Abstract

Introduction: The medical education system of Myanmar has evolved through a dynamic history influenced by colonial legacies, national development efforts, and global collaborations. This article explores the progression of medical education in Myanmar, focusing on its historical milestones, challenges, and advancements in response to societal and healthcare needs.

Method: This study is based on a comprehensive review of historical records, policy documents, and academic literature, with “A Concise History of Medical Education in Myanmar” by Aung Than Batu as a primary reference. Key milestones, collaborations, and innovations were analysed to trace the evolution of medical education from the colonial period (1907) to the present day. Quantitative data, including the number of medical universities, training durations, and infrastructure developments, were included for a clearer perspective.

Results: The analysis highlights transformative milestones, including the establishment of the first medical school in 1907 and Rangoon Medical College in 1927. Over time, Myanmar has adapted to challenges such as resource constraints and political instability by fostering international collaborations and leveraging technology. Teaching methods have evolved significantly, integrating modern technologies alongside traditional pedagogies.

Conclusion: Myanmar’s medical education exemplifies resilience and adaptability. By aligning its system with global standards, fostering research, and leveraging international expertise, the nation continues to contribute to global medical education and healthcare. This narrative serves as an inspiration for countries navigating similar challenges in medical education.

Abstract

Introduction: Niigata University School of Medicine and Niigata University Graduate School of Medical and Dental Sciences have been engaging in medical exchanges with Russian medical universities for over 30 years. In 2015, a double-degree program with Russian medical universities was initiated, leading to a multi-layered education project that included short-term undergraduate student exchange programs and graduate-level double-degree programs, resulting in the circulation of human resources.

Methods: The program was conducted in English, and a maximum of 15 credits could be transferred based on the universities’ regulations. Degree examinations were conducted independently, and successful candidates were awarded degrees from both Niigata University and their home university in Russia. The project was overseen by the G-MedEx Centre at Niigata University, which included staff with international experience.

Results: The difference in standard study duration between Japan and Russia was eliminated by using a four-year system in the graduate school doctoral programs. Three study models were proposed by Russian universities, considering each university’s regulations and various circumstances. The curriculum was determined based on the rules of the universities in Russia and the circumstances of the students. Agreements were made with each university in supplementary documents.

Conclusion: Despite the differences in educational standards and the lack of a common educational framework between Japan and Russia, the difficulties can be overcome, and educational compatibility can be increased.

Abstract

Introduction: Pharmacology, though challenging, is fundamental in medical practice, necessitating effective knowledge acquisition and retention for future application. This study aims to analyse student perceptions of the newly introduced teaching method, peer assessment, to enhance pharmacology teaching.

Method: Eighty-six third-year medical students of the Faculty of Medicine, University of Peradeniya participated in the peer assessment. They were divided into two groups of 40-45 and a case scenario in pharmacology was given to answer. Three volunteers from each group presented the answers. Peers evaluated the answers using provided criteria and gave feedback. The teacher then facilitated discussions, highlighting key points. Assessors and assesses perceptions on the teaching learning method was assessed using questionnaire and focus group discussions (FGD).

Results: The majority of students (n=64) (74.41%) enjoyed the task of assessing their peers. 80.23% (n=69) acknowledged the value of peer assessment for student engagement. However, 34.88% (n=30) mentioned that they did not feel they had the skills and knowledge to assess their peers. 17.43% (n=15) mentioned that they were reluctant to be critical of their peers. In the FGD students mentioned that in this student-centered learning method all students actively participated than the usual small group discussion sessions. They could compare peers’ knowledge with their own knowledge and preferred the teacher grading to be combined with peer grading.

Conclusion: Peer assessment for enhancing pharmacology teaching was well received by the students. Also, students emphasise the importance of lecturer guidance and advocate for a combined assessment approach to improve engagement and learning outcomes.

Abstract

Introduction: The effective implementation of changes in medical school curricula requires modifications to assessments alongside teaching strategies. The World Federation for Medical Education emphasises the need for assessment policies to align with educational outcomes. In Myanmar, the Defence Services Medical Academy (DSMA) has adopted an outcome-based curriculum since 2017, but the standard setting in assessments remains pending. This study explores concerns and challenges for enhancing assessment practices.

Methods: An explanatory sequential design was used. For a quantitative approach, 36 assessment committee members were surveyed using questionnaires, and pre-and post-test analyses were conducted using SPSS Statistics Version 25. Qualitatively, eight committee members were selected through purposive sampling for in-depth interviews using interpretative methodology with thematic analysis by MAXQDA Software 2022.

Results: It shows that most committee members acknowledge the advantages of standard settings, such as improved teaching and learning defect identification, staff knowledge application, enhanced educational programs, and personal contributions to education quality. Half of the committee members expressed concerns about the increased workload and administrative burden, while another half-supported standard-setting implementation. They all appreciate the integration of standard setting in the outcome-based curriculum, recognising its positive impact on student quality and accreditation standards. Challenges include limited human resources, resistance to change, time-consuming, and an increased workload.

