Rheumatoid arthritis is an ideal testing ground for this question. The disease is a chronic autoimmune condition in which the immune system attacks the synovial lining of joints, producing symmetric, typically small-joint inflammation that, if unrecognized, progresses to irreversible cartilage and bone destruction. Diagnosing it early is one of the most consequential decisions a clinician can make, because modern immunomodulatory therapies can halt joint damage only if they are started before structural erosion takes hold. Yet the diagnostic pathway is genuinely demanding for a trainee. It requires a structured history that probes morning stiffness duration, joint distribution, and functional impact; a careful physical examination distinguishing soft-tissue synovial swelling from bony hypertrophy; and a rational interpretation of complementary investigations, including inflammatory markers, rheumatoid factor, and anti-citrullinated protein antibodies, the highly specific autoantibodies that feature prominently in modern classification criteria. A student who knows these facts cold may still falter when asked to orchestrate them into a coherent diagnostic strategy for a real or simulated patient.

The Rabat team, led by Fatine Kronbi and colleagues in the Department of Rheumatology B at Ayachi Hospital within the Ibn Sina University Hospital Center, designed their trial to isolate the effect of training format with unusual rigor. Sixty sixth-year medical students were enrolled, all of whom received identical preparatory teaching material on the diagnostic strategy for rheumatoid arthritis one week before the trial began. This shared baseline was a critical design choice: any difference in outcome between the groups could then be attributed to the training method rather than to unequal exposure to content. On the first day, every participant completed a pre-training multiple-choice questionnaire assessing their theoretical grasp of the RA diagnostic pathway, and only then were they randomized into two groups of thirty, ensuring that baseline knowledge was measured before the intervention could influence anyone.

The intervention group then received formative OSCE-based training specifically constructed around the rheumatoid arthritis diagnostic strategy. The OSCE format breaks clinical competence into discrete stations, each with a defined task, a standardized patient or scenario, and an observer checklist. In this trial, the supplementary materials published with the article describe three stations covering history-taking, physical examination, and complementary investigations, each accompanied by candidate instructions, standardized-patient briefings, trainer guidance, and formative observation checklists. The word formative is doing heavy lifting here: rather than grading students, the stations were designed as rehearsal spaces where learners could perform, receive structured feedback against explicit criteria, and correct their approach in real time. The control group, by contrast, received traditional training delivered through lectures and clinical case studies, the pedagogical mainstay of most medical faculties worldwide.

On the second day, all sixty students faced the same summative evaluation: a formal OSCE assessing their clinical performance on the rheumatoid arthritis diagnostic strategy, supplemented by a post-training multiple-choice questionnaire and a self-satisfaction survey. The results split in a way that is scientifically fascinating and pedagogically profound. The OSCE-trained group achieved a significantly higher score on the summative OSCE than the control group, with a 95 percent confidence interval for the difference spanning 1.87 to 3.92 points and a p-value below 0.01, a threshold that makes chance an unlikely explanation. Yet when the researchers compared post-training MCQ scores between the two groups, they found no significant difference at all, with a p-value of 0.23. Both groups had absorbed the theoretical knowledge to a comparable degree; only one group had converted that knowledge into demonstrable clinical performance.

This dissociation between knowledge and performance is arguably the most important finding in the study. Multiple-choice questionnaires measure what students can recall and recognize, a declarative form of competence that has historically dominated medical licensing and assessment. The OSCE measures something closer to what clinicians actually do: eliciting a history in a logical sequence, inspecting and palpating joints systematically, deciding which investigations to order and in what order, and integrating the results into a diagnostic judgment. The trial’s data suggest that lecture-based training and OSCE-based training can produce equivalent gains on the first kind of measure while diverging sharply on the second. In other words, the intervention did not teach the students more facts about rheumatoid arthritis; it taught them to deploy the facts they already had, under pressure, in the structured choreography of a clinical encounter.

