It has been almost three decades since Boyer (1990) introduced the concept of the Scholarship of Teaching and Learning (SoTL). In their own disciplines, faculty members are required to stay abreast of emerging knowledge and to contribute to the literature so that they advance their field through well-informed inquiry and disseminated work. Although they also have educational responsibilities, faculty are neither similarly motivated nor are they incentivised to participate in educational scholarship. Consequently, their efforts in this regard are often based on personal belief and opinion rather evidence and scientific inquiry. This problem persists despite a growing body of evidence that adopting sound instructional practices and pursuing scholarly work related to teaching, will increase the quality of the institution’s educational processes. In turn, this will enhance student learning and ultimately lead to better patient care. To achieve this end, teaching and learning must be scrutinised in terms of theory, methods, evidence, and outcomes. And faculty members who engage in teaching need to be rewarded for their participation in educational scholarship just as they are for efforts in their own disciplines.

Abstract

Introduction: This study aimed to examine the usefulness of Community Based-Education (CBE) and Interprofessional Education (IPE) to community health outcomes.

Methods: The design was a mixed-method study. Each small group worked together to identify family health problems, implement interventions, and evaluate the results. The Readiness for Interprofessional Learning Scale (RIPLS) questionnaire was applied to compare students’ perceptions before and after the implementation. In addition, qualitative data were acquired from students’ comments on the questionnaire, interviews with community representatives, and FGDs with instructors at the end of the program.

Results: Three hundred and sixty-seven out of 465 students returned the completed paired questionnaire (78.9 % response rate). Paired t-test showed that student perception of responsibility slightly increased, whereas teamwork and collaboration, negative and positive professional identity decreased somewhat. However, most pre-post students’ responses already trended to the positive side (scales 4 and 5). Moreover, the Chi-square test showed that pre-post students’ confidence levels significantly increased. Most small groups of students successfully empowered the community to solve health problems. Students, instructors, and representatives of community members appreciated the program. However, several students felt their instructors were not motivated to mentor their tasks, and sometimes they had difficulty conducting home visits together. 

Conclusion: This study showed that the combination of CBE-IPE contributes to more favourable community health outcomes. However, it was challenging in several aspects of preparation, including highly motivated instructors. Nevertheless, pre and post-implementation students’ attitudes are still positive.

Keywords:        Interprofessional Education (IPE), Community Based Education (CBE), Health Profession Students, Readiness

Abstract

Introduction: There are various difficulties in treating foreign patients; however, the existing educational programs are still insufficient for addressing this issue. The purpose of this study is to investigate what difficulties are encountered in the treatment of foreigners in emergency departments, and to create scenarios for simulation-based education using real-life cases.

Methods: A cross-sectional anonymous survey to 457 emergency departments was conducted in 2018. Additionally, we conducted a survey of 46 foreign residents who had visited hospitals for treatment in Japan. The data was analysed quantitatively, and the narrative responses were thematically analysed.

Results: Of the 141 hospitals that responded (response rate: 30.9%), 136 (96.5%) answered that they had treated foreign patients. There were 51 and 66 cases with cultural and linguistic difficulties, respectively. In the qualitative analysis, different ideas/beliefs towards treatments or examinations (51.0%) and communication with non-English speaking patients (65.2%) were most common categories in the cases with cultural and linguistic difficulties, respectively. The survey of 46 foreign residents on the surprising aspects of Japanese healthcare showed, 14% mentioned difference in treatment plans between own country and Japan, 12% each mentioned a lack of explanation by medical staff, and a lack of privacy in the examination room. Based on the survey results, we created 2 scenarios of simulation.

Conclusions: Scenarios of simulation-based education using real-life cases may be effective materials for cultivating cultural awareness of medical staff.

