Abstract

Abstract

Introduction: This study explored motivation among a cohort of New Zealand medical students from The University of Auckland. The research questions were: 1) What motivates students to attend medical school? 2) What are the values, beliefs or cultural practices that influence students’ decisions to go to medical school? 3) How do students’ families influence their decisions to go to medical school?

Methods: Twenty medical students from The University of Auckland in Years Two and Five of a Bachelor of Medicine and Bachelor of Surgery (MBChB) degree participated in semi-structured focus group interviews. Two cohorts of medical students were involved, Māori and Pacific Admission Scheme students (MAPAS), and non-MAPAS students. An interpretive methodology was used, and data analysed using thematic analysis.

Findings: This study found both MAPAS and non-MAPAS students have intrinsic and extrinsic motivation to attend and continue medical school. However, the non-MAPAS students had more individualised motivations to study medicine whereas the MAPAS students were more motivated by collectivism. Family and cultural customs influenced MAPAS students’ motivation to study medicine. Non-MAPAS students were influenced by positive school experiences.

Common to both cohorts was the significant influence of family. Non-MAPAS students specified family members’ professions and educational support as influencing factors. In contrast, MAPAS students identified being motivated to study medicine to improve the financial and health situations of their families.

Conclusion: All students have different motivations for attending medical school which is influenced by their culture and environment. Culture encompasses the individual and their family, inclusive of ethnicity, beliefs, values and behaviours. Family plays a crucial role in motivating and influencing students to pursue medicine.

Keywords:         Motivation, Medical Students, Culture, Indigenous, Ethnic Minority

Abstract

Introduction: The demanding nature of medical and health sciences studies can cause stress among students in these disciplines affecting their wellbeing and academic performance. The Perceived Stress Scale (PSS-10) is a widely used measure of perceived stress among medical students and healthcare professionals that has not yet been validated among medical and health sciences students in Hong Kong. The aim of this study is to establish the construct validity and reliability of the PSS-10 in this context.

Methods: 267 final year medical and health sciences students were surveyed using the PSS-10. The data were analysed using exploratory factor analysis for construct validity and Cronbach’s alpha coefficient and corrected item-total correlations for reliability.

Results: Exploratory factor analysis revealed a two-factor structure for PSS-10, with Cronbach’s alpha of 0.865 and 0.796, indicating good internal consistency. Corrected item-total correlations showed satisfactory correlation ranged from 0.539 to 0.748 for all items and their respective subscale. Both tests supported PSS-10 as a two-factor scale.

Conclusion: The PSS-10 is a valid measure for assessing perceived stress in Hong Kong medical and health sciences students.

Keywords:            Undergraduate Students, Medicine, Nursing, Pharmacy, Health Sciences, Validation, Perceived Stress

Abstract

Introduction: The forced transition to online learning due to the COVID-19 pandemic has impacted medical education significantly.

Methods: In this paper, the authors compare the performance of Year 1 and 2 classes of medical students who took the same courses either online (2019-2020) or face-to-face (2018-2019), and compare their evaluation of these courses. The authors also present results of three survey questions delivered to current Year 1 medical students on the perceived advantages and disadvantages of online learning and suggestions for improvement.

Results: Performance and evaluation scores of Year 1 and 2 classes was similar irrespective of the mode of delivery of the course in question. 30 current (2019-2020) Year 1 students responded to the survey questions with a response rate of 25.4%. Some of the cited disadvantages had to do with technical, infrastructural and faculty know-how and support. But the more challenging limitations had to do with the process of learning and what facilitates it, the students’ ability to self-regulate and to motivate themselves, the negative impact of isolation, loss of socialisation and interaction with peers and faculty, and the almost total lack of hands-on experiences.

Conclusion: Rapid transition to online learning did not affect student knowledge acquisition negatively. As such, the sudden shift to online education might not be a totally negative development and can be harnessed to drive a more progressive medical education agenda. These results are particularly important considering the several disadvantages that the students cited in relation to the online delivery of the courses. 

