We are delighted to present this fourth thematic issue of The Asia Pacific Scholar (TAPS) on Developing a Holistic Healthcare Practitioner for a Sustainable Future. This issue encapsulates a wealth of contributions from authors across regions and disciplines, reflecting the shared agency in addressing the changing landscape of healthcare. Authors were invited to explore how sustainability, inclusivity, and innovation could be interwoven into the formation of the modern practitioner. In response, 14 thought-provoking papers were submitted and accepted. These papers explored the vital shift from siloed clinical training toward education that integrates empathy, well-being, interprofessional collaboration, and environmental consciousness.

Abstract

Introduction: The provision of higher education has been for the longest time the responsibility of the state. With increasing demands for places in institutions of higher learning, there has been increasing involvement of the non-public (private) sector in this area. The extent of this involvement is wide and encompasses both nonprofessional and professional qualifications. This involvement has brought the issue of ensuring that graduates from the non-public sector institutions are on par with their public sector counterparts.

Methods: This paper looks at strategies that are in place or that may be employed to ensure that the non-public sector plays its part in developing holistic and fit for purpose healthcare practitioners with a primary focus on the Malaysian doctor. It is largely based on the local landscape, referring to global standards, expectations and recommendations.

Results: Developing a holistic healthcare practitioner begins with appropriate selection and delivering accredited standardised training and assessment.

Conclusion: It is expected that these strategies are similar for all healthcare professionals, and that adhering to the required measures will meet the expectations of the primary stakeholder, the patient.

Abstract

Introduction: The growing prevalence of burnout among healthcare professionals has emerged as a global crisis, adversely affecting individual well-being, patient care, and healthcare systems while imposing significant economic burdens. Addressing this systemic problem requires innovative, scalable interventions that target the root causes of burnout. Mindful Practice in Medicine (MPIM), developed at the University of Rochester School of Medicine and Dentistry, represents a promising approach. MPIM fosters self-awareness, emotional intelligence, teamwork, and compassion. With over 20 years of evidence-based implementation, MPIM has demonstrated substantial improvements in clinician well-being, burnout, empathy, teamwork, and patient-centered care.

Methods: This global perspective highlights the program’s global impact through case studies of MPIM-trained facilitators who have embeded these programs into undergraduate, graduate, and postgraduate medical education as well as into institutional healthcare systems.

Results: Examples from Switzerland, the United States, the United Kingdom, Australia, and Canada illustrate MPIM’s adaptability and effectiveness for fostering systemic cultural changes, restoring joy in medicine, and promoting organisational resilience.

Conclusion: These efforts underscore the potential of MPIM to catalyse a global paradigm shift in healthcare, improving outcomes for both professionals and patients. Further research and strategic scaling are necessary to maximise MPIM’s reach and sustainability and to address the intertwined crises of professional burnout and healthcare quality.

Abstract

Introduction: The healthcare landscape is evolving rapidly, driven by technological advancements, an aging population, and the increasing complexity of patient care. The National University of Singapore (NUS)’s Common Curriculum for Healthcare Professional Education (CCHPE) is a comprehensive framework designed to foster collaboration, communication, and shared decision-making among future healthcare leaders. This article explores how NUS Medicine’s curriculum prepares students for the challenges of modern healthcare through a multi-disciplinary approach, with a focus on Singapore’s unique healthcare context.

Methods: NUS Medicine employs several strategies including: (1) Curriculum design with the CCHPE structured around five pillars that integrate multi-disciplinary perspectives; (2) Educational Strategies through the implementation of Interprofessional Education (IPE) initiatives, Longitudinal Patient Experience (LPE) programs, use of technology and digital tools, as well as the assessment and feedback mechanisms to foster collaboration among students of different healthcare disciplines; and (3) Stakeholder Management though relationship building and ensuring leadership support.

Results: The CCHPE enhances teamwork, communication, and patient outcomes, preparing graduates to thrive in team-based healthcare environments. NUS Medicine graduates are known for their ability to effectively work in multi-disciplinary teams, contributing to high standards of care in Singapore.

Conclusion: NUS Medicine’s CCHPE emphasises the importance of collaboration in modern healthcare, preparing students to meet complex healthcare challenges, and is essential for ensuring that our graduates are able to meet the demand for high-quality, team-based care in Singapore.

