Evidence map›Paper›PMID 42358800›Full record

ArticleEClinicalMedicine2026

A competency-based digital medical education model in conflict-affected settings.

Karim Qayumi, Farid Omar, Masood Noora, Seyedeh Toktam Masoumian Hosseini, Mohsen Masoumian Hosseini, Asmat Naebkhilh, Sohaila Aziz, Parwin Mansurih, Somaya Waqef, Nasrin Oryakhil and 17 more

Abstract read
In one paragraph

Article in EClinicalMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Karim QayumiDepartment of Surgery, University of British Columbia, Vancouver, Canada.
Farid OmarCanadian Virtual Medical University Initiative (CVMUI), Canada.
Masood NooraCanadian Virtual Medical University Initiative (CVMUI), Canada.
Seyedeh Toktam Masoumian HosseiniCanadian Virtual Medical University Initiative (CVMUI), Canada.
Mohsen Masoumian HosseiniCanadian Virtual Medical University Initiative (CVMUI), Canada.
Asmat NaebkhilhCanadian Virtual Medical University Initiative (CVMUI), Canada.
Sohaila AzizCanadian Virtual Medical University Initiative (CVMUI), Canada.
Parwin MansurihCanadian Virtual Medical University Initiative (CVMUI), Canada.
Somaya WaqefCanadian Virtual Medical University Initiative (CVMUI), Canada.
Nasrin OryakhilCanHealth International, Vancouver, Canada.
Anoosha WahidiCanadian Virtual Medical University Initiative (CVMUI), Canada.
Hasiba KarimiCanadian Virtual Medical University Initiative (CVMUI), Canada.
Anmol KapoorCanadian Virtual Medical University Initiative (CVMUI), Canada.
Sayed FekratCanadian Virtual Medical University Initiative (CVMUI), Canada.
Manizha NoorandishCanadian Virtual Medical University Initiative (CVMUI), Canada.
Farida Homa TaninCanadian Virtual Medical University Initiative (CVMUI), Canada.
Zahra RostamiCanadian Virtual Medical University Initiative (CVMUI), Canada.
Hamida EbadiCanadian Virtual Medical University Initiative (CVMUI), Canada.
Hamasa EbadiCanadian Virtual Medical University Initiative (CVMUI), Canada.
Roohullah ShabonCanadian Virtual Medical University Initiative (CVMUI), Canada.
Yaar MohammedCanadian Virtual Medical University Initiative (CVMUI), Canada.
Shafiqa AllahyarCanadian Virtual Medical University Initiative (CVMUI), Canada.
Aurelia SoltanCanadian Virtual Medical University Initiative (CVMUI), Canada.
Mariam HazhirCanadian Virtual Medical University Initiative (CVMUI), Canada.
Stefan WisbauerCo-Chief Executive Officer, Lecturio, Leipzig, Germany.
Mohibullah WaziriCanHealth International, Vancouver, Canada.
Alberto FerreresoDepartment of Surgery, University of Buenos Aires, Buenos Aires, Argentina.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Medical education in conflict-affected settings faces severe barriers, including collapsed infrastructure, faculty shortages, and sex-based exclusion. This study evaluated first-term learning outcomes among Afghan female medical trainees whose university education was interrupted following restrictions on women's access to higher education. Most participants resided in Afghanistan, with a minority in neighbouring countries. The Canadian Virtual Medical University Initiative (CVMUI) delivers a fully online, competency-based curriculum aligned with Entrustable Professional Activities (EPAs). Methods: We implemented a multi-system, pre-internship digital curriculum spanning five EPAs (cardiovascular, respiratory, gastrointestinal, musculoskeletal, and central nervous systems). Lecturio provided theoretical instruction, and CyberPatient enabled simulation-based clinical training. The study was conducted from November 2024 to July 2025 at a single virtual site (CVMUI). Ninety-two Level I-II female students who had previously been enrolled in medical school in Afghanistan were recruited; inclusion criteria were English proficiency (TOEFL iBT ≥70), reliable internet access, and commitment ≥15 h/week. The main outcomes were changes in knowledge (multiple-choice questions) and clinical skills (virtual Objective Structured Clinical Examinations) measured pre- and post-training. Secondary outcomes included student satisfaction and curriculum quality. Analyses used Shapiro-Wilk tests for normality, paired t-tests or Wilcoxon tests, and effect sizes. Findings: Level I students demonstrated significant knowledge gains across all systems (mean increases +52 to +58 points; p < 0.0001). Level II students showed substantial improvements in knowledge, clinical performance, and total scores (mean differences 57-62 points; large effect sizes). More than 90% of participants rated learning objectives, feedback, and educational climate as very good or excellent. Convergent findings across knowledge, skills, and satisfaction supported strong construct validity and alignment with prior pilot data. Interpretation: A fully digital, simulation-enabled, competency-based model can deliver high-quality pre-internship medical education in conflict-affected settings, offering a scalable and equitable pathway for women excluded from traditional training. Future work should examine integration of this model into national and international credentialing frameworks. Funding: CanHealth International and philanthropic contributions.

Indexed as

Competency-based educationCurriculum developmentSimulationVirtual education

Identifiers

PMID42358800
PMCPMC13292264

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.