Keywords:           Online Learning, COVID-19 Pandemic, Medical Students

Abstract

Introduction: The Coronavirus-19 pandemic has had profound effects on health professions education (HPE) posing serious challenges to the continued provision and implementation of undergraduate, postgraduate and continuing medical education (CME). Across these HPE domains, the major disruptions included the exclusion of undergraduate learners from clinical learning environments, restricted intra-, inter-institutional and overseas movement of medical professionals, termination of face-to-face learner-educator interactions, deployment of postgraduate learners into non-scope service settings, and CME postponement.

Methods: In this review we report on how in Singapore various adaptive measures were instituted across the 3 HPE domains at institutional and national level to maintain adequate resources at the frontline to meet service exigencies, promote healthcare professionals’ wellbeing and safety as well as mitigate the spread of the pandemic.

Results: We identified several strategies and contingencies developed to address these challenges. These involved the use of online learning platforms, distributed and asynchronous learning, an undergraduate Pathway Programme, and use of innovative hands-on technology like simulation. Robust, well pre-planned pandemic preparedness, effective communication, as well as provision of psychological support resources ensured maintenance of service and academic continuity, trust and resilience within HPE. However, several challenges remain, namely the timing and manner of conducting formative and summative assessments, cybersecurity, and the indispensable hands-on, in-person experiential learning for surgical training.

Conclusion: Strong leadership with vision and planning, good communication, prioritising learners’ and educators’ wellbeing and safety, and harnessing existing and emerging online learning technologies are crucial elements for effective contingencies for HPE disruption during pandemics.

Keywords:           Pandemic Preparedness, COVID-19, Curriculum Development, Online Learning and Assessment, Learner Wellbeing and Safety, Health Profession Education

I. INTRODUCTION

The Foundation for Advancement of International Medical Education and Research (FAIMER^®) is a non-profit foundation committed to improving the health of communities by enhancing the quality of health professions education. This article highlights several of FAIMER’s international efforts, with particular emphasis on the fellowship programs developed in partnership with institutions in the Asia-Pacific region.

Abstract

Healthcare professionals worldwide participate in continuing professional development (CPD) to remain competent in practice, and to ensure they provide high-quality care to patients. Globally, CPD systems have evolved at different rates resulting in significant variation in structure, requirements, and oversight. In some countries, CPD has moved from single profession educational designs and formal didactic methods of delivery to educational models that are innovative, dynamic, and learner-centric. In other countries, CPD is a neglected part of the healthcare education continuum. This article provides a global perspective on the evolution of CPD over the past 20 years, and identifies opportunities for the future.

I. INTRODUCTION

A. Why this is an issue of global relevance

India is the world’s largest exporter of doctors and healthcare workforce to other nations. More than 70,000 medical graduates from India (nearly 10% of the qualified doctors in India) are in the USA, UK, Europe, and the other nations. Therefore, the quality of medical education and the competence level of medical professionals from India acquire global relevance. Over the years, several critiques have been published on Indian Medical Education (Solanki & Kashyap, 2014).

Abstract

Medical education in Indonesia has undergone a long journey. It began with the establishment of medical training for native youth in a military hospital in Jakarta during the Dutch colonial period in 1849. Since then, the number of medical schools has increased according to socio-political needs. Currently, there are 83 medical schools, public and private, which generate approximately 8000 graduates per year. The explosion in the number of medical schools challenged quality of medical education. Indeed, several curriculum changes and improvements applied to elevate the quality. Undergraduate program was initially implementing Dutch curriculum, but was then changed into American curriculum. The improvement continued by implementing the first and the second national curriculum. Since 2005 a national level competency-based curriculum (CBC) was carried out for undergraduate programs, while for postgraduate clinical training the CBC began later on. Moreover, Medical Internship Program and the National Competency-based Examination were introduced following the CBC. Nevertheless, some problems with advancement of medical schools were identified, including lack of staff and facilities, existing learning cultures and limitation of experts. Accordingly, many efforts have been made, including enactment of law on medical education and national accreditation. In the future, support from international organizations in terms of financial, consultation, faculty development and accreditation should be optimized. In addition, collaboration with medical education community elsewhere would be beneficial to overcome the challenges and promote the quality of medical education.