Abstract

Introduction: The application of modern and innovative technology into anatomical science education has been on a rapid increase globally in recent years with the anatomy tutors and students playing important and complementary roles in the process of the integration.

Methods: This narrative perspective presents the current state of technological applications adopted in anatomy education in medical colleges in Africa and the roles of the anatomy tutors and students in the process.

Results: The role of the anatomy tutors in African medical colleges include facilitation of technological integration into anatomy education and curriculum, promotion of active learning in anatomy, design of innovative assessment strategies, provision of relevant technological support, and advocate for provision of resources and infrastructure. Similarly, the trainees played important roles in the process of technological integration into anatomy education in Africa which include increased acceptability of technology for anatomy learning, utilisation and validation of innovative assessment methods, peer-advocacy for technology-driven learning, and bridging the technological gap.

Conclusion: The active participation of both the tutors and students in the adoption of technological solutions and tools will continue to enhance the quality of anatomical science pedagogy across African medical colleges.

Abstract

Introduction: Reflection offers many benefits for medical students, improving self-awareness and integration of theory into real situations. However, like any skill, reflection must be learned and practiced. Reflective learning is also influenced by the workplace, particularly in students’ clinical training years. This study explored the factors perceived by educators to influence reflective learning amongst medical students undertaking a rural longitudinal integrated clerkship (LIC).

Methods: All educators within the LIC program were invited to participate. Educators come from both a medical and nursing background. Two focus groups (FG) were conducted. FG were facilitated by experienced researchers. Transcripts were analysed by two researchers using Braun and Clark’s approach to thematic analysis.

Results: Eleven educators participated in two focus groups (six medical educators; five nursing educators). Educators perceived that reflective learning was influenced at three levels: student, educator and institution. These findings aligned with workplace learning theory. Educator and institutional influences were identified as “affordances” which support or hinder reflection. Supportive affordances included labelling of reflection, multidisciplinary collaborative learning, and the longitudinal nature of the rural model. Hindering affordances included using artificial reflective assessments. Educators also identified characteristics of the individual student which may contribute to student decision-making about reflection.

Conclusion: This study provides a deeper understanding about educator experiences of reflective learning within LIC settings. The findings provide insights into the ways in which educators, educational institutions and student workplace settings may support or hinder reflective practice. This study also highlighted the potential for the LIC model to support reflective practice.

Keywords:           Reflective Practice, Undergraduate Medical Education, Rural Medical Education, Longitudinal Integrated Clerkship, Workplace Learning

Abstract

Introduction: An action research-guided national pre-registration pharmacist (pre-reg) training programme was implemented in two phases: July 2023 to January 2024, and May 2024 to January 2025. The programme is based on professional activities (PAs) required for independent practice, aligning with the Singapore Development Framework for Pharmacists’ competency standards. Workplace-based assessments (WBAs) graded using a supervision scale form the assessment framework.

Objective: This study aims to evaluate the appropriateness of PAs for training and assessment while gathering feedback on user experience.

Methods: Pre-regs and preceptors were selected through purposive sampling with randomisation. Data was collected via online surveys and group interviews. Interviews were conducted separately for pre-regs and preceptors using similar question guides, and audio-recorded, transcribed, then thematically analysed.

Results: Responses from 14 pre-regs and 16 preceptors during Phase One highlighted the strengths, challenges, and recommendations for improving PAs and WBA templates. Pre-regs felt the framework supports a seamless transition to post-course training, while preceptors recognised their role in ensuring that pre-regs attain appropriate supervision levels. The framework was positively received, with well-performing elements retained and areas for improvement identified. Insights gained from action research informed refinements to the framework. Action research for Phase Two is ongoing, with results forthcoming.

Conclusion: The study’s findings led to framework modifications for Phase Two implementation from May 2024. Adjustments were made to individual PAs and WBA forms, with consolidated guidance provided in a user toolkit for dissemination.

Keywords:           Action Research, Pre-registration Pharmacist Training, Entrustable Professional Activities

Abstract

Introduction: Although effective healthcare communication is widely acknowledged as essential, a significant gap remains in practical communication training for healthcare students. The Theory of Planned Behaviour (TPB) provides a framework for designing communication activities that positively influence healthcare students’ attitudes towards and perceived control over their communication skills. TPB also incorporates societal expectations around healthcare communication, encouraging students to apply their learned skills effectively. This study aimed to explore students’ experiences of interprofessional healthcare communication activities structured around the TPB within an interprofessional healthcare curriculum.

