The impact of a 2-week radiology program on year 4 medical students’ perception of radiology in clinical practice

Submitted: 16 August 2024
Accepted: 12 September 2025
Published online: 1 April, TAPS 2025, 10(2), 104-105
https://doi.org/10.29060/TAPS.2025-10-2/LE3494

Thazin Han1, Tun Tun Win2, Zaw Phyo1 & Zin Min Htike1

1Department of Medical Education, Defence Services Medical Academy, Myanmar; 2Department of Preventive & Social Medicine, Defence Services Medical Academy, Myanmar

Dear Editor,

The Department of Radiology, Defence Services Medical Academy reports the results on the impact of a 2-week radiology program on year 4 medical students’ perception of radiology. Advances in imaging modalities has led to almost every patient getting a scan prior to any planned management making it essential for medical students to understand the importance of radiology’s role in clinical practice. Limited exposure to radiology can perpetuate negative stereotypes by perceiving radiology as providing no significant contribution to patient care (Grimm et al., 2021). In the academic year of 2020/2021, we piloted a 2-week radiology program for 4th year medical students and conducted a qualitative, experiential, and phenomenological study design using Focus Group Interviews (FGIs) from January to July 2022 after obtaining ethical approval to find out the effectiveness of exposure to radiology impacts on 4th year medical students’ opinions and views on radiology. Eighteen out of 20 4th year medical students volunteered to participate. FGIs can be used to gather rich data through participant exchange of ideas or comments on each other’s views (Stalmeijer et al., 2014). We found that students who were hesitant to express their views individually were willing to do so in small groups.

The thematic analysis of the coded transcripts produced 6 themes which are (1) Earlier exposure to radiology-; (2) Integration of radiology into the undergraduate curriculum-; (3) Collaborative learning and practice-; (4) Motivation to learn radiology-; (5) Genuine interest in radiology and (6) Importance of radiology in clinical practice. Students reflected during FGIs that the radiology program provided meaningful learning when correlating radiology images to clinical findings. Learning is a continuous process grounded in experience and the educator’s job is to dispose, modify or implant new ideas as propounded by Kolb. This study showed that the 2-week radiology program disposed of the idea that radiology did not have any significant role on clinical management and implanted new ideas concerning the importance and appropriate use of radiology. The study is evaluated up to Kirkpatrick’s level 3 whereby there is change of students’ behavior as they now appreciated the importance of the role of radiology in clinical practice as evidenced by theme 6.

In conclusion, the radiology program was impactful in changing 4th year medical students’ perceptions regarding the role of radiology in clinical practice and provided justification to roll out the 2-week radiology program for consecutive academic years.

Notes on Contributors

Thazin Han developed the conceptual framework and piloted the radiology program. Tun Tun Win did data sampling, acquisition and analysis. Zaw Phyo recorded the FGIs. Zin Min Htike did member checking and data transcribing. All 4 took turns to conduct and moderate the FGIs and review the data.

Acknowledgement

We wish to express our gratitude and thanks to the Rector of the Defense Services Medical Academy for allowing us to conduct this research. We would like to express special thanks to the Head of the Medical Education Department for providing us with the logistic support. Finally, thanks to the study team members without whom this research would not have been achieved.  

Funding

No funding is involved for this research. The research was conducted based on situation analysis of the undergraduate curriculum regarding radiology.

Declaration of Interest

There is no conflict of interest for the current research.

References

Grimm, L. J., Fish, L. J., Carrico. C. WT., Martin, J. G., Nwankwo, V. C., Farley, S., Meltzer, C. C. & Maxfield, C. M. (2022). Radiology stereotypes, application barriers, hospital integration: A mixed methods study of medical student perceptions of radiology. Academic Radiology, 29(7), 1108-1115. https://doi.org/10.1016/j.acra.2021.08.020

Stalmeijer, R. E., Mcnaughton, N. & Van Mook, W. N. (2014). Using focus groups in medical education research: AMEE Guide No. 91. Medical Teacher, 36(11), 923-939. https://doi.org/10.3109/0142159X.2014.917165

*Thazin Han
No. 94, D-1, Pyay Road
Mingaladon Township
Yangon, Myanmar
Postal code – 11021
Email: thazinhn@gmail.com