Keywords:            Medical Schools, Curriculum Changes, Medical Education, Indonesia

Abstract

Introduction: As healthcare educators undergo a career transition from providing care to providing education, their professional identity can also transition accompanied by significant threat.  Given their qualifications are usually clinical in nature, healthcare educators’ knowledge and skills in education and other relevant theories are often minimal, making them vulnerable to feeling fraudulent in the healthcare educator role. This threat and vulnerability is described as the impostor phenomenon. The aim of this study was to examine and map the concepts of professional identity and the influence of impostor phenomenon in healthcare educators. 

Methods: The authors conducted a scoping review of health professions literature.  Six databases were searched, identifying 121 relevant articles, eight meeting our inclusion criteria.  Two researchers independently extracted data, collating and summarising the results.

Results: Clinicians who become healthcare educators experience identity ambiguity. Gaps exist in the incidence and influence of impostor phenomenon in healthcare educators. Creating communities of practice, where opportunities exist for formal and informal interactions with both peers and experts, has a positive impact on professional identity construction.  Faculty development activities that incorporate the beliefs, values and attributes of the professional role of a healthcare educator can be effective in establishing a new professional identity.

Conclusion: This review describes the professional identity ambiguity experienced by clinicians as they take on the role of healthcare educator and solutions to ensure a sustainable healthcare education workforce.

Keywords:           Professional Identity, Impostor Phenomenon, Healthcare Educators, Health Professions Education, Scoping Review

Abstract

Introduction: Several nations around the world had to close schools, colleges, universities, and other educational institutions as they were badly affected by the spread of COVID-19. The purpose of this study was to measure the effectiveness of online vs physical teaching during the COVID-19 pandemic, at the Faculty of Allied Health Sciences (FAHS), University of Ruhuna (UoR) Sri Lanka.

Method: A cross-sectional study was conducted among 200 undergraduates. The data were collected through displayed/approved results sheets of the students of selected batches in the Department of Nursing, Department of Pharmacy, and Medical Laboratory Science (MLS). Paired sample T-test was used to compare the results of undergraduates.

Results: The examination results of 47-54 undergraduates in nursing, 28 in pharmacy, and 22 in MLS were analysed. Significant differences in Psychiatry in Nursing and Nursing Clinical Attachment were identified in the Department of Nursing (p=0.001). In the Department of Pharmacy, only Pharmaceutical Chemistry I (p=0.012) reported a significant difference. The undergraduates of MLS who underwent online theory sessions had scored more in Microbiology and Immunology (p=0.022) and Basic Genetics and Molecular Biology (p=0.000) whereas in Research Methodology and Epidemiology, the undergraduates who participated in physical lectures had scored more marks (p=0.001).

Conclusion: Practical/interactive session-based course units and clinical appointments had a higher impact on the mode of teaching than many theoretical course units. The results might serve as a primer for the creation of an action plan to support the academics and clinical/practical components of undergraduates.

Keywords:           Undergraduates, Online Teaching, Physical Teaching, Examination Results, COVID-19

Abstract

Medical education in Indonesia has undergone a long journey. It began with the establishment of medical training for native youth in a military hospital in Jakarta during the Dutch colonial period in 1849. Since then, the number of medical schools has increased according to socio-political needs. Currently, there are 83 medical schools, public and private, which generate approximately 8000 graduates per year. The explosion in the number of medical schools challenged quality of medical education. Indeed, several curriculum changes and improvements applied to elevate the quality. Undergraduate program was initially implementing Dutch curriculum, but was then changed into American curriculum. The improvement continued by implementing the first and the second national curriculum. Since 2005 a national level competency-based curriculum (CBC) was carried out for undergraduate programs, while for postgraduate clinical training the CBC began later on. Moreover, Medical Internship Program and the National Competency-based Examination were introduced following the CBC. Nevertheless, some problems with advancement of medical schools were identified, including lack of staff and facilities, existing learning cultures and limitation of experts. Accordingly, many efforts have been made, including enactment of law on medical education and national accreditation. In the future, support from international organizations in terms of financial, consultation, faculty development and accreditation should be optimized. In addition, collaboration with medical education community elsewhere would be beneficial to overcome the challenges and promote the quality of medical education.

