Submitted: 1 January 2025
Accepted: 12 August 2025
Published online: 7 October, TAPS 2025, 10(4), 44-54
https://doi.org/10.29060/TAPS.2025-10-4/OA3613

Dinushee Atapattu-Bakmeewewa¹, Bhagya Devagiri¹, Gayanthi Kodituwakku¹ & Madawa Chandratilake²

¹Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Sri Lanka;  ²Department of Medical Education, Faculty of Medicine, University of Kelaniya, Sri Lanka

Abstract

Introduction: Tele-clinical training is an effective approach, increasingly adopted post-pandemic and in resource-limited settings. However, it requires systematic development. This study details the first-time implementation of a tele-clinical training in an undergraduate Speech and Hearing Sciences programme, exploring student experiences and validating a novel evaluation tool, specifically designed for tele-clinical training programmes.

Methods: The study used a mixed-method approach. Quantitative data were gathered from 128 students using the developed 23-item Kelaniya Tele-Clinical Evaluation Tool (KeTCET), which covers three broad areas: Learning Environment, Supervisory Attributes, and Telehealth Teaching Practices. Qualitative insights from 13 participants were thematically analysed. The tool was validated for reliability and psychometric robustness using expert feedback and statistical evidence.

Results: Quantitative analysis showed high domain scores: Learning Environment 80.64%, Supervisory Attributes 81.67%, and Telehealth Teaching Practices 80.31%. Strong positive correlations between domains (r > 0.86, p < 0.001) indicated interconnectedness. The 23-item evaluation tool demonstrated high internal consistency (Cronbach Alpha = 0.98) and a single-factor structure (Eigenvalue = 17.12, 74.44% variance explained). Qualitative data highlighted strengths in supervisor interaction and resource availability, also noting challenges such as issues in connectivity and limited peer learning. Students appreciated structured feedback and supervisor presence during tele-clinical sessions.

Conclusions: The successful development of a tele-clinical programme requires consideration of multiple elements broadly categorised as pedagogical environment, supervisory characteristics, and virtual teaching practices. Well-structured programmes can effectively meet training needs in resource-limited settings, although strengths and challenges may vary across learning environments. The validated 23-item KeTCET offers a reliable framework for evaluating and improving tele-clinical programmes.

Keywords:           Tele-clinical Programmes, Tele-clinical Supervision, Speech and Language Therapy, Audiology, Tele-clinical Evaluation, Tool Development, Undergraduate Clinical Training, KeTCET

Practice Highlights

• Tele-Practice based clinical programmes can be delivered successfully even in countries with limited resources.
• Robust planning is required to ensure that tele-clinical programmes address specific training needs and satisfy student expectations.
• Incorporating virtual clinical training modules into the regular curriculum can effectively address some of the barriers students have identified in tele-clinical learning.
• The unique features of tele-clinical training should guide the formulation of tailored guidelines and supervisory models for the virtual format.
• The evaluation of tele-clinical programmes is most effective when customised tools are developed to incorporate elements of the virtual format of training.

I. INTRODUCTION

The COVID-19 pandemic necessitated a global shift to online platforms in healthcare and education. Higher education institutions implemented online teaching methods, including webinars and interactive sessions (Hameed et al., 2020), while healthcare education adopted tele-medicine as a platform to continue clinical training, ensuring graduate preparedness for professional practice. Speech and language therapy and audiology professionals swiftly utilised tele-therapy, a method previously endorsed by the American Speech-Language-Hearing Association (ASHA, n.d.). This model of service delivery employs synchronous, asynchronous, and hybrid methods, tailored to patient needs and available resources. Beyond the pandemic, tele-medicine programmes offer enduring benefits, including improved access to care for remote and underserved populations, enhanced patient satisfaction and cost-effectiveness (Car et al., 2020). The World Health Organization emphasises the role of tele-medicine in broadening healthcare access, especially for people in remote areas and underserved communities (WHO, 2022).

Tele-clinical programmes, that is, clinical training conducted using tele-therapy have proven to be an effective method in clinical teaching and skills training. Considerable evidence demonstrates the tele-clinical programmes can be successfully used for clinical training, not limiting it to practical skills (Anderson et. al., 2023) but also addressing attitudinal changes (Wearne et. al., 2015) and clinical soft skills (Bramstedt et. al., 2014; Liu et. al., 2022).

Clinical supervision, distinct from classroom teaching, involves case-based learning, critical thinking, and professional behaviour modelling (Council of Academic Programmes in Communication Sciences and Disorders (CAPCSD), 2013). Traditionally conducted face-to-face clinical supervision shifted to tele-clinical supervision during the pandemic, utilizing a variety of strategies (Shawwa, 2023). However, much of the available literature on tele-supervision does not clearly state whether important aspects of clinical teaching, such as supervisor–student relationships and feedback (Kilminster & Jolly, 2000), were considered during programme design.

Evidence suggests that the effectiveness of tele-supervision depends significantly on the qualities of both the supervisor and the supervisee (Martin et al., 2017). Positive supervisory relationships, characterised by structure and support (Martin et al., 2014) are achievable in both virtual and face-to-face formats (Reese et al., 2009). Effective tele-supervision also depends on communication strategies, supervisor availability, and feedback models (Gibson et al., 2007; Snowdon et. al., 2019). Technological barriers, such as poor connectivity and equipment issues, can hinder outcomes, necessitating proactive solutions (Martin et al., 2017; Reese et al., 2009; Tarlow et al., 2020).