Submitted: 5 June 2024
Accepted: 24 July 2024
Published online: 7 January, TAPS 2025, 10(1), 65-66
https://doi.org/10.29060/TAPS.2025-10-1/LE3428

Sulthan Al Rashid1 & Mohmed Isaqali Karobari2

1Department of Pharmacology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), India; 2Department of Dental Research, Centre for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), India

Dear Editor,

Comprehensive review articles require more than just gathering information; they require careful synthesis, analysis, and effective communication (Dhillon, 2022). Benjamin Bloom’s Taxonomy offers a systematic framework, guiding authors through remembering, understanding, applying, analysing, evaluating, and creating (Adams, 2015). Leveraging Bloom’s Taxonomy enriches writing, ensuring impactful and thorough reviews.

At the foundational level of remembering, authors embark on a meticulous literature search to gather pertinent studies. For instance, in a review exploring “Innovative Pedagogical Approaches in Medical Education,” authors meticulously scour databases such as PubMed and ERIC using keywords like “medical education” and “innovative teaching methods.”

In transitioning to Understanding, the authors synthesise the literature, identifying key concepts such as problem-based learning and simulation-based training. This enables a more profound comprehension of fundamental principles, such as how active learning strategies enhance student engagement and knowledge retention.

Applying involves contextualising synthesised information within broader educational frameworks. By referencing theories such as cognitive load theory, the authors elucidate how instructional design principles can optimise learning outcomes in medical education.

Analysis necessitates evaluating the strengths and weaknesses of existing educational practices. Despite the prevalent use of lecture-based teaching, the review highlights the benefits of active learning approaches in improving critical thinking skills and clinical reasoning among medical students.

During evaluation, authors assess the overall quality and significance of synthesised literature. While some studies demonstrate the effectiveness of flipped classroom models in medical education, others yield mixed results, underscoring the need for further research with rigorous methodologies.

Lastly, creating involves synthesising information to propose innovative educational interventions. Drawing insights from the review, the authors propose a comprehensive model illustrating the integration of technology-enhanced learning tools and interprofessional education strategies. Future research recommendations include exploring virtual reality simulations’ impact on clinical skill acquisition.

By embracing Bloom’s Taxonomy, writers adeptly navigate the complexities of review article writing with clarity and depth. This systematic approach empowers scholars to recapitulate existing literature and assess, integrate, and expand knowledge within the field, thereby enhancing the credibility and significance of scholarly endeavours in any educational field.

Notes on Contributors

Sulthan Al Rashid contributed to the concept, scientific content, data collection, and manuscript preparation.

Mohmed Isaqali Karobari helped with the review and editing of the manuscript.

The final manuscript has been read and approved by all the authors.

Acknowledgement

The authors would like to acknowledge the director of Saveetha Medical College and Hospital for support in this educational research.

Funding

For this study, the authors were not given any funding.

Declaration of Interest

The authors claim to have no conflicts of interest.

References

Adams, N. E. (2015). Bloom’s taxonomy of cognitive learning objectives. Journal of the Medical Library Association, 103(3), 152-153. https://doi.org/10.3163/1536-5050.103.3.010

Dhillon, P. (2022). How to write a good scientific review article. The FEBS Journal, 289(13), 3592-3602. https://doi.org/10.1111/febs.16565

*Sulthan Al Rashid
Department of Pharmacology,
Saveetha Medical College and Hospital,
Saveetha Institute of Medical & Technical Sciences (SIMATS),
Chennai, Tamil Nadu, India
+919629696523
Email: sulthanalrashid@gmail.com

Submitted: 9 June 2024
Accepted: 16 July 2024
Published online: 7 January, TAPS 2025, 10(1), 67-68
https://doi.org/10.29060/TAPS.2025-10-1/LE3433

Virak Sorn

Faculty of Health Science and Biotechnology, University of Puthisastra, Cambodia

Dear Editor,

Cambodia, like many other countries around the world, is facing a concerning rise in non-communicable diseases (NCDs) incidences. The rise of NCDs in Cambodia, pressing public health concerns that demand immediate attention. NCDs account for 64% of all deaths in Cambodia, with the population having a 23% probability of dying between the ages of 30 and 70 from one of the four main NCDs, which include cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes (World Health Organization, 2023). These NCDs pose a significant threat to the population’s health and well-being.