Keywords:            Medical Schools, Curriculum Changes, Medical Education, Indonesia

Abstract

Healthcare professionals worldwide participate in continuing professional development (CPD) to remain competent in practice, and to ensure they provide high-quality care to patients. Globally, CPD systems have evolved at different rates resulting in significant variation in structure, requirements, and oversight. In some countries, CPD has moved from single profession educational designs and formal didactic methods of delivery to educational models that are innovative, dynamic, and learner-centric. In other countries, CPD is a neglected part of the healthcare education continuum. This article provides a global perspective on the evolution of CPD over the past 20 years, and identifies opportunities for the future.

Abstract

Although the flipped classroom approach has been theorised to encourage active learning, recorded lectures were used as flipped learning activities in the majority of the flipped learning studies, which many still consider to be passive knowledge input. To further promote active learning, the first four modules in a pathology course at University of Otago Wellington were flipped and delivered to fourth year medical students with redesigned active learning activities based on constructive theory of learning. The innovative active learning tasks were delivered via “kuraCloud” (an online-learning platform) and included short video clips, labeling exercises, written questions with immediate feedback, multiple-choice questions with explanatory text and links provided for further information. Students were required to complete all the activities prior to a face-to-face tutorial. A mixed methods design was used in which student engagement was assessed using both survey instruments and focus groups. Results showed that students did not engage with the new flipped learning activities designed to improve active learning, they preferred the passive learning approach with exam- or clinical practice- based core knowledge summarized and delivered to them directly. Three themes emerged: 1. Students considered the time invested in the active learning activities was inefficient. 2. The flipped course challenged students’ sense of predictability. 3. The knowledge construction process was valued as application rather than learning. This might be attributed to time-poor medical students judging the value of the learning task based on the relevance to their immediate learning goal: pass the exam, the new flipped learning activities imposing a heavy cognitive load that impairs the knowledge construction process and the less predictable structure of the flipped learning environment compared to the familiar traditional lectures. 

Keywords: Passive Learning; Active Learning; the Flipped Classroom; Course Structure; Cognitive Load

Abstract

Background: The Northern Ontario School of Medicine (NOSM) opened in 2005 with a social accountability mandate to contribute to improving the health of the people and communities of Northern Ontario. NOSM recruits students from Northern Ontario or similar backgrounds and provides Distributed Community Engaged Learning in over 90 clinical and community settings located in the region, a vast underserved rural part of Canada. This paper presents outcomes for graduates of NOSM’s undergraduate and postgraduate medical education programs with emphasis on NOSM’s social accountability mandate.

Methods: NOSM and the Centre for Rural and Northern Health Research (CRaNHR) used mixed methods that include administrative data from NOSM and external sources, as well as surveys and interviews of students, graduates and other informants.

Results: 92% of all NOSM students come from Northern Ontario with substantial inclusion of Aboriginal (7%) and Francophone (22%) students. 62% of NOSM graduates have chosen family practice (predominantly rural) training. 94% of the doctors who completed undergraduate and postgraduate education with NOSM are practising in Northern Ontario. The socio-economic impact of NOSM included: new economic activity, more than double the School’s budget; enhanced retention and recruitment for the universities and hospitals/health services; and a sense of empowerment among community participants attributable in large part to NOSM.

Discussion: There are signs that NOSM is successful in graduating doctors who have the skills and the commitment to practice in rural/remote communities and that NOSM is having a largely positive socio-economic impact on Northern Ontario.

Keywords: Social Accountability; Community Engagement; Distributed Medical Education

Abstract

Objective: To investigate patients’ decision-making in the informed consent process in a hierarchical and communal culture.

Methods: This qualitative study took place in an Indonesian hospital and was conducted in line with the Grounded Theory approach. Fifteen patients and twelve family members were interviewed to understand the patients’ decision-making process and factors that contributed to this process. Interview transcripts were analysed using the constant comparison method.

Results: Patients used information to develop an explanation of their illness and treatment. They consented to a medical procedure if information from their physicians matched their own explanation. An increasing severity of the disease urged patients to decide, even when a satisfying explanation had not been developed. A hierarchical relationship between physicians and patients hampered patients’ discussing concerns or sharing emotions with their physicians. To maintain a harmonious relation with their physicians, patients accepted that some questions remained unanswered even after a decision had been made.