Systematic evaluation of student experiences in tele-clinical programmes is essential to understand their effectiveness. Most studies that report on tele-clinical programmes in allied health sciences (e.g., Bacon et al., 2023; Snowdon et al., 2019) and medicine (e.g,. Pit et al., 2021; Wearne et al., 2015) rely primarily on qualitative interview data. Ideally, such qualitative data should be supplemented with the use of a validated and reliable tools specifically designed to evaluate a virtual model of clinical training. This ensures that tele-clinical learning meets the professional standards and training requirements of audiology and speech and language therapy. The objectives of this study were to evaluate student experiences in an undergraduate Speech and Hearing Sciences tele-clinical training programme, and to validate a feedback tool to evaluate similar tele-clinical programmes.

II. METHODS

A. Context and Setting

The BSc (Hons) Speech and Hearing Sciences is a full-time, four-year undergraduate programme. The qualification allows graduates to practice as speech and language therapists or audiologists following registration at the national medical regulatory body. The programme consists of theoretical classroom-based sessions, synchronous to intensive supervised clinical training offered across the four years of study. Speech and Language Therapy (SLT) undergraduates are trained to work with communication and swallowing disorders while audiology undergraduates train in the detection and management of hearing loss, across the life span.

The data gathered in this study reflects experiences from the pandemic period, when clinic and hospital-based teaching was significantly limited. For almost two and a half years since the commencement of the pandemic, SLT and audiology service provision shifted fully into a tele-therapy programme. Simultaneously, students were enrolled in a tele-clinical programme, offered two to three times per week, where they worked with the patient under the supervision of an academic or qualified clinician. All sessions took place using the Zoom platform, which was made freely available to students by the university. Tele-therapy for adult patients requiring SLT services was delivered primarily using a synchronous method and for paediatric clients using an asynchronous or a mixed method. Audiology clinical services were primarily synchronous. The tele-clinical training was designed to align with the method of tele-therapy (Table 1).

Format	Synchronous Method	Asynchronous Method	Hybrid Method
Tele-therapy	Conducted in real time using audio or video interactive sessions.	Clinical management through stored images and captured data.	Combines both synchronous and asynchronous methods.
Tele-clinical Supervision	Students conduct session. Supervisor joins in. Feedback is provided simultaneously and after session.	Students join session. Supervisor shares recorded videos and relevant clinical information/documentation. Students are given time to reflect.	Students conduct session. Supervisor joins in. Following a short real-time session, a recorded video is watched together. A discussion follows.

Table 1. Modes of Tele-therapy and tele-supervision delivery

The general arrangement of a synchronous session was that the patient, student and supervisor joined the session at a mutually agreed time, but from three separate locations. Material for the therapy session, if required, was developed and shared on the screen by the student. For paediatric clients, parents arranged the toys needed. In audiology, students gathered patient data through interviews and questionnaires with limited use of conventional hearing tests. Auditory verbal training  (AVT sessions) in audiology followed a similar format to SLT synchronous sessions. The supervisor remained a silent observer unless intervention was required. In all sessions, supervision concluded with an interactive patient discussion, facilitated by the supervisor using Zoom features such as whiteboard, break out rooms etc.

The evaluation of the tele-clinic programme was conducted using mixed methods by collecting students’ perceptions quantitatively (Phase I) and qualitatively (Phase II).

B. Phase 1- Development of Evaluation Tool and Quantitative Feedback

The quantitative evaluation of the tele-clinical programme was conducted with the aim of developing and validating a standardised tool for evaluating similar programmes.

1. Tool Development

As there are no existing tools available to evaluate SLT or audiology clinical programmes, whether face-to-face or virtual, a new evaluation tool was developed based on the Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale (CLES +T ) (Mikkonen et al., 2017) and the Nursing Clinical Facilitator Questionnaire (NCFQ) (Espeland & Indrehus, 2003). The resulting 23-item tool, named the Kelaniya Tele-Clinical Evaluation Tool (KeTCET), was designed to map onto three primary domains: pedagogical/learning environment (LE; 9 items), supervisory relationship (SA; 6 items), and telehealth teaching practices (TTP; 8 items). The stem question used here was, how often did you experience this aspect in the online clinical learning sessions provided for the SHS programme during university closure? (Table 2). Participants rated each item on a 5-point Likert scale (0 – never, 1 – rarely, 2 – sometimes, 3 – often and 4 – always).

To enhance face and content validity, a panel of 10 experts in speech and language therapy and/or audiology  rated the tool items on a five-point scale for [a] content appropriateness, [b] relevance, and [c] technical accuracy (1 = Very Low, 5 = Very High). Experts could also provide comments to refine the items. The panel scored the items high across all three aspects (mean[a]=4.8; mean[b]= 4.8; mean[c]=4.7). A measure of item relevance, I-CVI (Item- Content validity Index) scores for all items (n=23) were > 0.9. Minor language adjustments suggested were incorporated. The tool was then translated into Sinhala and Tamil and pre-tested with five students (three Sinhala speakers and two Tamil speakers) to confirm clarity and translation accuracy.