Conclusion: Committee members suggested that targeted interventions are needed to improve awareness, collaboration, and successful implementation. These should consider perspectives, enhance understanding, define roles, and address resources and resistance. This will optimise standard setting, ensure educational quality, and meet accreditation standards.

Keywords:           Assessment, Standard Setting, Integrated Curriculum, Awareness, Perception, Attitude, Lifelong Learning

Abstract

Introduction: As healthcare becomes increasingly digital, undergraduate medical students receive limited formal training in digital healthcare technologies (DHTs). Additionally, stakeholders’ perspectives on essential digital health competencies (DHCs) across generations remain underexplored. This comparative study aims to identify knowledge gaps, inform evolving expectations, and promote continuous learning by comparing medical students’ and senior clinicians’ views on essential DHCs in Singapore.

Methods: Individual semi-structured interviews were conducted with medical students, clinical educators, and clinical teachers. Clinical-year medical students from all three local medical schools were recruited using convenience and snowball sampling, while purposive sampling ensured diverse representation of clinicians across Singapore’s public healthcare organisations, focusing on those engaged in education-related activities. Data were collected from September 2020 to February 2023 until thematic saturation was achieved, and analysed using qualitative thematic analysis.

Results: Sixty-three participants took part, including 30 medical students, 12 clinical educators and 21 clinical teachers. All clinicians had more than 10 years of clinical experience and came from 24 different disciplines and 12 healthcare institutions. The findings showed unanimous support for integrating electronic health records in patient communication, and training in DHTs like telemedicine and point-of-care ultrasound. Discrepancies emerged; clinicians prioritised physical examination, while students viewed it as potentially replaceable by DHTs. Furthermore, while students valued healthcare-related smartphone applications in patient care, few clinicians shared this view, citing privacy and security concerns.

Conclusion: Evaluating stakeholders’ perspectives highlights evolving clinical skills and essential DHCs for medical students, potentially informing global DHC training programmes.

Keywords:           Technology, Medical Education, Curriculum, Clinical Competence, Digital Competence, Qualitative, Singapore

Abstract

Introduction: Every medical graduate is expected to fulfil the teaching responsibilities stated by the General Medical Council (GMC). It is beneficial to nurture both teaching motivation and skills early in the undergraduate program. This study aims to evaluate the outcomes of final-year medical students as near-peer teachers in a student-led near-peer teaching program and their fulfilment of the educational responsibilities stated by the GMC.

Methods: A cross-sectional study was conducted among the year 5 medical students who participated in the Peer Teaching Program. A structured post-participation 6-point Likert scale questionnaire with written consent was distributed to the near-peer teachers to assess their perspectives on skills enhancement, motivation, and career direction. Additionally, the Peer Tutor Assessment Instrument questionnaires were distributed to the near-peer students to evaluate the performance of the near-peer teachers in five areas: responsibility and respect, information processing, communication, critical analysis, and self-awareness.

Results: There were 28 near-peer teachers, and 49 near-peer students participated in the study.  The near-peer teachers score the highest in skills (5.36 ± 0.53), followed by motivation (5.16 ± 0.60) and career direction (4.79 ± 0.82). Three quarters of the near-peer teachers considered teaching to be their future primary career path after experiencing this teaching experience (4.36 ±1.34). Generally, the near-peer teachers were highly evaluated by the near-peer students across all domains (5.06 ± 0.51).

Conclusion: Overall, the near-peer teaching programme likely improved the final-year medical students in fulfilling the “Doctors as Teachers” responsibilities outlined by the GMC.

Keywords:           Near-peer Teaching, Medical Students, Undergraduate Medical Education, General Medical Council, Doctors as Teachers

Abstract

Introduction: Numerous studies have been conducted on COVID-19, with the majority focusing on interventions involving students and teachers. However, limited research has delved into the pandemic’s impact on the wellness of various stakeholders and how they have adapted to the challenges it presented. This study aims to fill this gap by exploring these neglected areas.

Methods: This study employs a sequential mixed-method approach to study these areas. The quantitative data collection was carried out using a combination of validated surveys (ranging between 63-88 items) for students, faculty and administrators.  Subsequently, qualitative data collection was gathered via semi-structured interview using a convenient sampling method.

Results: Seventeen faculty, 18 administrators and 369 students responded to the survey. The quantitative data indicated faculty (teachers) exhibited the lowest stress levels and the highest resilience during the pandemic. In comparison, administrators and students experienced moderate levels of stress, with students scoring slightly higher on the stress level. The themes that emerged from the qualitative data were personal endurance, emotional reaction, cognitive-behavioural reaction and social support.

