Abstract

During the years preceding 1910, the education and training of physicians (doctors)-to-be was based mainly on a master-apprentice model; the primary focus then was on the teaching and development of clinical skills.

In 1910, however, Flexner submitted a highly influential report to the American medical authorities: in it he recommended that all medical schools should be university-based and that, importantly, medical practice should have a scientific basis strongly underpinned by the basic medical sciences such as anatomy, biochemistry and physiology. Flexner’s¹ recommendation was readily accepted, not only in the USA, but also globally- including Asia.

I. INTRODUCTION

A. Why this is an issue of global relevance

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

Abstract

I. SUMMARY

The ASPIRE-to-Excellence Initiative was established in 2013 to provide a mechanism where Excellence in teaching in a medical school received international recognition. Excellence was recognised in one or more of the following areas – Student Assessment, Student Engagement with the curriculum, Social Accountability of the medical school, Faculty Development and Simulation. Dental and Veterinary schools were included in the programme in 2015. To date, 23 schools from 12 countries around the world have received an ASPIRE award in one or more of the areas.

Abstract

This article (and its accompanying and complementary presentation blog [https://telat14apmec.blogspot.sg/2017/01/elearning-in-medical-education-costs.html]) expands on ideas presented and elaborated on during the pre-conference workshop (https://telat14apmec.blogspot.sg/2016/09/essential-skills-in-elearning-pre.html), and main conference symposium (https://telat14apmec.blogspot.sg/2016/09/educational-technologies-propaganda-or.html) on this topic at the 14th APMEC. It will specifically address the issue of the costs involved, and value add of eLearning. It is presented in two sections, 1) as a series of short conversational style quotes intended to make a case for the use (or not) of eLearning / Technology enhanced learning, which were recently shared in the preamble to a more formal presentation on this topic; and 2) as a single paragraph compact article, augmented by internal keyword links to additional resources, links to the original workshop and symposium presentation blogs, an audio podcast (https://www.dropbox.com/s/7ltmt6z5unh6r6j/TeLforTAPS.m4a?dl=0), video (example1) (https://www.dropbox.com/s/igvpiya9j26kldg/TeLvid1TAPS.mov?dl=0) or video (example 1, embedded version below) demonstration, and interactive online bulletin (https://padlet.com/dnrgohps/practicalTipsToUseTeL) board (most updated versions of these media, and multimedia links will be on the blog).

Abstract

In the current healthcare environment, team-based models in the teaching and practice of medicine have become more a norm than a preference.  Renewed focus on team-based practice discloses the effect that poorly functioning teams may have on successful outcomes in team-based delivery of patient care. Team incompetence compromises learning and work performance for all members; an outcome often rooted in poor communication and understanding of role responsibilities within the team. Business schools have been innovative and proactive in recognizing this problem and have instituted team charters to align team expectations and norms through discussion and consensus. Team charters were introduced in Block 2 Microscopic Anatomy and Block 3 Human Structure courses at Mayo Medical School in the first year curriculum. Teams were oriented on the concept of the team-charter and given the opportunity to create individual team charters to suit each team’s work ethos.  Teams were encouraged to revisit their charters midway through the course to maintain a dynamic contract.  Students took time to reflect on and adapt their strategy in order to facilitate better team cohesiveness, communication, interaction and ultimate performance.  Qualitative student feedback indicated that the exercise fostered better group dynamic and improved communication within the team. Students were empowered to take responsibility for their own learning, professional identity formation, performance, academic development and their impact on total performance of the team.

Keywords:          Gross anatomy education; Medical education; Team-based learning; Team charters; Assessment

I. INTRODUCTION

The ultimate goals of health professions education are to enhance practice readiness, improve delivery of safe patient care and ideally, improve patient outcomes. Simulation based education (SBE) is now well established as an educational approach, in undergraduate programs and for continuing professional education, that complements existing models in development of core clinical knowledge and skill acquisition for health professions students and clinicians. It is known that the various domains of learning, such as knowledge, the psychomotor, affective and behavioural elements of practice, can be incorporated into holistic patient care simulation scenarios (Kelly, Hopwood, Rooney & Boud, 2016). Ways of determining the impact of SBE are topics emerging in the literature. Increasingly, those who design and deliver SBE are becoming more attuned to the spectra of cultural considerations important for learning and practice (Bahreman & Swoboda, 2016).