Conclusion: The strong hierarchical and communal context added to the complexity in the physician-patient relationship and consequently influenced patients’ decision-making. In addition to strengthening physicians’ communication skills, involving other health professionals as patient advocates or mediators is recommended to ensure patients make voluntary and informed decisions.

Keywords:         Decision-making, Informed Consent, Hierarchical Culture, Communal Culture, Grounded Theory

Abstract

Introduction: The demanding nature of medical and health sciences studies can cause stress among students in these disciplines affecting their wellbeing and academic performance. The Perceived Stress Scale (PSS-10) is a widely used measure of perceived stress among medical students and healthcare professionals that has not yet been validated among medical and health sciences students in Hong Kong. The aim of this study is to establish the construct validity and reliability of the PSS-10 in this context.

Methods: 267 final year medical and health sciences students were surveyed using the PSS-10. The data were analysed using exploratory factor analysis for construct validity and Cronbach’s alpha coefficient and corrected item-total correlations for reliability.

Results: Exploratory factor analysis revealed a two-factor structure for PSS-10, with Cronbach’s alpha of 0.865 and 0.796, indicating good internal consistency. Corrected item-total correlations showed satisfactory correlation ranged from 0.539 to 0.748 for all items and their respective subscale. Both tests supported PSS-10 as a two-factor scale.

Conclusion: The PSS-10 is a valid measure for assessing perceived stress in Hong Kong medical and health sciences students.

Keywords:            Undergraduate Students, Medicine, Nursing, Pharmacy, Health Sciences, Validation, Perceived Stress

I. INTRODUCTION

One of the biggest challenges at engaging undergraduates effectively in Biology modules is large class size (Wood, 2009). Typically, the class size of an undergraduate Cell Biology module in our institution ranges from 200 to 300 students. Instructors of large class modules traditionally teach didactically by simply disseminating facts, which become outdated quickly in this growing field of science. Furthermore, using didactic instruction, it is difficult to help students develop skills such as critical-thinking expected of our university graduates.

I. INTRODUCTION

Many countries enforce limits on the number of hours that medical residents work. For example, in the United States, regulations about duty hours were instituted by the Accreditation Council of Graduate Medical Education as early as in 2003, reinforcing those limits in 2011 and again in 2017 (Accreditation Council for Graduate Medical Education, 2017). These reforms triggered discussion in medical education literature about their wide-ranging effects on resident education, resident wellness, and patient care (Bolster & Rourke, 2015).

In Japan, restrictions on working hours will be implemented for physicians in April 2024 (Shibuya & Unno, 2019). Because of its rapidly shifting demographics to being a super-aged society with a low birth rate, Japan is now facing issues with residents’ learning and working that other countries will need to confront in the near future as their populations shift as well (as of late 2020). Here we report on the history and current situation of postgraduate medical education in Japan, which are highly relevant to re-evaluating postgraduate training in other countries.

Abstract

It has been a pleasure for us to act as guest editors for this themed issue on the Implications of Culture in the Education and Practice of Healthcare Professionals. We thank the TAPS Editorial team, our reviewers, and authors for all their hard work and patience and we hope you enjoy this varied issue with articles from around the region, and the world.

The present healthcare environment requires practitioners who are not only technically proficient but also compassionate, empathetic, and fully committed to a patient-centred approach. These professionals can be best described as “holistic practitioners,” given their emphasis on supporting the complete well-being of patients, as well as addressing patients’ physical, emotional, social, and spiritual needs. Our editorial explores strategies for nurturing such practitioners who focus on the person as a whole, rather than merely treating individual diseases.

Building Competence Through Integrated Knowledge and Skills

Competence in healthcare now requires more than a strong grounding in biomedical and clinical sciences. It requires blending knowledge and skills across various disciplines with a focus on a patient-centred approach. This holistic approach involves embracing interprofessional education, which allows students to learn alongside other healthcare roles, while fostering the teamwork essential for comprehensive care (Samarasekera et al., 2024).

Abstract

Introduction: This article explores the dynamic relationship between the Scholarship of Teaching and Learning (SoTL) and the well-being of students and educators within the context of medical education.