Methods: A qualitative descriptive study design was used to assess communication skill development among first- to third-year healthcare students participating in an interprofessional curriculum. Data were collected via an annual institutional module evaluation and anecdotal feedback and analysed thematically under the TPB’s key constructs: attitudes, subjective norms, and perceived behavioural control.

Results: Students reported positive experiences with communication-based activities, particularly those that involved real-world applications. Feedback indicated that interprofessional group activities and community engagement significantly improved students’ perceived communication efficacy, although some challenges in managing group dynamics were noted.

Conclusion: Intentionally integrating communication skills training within an interprofessional curriculum to create behavioral intention positively impacts students’ attitudes, motivation, and ability to communicate effectively in diverse healthcare settings. The TPB framework supports the purposeful design of communication-based activities, fostering a more patient-centered approach among future healthcare professionals. Further research should investigate the long-term effects of this curricular approach on professional communication practice.

Keywords:           Healthcare Communication, Interprofessional Education, Theory of Planned Behaviour, Curriculum Development

Abstract

Introduction: There are limited medical professionalism assessment tools that are adapted for Singapore. We aimed to evaluate the validity, reliability and feasibility of the Singapore version of the Professionalism Mini-Evaluation Exercise (P-MEX) for assessment of professionalism of residents at a teaching hospital in Singapore.

Methods: We collected assessment data from residents from July 2019 to January 2020. Content validity was evaluated through cognitive debriefing interviews (CDIs). Construct validity was evaluated using a priori hypothesis with another comparator instrument. Structural validity was assessed through both confirmatory factor analysis (CFA) using the original four-factor model and exploratory factor analysis (EFA). Internal consistency was assessed using Cronbach’s alpha.

Results: CDIs conducted with nine faculty supported content validity of the Singapore version of P-MEX. The cross-sectional data demonstrated satisfactory construct validity (83% of hypotheses met) and good internal consistency (Cronbach’s alpha ranged from 0.72 to 0.93). The CFA of the original four-factor model of the P-MEX did not obtain meet all the acceptable fit of indexes. EFA suggested a two-factor model—the first factor had an eigenvalue of 8.52 and explained 73.8% of the variance, while the second factor had an eigenvalue of 1.90 and explained 26.2% of the variance.

Conclusion: This study supports the content validity, construct validity, internal consistency of the Singapore version of P-MEX in assessing medical professionalism in the local residency training programme. However, there was no conclusive support for the original four-factor model of the P-MEX. EFA identified 2 main factors, which appeared to encompass “Patient care and inter-professional relationship skills” and “Reflective skills”.

Keywords:           Professionalism, Singapore, Validation, Assessment

Abstract

Introduction: Through collaborative pedagogical initiatives, the medical humanities (MH) have the potential to support healthcare professionals in developing various competencies in medical education (ME). However, there is a lack of data on faculty development programmes specific to this field.

Methods: Based on our experience in designing a medical humanities workshop for medical students, we conducted two faculty development (FD) workshops that adopted an interdisciplinary approach towards faculty training. These FD workshops served to train fellow clinician educators in the integration of the MH in ME.

Results: A total of 17 participants completed two workshops over two years, with seven participants in 2023 and 6 in 2024 completing pre- and post-workshop surveys that evaluated their experience, knowledge and skills. The survey consisted of six self-rated questions based on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree) with an open-ended question embedded in the post-workshop survey. A paired t-test evaluation of the results suggests that there was an increase in awareness, knowledge, and confidence.

Conclusion: Our MH-based FD programme is limited by the lack of qualitative data and further studies are needed. Similar programmes should include an introduction to the medical humanities and its methodologies so that a train-the-trainers approach is adopted. Programmes should also look beyond teaching effectiveness to include developing systemic awareness and support, assess outcomes such as professional identity formation, and build communities of practice for faculty members.

Keywords:           Faculty Development, Medical Humanities, Medical Education, Health Professions Education

Abstract

Introduction: Limited resources have caused many challenges in health care. Health workers faced dilemmas that potentially cause burnout. Medical students must be strengthened with resilience when facing dilemmas. This study aimed to investigate Indonesian students’ strategies for strengthening resilience after participating in a bioethics workshop based on reflective and collaborative principles.