Abstract

Aims: To assess the importance of compounding training in today’s pharmacy education in Singapore, this study examined the perception of final year National University of Singapore (NUS) pharmacy undergraduates on compounding training in pharmacy education and their awareness of compounding services in Singapore in relation to compounding pharmacists’ perception, practice and role of pharmacy compounding in Singapore.

Methods: A cross-sectional survey was carried out between November 2013 and January 2014. It comprised of a questionnaire survey conducted on 134 final year pharmacy undergraduates, and face-to-face interviews conducted on 7 retail compounding pharmacists. Questionnaire responses were analysed using descriptive statistics, while the interviews were transcribed verbatim and analysed by thematic coding.

Results: Less than 40% of final year pharmacy undergraduates were aware of compounding activities and compounding pharmacies in Singapore. Nonetheless, majority agreed that compounding should be included in the pharmacy curriculum (83.6%) as it is an important part of pharmacy education (78.3%) and pharmacy profession (61.2%). All the interviewed compounding pharmacists felt that compounding in pharmacy education has provided them with the basics to build on knowledge and skills at work. Compounded medications were also viewed as necessary by 71.4% of the pharmacists in fulfilling the needs of certain patient populations.

Conclusion: Compounding training is necessary in pharmacy education. Pharmacy compounding has evolved from its traditional role into a professional speciality of customizing medications to meet different patient needs today. Hence, knowledge and skills in pharmacy compounding remain a relevant foundation for practising pharmacists to enhance pharmaceutical care at work.

Keywords:      Pharmacy compounding; Pharmacy education; Pharmacy students; Compounding pharmacists; Perceptions; Survey

Abstract

This study highlights the use of multi-factor analytical approaches in the investigation of students’ academic performance and their well-being. The aim of the study was to explore the relationships among physical health, competitiveness, perceived stress, motivation, and academic achievement in pre-medical and health science students. Responses were elicited from 339 students preparing for medical and other health science programmes. Questionnaires obtained information regarding gender, age, grade achievement, perceived stress, motivation, physical health, and competitiveness. Due to the subtle gender differences evident in the literature and substantiated by the findings in this study, two structural equation models were generated, one representing male students and the other female students. In general, the illustrated models showed a positive relationship between physical health and enjoyment of competition. Next, physical health was negatively associated with perceived stress, which showed a negative association with self-efficacy and a positive association with test anxiety. Enjoyment of competition was positively associated with self-efficacy. Grade achievement was positively associated with self-efficacy. The models suggest that students, as a whole, experiencing good physical health report less perceived stress and less test anxiety, and more self-efficacy which are associated with positive grade outcomes. These models give insights into how physical health and learning variables may influence grade outcome providing scope for further research into how these relationships impact learning environments, team behaviours, and professional training.

Keywords:            Biomedical and Health Science Students, New Zealand, Motivation, Physical Health, Competitiveness, Academic Achievement

Abstract

Inter-professional education (IPE) contributes to the development of an ‘inter-professional, collaborative and practice-ready’ healthcare workforce that is well prepared to respond to local healthcare needs. Little is known about the extent, to which health professional students who are nearing graduation understand the competencies of diverse health professions. The aim of this study was to investigate the perception of final-year undergraduate students’ towards interprofessional team working and their knowledge of the competencies of 6 health professions. This study evaluated the final-year health professional students’ from six (6) health professions programmes namely medical, dental, nursing, pharmacy, dietetics and biomedical sciences programmes. Attitudes towards Health Care Team Scale (ATHCTS) was used to measure students’ attitudes towards teamwork while a checklist was used measure students’ knowledge of 6 health professionals competencies. Construct validity was ascertain and findings from ATHCTS showed mean scores ranges from 48.57 to 54.23 indicating positive attitudes toward working within interprofessional health care teams. While the ACTHS findings were positive, the competencies checklist showed mixed findings in that students correctly identified some competencies and had misconceptions for others. For example, the majority of students regarded physicians as competent in ‘assessment and evaluation’ and ‘medication management’ while less than 50% of participants recognised the importance of assessment of patient’s health-illness as a competency for dieticians. Gaps identified in final year students’ knowledge of the roles and competencies of health professions has an impact on future interprofessional collaborative practice suggesting a need to further improve curriculum design and delivery of IPE.