Keywords:       Cultural Awareness, Cultural Humility, Emergency Department, Foreign Patients, Simulation-based Education

Abstract

Introduction: Increases in vaccine hesitancy continue to threaten the landscape of public health. Literature provides recommendations for vaccine communication and highlights the importance of patient trust, yet few studies have examined medical student perspectives on vaccine hesitancy in clinical settings. Therefore, we aimed to explore medical student experiences encountering vaccine hesitancy, mistrust, and personal biases, with the goal of informing medical student education.

Methods: A health disparities course including simulated clinical scenarios required students to complete a written reflection. We sorted reflections written in 2014-2016 to identify common topics and used inductive thematic analysis to identify themes relevant to vaccine hesitancy by group consensus.

Results: Our sample included 84 de-identified essays sorted into three non-exclusive topics: vaccine hesitancy (n=42), mistrust (n=34), and personal bias (n=39). We identified four themes within medical students’ reflections: 1) Building a Relationship, including emphasis on patient-centred approaches; 2) Preparedness and Need to Prepare for Future Encounters, including highlighting gaps in medical education; 3) Reactions to Encountering Hesitant Patients, including frustration; 4) Insights for Providing Information and Developing a Plan with Hesitant Patients, including approaches to presenting knowledge. 

Conclusion: Reflections in the context of simulated encounters and discussion are useful in students identifying their preparedness for vaccine discussion with patients. Student reflections can assist educators in identifying missing educational frameworks for particular scenarios such as vaccine hesitancy. Without a structured framework regarding addressing vaccine hesitancy, students draw upon other skills that may contradict recommended practices.

Keywords:           Medical Education, Vaccine Hesitancy, Reflective Writing, Bias, Mistrust

Abstract

Introduction: Digital Badges have emerged as an alternative credentialing mechanism in higher education. They have data embedded in them and can be displayed online. Research in education suggests that they can facilitate student motivation and engagement. The authors introduced digital badges in a Psychiatry module in an Irish University. Completion of clinical tasks during the student’s clinical placements, which were previously recorded on a paper logbook, now triggers digital badges. The hope was to increase students’ engagement with the learning and assessment requirements of the module.

Methods: The badges – gold, silver and bronze level – were acquired on completion of specific clinical tasks and an MCQ. This was done online and student progress was monitored remotely. Data was collected from the students at the end of the module using a questionnaire adapted from validated questionnaires used in educational research.

Results: The response rate was 68%. 64% of students reported that badges helped them achieve learning outcomes. 68% agreed that digital badges helped them to meet the assessment requirements. 61% thought badges helped them to understand their performance. 61% were in favour of the continuing use of badges. Qualitative comments suggested that badges should contribute to a higher proportion of the summative mark, and identified that badges helped students to structure their work.

Conclusions: The findings are in keeping with the literature in that engagement and motivation have been facilitated. Further evaluation is required but the use of badges as an educational tool is promising.

Keywords:           Medical Education, Digital Badges, Students’ Engagement, Continuous Assessment Gamification, Health Profession Education

Abstract

Introduction: Summative assessments play a major role in shaping the student’s learning. There is little literature available on validity of summative assessment question papers in Forensic Medicine & Toxicology. This study analyses 30 question papers from 6 reputed universities for content validity.

Methods: A retrospective cross-sectional record-based observational study was conducted where 30 university summative question papers in Forensic Medicine & Toxicology from 6 universities across India were evaluated for content validity. The learning domain assessed, the type of questions asked, and sampling of the content was compared and presented in the results.

Results: From the results of the study, it was noted that 80% weightage was allotted to recall in most papers and only one paper tested for application. 70 to 80% of the marks were allotted to Forensic Pathology leading to disproportionate sampling. Core areas in Toxicology and Medical Jurisprudence were sparsely assessed. 

Conclusion: The content validity of the summative question papers in Forensic Medicine and Toxicology was unsatisfactory, emphasising the need for evaluation of the clarity and efficacy of the blueprints being used by the universities. Faculty training to motivate and influence a change in the mindset is necessary to bring about a course correction.