There are several factors affecting an increase in NCDs, including changing lifestyles, air pollution, physical inactivity, excessive intake of salt and alcohol, and limited access to healthcare services, which have contributed to the growing burden of NCDs in the country (Kulikov et al., 2019). The impact of NCDs is substantial, leading to increased mortality rates, reduced quality of life, and significant economic burdens on individuals, families, and the healthcare system as a whole.

Effective strategies must be implemented to combat this epidemic. Raising awareness about the risk factors associated with NCDs through public health campaigns and educational programs is crucial. Encouraging healthy behaviours like regular physical activity, maintaining a balanced diet, and avoiding tobacco and excessive alcohol consumption can significantly reduce the incidence of NCDs. Access to healthcare services plays a pivotal role in the early detection and management of NCDs. Cambodia faces challenges in terms of healthcare infrastructure, workforce capacity, and financial resources. Strengthening the healthcare system, expanding primary care services, and training healthcare professionals are essential steps to effectively address the NCD burden.

Population-based interventions, including promoting vaccinations, reducing environmental pollution, and ensuring access to essential medicines, are key in the fight against NCDs in Cambodia. Collaborative efforts involving government agencies, non-governmental organisations, healthcare providers, and communities are necessary to develop and implement comprehensive strategies. A multi-sectoral approach that emphasises prevention, early detection, treatment, and management is vital to addressing NCDs in Cambodia. By integrating awareness campaigns, improving healthcare access, and implementing population-based interventions, Cambodia can make significant progress in combating the growing burden of NCDs and enhancing the health outcomes of its population.

In conclusion, concerted efforts and coordinated actions are essential to successfully tackling the NCDs epidemic in Cambodia. Prioritising prevention, early detection, and comprehensive healthcare services will be key to curbing the impact of NCDs and improving the overall health and well-being of the Cambodian population.

Notes on Contributors

Sorn, V. wrote and edited the manuscript.

Acknowledgement

Sorn, V. would like to thank Menghourn Pin, who has always provided care over the years. Also, thank you to Bella Virak, who was my personal assistant when I wrote this paper.

Funding

There is no grant or funding involved for this paper.

Declaration of Interest

The author declares no conflict of interest.

References

Kulikov, A., Mehta, A., Tarlton, D., Grafton, D., & Aarsand, R. (2019). Prevention and control of noncommunicable diseases in Cambodia: The case for investment. United Nations Development Programme. https://cdn.who.int/media/docs/default-source/unitaf/cambodia-ic-report-final.pdf?sfvrsn=f14b8683_3&ua=1

World Health Organization. (2023). Noncommunicable diseases. https://www.who.int/en/news-room/fact-sheets/detail/noncommunicable-diseases

*Virak Sorn
#55, St. 184-180,
Sangkat BoeungRaing,
Khan Daun Penh,
Phnom Penh, Cambodia 12211
Faculty of Health Science and Biotechnology,
University of Puthisastra
Email: viraksorn2013@gmail.com

Submitted: 21 June 2024
Accepted: 17 July 2024
Published online: 1 October, TAPS 2024, 9(4), 90-91
https://doi.org/10.29060/TAPS.2024-9-4/LE3444

Tomoko Miyoshi1,2, Masaki Chuuda3 & Fumio Otsuka2

1Center for Medical Education and Internationalization, Kyoto University, Kyoto, Japan; 2Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan; 3Department of Clinical Laboratory, Japanese Red Cross Okayama Hospital, Okayama, Japan

Advance care planning (ACP) enables individuals to define their goals and preferences for future treatment and care, discuss them with their families and healthcare providers, and record and review their preferences if appropriate (Rietjens, et al., 2017). In Japan, guidelines for ACP were developed in 2007, and the Ministry of Health, Labour and Welfare (MHLW) promoted it. However, whether the COVID-19 pandemic, which infected many people and led to the deaths of many, affected ACP practices needs to be explored.