Methods: The author critically reviewed the salient views and knowledge at the intersection of SoTL, well-being, and resilience. By critically examining literature, insights from various studies were synthesised, offering a detailed overview of the current state of knowledge in this field. This review guided the identification of key practices and recommendations.

Results: SoTL emerges as a transformative force, enhancing well-being for both students and educator through evidence-based practices and innovative teaching methods. The article explores the crucial role of SoTL in fostering resilience, not only among students but also among educators. Despite promising evidence, challenges in implementing SoTL for well-being persist, requiring strategic approaches to overcome traditional paradigms. The discussion extends to the global implications of SoTL, emphasising the need for collaborative efforts to foster better educational practices and establish inclusive learning environments.

Conclusion: As we assess the evidence for transformative change, a call-to-action echoes, urging global collaboration, research endeavors, and institutional support to realise the full potential of SoTL, ultimately creating environments where both learners and educators thrive.

Abstract

Introduction: Despite significant efforts to address gender equality in medical education, the issue persists. The narrative review aimed to address the research question: What are the strategies implemented to address issues of gender inequality in medical education and what were their outcomes?  

Methods: Seven major electronic databases of CINAHL, Embase, ERIC, PsyInfo, PubMed, SCOPUS and Web of Science were reviewed. Search phrases used were (Medical education) AND (Gender equality) OR (Gender bias) OR (Gender diversity) OR (Gender discrimination). Original research articles were included, together with systematic reviews with outcomes reporting on strategies to address gender equality.

Results: Articles unrelated to medical education (e.g. allied health and nursing education) and non-English articles were excluded from the study. A total of 1248 articles were identified, and 23 articles met the inclusion criteria. Training programs (n=14; 60.8%) for medical students and faculty have successfully increased awareness on the issues of gender equality and boost confidence in handling cases on gender inequality, yet implicit bias remains with leadership continuing to be associated more strongly with males.

Conclusion: Leadership bodies in Institutions of Higher Education and policymakers would be in an ideal position to address these issues through shaping policies and provision of training for hiring bodies and faculty.

Keywords:           Medical Education, Gender Equality, Strategies

Abstract

Introduction: COVID-19 pandemic disruptions to medical educational programs have been felt worldwide. However, little is understood about the experience of Low to Middle Income Countries’ (LMIC) and the impact of ensuing disruptions on medical education. We aimed to develop a collective understanding of this through the perspectives of individual LMIC educators, exploring how they continued to deliver undergraduate and postgraduate medical education in the context of pandemic barriers, by reflecting on their successes and shortcomings.

Methods: A phenomenological study was conducted with ten purposefully recruited educators involved in medical education from mainly the Asia-Pacific region. In-depth interviews via web-conferencing were conducted, and data analysed using Braun & Clarke’s (2006) framework. 

Results: Four major themes were identified: ‘Navigating Change, ‘Altered and Divided Teaching Roles and Spaces’, ‘Curricula Impact’ and ‘Challenges and Affordances of Remote Learning’. Educators described major disruptions to delivering medical education, particularly clinical education. Remote learning was the mainstay of facilitating continued education, often requiring investment into infrastructure that was non-existent pre-pandemic.

Conclusion: LMIC educators’ pandemic response have been robust in pursuit of continued medical education. Necessary adoption of online teaching approaches has provided avenues to close healthcare education gaps by facilitating improved reach and quality of medical education in these regions. Building on this requires strategies that meet LMICs areas of need, focusing on capacity building that sustains and grows new pedagogical practices.  We must ensure educational advances are equitable and accessible for all, identifying and supporting countries and contexts at risk of being left behind.

Keywords:           Low to Middle Income Countries, COVID-19, Medical Education, Remote Learning, Qualitative

Abstract

Introduction: Professional identity formation requires students’ ability to reflect, which can be supported by constructive feedback from teachers. Feedback practice faces many challenges, including those related to sociocultural aspects. Feedback can be optimised by implementing a model suitable to the attributes of students, teachers, and the clinical environment. This study aimed to develop a suitable feedback model and test its effectiveness in promoting reflection.