Keywords:           Forensic Medicine & Toxicology, Summative Assessments, University Assessments, Blueprint, Content Validity, Learning Domains

Abstract

Introduction: For all clinical providers in healthcare, decision-making is a critical feature of everything they do. Every day physicians engage in clinical decision-making where knowledge, evidence, experience, and interpretation of clinical data are used to produce decisions, yet, it is fair to say that most do not have an explicit insight or understanding of this complex process. In particular, few will have training in teaching and assessing the cognitive and affective factors that underlie clinical decision-making.

Methods: To foster an increased awareness and understanding of these factors, the Dalhousie Critical Thinking Program was established with the mandate to develop and deliver curriculum for critical thinking in the 4-year undergraduate program. To assist teaching faculty with the goal and objectives of the program, the Teaching and Assessing Critical Thinking Program (TACT) was introduced.

Results: Using the dual process model as a platform for decision-making, this program introduces general principles of critical thinking and provides tools to teach learners how to strengthen their critical thinking skills. To offer flexible learning, an online approach was chosen for delivery of the program.

Conclusion: To date, we have offered eleven iterations of Part 1 to a total of 261 participants and six iterations of Part 2 to a total of 89 participants. Evaluations show the online approach to content delivery was well received and the content to be of practical use.

Keywords:     Critical Thinking, Clinical Decision-Making, Faculty Development, Asynchronous Learning

Abstract

Introduction: Coaching has gained acceptance in the education field as a way to enable learners to achieve their fullest potential. In the endeavor to set up a coaching ecosystem in our university, we started by equipping our educators with fundamental coaching skills and techniques. Our training workshop, Coaching As An SIT Educator, covers the key coaching competencies and is highly practice focused. Participants get hands-on skills practice using contextualised scenarios that are based on realistic academic, workplace and clinical placement settings.

Methods: To address concerns on time-effectiveness, we adopt a solution-focused approach to coaching. We want to create a mindset shift for educators, from subject experts providing advice and solutions, to coaches asking powerful coaching questions that help students make discoveries and work towards their goals. We encourage our educators to engage students holistically by finding coachable moments in their daily student interactions.

Results: Competency-based assessments are conducted to determine achievement of the learning outcomes, articulated by the knowledge, attitude, and demonstration of coaching skills with students. Assessments consist of a reflection, multiple-choice question (MCQ) quiz, and scenario-based coaching role plays. Participants achieved the learning outcomes as demonstrated from the assessments.

Conclusion: The coach training workshop is the major pillar of our coaching initiative. Beyond the workshop, ongoing coaching development is supported through other activities and resources, including community of practice, coaching circle and knowledge repository. Opportunities for continuous learning and conversation platforms for sharing coaching experiences are part of the growing coaching ecosystem at SIT.

Keywords:         Assessments, Coaching Competencies, Coaching Conversations, Coaching Ecosystem, Coachable Moments, Faculty Development, Feedback, Holistic Development, Solution-Focused

Abstract

Introduction: The aim of this short communication is to examine the journey of scholarship in health professions education (HPE).

Methods: We will focus on tangible small steps to start, sustain, and succeed along this journey. Through a proposed innovation in scholarship – micro-scholarship – we will describe how this is similar to and an extension of bite-size or micro-learning, and workplace micro-practice related to just-in-time (JiT) learning settings.

Results: We will demonstrate how the small steps for generating and engaging with micro-content can be similarly applied to micro-scholarship. Then, progressive and iterative refinement of output and practice of micro-scholarship can be combined and result in macro-scholarship after cycles of public engagement for final digital or print publication. This stepwise approach creates an accessible, sustainable strategy to achieve success as a scholar in HPE. We will elaborate on micro, macro, and meta matters and celebrate how these small steps encourage and allow broad participation in the creation, critique, and progressive refinement of scholarship.

Conclusion: Small, sustainable, steps leads to success as a scholar in Health Professions Education – Micro (macro and meta) matters.