Before and after the pandemic, the MHLW conducted a national survey on ACP in Japan among individuals aged 20-80 years. It was found that 2.8% and 39.4% of the 2179 citizens discussed ACP in detail before the COVID-19 pandemic in 2012, whereas 3000 citizens showed a downward trend of 1.5% and 28.4% after the pandemic in 2022, respectively. The most common reason for not discussing the issue was a lack of opportunity to discuss it (62.8%), followed by lack of knowledge and not knowing what to discuss (31.0%), not feeling the need to discuss it (21.8%), and not wanting to discuss it (2.1%). The most common events that might trigger relevant discussions were family illness (54.8%), own illness (47.7%), caring for a family member (40.7%), and death of a family member (31.1%), while the spread of coronavirus infections was only 5.2%. Thus, it was found that the public may face barriers to ACP practices unless someone close to them is ill or is dying.

Cinemeducation, which uses films as a method of medical education, is one of the most effective educational strategies for medical ethics and professionalism education (Shankar, et al., 2019). In this study, we used the Cinemeducation method to conduct a public lecture on thinking about what to value in life after watching a short film on end-of-life care following the COVID-19 pandemic. Twenty people attended the lecture and 18 completed the questionnaire. Fourteen (77.8%) had previously practiced ACP, while three (16.7%) showed interest in practising it.

Hence, the COVID-19 pandemic did not motivate the public to practice ACP. This lack of ACP awareness could be mitigated by Cinemeducation for the public and encourage its practice. As the field of medical care advances and life expectancy grows, it is essential to maintain ongoing awareness and implementation of ACP to improve the quality of life.

Notes on Contributors

TM conceptualised the study, analysed the literature, and wrote the manuscript.

MC conceptualised the study and revised the manuscript.

FO conceptualised the study and revised the manuscript.

 Acknowledgement

We would like to thank Dr. Sun Daisuke for his lecture on ACP.

Funding

No funding was received.

Declaration of Interest

All authors have no conflict of interest to declare.

References

Rietjens, J. A. C., Sudore, R. L., Connolly, M., van Delden, J. J., Drickamer, M. A., Droger, M., van der Heide, A., Heyland, D. K., Houttekier, D., Janssen, D. J. A., Orsi, L., Payne, S., Seymour, J., Jox, R. J., & Korfage, I. J. (2017). Definitions and recommendations for advance care planning: An international consensus supported by the European Association for Palliative Care. Lancet Oncology 18, e543-e551.

Shankar, P. R. (2019). Cinemeducation: Facilitating educational sessions for medical students using the power of movies. Archives of Medicine and Health Sciences, 7(1), 96-103.

*Tomoko Miyoshi
Yoshida Konoe-cho,
Sakyo-ku, Kyoto City,
Japan, 606-8501
+81-75-753-9454
Email: miyoshi.tomoko.7z@kyoto-u.ac.jp

Submitted: 25 April 2024
Accepted: 29 May 2024
Published online: 1 October, TAPS 2024, 9(4), 88-89
https://doi.org/10.29060/TAPS.2024-9-4/LE3340

Virak Sorn

Faculty of Health Science and Biotechnology, University of Puthisastra, Cambodia

Dear Editor,

Healthcare professionals are crucial for achieving universal health coverage (UHC) and ensuring public health for all citizens. However, disparities in healthcare services are prevalent in rural areas, particularly in lower-middle-income countries like Cambodia. In 2021, with a population of 17 million and an annual health expenditure of $122 per capita, the country faces challenges due to an inadequate and unevenly distributed healthcare workforce. Cambodia had only 1.4 health workers per 1000 people, falling below the WHO critical shortage threshold in 2012.  In addition, 3/4 of people live in rural areas, while approximately 2/4 of physicians and 3/4 of specialists work in Phnom Penh, the country’s capital (Ozano et al., 2018). This disparity results in a three-fold higher infant mortality rate in rural areas compared to urban centers.

Cambodia’s healthcare system comprises the public and private sectors, with 34 national and provincial-municipal level hospitals, 92 referral hospitals, 1222 health centers (HC), and 128 health posts. However, outpatient services utilisation is low in public sectors, while 2/4 of people seeking care from private providers (World Health Organization, 2016), highlighting the need for strengthening the public health sector through infrastructure, training, and resource allocation.