2. Study Participants

All 155 SLT undergraduate students in the SLT and audiology programmes who had attended at least 80% of the tele-clinical training sessions were considered eligible for participation in phase I. All eligible students were invited to participate in the study. At the time of data collection, these students were in their second, third, and fourth years of study. The minimum sample size required was calculated based on the recommended item-to-response ratio of 1:5 for factor analysis (Bujang et al., 2012; Gorsuch, 1983), requiring at least 115 responses. A total of 128 students responded (82.6%) to phase I.

https://doi.org/10.29060/TAPS.2025-10-4/TT004

Lambert Schuwirth

Professor of Medical Education
NewMedSchool, Australia

We are currently living in a time in which different assessment paradigms co-exist. There are contexts in which assessment is purely seen as a measurement, for instance national licensing. There are contexts in which assessment is predominantly judgement, such as in VIVAs and there are contexts in which these are combined to form an integral programmatic assessment for learning program.

Although a programmatic assessment for learning aims to combine both measurements and judgements, the manner in which all assessment data is synthesised and fed back to the learner is always through judgement and narratives. That is inevitable because numerical outcomes without added narratives are as meaningless as a scientific paper without an introduction, methods and discussion section and only the tables of the results. Numerical outcomes can only drive learning purely by punishment and reward and cannot provide the learner agency or support with meaningful self-regulation of their learning. Modern professionals, however, need capabilities to self-regulate their learning.

Assessment for learning therefore always needs to be programmatic – as opposed to formative assessment which can simply be a test that does not count.

But are narratives defensible? This is a common concern as we tend to trust quantitative outcomes more than qualitative. I find this odd. We trust healthcare as a system, even though the history, physical examination results, pathology and imaging reports and even contextualised lab values are all narratives, as are the diagnosis and management plan.

In an educational context, I would therefore plea that assessment should be more like a diagnostic and therapeutic relationship with the medical student. Assessment should guide them to become the best doctor they can be, and with our intake of the brightest and most hard-working young people the vast majority are. But what about the minority? Yes, they need to be identified as well but focusing an entire system on an issue with a low prevalence (the irremediable student) creates a huge NNT problem and is a waste of money and resources.

But assessment needs to be credible and fair. That is where programmatic assessment differs from a testing approach. Testing defines fairness as equality – everybody receives the same standardised test. Programmatic assessment defines fairness as equity – everybody receives the same quality of assessment. Just like we don’t push all patients through the same template in healthcare, but offer bespoke and high-quality diagnostic and therapeutic care, we should do the same with assessment.

Submitted: 10 March 2025
Accepted: 5 July 2025
Published online: 7 October, TAPS 2025, 10(4), 55-62
https://doi.org/10.29060/TAPS.2025-10-4/OA3690

Aaron Tigor Sihombing^1,2, Antonia Kartika^3,4 & Anglita Yantisetiasti^2,5

¹Department of Surgery, Division of Urology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; ²Hasan Sadikin General Hospital, Bandung, Indonesia; ³National Eye Center-Cicendo Eye Hospital, Bandung, Indonesia; ⁴Department of Ophthalmology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; ⁵Department of Anatomical Pathology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia

Abstract

Introduction: Music preferences have been linked to personality traits, which in turn may influence career choices. This study explores the potential relationship between music genre preferences and medical specialty selections among residents at Padjadjaran University, Indonesia.

Methods: A cross-sectional survey was conducted among all residents trained in urology, ophthalmology, and anatomic pathology. Data collected included demographic characteristics, music genre preferences, and work habits related to music. Independent t-tests are used when data are normally distributed, whereas Kruskal-Wallis tests are used when data are not normally distributed.

Results: The study included 125 residents (19 pathology anatomy, 33 urology, 73 ophthalmology). Pop was the most preferred music genre across all specialties (48% in urology, 61% in ophthalmology, 52% in pathology anatomy). However, secondary preferences varied: rock (21%) was the second most popular among urology residents, jazz (10.9%) and indie (10.9%) among ophthalmology residents, and classical music (26%) among pathology anatomy residents. Demographic differences were noted, with pathology anatomy residents being older and urology residents having a higher proportion of males. Ethnic distribution was relatively consistent across specialties, primarily mixed ethnicity, Sundanese, and Javanese.

Conclusion: While pop music was the predominant preference across all specialties, secondary music preferences varied, potentially reflecting different personality traits associated with each specialty. The study’s findings are limited by its single-institution sample and cross-sectional design, necessitating further research with larger, more diverse populations to explore the underlying mechanisms linking music preferences to medical specialisation choices.

Keywords:           Music Preferences, Medical Specialty Selection, Personality Traits

Practice Highlights

• Personality traits could predict specialty preferences among medical students.
• Music genre preferences are associated with personality traits, thus are drawn to particular type of music.
• Residents in different specialties distributed music genres differently.

I. INTRODUCTION

The notion that music genres reflect and influence personality traits is a topic of much debate and interest. Research has shown a correlation between musical preferences and personality traits, with certain genres being associated with specific characteristics (Andrews et al., 2022; Wang et al., 2024). For example, music in slow tempo and music in minor keys were significantly predicted by emotional stability and optimism, whereas music in fast tempo and music in major keys was significantly predicted by openness to experiences, introversion, and gender (Dobrota & Reić, 2014; Upadhyay et al., 2017). Some evidence suggests that individuals drawn to certain music genres may exhibit personality profiles that align with specific career paths. For instance, individuals who prefer classical music tend to score higher in openness and introversion—traits associated with analytical or solitary professions—while those who enjoy rock or pop may display extraversion and sensation-seeking behaviors, often linked to high-energy or interactive professions (Rentfrow & Gosling, 2003; Schäfer & Mehlhorn, 2017). Moreover, individuals with high levels of achievement tend to prefer music that reflects their professional identity, indicating a potential association between occupational roles and musical preferences (Knox & McDonald, 2017).