Keywords:      Allied health, Inter-professional, Learning, Inter-professional education

Abstract

Keywords:            Empathy, Palliative Care, Medical Students, Reflective Reports

Abstract

Aim: Evidence suggests that Team Based Learning (TBL) is an effective teaching method for promoting student learning. Many people have also suggested that TBL supports other complex curriculum objectives, such as teamwork and communication skills.  However, there is limited rigorous, substantive data to support these claims. Therefore, the purpose of this study was to assess medical educators’ perceptions of the outcomes affected by TBL, thereby highlighting the specific areas of TBL in need of research.

Methods: We reviewed the published research on TBL in medical education, and identified 21 unique claims from authors regarding the outcomes of TBL.  The claims centred on 4 domains: learning, behaviours, skills, and wellbeing. We created a questionnaire that asked medical educators to rate their support for each claim.  The survey was distributed to the medical educators with experience teaching via TBL and who were active users of the Team Based Learning Collaborative listserv.

Results: Fifty responses were received.  Respondents strongly supported claims that TBL positively impacts behaviours and skills over traditional, lecture based teaching methods, including the promotion of self-directed learning, active learning, peer-to-peer learning, and teaching. In addition, respondents strongly supported claims that TBL promotes teamwork, collaboration, communication and problem solving.  Most participants reported that TBL is more effective in promoting interpersonal, accountability, leadership and teaching skills.

Conclusion: Medical educators that use TBL have favourable perceptions of the practice across a variety of domains.  Future research should examine the actual effects of TBL on these domains.

Keywords:      Team based learning; Medical education; Teaching

Abstract

Background: Teddy Bear Hospital (TBH) was initiated to address children’s fear through role-play. We aim to assess effectiveness of Singapore TBH sessions in decreasing childhood anxiety and enhancing their healthcare knowledge.

Methodology: We performed a cross sectional descriptive study of children (5-8 years) participating in TBH between March and May 2016. Each child completed two multiple-choice questionnaires with pictorial aids. The first survey assessed baseline knowledge and feelings towards healthcare, whilst the second survey assessed the same knowledge and how feelings towards healthcare may have changed after attending TBH.

Results: Data from 334 completed surveys were collected. We excluded 82 children with incomplete data, leaving data from 252 children for analysis; 96 pre-school (38.1%) and 156 primary school (61.9%).

Most children did not have negative feelings towards visiting the doctor or hospital before TBH. Children with positive feelings towards visiting the doctor and hospital increased from 82.5% to 94.4% (p-value <0.001) and 70.2% to 73.4% (p-value 0.035) respectively.

After TBH, majority of children (57.9%) improved scores in knowledge-related questions. Children who answered all knowledge-related questions correctly increased from 81 (32.1%) to 185 (73.4%)  Children in primary school (OR 3.08, 95% CI 1.66 – 5.70) and those who wanted to visit the doctor (OR 3.38, 95% CI 1.08 – 10.55) were more likely to obtain full marks in knowledge-related questions.

Conclusion: We found that most Singaporean children were positive towards healthcare encounters. A TBH experience was able to further increase this number, as well as increase their healthcare knowledge.

Keywords:            Teddy Bear Hospital, Singapore, Hospital Role-play, Childhood Anxiety, Educational Tool

Abstract

Introduction: Simulation is the imitation of the operation of a real-world process or system over time. Innovative simulation training solutions are now being used to train medical professionals in an attempt to reduce the number of safety concerns that have adverse effects on the patients.

Objectives: (a) To determine its usefulness as a teaching or learning tool for management of surgical emergencies, both in the short term and medium term by students’ perception. (b) To plan future teaching methodology regarding hi-fidelity simulation based on the study outcomes and re-assessment of the current training modules.

Methods: Quasi-experimental time series design with pretest-posttest interventional study. Quantitative data was analysed in terms of Mean, Standard Deviation and standard error of Mean. Statistical tests of significance like Repeated Measure of Analysis of Variance (ANOVA) were used for comparisons. P value < 0.001 was considered to be statistically significant.

Results: The students opined that the simulated sessions on high fidelity simulators had encouraged their active participation which was appropriate to their current level of learning. It helped them to think fast and the training sessions resembled a real life situation. The study showed that learning had progressively improved with each session of simulation with corresponding decrease in stress.

Conclusion: Implementation of high fidelity simulation based learning in our Institute had been perceived favourably by a large number of students in enhancing their knowledge over time in management of trauma and surgical emergencies.

Keywords:      High fidelity simulation, Simulation in medical education, Stress in simulation

Abstract

Aims: The evidence on how reflection associates with clinical teaching is lacking. This study explored the reflection pattern of nursing clinical instructor trainees on their clinical teaching and its association with their teaching performance.