Cambodia is addressing the shortage of medical professionals by focusing on medical education and training for nurses and midwives. However, challenges persist, such as limited access to medical universities and limited training opportunities for rural healthcare workers. Many young nurses leave rural facilities due to insufficient salaries, long working hours, and challenging environments. Improvements in financial support, working conditions, and social factors are essential to retain healthcare workers in rural areas.

The Cambodian government is committed to improving healthcare access and quality, despite challenges such as high out-of-pocket expenditures and a poorly regulated private sector. Initiatives like Health Equity Funds and voucher schemes provide financial risk protection for the poor. Still, challenges remain in access to and quality of healthcare services, highlighting the need for continued efforts to enhance healthcare access.

To improve rural healthcare, investing in the referral system between public and private sectors could be a strategic approach. This would enhance collaboration and ensure that all residents, especially those in rural areas, have access to essential health services, including emergency care and NCD treatment, at their nearest HC. By prioritising investments in HC services, which include financial investments, improvements in infrastructure and training, and policy reforms, Cambodia can better care for its rural residents and move closer to achieving UHC.

Notes on Contributor

Sorn, V. wrote and edited the manuscript.

Acknowledgement

Sorn, V. would like to thank Menghourn Pin and Bella Virak, who have always provided care and support over the years.

Funding

There is no grant or funding involved for this paper.

Declaration of Interest

The author declares no conflict of interest.

 

References

Ozano, K., Simkhada, P., Thann, K., & Khatri, R. (2018). Improving local health through community health workers in Cambodia: Challenges and solutions. Human Resources for Health, 16(1), 1-12. https://doi.org/10.1186/s12960-017-0262-8

World Health Organization. (2016). Cambodia–WHO, Country Cooperation Strategy 2016–2020. https://iris.who.int/bitstream/handle/10665/246102/WPRO_2016_DPM_004_eng.pdf?sequence=1&isAllowed=y 

*Virak Sorn
#55, St. 184-180,
Sangkat BoeungRaing,
Khan Daun Penh,
Phnom Penh, Cambodia 12211
Faculty of Health Science and Biotechnology
University of Puthisastra
Email: viraksorn2013@gmail.com

Submitted: 11 August 2023
Accepted: 23 August 2023
Published online: 2 January, TAPS 2024, 9(1), 64-65
https://doi.org/10.29060/TAPS.2024-9-1/LE3109

Mildred Lopez

Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico

Artificial intelligence (AI) in education has raised several ethical questions regarding academic integrity, privacy, and bias in language algorithms (Master, 2023). These concerns have yielded to distrust to the point that several institutions banned chatbots at Campus locations. Still, the discussion should not be about whether we should use them but how fast we can leverage the data-crunching possibilities to address the biggest challenges of medical education. To do so, educators have the task of transforming the generic use of generative AI to a specific task, such as designing an educational case, a grading rubric, or an exam. However, the quality of the designs depends heavily on the clarity of the educational intent and the technological savviness of the user to provide clear instructions for the algorithm to process.

Early experimentation of educators with generative AI, such as ChatGPT, could be an opportunity to refine the technological savviness and the specificity of prompts we supply to make the algorithm produce more effectively. Recently, Rospigliosi (2023) discussed that the challenge is to define what to ask of ChatGPT, as the quality of the prompt makes the quality of the response. In this ideation and creation stage, where early adopters are piloting small-scale interventions and experimenting with the tool’s limits, educators must work collaboratively across continents and among fields to define guidelines and identify effective strategies for large-scale implementations. While doing so, we speed up the developing process of learning resources in medical education and aspire to have more updated content in the curriculum.

Nevertheless, once a recipe to generate a learning resource has been implemented, the quality of the produced content should be assessed by specialists in the field. The definition of that quality level is also a field for discussion but should be closely aligned with the educational intent. In the future, not so far away, we could even have an AI tool to assess the quality of the content that the generative AI created. Then the question remains: What AI prompt would be the best to do what I, as an educator, need to work on?  

Notes on Contributors

ML wrote the manuscript and edited it.

Funding

No funding was received for writing this paper.

Declaration of Interest

The author declares that there is no conflict of interest to disclose.