Methods: The model was designed based on the theoretical framework and identified feedback-related attributes in FMUI. Expert reviews and cognitive interviews were conducted before the model was tested. The model’s effectiveness was tested using a quasi-experimental design involving 74 students in the Paediatric Module. Students were asked to reflect on their mini-CEX experience after receiving feedback from teachers, and the depth of reflection was compared between students in the intervention and control group. The depth of reflection was measured using Kember scoring, and bivariate analysis was conducted using SPSS 20.0.

Results: The model consists of 5 steps including: Rapport building, Acknowledge students’ strengths, Identify aspect(s) that need improvement, Share teachers’ experiences, and Establish a plan to improve. Deep reflection was more frequently found in the intervention group. Mann-Whitney test showed that the difference between groups was statistically significant (Z=2.964, p=0.003), indicating that reflection in the intervention group was deeper than the control group.

Conclusion: The feedback model formulated based on feedback-related attributes in FMUI was named the RAISE model. Upon testing, students receiving the model could reflect more deeply compared to those receiving the standard model.

Keywords:           Feedback, Clinical, Reflection, Sociocultural

Abstract

Introduction: Selection for basic medical training is highly contextual. The use of cognitive aptitude tests, which commonly supplement measures of prior academic achievement in the selection process of medical schools internationally, is rarely reported from resource-constrained settings in South Asia. We report on the psychometric properties of an aptitude test designed based on the UCAT format, administered to first-year medical undergraduates to determine its utility.

Methods: The aptitude test was administered online to first-year medical students shortly after their admission to two medical faculties in Sri Lanka (n=328). The reliability of the test was determined using Cronbach’s alpha. Overall and subtest scores were computed, and the scores of different demographic groups were compared using the t-test. Factor analysis of the subtests was performed.

Results: The internal consistency of the test was 0.63. The difficulty and discrimination indices were within the acceptable range. The mean score of the aptitude test (AT) was 70.9/100 (SD 8.88). The mean score for females was higher than for males (p=0.04). No statistically significant differences in AT scores were observed between different ethnicities or religions. The entry academic scores demonstrated a weak correlation with the overall AT score (Pearson’s correlation coefficient r=0.27), verbal reasoning (r=0.24), the human body (r=0.19), quantitative reasoning (r=0.18), and situational judgement (r=0.128). Factor analysis indicated items that need revision.

Conclusion: The results indicate the potential value of aptitude tests in Sri Lanka and in similar jurisdictions where selection criteria have yet to expand beyond prior academic performance. A way forward in introducing such tests has been outlined.

Keywords:           Medical Student Selection, Medical Student Admission, Selection Criteria

Abstract

Introduction: We aimed to determine the extent to which non-technical skills and attitudes acquired during undergraduate interprofessional simulation in an Advanced Cardiac Life Support (ACLS) course translated into clinical work.

Methods: Following ACLS simulation training for final-year nursing and medical students, we conducted a 1-year follow-up survey, when graduates were in clinical practice. We used the Readiness for Interprofessional Learning Scale (RIPLS – higher scores indicate better attitudes to interprofessional practice), and nine contextual questions with prompts for free-form comments. RIPLS scores underwent repeated-measures between-groups (nurses vs doctors) analysis at three timepoints (pre-course, post-course and 1-year).

Results: Forty-two surveys (58% response) were received, demonstrating translation of non-technical skills and attitudes to clinical practice, including insights into the skills and roles of others, the importance of communication, and improved perceptions of preparedness for clinical work. However, RIPLS scores for doctors decreased significantly upon beginning clinical work, while scores for nurses continued to increase, demonstrating a significant interaction effect (reduction of 5.7 points to 75.7 versus an increase of 1.3 points to 78.1 respectively – ANOVA, F(2,76)=5.827, p=0.004). Responses to contextual questions suggested that reductions in RIPLS scores for doctors were due to a realisation that dealing with emergency life support was only a small part of their practice. However, the prevailing work cultures of nurses and doctors in the workplace may also play a part.

Conclusion: We demonstrated the translation of non-technical skills and attitudes acquired in undergraduate simulation to the clinical workplace. However, results are tempered for junior doctors beginning practice.