Methods: Reflection entries on two teaching sessions and respective teaching assessment data of a cohort of Registered Nurses participating in the National Healthcare Group College Clinical Instructor program (n=28) were retrieved for this study. Reflection entries were subjected to thematic analysis. Each reflection statement was coded and scored according to topics in relevance to three clinical teaching phases – preparation, performance and evaluation. Teaching assessment scores were then used to group the participants into different performance group. Reflection patterns derived from the coding scores were compared across these groups.

Results: Participants’ reflections focused on the performance phase (57% of reflected items), followed by preparation (30%) and evaluation (13%) phases. To assess the reflection pattern of trainees with differing teaching performance, participants whose teaching assessment scores were already high from first teaching session were classified into Consistently High group (score>22). Remaining participants were further categorized based on their improvement in teaching assessment scores into Higher Change (score difference>1) and Lower Change (score difference≤1). Compared to Lower Change group, participants in the Consistently High and Higher Change groups had higher trend of reflection focus on performance (57% and 59% vs 48%) and evaluation phases (14% and 14% vs 8%), but lower on preparation phase (29% and 27% vs 44%).

Conclusions: The finding suggests a possible role of reflection in teaching performance of nurse clinical instructors, warranting further investigation.

Keywords:            Registered Nurses, Clinical Instructor, Reflective Thinking, Clinical Teaching, Reflective Journal

I. Introduction

The advent of the silver tsunami (Gan, 2015) highlights the need for the younger generations to be aware and exposed to the challenges and struggles that our elderly face daily. 2 medical students, Kennedy and Angeline, foresaw this need. Many of our elderly are afflicted with chronic conditions that result in frequent readmissions and associated morbidity. They are besieged (Donaldson, Smith, Balakrishnan, Kadir & Mudaliar, 2015) with multiple non-medical issues such as insufficient finances, poor medical literacy and a lack of social and family support, resulting in poor control of their diseases – many of which can potentially be arrested in the community.

Abstract

Objectives: Do Not Attempt Resuscitation (DNAR) orders have been used in hospitals worldwide for the past 30 years, but are still considered to be a challenging and difficult area of practice. Nurses being the frontline healthcare professionals should be involved during the decision-making process and are required to have good understanding of the DNAR order, in order to provide effective and efficient care. Our aim was to investigate: nurses’ involvement during decision-making process, level of understanding of issues surrounding DNAR orders; and how they perceive care for patients with DNAR orders.

Methods: A descriptive crossed sectional study design using electronic questionnaires was adopted for the study. The study was conducted among 400 nurses at a tertiary hospital in Singapore.

Results: This study showed that 44.5% of nurses reported physicians did not involve them in decisions for DNAR orders; only 8% felt that they should be involved in the decision-making process. Even if they did not agree with the order, 63.2% would still comply whilst 21% of them were willing to discuss this further with the treatment teams. Most agreed that antibiotics, intravenous fluids, oxygen therapy and artificial feeding were appropriate for patients with DNAR orders. Majority (57.1%) expressed uneasiness in discussing end of life issues with patients even in specialty areas.

Conclusion: Nurses should be encouraged to advocate for their patient and take part in the decision-making process. Communication between the medical team and nurses can be improved and there is an obvious need for further improvement in education and collaboration in this area.

Keywords:            Do Not Attempt resuscitation, End-of-Life, Withdrawal, Palliative Care

Abstract

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

Abstract

This paper describes the revision of a national post-graduate medical examination to incorporate formal quality assurance and psychometrics. We discuss the considerations and rationale leading to the new format, challenges faced and lessons learned in making the change. The processes described were successfully implemented in the 2015 examination administration. We continue to reflect on and analyse these processes to improve the examination.

Keywords:           Post-graduate, Examination Reform, Quality Assurance, Psychometrics, Family Medicine, Standardised Patient

Abstract

Aims: Career counselling is a complex process. Traditional career counselling is unidirectional in approach and ignores the impact and interactions of other factors. The Systems Theory Framework (STF) is an emerging framework that illustrates the dynamic and complex nature of career development. Our study aims to i) explore factors affecting senior residency (SR) subspecialty choices, and ii) determine the suitable utility of the STF in career counselling.

Methods: A prospective observational cohort study of internal medicine residents was done. Surveys were collected at three time points. The Specialty Indecision Scale (SIS) assesses the individual components and expert consensus group derived the questions for the contextual components. We measured burnout using the Mashlach Burnout Inventory. Process influences were assessed via thematic analysis of open-ended question at the 3^rd survey.