Similarly, in the field of medicine, there is a growing interest in understanding how personality traits may influence medical residency preferences. Studies suggest that certain personality types may be drawn to specific medical specialties, and this alignment could impact their satisfaction and performance within that field. This intersection of music, personality, and medical career choices highlights the complex ways in which our preferences and personalities shape and reflect our identities and professional paths.

Culture and environment have a profound effect on a person’s personality (Smaldino et al., 2019; Triandis & Suh, 2002). Culture provides a framework within which individuals develop beliefs, values, and behaviours that are in harmony with their societal norms. It shapes personality through language, customs, and social norms, which guide an individual’s actions and interactions. Environment, encompassing family dynamics, social relationships, and educational experiences, also plays a pivotal role in molding personality traits. As individuals navigate through different environmental contexts, their personalities adapt and evolve, reflecting the dynamic interplay between their innate dispositions and external influences. This complex interconnection suggests that personality is not a static entity but a fluid construct that changes over time, influenced by the cultural and environmental landscapes we inhabit.

Indonesia’s rich of cultures is indeed a testament to its diversity, with over 300 ethnic groups calling it home. This multicultural environment offers a unique blend of traditions, languages, and beliefs, which can significantly shape an individual’s personality. Exposure to diverse cultural practices and values can foster open-mindedness, adaptability, and a complex worldview. Research suggests that multicultural experiences can enhance creativity, reduce stereotypes, and provide a broader perspective on life. Moreover, individuals who navigate multiple cultures may develop a multicultural identity, integrating different cultural influences into their personal identity, which can contribute to their overall well-being and social harmony.

The exploration of a potential correlation between musical preferences and medical specialty choice in Indonesia is indeed a fascinating subject. Since music has been noted to affect personality, which in turn influences the choice of medical specialisation, Indonesia is a multicultural country, and this correlation is intriguing. As a result, this study aims to determine if there is a distribution difference between music genre preferences and healthcare specialisations in Indonesia.

II. METHODS

This research employed a cross-sectional study design, with total sampling of all Padjadjaran University resident utilising a comprehensive survey administered to all residents. The study population comprised residents specialising in three distinct medical disciplines: urology, ophthalmology, and anatomic pathology. All residents in urology, ophthalmology, and anatomic pathology were eligible to be included. Exclusion criteria included incomplete responses or refusal to provide consent. This selection allowed for a comparative analysis across specialties with varying degrees of procedural and cognitive demands. In this study we utilised total sampling, all eligible residents during the study period were invited to participate. The survey instrument was designed to collect a range of demographic and preference-based data. Participants were asked to provide information regarding their age, current year of residency training, and their preferred music genres. Crucially, the survey also explored the residents’ work habits related to music, specifically inquiring whether they typically worked with or without background music and their preferred music genre. The survey also collected information on spouse employment status, which was divided into two groups: physicians and non-physicians.

Statistical analysis was performed to assess the difference between groups within the collected data. The independent t-test was employed to analyse continuous data that demonstrated a normal distribution. For continuous data that did not meet the assumptions of normality, the non-parametric Kruskal-Wallis test was utilised. In all statistical analyses, a significance level (p-value) of 0.05 was established as the threshold for statistical significance, indicating a 5% risk of concluding a relationship exists when it does not. All participants have given informed consent before any data were collected.

III. RESULTS

A total of 125 residents participated in this study. Nineteen pathology anatomy residents, 33 urology resident and 73 ophthalmology residents were included. The descriptive statistic of age and sex are presented in Table 1. Marital status and ethnicity are presented in Appendix 1.

		Pathology Anatomy (n = 19)	Urology (n = 33)	Ophthalmology (n = 73)	p-value
Age
	Mean ± SD	33.16 ± 3.11	30.09 ± 2.11	30.51 ± 2.55	0.002*
	Median (Range)	34.00 (29-39)	30.00 (27-37)	30.00 (26-36)
Sex
	Male	4 (21.1%)	26 (79.8%)	22 (30.1%)	<0.01
	Female	15 (78.9%)	7 (21.2%)	51 (69.9%)

*Kruskal Wallis Test

Table 1. Age, sex, ethnicity and marital status of the residents

In male resident population, distribution between married and not married is quite equal between specialty (Figure 1). In urology, married male residents is 58%, while it is 68% and 50% in ophthalmology and pathology, respectively. There is sharp difference in female urology resident compared to other specialties. There are only 14% female urology residents who is married, while in ophthalmology and pathology is 63% and 67%, respectively.

Figure 1. Marital status proportion in male (A) and female (B) residents

Figure 2. Proportion of married residents with physician spouse

In urology, 81% of residents also married to physicians, while it is only 55% in ophthalmology and 42% in pathology (Figure 2).