The mechanism behind this effect is well theorized in the learning sciences, even if it has been difficult to demonstrate experimentally in real curricula. Deliberate practice, the concept popularized by psychologist Anders Ericsson, holds that expertise grows most efficiently when learners perform a task at the edge of their ability, receive immediate and specific feedback, and repeat the task with corrections incorporated. A formative OSCE station is almost a laboratory-perfect instantiation of this principle: the standardized patient presents a reproducible challenge, the observation checklist converts vague impressions into concrete behavioral targets, and the trainer’s guidance arrives within seconds of the performance. Lectures, however eloquent, place the learner in a passive receptive mode, and even well-taught clinical case discussions rarely require each individual student to execute the full diagnostic sequence end to end while being observed.

The study’s single-blind design deserves attention as a marker of methodological quality. Although students necessarily knew which training they had received, the evaluators assessing the summative OSCE were blinded to group assignment, which protects the primary outcome from the most dangerous form of bias in educational research, namely examiners unconsciously favoring students they know received the novel intervention. The trial was also prospectively registered on 15 May 2025 under number PACTR202505840416202, and the authors declare no competing interests and no specific funding, factors that collectively strengthen confidence in the reported effect. The research was conducted in accordance with the Declaration of Helsinki, with written informed consent obtained from all participants before inclusion.

For medical schools, particularly those in resource-constrained settings, the findings carry a practical message that is both encouraging and demanding. OSCE-based training does not require exotic technology; the Rabat stations relied on standardized patients, checklists, and trained faculty observers rather than high-fidelity simulators. What it does require is institutional commitment: faculty time to run stations, trained standardized patients, and a willingness to shift curricular hours from content delivery toward supervised performance and feedback. The authors argue that their results support broader implementation of skill-based educational approaches such as OSCEs in medical curricula to enhance clinical competencies, and the trial’s clean design gives that argument unusual weight. If a single day of formative OSCE training can measurably improve a student’s ability to execute a complex diagnostic strategy, the return on that institutional investment appears substantial.

The broader implications reach beyond rheumatology. The diagnostic strategy for rheumatoid arthritis was, in this trial, a vehicle for a general question about how clinical reasoning is best taught, and the answer generalizes to any domain where students must integrate history, examination, and investigation into a decision: chest pain, fever in a returning traveler, a painful swollen limb. Medical education has spent decades accumulating evidence that knowledge alone does not produce competent clinicians, yet curricula worldwide remain dominated by the lecture. This trial adds a randomized, blinded, registered data point to the case that assessment and rehearsal formats are not neutral containers for content but active ingredients in learning. The students in Rabat who practiced being doctors, rather than merely studying medicine, were measurably better at it the very next day.

Subject of Research: Effectiveness of formative OSCE-based training on medical students' diagnostic strategy for rheumatoid arthritis

Article Title: Effectiveness of formative OSCE-based training for sixth-year medical students on the diagnostic strategy for rheumatoid arthritis: a randomized controlled trial

Article References: Effectiveness of formative OSCE-based training for sixth-year medical students on the diagnostic strategy for rheumatoid arthritis: a randomized controlled trial. (n.d.). https://doi.org/10.1186/s12909-026-10578-z

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10578-z

Keywords: OSCE, medical education, rheumatoid arthritis, randomized controlled trial, formative assessment, simulation-based learning, clinical skills, diagnostic performance, undergraduate training, Morocco, BMC Medical Education, Effectiveness

The scale of the shortage the program addresses is substantial. According to the editorial, attrition during the COVID-19 pandemic worsened an existing deficit in the public health workforce, which now needs an estimated 80,000 full-time workers to provide basic community services. Agencies at every level of government are understaffed, and the authors attribute this largely to a lack of qualified applicants rather than a lack of available positions. The paradox at the heart of the problem is that the pipeline of public health students has never been larger. Undergraduate public health degrees awarded in the United States grew from just 1,480 in 2001 to 18,289 in 2020, and in the spring of 2020 the number of bachelor’s degrees conferred surpassed the number of public health master’s degrees for the first time. Yet only about one in ten graduates holding an undergraduate public health degree reports employment with a government agency, meaning that the vast majority of this expanding talent pool never enters the governmental public health sector where the need is most acute.