Results: 82 responses were collected. There was a trend towards older residents being ready to commit albeit not statistically significant. At year 1, overseas graduands (OR = 6.87, p= 0.02), lifestyle factors (t(29)=2.31, p=0.03, d= 0.91), individual factors of readiness (t(29) = -2.74, p=0.01, d= 1.08), indecisiveness (t(27)= -0.57, p=0.02, d= 0.99) and self- doubt (t(29)= -4.02, p=0.00, d= 1.54) predicted the resident’s ability to commit to SR. These factors change and being married (OR 4.49, p= 0.03) was the only factor by the 3^rd survey. Male residents are more resolute in their choice (OR= 5.17, p= 0.02).

Conclusion: The resident’s choice of SR changes over time. The STF helps in understanding decision-making about subspecialty choices. Potential applications include: i) initiation of career counselling at year 1 and ii) reviewing unpopular SR subspecialties to increase their attractiveness.

Keywords:         Internal Medicine Residents, Career Counselling, Senior Residency

I. GENERAL UNDERSTANDING THROUGH ACTIVE PARTICIPATION

As one of the first generation of Standardised Patients in China, perhaps Asia as well, I have been working in the clinical skills training centre in West China Medical School of Sichuan University for 25 years. I would like to share with you how I joined this little-known and somewhat mysterious field, participated in this form of teaching, and progressed from a normal SP to a SP trainer. It is noted that the Standardised Patient (SP) was first introduced by Howard Barrows in 1963 (Pan & Luo, 2017). In 1993, West China School of Clinical Medicine, Sichuan University was the first to do the training courses and trained the first group of SPs. In 2003, China Medical Boar (CMB) America organized a “Student Evaluation Plan Program”; 8 Chinese medical schools joined and imported the training programme to China.

Abstract

Cognitively complex assessments encourage students to prepare using deep learning strategies rather than surface learning, recall-based ones. In order to prepare such assessment tasks, it is necessary to have some way of measuring cognitive complexity. In the context of a student-generated MCQ writing task, we developed a rubric for assessing the cognitive complexity of MCQs based on Bloom’s taxonomy. We simplified the six-level taxonomy into a three-level rubric. Three rounds of moderation and rubric development were conducted, in which 10, 15 and 100 randomly selected student-generated MCQs were independently rated by three academic staff. After each round of marking, inter-rater reliability was calculated, qualitative analysis of areas of agreement and disagreement was conducted, and the markers discussed the cognitive processes required to answer the MCQs. Inter-rater reliability, defined by the intra-class correlation coefficient, increased from 0.63 to 0.94, indicating the markers rated the MCQs consistently. The three-level rubric was found to be effective for evaluating the cognitive complexity of MCQs generated by medical students.

Keywords:            Student-generated Multiple-choice Questions, Cognitive Complexity, Bloom’s Taxonomy, Marking Criteria, Moderation of Assessment

I. INTRODUCTION

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

Abstract

Background: Smartphones are used worldwide. Consequently, it does seem to be having an impact on health-related problems if overused. However, it is uncertain whether it is associated with sleep problems or poor learning.

Objective: To determine the association between smartphone overuse and sleep problems in medical students as primary outcome and poor learning as secondary outcome.

Methods: A cross-sectional study was conducted in 89 students having their own smartphones, at Hatyai Medical Education Centre, Thailand. The habits of using smartphone were obtained. Smartphone overuse during bedtime was defined as using longer than 1 hour according to Smartphone Addiction Scale (SAS). The primary outcome was napping in a classroom that was defined as a problem if it happened more than 20% of the time attending class. Sleep problems using Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were obtained by self-assessment. Learning outcome measured by grade point average was the secondary outcome. Multivariable analysis was performed for the association between smartphone overuse and sleep problems.

Results: Of all students, 77.5% had sleep problems and 43.6% had napped in the classroom No personal characteristics, daily life behaviours, and physical environments were associated with sleep problems. 70.8% of all students found to over use smartphones during bedtime. The Facebook website was the most popular. Smartphone overuse was significantly associated with poor sleep quality (odds ratio= 3.46) and napping in the classroom (odds ratio=4.09) but not grade point average.

Conclusion: Smartphone overuse during bedtime in medical students is associated with sleep problems but not learning achievement.