Conclusion: Our study highlighted that, apart from personal endurance, the tension arises from emotional and cognitive-behavioural responses of students, teachers, and administrators can be mitigated based on the presence or absence of support mechanisms.

Keywords:           Wellbeing, Change, Stakeholders, Educational Environment, Culture

Abstract

Introduction: Career selection is a critical decision influenced by various factors, including media exposure. As a popular genre among adolescents, medical dramas may shape perceptions of the medical profession. This study explores the impact of medical dramas on medical students’ motivation to pursue a career in medicine.

Methods: This study was conducted at the School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, between February and March 2024, using a mixed-method approach. Quantitative data were gathered through a questionnaire, followed by qualitative insights from in-depth interviews. A two-stage sampling strategy was employed, initially identifying first-year students influenced by medical dramas through screening, followed by purposive sampling to select participants for in-depth interviews.

Results: Analysis identified six key motivational aspects through which medical dramas influence students’ decision to pursue medicine. These include the detailed portrayal of doctors’ roles, their daily lives, and the reinforcement of a positive perception of the profession. Notably, emotional engagement- such as inspiring doctor characters- and the realistic depiction of challenges, including the dedication and hardships of becoming a doctor, emerged as significant factors.

Conclusion: Medical dramas play a significant role in shaping students’ motivation and perception of the medical profession. This study highlights six key motivational aspects influencing career decisions, offering new insights into media-driven career choices and their potential implications for medical education.

Keywords:           Medical Dramas, Medical Education, Medical Students, Student Motivation, Career Choice

Abstract

Introduction: To explore the current situation regarding teaching evidence-based practice (EBP) in Indonesian dental schools as a low-middle-income country (LMIC) setting.

Methods: Two nation-wide surveys were administered to all Indonesian dental schools (N=32) to capture the perceived value of the deans about EBP skills and teaching with its resource-related situation, as well as the actual teaching implementation and its challenges by their curriculum teams. The analysis was performed descriptively as national aggregate data.

Results: The response rates were 96.9% and 90.6%, respectively. The deans considered EBP skills to be very important (61.3%) or important (38.7%). However, only 16.1% of deans reported that the implementation of teaching EBP met their expectations. Most schools (75.9%) considered providing training for teachers as the priority plan. Most schools (62.1%) had an independent EBP course in their curriculum, while 86.2% incorporated EBP teaching (also) into other courses. All dental schools employed a lecture strategy for teaching EBP topics, but also used other strategies such as interactive strategies with a wide range of percentages being utilised (10.3 – 89.7%). EBP-specific topics were generally taught with a level of implementation varying from 34.5% to 96.6% in the pre-clinical and from 10.3% to 62.1% in the clinical programme.

Conclusion: The used approach can be considered an effective strategy to provide opportunities for schools to reflect their EBP teaching. This study confirmed the necessity for improvement, especially the need to support faculty development. The deans and their curriculum teams highly value collaborative improvement plans.

Keywords:           National Survey, Evidence-based Practice, Faculty Perception, Low-middle-income Country

Abstract

Introduction: Case-Based Learning (CBL) is increasingly used in modern medical schools to improve students’ critical thinking and problem-solving skills. While CBL is established in Western Resource-Structured (WRS) educational settings, its use in Asian-Pacific regions like Myanmar is under explored. This research studied the integration of CBL at the Defence Services Medical Academy (DSMA) in Myanmar, focusing on the perspectives of both students and faculty involved in curriculum reforms.

Methods: This study used constructivist grounded theory to gather data from 24 DSMA participants through four focus group discussions. Twelve students and twelve faculty members, were invited a subgroup of six, and after providing informed consent discussed their experiences of CBL, aiming to assess its effectiveness and relevance in their specific educational and cultural context.

Result: Analysis shows that students valued CBL for enhancing group discussions, reflecting upon real-world situations, and building critical thinking abilities. Faculty members also appreciated CBL for its capacity to create realistic applications and its support for student-centered learning and interpersonal skills development. Both groups acknowledged CBL as an effective method for simulating the complexities of medical practice.

Conclusion: This study found that CBL is well-regarded at DSMA for preparing students competence and confidence for clinical encounters. However, faculty indicated that the extensive time required in preparation of this teaching modality was a significant challenge for the wider adoption of CBL. These insights highlight the adaptability and potential challenges of implementing CBL in non-Western educational settings and suggest possible areas for development for its broader application in the Asia-Pacific region.

Keywords:           Medical Education, Case-based Learning, Perceptions, Grounded Theory, Focus Group Discussion

Abstract

Introduction: Virtual reality (VR) has been widely used in medical and health sciences education since the late twentieth century. VR complements the conventional teaching and learning (T&L) approach by providing an engaging and immersive 3D spatial learning environment, especially for understanding the orientation of anatomical structures. Despite these advantages, the usability and student preference of highly immersive head-mounted display-based (HMD) and less immersive desktop-based (DB) VR in human anatomy courses have yet to be determined.