Most residents in urology (69.70%) and pathology (73.68%) reported that they were listening to musical background while working (Figure 3). While only 38.36% in ophthalmology that worked with musical background.

Figure 3. Comparison between residents working with musical background and those without

Figure 4. Residents’ music genre preference (in percentage)

IV. DISCUSSION

This study explored the relationship between music genre preferences and medical specialty selections among residents at Padjadjaran University. There is a higher median age among pathology anatomy residents than among urology and ophthalmology residents, and there is a greater proportion of males in the urology department (Table 1). In spite of this, all residents from the three departments belong to the same generation (Juekiewicz, 2023). As residents in the same generation (generation Y), they are influenced by similar external influences, values, and ethical principles which influence their music genre preferences (Juekiewicz, 2023; Krumhansl, 2017).

Given that Indonesia is composed of multiple ethnic groups, and ethnicity could influence music genre preference, we found that the top three ethnic groups that reside in the three departments are somewhat similar, namely mixed ethnicity, Sundanese, and Javanese (Table 1). This percentage ranking differs from that of the Badan Pusat Statistik (BPS), which indicates that the top three groups by population are Java (40.22%), Sundanese (15.5%), and Batak (3.58%) (Badan Pusat Statistik [BPS], 2010).

Since music serves as a connection function between people, we evaluate the marital status of the residents (Bamford et al., 2024). In urology, 52% of residents are married, while in pathology and anatomy, 37% and 36% are married, respectively (Table 1). While females comprise only 21% of urology residents, the majority of them are unmarried (86%), which is compared to only 33% and 37% of female pathology anatomy and ophthalmology residents who are unmarried, respectively (Figure 1).

Eighty-one percent of urology residents are married to a physician compared to 55% of ophthalmology residents and 42% of pathology anatomy residents (Figure 2). Study by Dutta RR, et all showed that only 26.1% of physician married with physician (Dutta et al., 2024). However, the study did not compare the percentage of physicians who are married to other physicians in each specialty.

Compared with urology residents (69.7%) and pathology anatomy residents (73.68%), only 38.36% of ophthalmology residents listen to music while working (Figure 3).

Pop genre is the most preferred genre among three groups of residents, comprising 48% of residents in the urology and 61% of residents in the ophthalmology groups, as well as 52% of residents in the pathology anatomy groups (Figure 4). This finding is similar to a study by Krumhansl that the pop genre is the most preferred genre for individuals born between 1940 and 1999 (Krumhansl, 2017). However, the second most preferred genre among urology residents is rock (21%), while jazz (10.9%) and indie (10.9%) are the second most preferred genres in ophthalmology, and classical music (26%) is the second most preferred genre in pathology anatomy. The difference in genre music preference can also be observed in the third to last rank on the list (Figure 4).

The variation in secondary music genre preferences among specialties may be partially explained by psychological theories of personality, particularly the Five-Factor Model (FFM), which posits five broad domains of personality: openness, conscientiousness, extraversion, agreeableness, and neuroticism. Prior research has shown that individuals who prefer classical music tend to score high in openness and introversion—traits often linked to reflective and analytical disciplines such as pathology. In contrast, rock and pop fans tend to exhibit higher levels of extraversion and openness to experience, traits more commonly observed in high-intensity, procedurally driven fields like urology (Rentfrow & Gosling, 2003; Schäfer & Mehlhorn, 2017). However, in our study, most residents prefer pop music.

From a sociological perspective, medical specialties may be seen as “occupational subcultures” (Becker, 1963), each with distinct values, stress profiles, and interaction patterns. These subcultures attract individuals whose identities align with the implicit norms of the field (Light, 1979), potentially explaining the alignment between music preference and specialty. For example, the high-paced, team-intensive nature of urology might attract residents who identify with more energetic and expressive music like rock. Conversely, fields like pathology, which involve solitary analysis, may appeal to those who appreciate structured and introspective genres like classical music.

This study has several limitations that affect generalisability of the findings. While the study used a total sample of residents from three departments, the number of residents from each specialty varies, with 19 respondents from pathology anatomy, 33 respondents from urology, and 73 respondents from ophthalmology. In addition, the study’s sample was drawn exclusively from residents of one university.

Despite its limitations, this study presents several strengths that contribute to its value. The study explores a unique and interesting relationship between music genre preferences and medical specialty selection, particularly within the Indonesian cultural context. This area is relatively understudied and by focusing on medical residents, a specific population facing unique career pressures, the research addresses a relevant and understudied group. Furthermore, we acknowledgment of Indonesia’s diverse cultural influences, highlighting the potential impact of environment on both musical tastes and professional choices. We hope that this study will open avenues for further research and raising awareness about the potential influence of external factors like music on medical professionals.

V. CONCLUSION

This cross-sectional study explored the relationship between music genre preferences and medical specialty selections among residents at Padjadjaran University in Indonesia. While the study revealed variations in music preferences distribution across different specialties, pop being the most favored genre and different preference in second to last rank.

We found that there are differences in demographic distributions, particularly age and gender, among the resident groups, it is important to acknowledge the limitations of the study’s design. The use of a single-institution sample and the cross-sectional methodology limit the generalisability of the findings and preclude the establishment of causal relationships. Nevertheless, the study offers a preliminary investigation into the potential interplay between musical tastes and career choices within the medical field, raising intriguing questions for future research.