Keywords:           Work Culture, Translation, RIPLS, Simulation, Advanced Cardiac Life Support, Undergraduate Education, Skills and Attitudes, Patient Safety

We are writing to express our strong support for a crucial initiative aimed at improving health profession education, particularly in dental education. Dental education, like all healthcare fields, evolves continuously due to advances in research, technology, and patient expectations (Wong et al., 2020). Dental schools have a pivotal role in shaping the future of oral healthcare professionals, and the absence of such departments may hinder their ability to prepare competent, patient-focused dental professionals. Currently, curriculum development in dental education often faces challenges in keeping pace with the rapidly evolving landscape of oral healthcare. While dental schools are renowned for their rigorous curriculum and comprehensive clinical training, the development of effective teaching methods, curriculum enhancement, appropriate assessment, and faculty development often receive insufficient attention.

I. INTRODUCTION

Contemporary undergraduate medical education is increasingly emphasising the cultivation of student ownership and autonomy, entrusting learners with the responsibility to take charge of their own studies. Across Asian countries, high school graduates embark on their medical education journey at the age of 19 to 20 years, stepping into the realm of adulthood and assuming accountability for their academic pursuits. As the landscape of medical education undergoes transformative shifts propelled by technological advancements and evolving pedagogical approaches, one enduring tradition faces scrutiny: the imposition of compulsory lecture attendance.

I. INTRODUCTION

Telemedicine is defined as delivering healthcare services across distances using telecommunication technology (Waseh & Dicker, 2019). It helps ensure continuity of care for vulnerable patients to address the unique demands on our health system, especially in times of crisis, such as the COVID-19 pandemic, via virtual follow-up. It is also helpful in engaging medical students in training and patient care (Aron et al., 2020).

During the pandemic, virtual follow-up (VF) home visits were introduced in the integrated family medicine curriculum for Year 4 students. The family medicine curriculum for Year 4 students highlights the significance of comprehending chronic illnesses within the broader framework of the patient’s family and environment via the Follow-up Study of Patients with Chronic Illnesses programme, traditionally conducted through in-person patient visits. This study investigated the challenges faced while conducting virtual follow-up (VF) patient visits amidst the COVID-19 pandemic.

I. INTRODUCTION

Providing comprehensive palliative care is a global challenge, particularly in resource-limited settings like Indonesia (Putranto et al., 2017). Palliative care education in Indonesia is often underrepresented in medical curricula, leading to gaps in understanding and application among future healthcare professionals. This issue is compounded by the dominance of lecture-based classrooms from elementary to high school in Southeast Asia, including most medical education in Indonesia. Implementing a flipped classroom approach, which reverses traditional lecture-based and promotes active learning, could transform the education of healthcare professionals by effectively integrating surgery and palliative care within the Indonesian context (Hew & Lo, 2018).

Dear Editor,

Comprehensive review articles require more than just gathering information; they require careful synthesis, analysis, and effective communication (Dhillon, 2022). Benjamin Bloom’s Taxonomy offers a systematic framework, guiding authors through remembering, understanding, applying, analysing, evaluating, and creating (Adams, 2015). Leveraging Bloom’s Taxonomy enriches writing, ensuring impactful and thorough reviews.

At the foundational level of remembering, authors embark on a meticulous literature search to gather pertinent studies. For instance, in a review exploring “Innovative Pedagogical Approaches in Medical Education,” authors meticulously scour databases such as PubMed and ERIC using keywords like “medical education” and “innovative teaching methods.”

Dear Editor,

Whenever I think about student and faculty wellness, I am reminded of two sayings. Firstly, a Taoist saying that recommends we should always “look close, not far” (Wee Kee Jin, personal communication, August 25, 2012). And secondly, William Osler’s saying, “Our main business is not to see what lies dimly in the distance but to do what lies clearly at hand” (Bryan, 1997). Both quotes suggest that the most prudent course of action for students and faculty is to always reflect on one’s own actions and focus on the tasks at hand.

There is also a strong sense of reflecting in- and on-action, whereby students and faculty need to reflect on their experiences in a timely manner to optimise the opportunity for constructive transformation (Schon, 1983). With this in mind, monitoring wellbeing engenders the prospect of the cultivation of wellbeing. To engage this mindset, it is crucial that students and faculty are aware of, and honest about, what is happening in their minds and bodies and accept that mistakes can happen, but these experiences can lead to transformation, i.e., that they invest in loss (Buchanan, 2024).