwarul Azim Majumder
  • + 6 authors+ 1 author

Background: The Objective Structured Clinical Examination (OSCE) has been the backbone of assessment in medical education, and the number of stations required to achieve sufficient reliability in high-stakes examinations is an important consideration...

  • Article
  • Open Access
490 Views
12 Pages

Preliminary Assessment of an Integrated Cadaver-Based and Patient-Specific Simulation Pathway for Total Hip Arthroplasty Training

  • Marina Carbone,
  • Rosanna Maria Viglialoro,
  • Edoardo Ipponi,
  • Branimir Scognamiglio and ,
  • Lorenzo Andreani,
  • Nicola Piolanti,
  • Enrico Bonicoli and
  • Paolo Domenico Parchi
  • + 3 authors+ 0 author

Introduction: The demand for structured training in orthopaedic surgery, particularly in total hip arthroplasty (THA), is increasing. Cadaver labs provide valuable experience for surgical access and anatomical exposure; however, the availability of s...

(This article belongs to the Special Issue Assessment and Performance in Surgical Training)
  • Article
  • Open Access
833 Views
15 Pages

Learning-Style Preferences Across Clinical and Surgical Specialties in a Brazilian Medical Residency Program

  • Gisele Massarani Alexandre de Carvalho,
  • Gilmar Cardozo de Jesus,
  • Ewerton Alexandre Galdeano,
  • Marcel Fernando Inácio Cardozo and ,
  • Maria Helena de Sousa,
  • Rogerio Leone Buchaim,
  • João Paulo Mardegan Issa,
  • Vinícius Rodrigues Silva,
  • Vinicius Barroso Hirota and
  • Marcelo Rodrigues da Cunha
  • + 6 authors+ 1 author

Medical residency is a demanding stage of specialty training characterized by extensive clinical exposure, heavy workloads, and ongoing knowledge acquisition. Characterizing residents’ learning-style preferences may help residency programs refi...

  • Article
  • Open Access
523 Views
16 Pages

Changes in Medical Students’ Perceptions of Family Medicine Following a Clinical Rotation: A Rural–Urban Comparison in Romania

  • Gheorghe Gindrovel Dumitra,
  • Linda-Nicoleta Bărbulescu,
  • Roxana Surugiu,
  • Constantin Kamal and ,
  • Elena Codruța Gheorghe,
  • Mirela Radu,
  • Carmen-Adriana Dogaru,
  • Lucian-Florentin Bărbulescu and
  • Virginia-Maria Rădulescu
  • + 4 authors+ 0 author

Background/Objectives: Romania faces a shortage of family physicians, particularly in rural areas. Undergraduate Family Medicine rotations may influence students’ perceptions before residency selection, but the contribution of rural versus urba...

  • Brief Report
  • Open Access
376 Views
9 Pages

Medical schools are increasingly reducing required contact hours and incorporating self-directed learning strategies, yet the impact of these curricular changes on academic performance remains uncertain. This retrospective cohort study compared perfo...

(This article belongs to the Special Issue Authentic and Transformative Learning in Medical Education for a Changing World)
  • Article
  • Open Access
410 Views
14 Pages

Preparing Leaders in Primary Care Transformation: A Mental Health Curriculum

  • Taylor Fenderbosch,
  • Daniel Hargraves,
  • Harini Pallerla,
  • Megan Rich and
  • Shanna D. Stryker

The demand for mental health services is rising, and given the continued shortage of mental health specialists, primary care remains a critical setting for mental health treatment. Training emerging leaders in primary care to integrate interprofessio...

  • Article
  • Open Access
537 Views
13 Pages

Background: Research on emotional intelligence and its associations with authentic leadership, general self-efficacy, and perceived stress among allied health students, particularly radiography students, remains scarce. This study described the level...

  • Article
  • Open Access
866 Views
20 Pages

Background: Nursing students spend a substantial proportion of their education in clinical practice; hence, the quality of these environments plays a critical role in shaping students’ learning outcomes. While research finds that nursing studen...