Further studies with larger and more diverse samples, are needed to expand upon these findings, and to explore the underlying mechanisms that might link music preferences to medical specialisation.

Notes on Contributors

ATS contributed to the conceptualisation, data curation, methodology, formal analysis, project administration, validation, investigation, funding acquisition, resources, visualisation, software, supervision, writing of the original draft, review and editing.

AK contributed to the methodology, formal analysis, resources, visualisation, software, supervision, writing of the original draft, review and editing.

AY contributed to the investigation, visualisation, software, supervision, writing of the original draft, review and editing.

Ethical Approval

This study was performed under the ethical approval from Hasan Sadikin Hospital Ethical Committee (Approval Number: DP.04.03/D.XXIV.16/14527/2024). This study is in line with the 1964 Declaration of Helsinki and existing ethical standards.

Data Availability

The data supporting this study are available upon reasonable request to Corresponding Author.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Declaration of Interest

The authors declare no relevant financial or non-financial competing interest from any party.

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Wang, Y., Qu, W., & Ge, Y. (2024). Relationship between personality and music preference: Psychometric adaptation of the music preference scales in a Chinese sample. Musicae Scientiae, 29(1), 109-130. https://doi.org/10.1177/10298649241287072

*Aaron Tigor Sihombing
Jl. Raya Jatinangor, Cikeruh, Kec. Jatinangor,
Kabupaten Sumedang, Jawa Barat 45363
+62 813-2132-9126
Email: aarontigor@gmail.com

Submitted: 11 February 2025
Accepted: 11 July 2025
Published online: 7 October, TAPS 2025, 10(4), 97-99
https://doi.org/10.29060/TAPS.2025-10-4/II3669

Suryanti Chan¹, Hamzah Hamzah² & Insan Sosiawan Tunru³

¹Department of Medical Education, Faculty of Medicine, Universitas Dian Nuswantoro, Indonesia; ²Airlangga Teaching Hospital, Airlangga University, Indonesia; ³Faculty of Medicine, University Yarsi, Indonesia

I. INTRODUCTION

Medical education is a cornerstone of effective healthcare delivery, directly shaping professionals responsible for addressing the complex and evolving needs of patients, families, and communities. Over the last few decades, medical education has undergone significant transformations due to global trends that have influenced curricula structures, learning methodologies, and competency requirements for healthcare professionals. These shifts reflect broader societal, technological, and policy changes, necessitating adaptable and forward-thinking medical education systems.

One key driver of change is globalisation, fostering interconnected healthcare systems and necessitating curricula that emphasise global health perspectives, cultural competence, and cross-disciplinary collaboration.

Additionally, technological advancements, such as simulation-based learning, virtual reality (VR), augmented reality (AR), and telemedicine training, have revolutionised medical education, improving accessibility and enhancing learning experiences.

The increasing importance of accreditation and quality assurance frameworks ensures standardisation in medical education across regions, promoting transparency and continuous improvement (Bedoll et al., 2021). Simultaneously, the shift towards outcome-based education (OBE) prioritise competency-driven frameworks over traditional content-heavy curricula, aligning medical training with healthcare needs. Furthermore, cultural and contextual adaptations are crucial in tailoring curricula to regional healthcare priorities while maintaining global standards.

This paper examines how these international trends, globalisation, technological advancements, accreditation, outcome-based education, and cultural contextualisation, are shaping the future of medical education and influencing curricula to remain responsive to evolving healthcare demands.

II. APPROACH TO SYNTHESIS

Drawing on peer-reviewed articles, academic texts, and authoritative reports published over the past decade, this paper explores key international trends influencing medical education curricula. Sources were identified through a purposive review of major databases, such as PubMed, Scopus, and Web of Science, using keywords including “medical education curriculum,” “globalisation,” “technological change in education,” and “outcome-based education.” Selection was guided by relevance, conceptual contribution, and alignment with contemporary educational discourse. Through interpretive synthesis, the emerging themes were organised to highlight the evolving priorities and challenges in curriculum development across diverse global settings.

III. GLOBAL TRENDS SHAPING MEDICAL EDUCATION

Synthesising insights from the existing literature, several key themes emerge, including globalisation, technological advancement, accreditation and quality assurance, and the shift toward outcome-based education, each significantly shaping curriculum design in medical education.

A. Globalisation and Medical Education

Globalisation necessitates the integration of global health perspectives in medical curricula, enhancing students’ cultural competence, global awareness, and adaptability in diverse clinical settings. Imafuku et al. (2021) report that international electives and exposure to various healthcare systems foster a broader understanding of global health challenges. Rukadikar et al. (2022) emphasise embedding cultural competence longitudinally rather than as isolated modules. However, integrating global content can be hampered by linguistic, ethical, and logistical barriers, particularly in low-resource regions. There is also a risk of curricular homogenisation that overlooks local relevance. Initiatives such as the ASEAN Medical Schools Network attempt to address this tension by fostering regional collaboration while maintaining context-sensitive design. Ultimately, globalisation challenges medical educators to balance international standards with localised priorities, cultivating graduates who are both globally minded and locally responsive.