The Lewis Scholars Program was designed to close that gap by intervening early in students’ academic trajectories. Over eight to eleven weeks, scholars participate in classroom learning and hands-on internships, supported throughout by intensive mentoring, professional development, and networking opportunities. A series of articles in the same special issue of the journal details how the programs function at each site and what they have accomplished over more than a decade of operation. The demand for these opportunities is striking: in total, the programs have accepted roughly 2,000 students from a pool of more than 40,000 applicants, an acceptance rate that underscores both the competitiveness of the program and the appetite among undergraduates for meaningful public health training.

The outcomes for program alumni suggest that the model is working. More than half of former scholars have gone on to enroll in advanced degree programs, including Master of Public Health, PhD, and MD programs. Forty-five percent of alumni work or have worked in public health or biomedical science roles, and another 20 percent have pursued careers in other areas of health care. Alumni now serve in health departments, advocacy organizations, community-based nonprofits, tribal health programs, and academic research centers, forming a distributed network of trained professionals across the breadth of the public health enterprise. For a field struggling to recruit qualified candidates into government positions, these figures represent a measurable return on a relatively modest educational investment.

Michael A. Joseph, PhD, MPH, Vice Dean for Education at Columbia Mailman and a co-author of the editorial, frames the program as more than a recruitment tool. The Lewis Scholars Program, he says, is a powerful model for how cultivating the talents of young public health students can open new pathways to fill the need for public health careers, particularly in government and in service of local communities. Recruitment is deliberate and targeted. The program intentionally seeks out first-generation college students and individuals who are members of groups that have historically been underrepresented in public health and biomedical science careers. The goal, Joseph explains, is to build a public health workforce that reflects the diversity of communities across the country, composed of professionals who are deeply connected to the communities and populations most in need.

A companion article in the special issue, authored by Troy Hoffman, MPA, director of SPHSP and Educational Initiatives at Columbia Mailman, examines the mentoring approach that underpins the program’s results. The programs offer scholars what the authors describe as a web of support designed to cultivate both academic and professional development. Each scholar is paired with one or more internship mentors who engage trainees in real-world public health challenges across a variety of domains, including governmental agencies, academic institutions, and community-based organizations. The scale of this mentoring effort is considerable: in 2025, across all seven sites, the programs recruited and trained 190 professionals to serve as mentors. Beyond internship mentors, scholars are also supported by advisors, preceptors, coaches, and near-peer mentors, creating multiple layers of guidance throughout the program and beyond.

Hoffman emphasizes that the support structure is holistic and responsive to individual circumstances. The program makes sure scholars get support where they are and when they need it, he says. Crucially, mentorship does not end when scholars complete the summer program. Instead, the programs create career-long connections with program staff, researchers, faculty, and community-facing public health professionals, all of whom continue to shape alumni trajectories in public health long after the formal training period concludes. This sustained engagement distinguishes the Lewis Scholars model from shorter-term internship programs and may help explain the strong rates of advanced degree enrollment and public health employment among its graduates.

The pathway from scholar to public health professional is illustrated by the experience of Kennedy Wade, MPH ’26, who applied to SPHSP in 2023 as a rising senior at Xavier University of Louisiana, a historically Black university. A public health major, Wade was drawn to the opportunity to do hands-on work in the field. After her acceptance, she expressed an interest in environmental health and housing, and the program placed her in an internship with a researcher studying smoke-free policies in public housing in New York City. Wade describes the placement as her first experience doing community-based public health work, an experience that deepened her interest in environmental health and helped her grow substantially as an aspiring public health professional.