  • Review
  • Open Access
1,336 Views
21 Pages

Transforming Mongolian Nursing Education: A Cultural–Historical Activity Theory Analysis of Historical Activity Systems

  • Buyandelger Batmunkh,
  • Munguntuul Enkhbat,
  • Tuguldur Gankhuyag,
  • Bat-Ulzii Enkh-Amgalan and ,
  • Enkhbold Dogmidsangi and
  • Oyungoo Badamdorj
  • + 1 author+ 0 author

Background: Nursing education has evolved in response to changing social, cultural, political, and healthcare contexts. Although Cultural–Historical Activity Theory (CHAT) has increasingly been applied in medical education research, its applica...

  • Review
  • Open Access
677 Views
18 Pages

Low Back Pain as a Nursing Education Priority

  • Juan A. Sanchis-Gimeno,
  • Juan Jose Valenzuela-Fuenzalida,
  • Andreea-Bianca Zuld,
  • Mathias Orellana-Donoso and
  • Guinevere Granite

Low back pain (LBP) is the leading cause of years lived with disability globally, and a major rehabilitation priority, yet nursing education often does not translate burden evidence into first-contact actions across care settings. This article aimed...

  • Review
  • Open Access
1 Citations
893 Views
11 Pages

Feedback and Feedback Culture in Medical Education: Evolution, Evidence, and Emerging Horizons

  • Kelly Peterec,
  • Sundes Kazmir,
  • David Chartash and
  • Uma Padhye Phatak

Feedback is a key component of medical education and is essential for progression throughout medical training. While extensive literature describes best practices for delivering feedback, less is known about the critical role of feedback culture and...

(This article belongs to the Special Issue Health Professions Education Advancements and Innovations—International Perspectives)
  • Review
  • Open Access
506 Views
17 Pages

Background: The global shortage of qualified nursing faculty continues to challenge schools of nursing by limiting program capacity and contributing to difficulties in recruiting and retaining new educators. Although mentoring has been widely recogni...

  • Article
  • Open Access
607 Views
10 Pages

Objectives: The aim of this study was to investigate radiography students’ perceptions of the usefulness of hands-on 3D-printed models for supporting their understanding of key image quality concepts in magnetic resonance imaging (MRI). Student...

  • Article
  • Open Access
532 Views
10 Pages

Effective Use of Curriculum Design Methodology and Simulation to Improve Applicant Review in a Doctor of Medicine Admissions Program

  • Simranjeet S. Sran,
  • Carson Flamm,
  • Kevin Nies,
  • Latricia Lombardi and ,
  • Pavan Zaveri and
  • Ioannis Koutroulis
  • + 1 author+ 0 author

Recruitment and admission of highly qualified applicants to Doctor of Medicine (MD) programs are vital components of many academic institutions. We aimed to develop a structured curriculum to facilitate consistent and mission-aligned review of applic...

  • Systematic Review
  • Open Access
1,025 Views
24 Pages

Drawing-Centred and Associated Visual-Representation Strategies in Anatomy and Histology Education: A Systematic Evidence Map

  • Alejandro Bruna-Mejias,
  • Loreto Paez-Alliendes,
  • Valentina Perez-Lira,
  • Diego Santander-Chavez and ,
  • Mathis Miranda-Schoen,
  • Rodrigo Vega-Salces,
  • Macarena Rodriguez-Luengo,
  • Diego Luengo,
  • Juan Jose Valenzuela-Fuenzalida and
  • Juan Sanchis-Gimeno
  • + 12 authors+ 7 authors

Drawing-centred and drawing-associated visual-representation strategies are used in anatomy and histology education, but the literature spans learner-generated drawing, guided drawing, screencasts, multisensory approaches, and model-based visual abst...

  • Article
  • Open Access
1,686 Views
19 Pages

Assessing Generative AI Adoption, Tool Preferences, and Cognitive Reliance Among Medical Students: A Cross-Sectional Study

  • Daian-Ionel Popa,
  • Codrina Mihaela Levai,
  • Florina Buleu,
  • Sonia Burtic and ,
  • Marius Militaru,
  • Iulius Juganaru and
  • Melania Lavinia Bratu
  • + 2 authors+ 0 author

Background and Objectives: Generative artificial intelligence (AI) chatbots have entered medical education faster than guidance for their responsible use. Although a rapidly expanding 2024–2026 literature has examined generative AI adoption, at...