B. Technological Advancements

The digital transformation of medical education, catalysed by the COVID-19 pandemic, has reshaped how knowledge and clinical skills are imparted. Simulation-based learning, virtual patients, high-fidelity manikins, and telemedicine platforms offer realistic, risk-free environments for students to practise complex procedures (Castro et al., 2021). Virtual and augmented reality hold immense promise, especially in underserved areas where traditional clinical exposure is limited (Li et al., 2024). Nevertheless, adoption remains uneven. Barriers such as digital illiteracy, inadequate infrastructure, and resistance to change among faculty hinder optimal implementation. Furthermore, technological integration demands a pedagogical shift towards student-centred, self-directed learning models that not all institutions are prepared to adopt. Addressing these challenges requires systemic investment in digital infrastructure, faculty development, and curriculum redesign to fully harness the potential of educational technology.

C. Accreditation and Quality Assurance

Global accreditation standards, such as those set by the WFME, aim to enhance comparability and mobility of medical graduates by ensuring a baseline of quality and accountability (Bedoll et al., 2021). These frameworks advocate for continuous self-evaluation, peer review, and outcome monitoring. However, rigid adherence to international benchmarks may marginalise unique local needs and strain under-resourced institutions. For example, some Southeast Asian medical schools struggle to meet standards due to shortages in qualified faculty, simulation resources, or research infrastructure. Regional mechanisms like the ASEAN-QA (Asian University Network-Quality Assurance) Framework provide a more flexible model, supporting capacity-building and mutual recognition of quality. Moving forward, accreditation should not be seen solely as a compliance mechanism but as a catalyst for meaningful institutional improvement rooted in contextual realities.

D. Outcome-Based Education

OBE represents a fundamental paradigm shift, placing student competencies at the heart of curriculum design and assessment. Instead of focusing on the amount of content delivered, OBE emphasises the achievement of predefined clinical, ethical, and interpersonal outcomes. The model supports accountability and alignment between educational outcomes and healthcare needs. Ten Cate advocates for the use of Entrustable Professional Activities (EPAs) to operationalise OBE, offering a structured way to assess readiness for clinical practice. However, the practical implementation of OBE remains challenging. Many institutions lack robust tools for assessing soft skills, professional attitudes, and interprofessional collaboration. Furthermore, faculty may be unfamiliar with the principles of formative, feedback-oriented assessment that OBE requires. Successful implementation demands long-term commitment to faculty development, curriculum mapping, and resource allocation, as well as a cultural shift toward continuous quality improvement.

IV. CONCLUSION

The evolution of medical education is shaped by globalisation, technological advancements, accreditation, cultural adaptation, and outcome-based education. These trends emphasise the need for medical curricula that are adaptable, inclusive, and aligned with global healthcare challenges. Moving forward, medical education must remain dynamic and forward-thinking to prepare graduates for both current and future healthcare landscapes.

Notes on Contributors

Suryanti Chan (SC) contributed to the study design, data collection, and manuscript writing. She was responsible for analysing the findings and drafting the discussion.

Hamzah Hamzah (HH) contributed to the study design, literature review, and manuscript revision. He provided insights on the impact of international trends on medical education curriculum, particularly from the perspective of clinical training and healthcare service management in teaching hospitals.

Insan Sosiawan Tunru (IST) contributed to the study design, literature review, and manuscript revision. He provided insights on the impact of international trends on medical education curriculum, particularly from the perspective of accreditation regulation in Indonesia.

Ethical Approval

This manuscript is a literature review based on existing published studies and does not involve any original data collection or interaction with human participants.

Acknowledgement

Authors would like to express their deepest gratitude and appreciation to Prof. Ir Edi Noersasongko, M.Kom, Prof. Pulung Nurtantio Andono, S.T., M.Kom, Dr. Abdul Syukur, M.M, Dr. Hendriani Selina, Sp. A (K), MARS which has supported during this review.

Funding

This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Declaration of Interest

The authors declare that there are no conflicts of interest related to this study.

References

Bedoll, D., Van Zanten, M., & McKinley, D. (2021). Global trends in medical education accreditation. Human Resources for Health, 19(70), 1­­–15. https://doi.org/10.1186/s12960-021-00588-x

Castro, M. R. H., Calthorpe, L. M., Fogh, S. E., McAllister, S., Johnson, C. L., Isaacs, E. D., Ishizaki, A., Kozas, A., Lo, D., Rennke, S., Davis, J., & Chang, A. (2021). Lessons from learners: Adapting medical student education during and post COVID-19. Academic Medicine, 96(12), 1671–1679. https://doi.org/10.1097/ACM.0000000000004148

Imafuku, R., Saiki, T., Hayakawa, K., Sakashita, K., & Suzuki, Y. (2021). Rewarding journeys: Exploring medical students’ learning experiences in international electives. Medical Education Online, 26(1), 1913784. https://doi.org/10.1080/10872981.2021.1913784

Li, X., Elnagar, D., Song, G., & Ghannam, R. (2024). Advancing medical education using virtual and augmented reality in low- and middle-income countries: A systematic and critical review. Virtual Worlds, 3(3), 384–403. https://doi.org/10.3390/virtualworlds3030021

Rukadikar, C., Mali, S., Bajpai, R., Rukadikar, A., & Singh, A. K. (2022). A review on cultural competency in medical education. Journal of Family Medicine and Primary Care, 11(8), 4319–4329. https://doi.org/10.4103/jfmpc.jfmpc_2503_21

*Suryanti Chan
MD, MPH, MMed, PhD (Health Sciences), FIHFAA
Universitas Dian Nuswantoro,
Pendrikan Kidul Number 184,
Semarang, Central Java Province, Indonesia
(62)851-011-56248
Email: suryanti83@yahoo.com

Submitted: 11 January 2025
Accepted: 11 August 2025
Published online: 7 October, TAPS 2025, 10(4), 77-80
https://doi.org/10.29060/TAPS.2025-10-4/SC3818

Yassar Alamri

Department of Medicine, University of Otago, Christchurch, New Zealand

Abstract

Introduction: Response rates to surveys of medical students and junior doctors have not previously been explicitly examined. Reasons for the observed response rates have not been scrutinised.  The aims of the present study were to establish an expected response rate to electronic survey among medical students and junior doctors, and to explore reasons behind non-response.