Wade’s trajectory continued at Columbia Mailman itself. She is one of 25 SPHSP graduates who have gone on to study for a master’s degree at the school since 2023, when Columbia Mailman took over leadership of the program from Columbia’s Vagelos College of Physicians and Surgeons. After graduating with a Columbia Mailman MPH in Epidemiology earlier this year, Wade became a CDC/CSTE Injury Epidemiology Fellow at the New York City Department of Health and Mental Hygiene, where she works in the Bureau of Environmental Surveillance and Policy. Since starting the position over the summer, she has explored a different side of environmental health, with work ranging from traffic-related injuries to falls among older adults. In November, she is scheduled to present her research on the impact of greened vacant lots on adolescent victimization and perpetration at the American Public Health Association’s annual meeting.

Three years after her own summer in the program, Wade says its influence remains strong. She credits the program with providing learning, hands-on experience, and a feeling of community, and notes that she is still close with everyone in her cohort, with program leaders remaining in her corner from the beginning. Her account, like the editorial’s broader analysis, points to the central argument of the special issue: that investing early in a diverse, well-mentored cohort of undergraduates can transform individual lives while simultaneously addressing a national staffing shortfall. As public health agencies continue to grapple with an estimated 80,000-worker gap, the Lewis Scholars Program offers a documented, replicable template for converting the growing population of public health graduates into the government workforce that communities depend on.

Subject of Research: The CDC John R. Lewis Undergraduate Public Health Scholars Program as a workforce development model for public health

Article Title: CDC undergraduate pathway program offers a model of success at Columbia Mailman and beyond

Article References: CDC undergraduate pathway program offers a model of success at Columbia Mailman and beyond. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: public health workforce, CDC, John R. Lewis Scholars Program, Columbia Mailman, undergraduate training, mentorship, health equity, epidemiology, government employment, workforce shortage, SPHSP, public health education

The rationale behind the work is straightforward. Advances in MRI technology, an expanding range of clinical applications, and steadily reduced scan times have driven up demand for MRI services around the world. That demand translates directly into pressure on the workforce: graduates are increasingly expected to arrive with genuine MRI competence, not merely a theoretical appreciation of what the modality can do. Undergraduate MRI education, the authors argue, must therefore be effective enough to meet evolving workforce needs safely and competently. Yet access to real scanners is expensive and logistically difficult, which is why structured, evaluated programs like this one matter.

The program itself was a revision of an earlier pilot study, and its structure reveals a deliberate pedagogical design. It comprised two parts. Part 1 consisted of two weeks of pre-reading, allowing students to build a conceptual foundation in MRI physics, instrumentation, and safety before they ever entered the scanner room. Part 2 was a five-day hands-on learning component spread across two consecutive calendar weeks, during which every participant personally performed MRI scanning. The target audience was students who had already completed the second-year instrumentation subjects of the course, ensuring they arrived with the technical grounding needed to make the practical experience meaningful rather than overwhelming.

The setting was as authentic as it gets in Australian research imaging. The program ran at the research MRI scanning facility of the Western Australia node of the National Imaging Facility, a national collaborative research infrastructure capability hosted at the Centre for Microscopy, Characterisation and Analysis at The University of Western Australia. Supervision during scanning was provided by MRI radiographers from Perth Radiological Clinic, and the delivery was supported by Siemens Healthcare. The program also earned recognition through the Curtin Extra co-curricular program, signaling that the university formally acknowledged the additional skills students were developing outside their standard curriculum.

Evaluation relied on two complementary instruments. Participants completed pre- and post-program questionnaires capturing their self-perceived competence, alongside revised 38-item MRI knowledge tests administered before and after the program. The knowledge test preserved the same broad content domains and scoring approach as the pilot-study instrument, which had previously demonstrated acceptable internal consistency, with a Cronbach’s alpha of 0.79, and convergent validity, reflected in a Pearson correlation of 0.40. On the analysis side, the team used descriptive statistics for the questionnaire and test data, Wilcoxon signed-rank tests to assess changes in self-perceived competence, paired t-tests for knowledge test performance, and an independent samples t-test to compare mean test score changes against the pilot study.