Keywords:      Micro-Scholarship, Micro-Learning, Just-In-Time (JiT) Learning, Community of Practice (CoP), Technology, Network Effects, Post-Publication Peer Review (PPPR)

A program director of a one-year-old Singapore surgical residency programme reads a publication about a new model of feedback. The paper describes how a US medical school successfully trialled and implemented this new feedback model. Excited, she then tries to implement this new model in her residency programme. Unfortunately, this fails to change faculty and resident behaviour, with disgruntled faculty and residents, and poor take-up by the various surgical departments within her programme. Disappointed, she stops using the new feedback model after a year.

What happened? Why would an educational intervention about feedback, published as part of Scholarship of Teaching and Learning (SoTL) (Steinert, 2017), and successfully implemented in a US medical school, fail to take root in a Singapore surgical residency programme? Might failure to consider context have contributed?  A review of the publication showed that while descriptions of the feedback model and the educational outcomes were rich, descriptions of the medical school environment and the broader educational context of the US were sparse.

I. TO BEGIN WITH MY VIEW

Medical education is a social science which addresses how people learn and teach medicine. The practice of education and training is therefore fundamental to its epistemology, whereby knowledge, and so scholarship, derives from practice. Where that practice is subject to social, contextual and cultural factors, we must question whether the tenets that are put forward are generalisable beyond the context from which they were derived (Fendler & Cole, 2006). This lack of automatic generalisability has implications for both the scholarship of the medical educationalist, and for the relationship between medical educationalist and teacher. Where educational practice is primary, and is contextually informed, then the teacher, the practitioner of medical education, must be the leader in developing scholarship, while the medical educationalist can support that development by enabling each teacher, context or culture, to tell their own truth well (Grant & Grant, 2022). 

I. INTRODUCTION

Interactive oral assessment has been identified as a form of authentic assessment that enables students to develop their professional identity, communications skills, and helps promote employability (Sotiriadou et al., 2020). It simulates authentic scenarios where assessors can engage students in genuine and unscripted interactions that represents workplace experiences (Sotiriadou et al., 2020). Unlike written examinations, interactive oral questions are not rigidly standardised as students and assessors role-play using workplace scenarios, enabling students to respond to the conversational flow and achieve authenticity (Tan et al., 2021). Using Villarroel et al. (2018) four-step ‘Model to Build Authentic Assessment’, this paper will present the use of oral interactive with first year occupational therapy students. This is within the context of a module named “Occupational Performance Across Lifespan” and students learn about children’s developmental milestones.

I. INTRODUCTION

For safe practice of medicine, proficiency in anatomy is important. Anatomy is mainly taught in the pre-clinical years. Knowledge retention decreases over time and this will affect clinical and practical application during clinical years (Jurjus et al., 2014; Zumwalt et al., 2007). Literature shows that integrating relevant anatomy with clinical teaching will reinforce the basic concepts and fill these knowledge gaps. Rajan et al. (2016) in their study show that integrating neuroanatomy refresher sessions to clinical neurological case discussions was effective in building relevant knowledge.

I. INTRODUCTION

Singapore raised its Disease Outbreak Response System Condition (DORSCON) from yellow to orange on the 7^th of February 2020 after it is first reported unlinked community COVID-19 case on the 6^th of February 2020.

The Department of Emergency Medicine (DEM) of Singapore General Hospital (SGH) hosted clinical rotations for medical students (MS) from Duke-NUS Medical School. Their clinical rotations lasted four weeks, during which MS were expected to achieve competence in history taking, physical examination, formulating a management plan, and performing minor procedures.

The local curriculum relies heavily on clinical rotations, during which MS directly contacts patients to fulfil their learning objectives. During DO, clinical postings were postponed, and the term break was brought forward (Ashokka et al., 2020). Restricting MS from entering hospitals and having face-to-face interactions with patients resulted in significant changes to clinical learning. Learning sessions involving direct contact that could not be held over remote platforms were cancelled.

We aimed to discover how MS felt excluded from clinical teaching during the COVID-19 pandemic and how teaching could be improved to support their learning.