Methods: A follow-up online survey was sent to 93 medical students and junior doctors. The primary method for participants to complete the survey was via the Internet using a well-known and established survey tool. Descriptive and inferential statistics were used to assess response rates and reasons for non-response.

Results: Out of 93 invited medical students and junior doctors, 47 returned the follow-up survey (response rate = 50.5%). The main reasons for non-response were: there were too many surveys (74.4%), lack of time (25.5%), and the original survey being too long (10.6%).

Conclusion: We found a mediocre response rate (50.5%) to electronic surveys by medical students and junior doctors included in this study. Several factors that may impede response to surveys (survey-related, and participant-related) have been identified, and these may be specifically targeted to improve survey response rates.

Keywords:           Medical Student, Survey, Response Rate, Research, Methodology

I. INTRODUCTION

Surveys offer an important method of collecting quantitative data from physicians and medical students on various aspects of medical and clinical research. The ease and convenience of online and web-based surveys (compared with telephone or face-to-face interviews) should theoretically enhance response rates. However, the ideal method of surveying the medical workforce (which would yield a high rate of and representative responses) is yet to be identified.

Physicians have traditionally been reported to have poor response rates to surveys in general. Studies that have specifically assessed response rates to surveys among physicians revealed overall rates of 35–50% (Cunningham et al., 2015). Response rates to surveys and reasons for non-response by medical students and junior doctors have seldom been specifically examined. Previous response rates to the National Physician Survey in Canada reported response rates of approximately 28–35% by medical students and junior doctors (Grava-Gubins & Scott, 2008), although these data are almost two decades old now.

Several reasons for non-response emerge from reviewing the pertinent literature; these can be divided into: survey-factors, and respondent-factors. Survey-factors include the length of the questionnaire (Grava-Gubins & Scott, 2008), perceived interest in and sensitivity of the surveyed topic (Cunningham et al., 2015), and the mode of survey delivery (i.e., electronic, telephone or face-to-face) (Grava-Gubins & Scott, 2008; Weaver et al., 2019). Several incentives have been instigated in order to improve response rates by addressing some of these survey-factors, including utilising electronic surveys that can be completed in more than one setting (at the participants’ convenience)(Weaver et al., 2019), monetary gifts or “educational credit” for participation (Grava-Gubins & Scott, 2008; Viera & Edwards, 2012), and employing internal “buy in” from a respected member of the intended sample (e.g., senior clinician or head of department) (Akl et al., 2011). Respondent-factors for non-response include lack of time, demographic differences, and the specialty of the respondent.

The aims of the present study were to establish an expected response rate to electronic survey among medical students and junior doctors, and to explore reasons behind non-response. No previous study has focused on medical students and junior doctors (i.e., junior medical workforce); therefore, addressing these issues would help fill several gaps in our knowledge.

II. METHODS

A. Study Setting

A previous study (Alamri et al, in press) invited all medical students at the University of Otago, and junior doctors at the Christchurch Hospital (both in Christchurch, New Zealand), to complete an electronic ‘index questionnaire’ on their research activities. The overall response rate of the original survey was 36% despite employing an online survey, several reminders and monetary gift vouchers.

B. Study Participants and Instrument

For the present study, eligible participants were medical student and junior doctor who had started the ‘index questionnaire’, but never completed it. The identified ‘non-responders’ were then invited to a secondary follow-up survey which was sent after the allotted time-period for the index questionnaire had lapsed (August–September 2018).

The follow-up survey was intentionally designed to be very brief, and based upon previous similar surveys (Cunningham et al., 2015). It only included four questions: participant age and sex, current career, and “what were the reasons for not completing [the index questionnaire]?”.

C. Statistical Analysis

Descriptive statistics (means ± standard deviations, and percentages) were used to analyse most of the data. Comparisons between medical students and junior doctors (two sub-populations with different responsibilities and time commitments) were conducted using Chi-square analyses for categorical values (e.g., sex, and entry to medical school), and Mann-Whitney U test for nonparametric continuous variables (e.g., age). Statistical significance was determined if type I error rate was < 5% (p-value < 0.05). All analyses were performed using the Statistical Package for Social Sciences software (SPSS Statistics®, version 22.0.0.0).

III. RESULTS

A. Study Participants

A total of 93 eligible participants were identified as potential participants. Following electronic invitation, 47 returned the follow-up survey (response rate: 47/93 = 50.5%). Two thirds (31/47; 66%) of the respondents were female. The median age was 23 years (range, 19–42). Most of the respondents (40/47, 85.1%) were medical students (see Table 1).