Methods: A bioethics workshop based on reflective and collaborative principles without didactic elements was conducted with 30 medical students. We collected quantitative data from the Adapted Version of the Adult Personal Resilience Questionnaire and qualitative data from the students’ reflections on strategies to strengthen resilience. Descriptive statistics and thematic analysis were used to analyse the quantitative and qualitative data, respectively.

Results: Thirty students participated in the study. The total score of the resilience questionnaire was 4.28 (SD 0.39), indicating that the students perceived themselves as having a moderate-to-high level of resilience for all items. The following four themes from the qualitative analysis were identified: faith, adaptation, self-management, and relationships.

Conclusion: Indonesian students’ strategies for strengthening resilience are related to faith, adaptation, self-management, and relationships. Although without a didactic approach, the reflective and collaborative learning in this workshop can raise medical students’ awareness of strategies for building resilience and provided an opportunity for students to reflect on their resilience level.

Keywords:           Resilience, Reflective Learning, Collaborative Learning, Self-Management, Relationships, Faith, Mixed-Method Approach

I. WHERE THE STORY STARTED…

Climate change and health tractions have loudly cumulated at the recent Asian Pacific Medical Education Conference, APMEC 2025. This has alerted us, the mental health professionals in Malaysia, to reflect and to wonder what has been put in place to address the mental health issues while climate change is impending in our country. Thus, this paper aims to skim through the websites of global and Malaysian mental health governing organisations and advocates for climate change and mental health information. The keywords used for searching the official websites were “mental health” and “climate change.” The official websites selected were those that discuss and outline action plans for both mental health and climate change.

I. INTRODUCTION

Medical education is transforming to nurture not just clinical expertise and theoretical understanding but also the holistic development of healthcare clinicians. In an era where sustainability in healthcare demands adaptable, resilient, and empathetic professionals, Personal Development Programs (PDPs) have emerged as vital tools. These programs aim to equip healthcare clinicians —doctors, nurses, and allied professionals—with essential skills like communication, empathy, and resilience while fostering lifelong learning and personal well-being. This personal view explores the critical role of PDPs in shaping healthcare clinicians who are prepared to meet the physical, psychological, and social challenges of their roles, thereby contributing to a sustainable future in healthcare. We highlight the benefits, current frameworks, challenges, and strategies necessary for effectively integrating PDPs into medical education to cultivate a holistic, future-ready workforce.

I. INTRODUCTION

In this article I will outline some of the personal and clinical challenges faced by medical and allied health professionals. Mindfulness will be proposed as a necessary skill to be taught in under and postgraduate training to address a number of these challenges. To provide some insights into how this can be done effectively, I will share our experience from Monash University where we have successfully integrated the mindfulness-based Health Enhancement Program (HEP) into medical and allied health professional training for over 20 years. The case will be made for why other medical schools around the world can benefit from adopting similar curriculum.

I. INTRODUCTION

Sustainability was the key topic at APMEC 2025. However, how can we maintain care quality when patient demands overshadow healthcare workers’ well-being? The mental health challenges faced by medical students and healthcare professionals – including high workload, burnout, and the emotional toll of the second victim phenomenon, which is the emotional and psychological distress healthcare professionals experience after being involved in or witnessing an adverse patient event or medical error – are well-documented yet often insufficiently addressed (Busch et al., 2021). Despite growing awareness, existing institutional policies for managing and monitoring mental well-being remain fragmented and unsustainable (Kuhlmann et al., 2024). In the Conference workshop session, “Promoting Mental Health in HPE and Healthcare: Partnering for Change”, we were able to create a safe space in which sincere and honest experiences were shared among the participants, who were medical doctors, medical educators, and support staff for medical students and they were able to learn from one another. Therefore, the aim of this paper is to share our insights and recommendations that can be helpful for medical educators and policymakers in ensuring that the healthcare workers well-being is maintained for a sustainable future.

“My student is not very professional.”

“They failed their OSCE station because they need to be more professional.”

“What’s the best tool to assess professionalism?”

These kinds of comments and questions are common in medical education – and they reflect an unhelpful tendency to treat professionalism as a singular, all-encompassing trait. In reality, professionalism is not one thing. It’s many things. It’s time we started talking about professionalisms – plural.