  • Article
  • Open Access
765 Views
18 Pages

Examining Clinical Educators’ Readiness for Artificial Intelligence in Medical Education: An Exploratory Qualitative Study

  • Tim Murphy,
  • Ginger Vaughn,
  • Rob E. Carpenter,
  • Benjamin McKinney and
  • Rochell McWhorter

Artificial intelligence (AI), treated in this study as an umbrella term for AI-enabled clinical and educational technologies rather than as a single platform, is reshaping medical education, including how diagnostic skills, treatment planning, and pa...

  • Article
  • Open Access
670 Views
8 Pages

Are We Talking About the Same Thing? US Medical Student Definitions of Value-Based Care

  • Kathleen L. Mulligan,
  • Elina Kurkurina,
  • Alexander M. Mass,
  • Brendan L. Rooney and ,
  • Shaila Gopal,
  • Jessica Riley and
  • Rahul Anand
  • + 2 authors+ 0 author

Wasteful care is a prevalent, costly problem in the United States. Medical schools are addressing this by teaching about value-based care. However, students still struggle with the application of this concept. We hypothesized that this struggle may b...

(This article belongs to the Special Issue Health Professions Education Advancements and Innovations—International Perspectives)
  • Article
  • Open Access
713 Views
16 Pages

A Systems-Based Mixed-Methods Approach to Identifying Work-System Factors Contributing to Burnout Among Internal Medicine and Internal Medicine Pediatrics Residents

  • Karthik Adapa,
  • Lisa Vizer,
  • Viola Goodacre,
  • Elizabeth Kwong and ,
  • Jennifer Bissram,
  • Emily Kertcher,
  • Nadia Charguia and
  • Lukasz Mazur
  • + 3 authors+ 0 author

Burnout among internal medicine (IM) and internal medicine–pediatrics (Med–Peds) residents is at epidemic levels, yet few studies use systems-based methods to identify the specific work-system factors that drive it. Guided by the National...

  • Article
  • Open Access
970 Views
19 Pages

Since the 1960s, Bioethics, Law and Deontology have become increasingly integrated into healthcare education in response to the growing ethical, legal and professional complexity of clinical practice. This national cross-sectional comparative study a...

  • Brief Report
  • Open Access
653 Views
10 Pages

Integrating Collaborative Learning, Artistic Mediation, and AI to Enhance Midwifery Clinical Reasoning Based on the NANDA–NIC–NOC Framework

  • Ilham Refki,
  • Mohamed Benfatah,
  • Abdelghafour Marfak,
  • Elmadani Saad and ,
  • Abderraouf Hilali and
  • Ibtissam Youlyouz-Marfak
  • + 1 author+ 0 author

Background: Clinical reasoning is a core midwifery competency, yet adopting standardized NANDA–NIC–NOC frameworks remains challenging due to perceived abstraction. Objective: To explore the effectiveness of a pedagogical intervention comb...

  • Article
  • Open Access
814 Views
14 Pages

From Classroom to Community: The Impact of Early Clinical Exposure Through the Health Outreach Project

  • Catherine A. MacNary,
  • Dimitrios E. Bakatsias,
  • Gianna M. Ungaro,
  • Krisha S. Shah and ,
  • Ada Liu,
  • Tresor-Ange G. Oertel and
  • Homaira M. Azim
  • + 2 authors+ 0 author

Early clinical exposure (ECE) has been associated with increased confidence, professionalism, and career exploration in undergraduate medical education. Student-run free clinics (SRFCs), such as the Health Outreach Project (HOP) at Drexel University...

(This article belongs to the Special Issue Authentic and Transformative Learning in Medical Education for a Changing World)
  • Review
  • Open Access
792 Views
10 Pages

Standardized Letters of Recommendation (SLORs) were introduced in the United States and Canada to address limitations of narrative letters in residency selection by improving objectivity, comparability, and reliability. This review evaluates their st...

  • Article
  • Open Access
588 Views
12 Pages

Introduction: Traditional instruments for measuring lifelong learning of health professionals fail to capture digital-age learning, creating a critical measurement disconnect. To address this gap, we developed a 16-item Self-Pursuits, Aspirations, an...

  • Article
  • Open Access
631 Views
11 Pages

Inner Triangle Outer Diamond (ITOD) Framework, presented and published in 2025, informed and guided the introduction of Artificial Intelligence (AI) ethics education into a Medical Humanities course for medical students. Central to the ITOD Framework...

XFacebookLinkedIn
Int. Med. Educ. - ISSN 2813-141X