The results, though drawn from a small cohort of eight enrolled students, were striking. Self-perceived MRI competence rose significantly from a mean of 2.63 to 3.13 on the program scale, a change reaching statistical significance at p = 0.046. More dramatically, overall MRI knowledge test performance climbed from 39.15 percent to 57.24 percent, a highly significant improvement with p = 0.002. The effect size for that knowledge gain was very large, Cohen’s d = 1.73, although the authors were careful to note that the wide 95 percent confidence interval, spanning 0.58 to 2.83, indicated substantial uncertainty about the true magnitude of the effect when the sample is this small.

Student perceptions of the program itself were overwhelmingly positive. Participants rated all aspects of the experience at 4.13 or higher on a five-point scale, with the sole exception of the supervision item. That item used a different response scale and returned a mean rating of 3.13, which the authors interpreted as supervision sitting close to the intended ideal of a perfect setting, in which students are watched and supported without being crowded or constrained. For a program that asks undergraduates to operate a research-grade MRI scanner, that balance between safety oversight and hands-on autonomy appears to have landed almost exactly where the designers hoped.

One of the more intriguing comparisons came from benchmarking the revised program against its pilot predecessor. The mean improvement in knowledge test scores in this study was 18.09 percent, which did not differ significantly from the 27.85 percent improvement observed in the pilot study, with the comparison yielding p = 0.139. The difference in means is notable on its face, but with eight participants the study was never powered to detect moderate differences between programs, and the authors appropriately declined to read too much into the gap. What the comparison does suggest is that the revised format, with its structured pre-reading phase and compressed hands-on week, sustained a meaningful learning trajectory rather than undermining the gains of the original design.

The authors are equally candid about the limits of what can be concluded. Because the study did not include a concurrent control group, the observed increases in competence and knowledge cannot be causally attributed to the program or to any individual program component. Students may have improved simply through repetition of testing, maturation, or the motivational effect of being selected for a voluntary enrichment activity. The findings, they write, provide further information for planning and evaluating future course-wide implementation but do not establish its feasibility. The suitability, scalability, resource requirements, safety, and effectiveness of compulsory course-wide delivery will require evaluation in larger studies using controlled designs.

Those caveats are a reminder of how science education research often has to proceed: small, voluntary, carefully instrumented pilots first, scaled implementation later, if and when the evidence justifies it. The study was retrospectively registered with the Australian New Zealand Clinical Trials Registry under ACTRN12626000824369, received ethics approval from the Curtin University Human Research Ethics Committee, and involved no external funding, with clinical supervision donated by working radiographers and technical support from an industry partner. Whether or not hands-on MRI training eventually becomes a compulsory element of every Australian medical radiation science degree, this study offers a concrete template: two weeks of disciplined pre-reading, five days at a real scanner console, validated knowledge testing before and after, and honest statistical reporting. For the eight students who got to drive one of medicine’s most powerful imaging machines themselves, the transformation in confidence and knowledge was measurable, significant, and, in the language of effect sizes, very large indeed.

Subject of Research: Hands-on MRI education for undergraduate medical radiation science students in Australia

Article Title: Hands‑on magnetic resonance imaging learning program for future course‑wide implementation in an undergraduate medical radiation science course in Australia

Article References: McNally, R. C., Parizel, P. M., Sun, Z., Vos, S. B., Moradi, H., Dickson, R., & Ng, C. K. C. (2026). Hands‑on magnetic resonance imaging learning program for future course‑wide implementation in an undergraduate medical radiation science course in Australia. BMC Medical Education. https://doi.org/10.1186/s12909-026-10490-6

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10490-6

Keywords: magnetic resonance imaging, medical radiation science, medical education, hands-on learning, undergraduate training, MRI competence, Curtin University, National Imaging Facility, knowledge testing, radiography education, Australia, curriculum implementation