Keywords:            Napping in Classroom, Sleep Problems, Smartphone Overuse

Abstract

The New Zealand Curriculum Framework (NZCF) for Prevocational Medical Training identifies a number of procedural skills that prevocational doctors should achieve during their first two years following graduation from medical school. This study aimed to identify the clinical confidence of graduate doctors in performing the list of procedures outlined in the NZCF at two points in time; following completion of undergraduate studies, and the first year of prevocational, preregistration training. An anonymous paper-based survey, consisting of 59 items, was completed by a cohort of PGY-1 doctors (n = 30) twice during 2015, with the first 48 items of the survey rating PGY-1s perceptions of their clinical confidence in performing procedures that fall under the 12 competencies identified in the Procedures and Interventions section of the NZCF. 70.8% of the procedures were rated above 2.0 at the start of the PGY-1 year, indicating that respondents had received teaching in, or viewed the procedure being performed, during undergraduate training. By year-end, procedural skills performance rated above 3.0 (i.e., confident in performing said procedure independently) was achieved in 52% of the listed skills. Low scores occurred in procedures listed under the categories ENT, Ophthalmology, Surgery and Trauma. While ratings of clinical confidence improved in many areas as expected during the PGY-1 tenure, some areas remained low. This highlights an issue that PGY-1 doctors may not be receiving adequate training in certain procedural skills listed as core NZCF competencies during the PGY-1 year.

Keywords:        Prevocational Doctors, Core Competencies, Procedural Skills, Clinical Confidence

Abstract

In the current healthcare environment, team-based models in the teaching and practice of medicine have become more a norm than a preference.  Renewed focus on team-based practice discloses the effect that poorly functioning teams may have on successful outcomes in team-based delivery of patient care. Team incompetence compromises learning and work performance for all members; an outcome often rooted in poor communication and understanding of role responsibilities within the team. Business schools have been innovative and proactive in recognizing this problem and have instituted team charters to align team expectations and norms through discussion and consensus. Team charters were introduced in Block 2 Microscopic Anatomy and Block 3 Human Structure courses at Mayo Medical School in the first year curriculum. Teams were oriented on the concept of the team-charter and given the opportunity to create individual team charters to suit each team’s work ethos.  Teams were encouraged to revisit their charters midway through the course to maintain a dynamic contract.  Students took time to reflect on and adapt their strategy in order to facilitate better team cohesiveness, communication, interaction and ultimate performance.  Qualitative student feedback indicated that the exercise fostered better group dynamic and improved communication within the team. Students were empowered to take responsibility for their own learning, professional identity formation, performance, academic development and their impact on total performance of the team.

Keywords:          Gross anatomy education; Medical education; Team-based learning; Team charters; Assessment

Abstract

Background: With the rapid aging of the population, collaboration among the various medical professions throughout the country is becoming increasingly indispensable in Japan. To promote collaboration in medical care, it is necessary to introduce the concept of collaboration to students at an early stage of their professional education. Despite this need, there are no core medical, healthcare and welfare education curricula in Japan that include interprofessional education (IPE). Therefore, the status of IPE in Japanese schools of medicine and other healthcare-related services is unclear.

Methods: We sent 3,430 questionnaires to 13 schools of medicine and related healthcare providers: doctors, nurses, physical therapists, registered dieticians, dentists, dental hygienists, social workers, pharmacists, occupational therapists, clinical psychologists, medical administrators, certified care workers, and speech therapists. The items addressed implementation rate of IPE, teaching methods and grading methods.

Results: Of the 3,430 surveys distributed, 572 completed surveys were returned (response rate 17%). Of the completed surveys, 493 qualified as valid, resulting in a final response rate of 14%. Only 19% (n = 93) of the analysed medical educational institutions included IPE instruction in their curricula.

Conclusion: While many educational institutions were conducting IPE, there were important inter-institutional differences with respect to attitudes towards IPE, teaching methods, and evaluation methods. This study was unprecedented in scale, and provides important basic information for the future development of IPE in Japan.

Keywords:        Interprofessional Education, Healthcare Professions, Teaching Methods, Grading Methods, Collaboration

Abstract

It was interesting to read the letter from Rajesh and Sengodan (2017) published in The Asia Pacific Scholar (TAPS) Volume 2 Number 3 regarding the Kurusowa approach to teaching and learning (Rajesh & Sengodan, 2017). The authors discuss the Rashomon effect in the letter and hence, I would like to elaborate further on the “Rashomon approach.”