Methods: In a cross-sectional study, 49 Year-2 medical students were recruited through a convenient sampling. The participants were asked to identify 15 skeletal system components using the HMD and DB platform with human anatomy VR application. Both applications’ System Usability Scale (SUS) and preference scores were obtained via a self-administered questionnaire. The data were expressed as median [IQR] and statistically analysed using MATLAB R2022b.

Results: Most participants preferred the HMD over the DB platform (p=0.04), especially the male participants (p=0.01). There was no significant difference in overall SUS scores between both platforms (p=0.14). However, when compared within and between genders, females scored significantly higher in the DB than HMD (p=0.02) and higher than males’ DB SUS scores (p=0.03).

Conclusion: The overall usability of HMD was comparable with the DB platform for learning human anatomy. Although most participants prefer to use the HMD, further exploration of why females prefer the DB is needed. Subsequently, VR application developers must consider gender-related adaptions to promote the equitability and inclusivity of the technology for all users.

Keywords:           Human Anatomy, Virtual Reality, Head-mounted Display, Desktop-based Application, Usability, Preference

Abstract

Introduction: Palliative care nursing (PCN) supports individuals with life-threatening illnesses, aiming to improve the quality of life (QoL) for patients and families. The objective was to assess the necessity of establishing an Advanced Certificate Course in PCN at University of Ruhuna, Sri Lanka.

Methods: A descriptive cross-sectional study was conducted among 220 registered nurses (RNs) using purposive sampling, working at National Hospital Galle. A pre-tested, interviewer-administered questionnaire was used, including questions on prior education or training experiences on palliative care (PC), and its principles, services, and management. Descriptive statistics and the chi-square test were used to analyse.

Results: The majority of the RNs were aged 31-40 years (45.2%), females (86.0%), and married (55.7%). A higher proportion of RNs were nursing diploma holders (67.4%), with 55.7% having less than ten years of nursing experience. Only 11.3% of the RNs had formal additional training on PC, such as workshops and a few training hours. Most RNs correctly identified PC aims: improving survival (59.7%), improving QoL of patients and their families (91.4%), providing relief and pain (93.7%), understanding PC (80.1%), etc. The majority (84.6%) had a good attitude toward palliative caregiving, though only 20.4% had average knowledge of PC. Formal PCN training was significantly associated with PC knowledge (p=0.004).

Conclusion: Limited educational exposure, average knowledge levels, and good attitudes toward PC suggest the need for a PCN course for nurses. Providing a special education programme reduces the current gaps in PC by equipping RNs with the respective knowledge, skills, and attitudes to deliver complex management for patients requiring PC.

Keywords:           Palliative Care Nursing, Sri Lanka, Educational Needs, Registered Nurse

Abstract

Introduction: The Objective Structured Clinical Examination (OSCE) is a popular method for assessing medical students’ clinical proficiency. Mock OSCEs are often incorporated into medical curricula to help students familiarise themselves with the examination format. While the impact of mock OSCEs on academic performance has been studied, their perceived utility remains less explored. This study aimed to assess the effectiveness of a mock OSCE in preparing medical students for their final examinations.

Methods: A prospective study was conducted at a tertiary hospital in Singapore, involving medical students undergoing their Obstetrics and Gynaecology posting. The mock OSCE consisted of five stations and included immediate feedback from examiners. Students completed three questionnaires: pre-mock OSCE, post-mock OSCE and post final examinations, rating the utility of the session and their confidence levels.

Results:  Of the cohort of 147 students, 121 responded to the pre-mock OSCE survey, 132 responded to the post-mock OSCE survey, and 105 to the survey after their final examinations. The percentage of students who found the mock OSCE useful/very useful increased significantly from 97.5% before to 98.5% after the session, and significantly decreased to 96.2% after the examinations. Confidence levels rose significantly from a mean score of 2.34/5 pre-mock to 3.89/5 post-mock, to 4.67/5 post-exam. Qualitative feedback was positive, highlighting the benefit of familiarisation with examination mark schemes.

Conclusion: The mock OSCE was well-received by students and perceived as a valuable tool in preparation for examinations. Despite the limited sample size, these findings support the implementation of mock OSCEs to enhance students’ learning and exam preparedness.

Keywords:           OSCE, Undergraduate, Medical Education, Medicine, Students’ Perception

Standard setting is the process of deciding the boundary or standard that separates the candidates into two (e.g. pass and fail) or more groups, based on their ability shown at an assessment. Standard setting methods can be broadly grouped into four clusters (see table below).

When to use which method, though a crucial decision for any Board of Examiners, is inadequately explored in the literature. The following brief guide attempts to bridge this literature gap.