References

Masters, K. (2023). Ethical use of Artificial Intelligence in Health Professions Education: AMEE Guide No. 158, Medical Teacher, 45(6), 574-584. https://doi.org/10.1080/0142159X.2023.2186203

Rospigliosi, P. (2023). Artificial intelligence in teaching and learning: What questions should we ask of ChatGPT? Interactive Learning Environments, 31(1), 1-3. https://doi.org/10.1080/10448 20.2023.2180191

*Mildred Lopez
Ave. Eugenio Garza Sada 2501 Sur. Col Tecnologico,
64710
Monterrey, Mexico
Email: mildredlopez@tec.mx

Submitted: 10 April 2023
Accepted: 15 May 2023
Published online: 3 October, TAPS 2023, 8(4), 59-60
https://doi.org/10.29060/TAPS.2023-8-4/LE3036

Siti Suriani Abd Razak, Bhavani Veasuvalingam, Pathiyil Ravi Shankar & Norul Hidayah Mamat

IMU Centre for Education, International Medical University, Malaysia

Dear Editor,

We read the article titled ‘Involving stakeholders in re-imagining a medical curriculum’ (Foster, 2022) with great interest. We would like to share our experiences and extend the importance of stakeholder involvement in postgraduate health professions education programmes (PGHPE). These programmes are utilised by educators for skills development, career progressions and advancement of health professions education across various health professions. Our institution started accredited PGHPE programmes in 2018 to equip health professional educators within and outside our institution with competencies to deliver evidence-based education and impact graduate outcomes positively. Our curriculum review conducted in early 2023, began with a stakeholder engagement meeting involving students, facilitators, alumni, employers, and ‘institutional partners’ (national and international HPE experts). Focus group discussions were held on four areas: (1) HPE ‘Industry’ institutional Needs and Graduate Competencies, (2) Student Experience, (3) Scholarship in HPE, and (4) Inter-Institutional Partnership and Collaboration.

Four key outcomes emerged from the engagement. The four outcomes were increased educators’ competency, digitalisation in health profession education, supporting scholarly work and publication and widening the scope of learning with global engagement.

The first theme of increased educators’ competency is related to the value of our PGHPE programmes. Our alumni strongly felt their teaching and learning competencies were enhanced and they were more confident in accepting leadership roles. Greater emphasis on contextualisation was requested for example local and regional accreditation frameworks. Stakeholders jointly highlighted the increasing use of artificial intelligence (AI) in HPE and emphasised that both awareness of and being able to work with digital tools is important. The use of AI in curriculum design, review and assessment may need greater emphasis. Greater HPE student engagement with online learning tools and assessments to promote deep learning was firmly echoed by our stakeholders.

The need for greater support to facilitate educational research and the possible formation of research consortiums was widely agreed upon by participants. The team has identified and initiated Health Professional Educational Research Clusters to facilitate HPE students achieve this goal. The final theme focused on widening engagement and collaboration. The centre’s strong international collaboration provides opportunities for HPE students to share ideas and thoughts and enhances networking and collaboration.

As a postgraduate programme, the number of alumni is more limited, and are educators with work experience, hence stakeholder involvement becomes more valuable to programme developers. Importantly, postgraduate programmes provider can utilise stakeholder engagement and feedback during different stages in a developmental manner.

Notes on Contributors

Siti Suriani Abd Razak organised and conducted the stakeholders’ engagement meeting, conceptualised and wrote the manuscript and approved the final version.

Bhavani Veasuvalingam organised and conducted the stakeholders’ engagement meeting, conceptualised, revised the manuscript and approved the final version.

Pathiyil Ravi Shankar organised and conducted the stakeholders’ engagement meeting, conceptualised, revised the manuscript and approved the final version

Norul Hidayah Mamat organised and conducted the stakeholders’ engagement meeting, revised the manuscript and approved the final version.

Acknowledgement

We would like to thank Professor Vishna Devi Nadarajah and Professor Er Hui Meng for their support and feedback in the process of conducting the stakeholders engagement meeting and writing this letter.  

Funding

No funds, grants, or other support were received. 

Declaration of Interest

No conflicts of interest are associated with this paper.

References

Foster, K. (2023). Involving stakeholders in re-imagining a medical curriculum. The Asia Pacific Scholar, 8(1), 43-46. https://doi.org/10.29060/TAPS.2023-8-1/SC2807

*Siti Suriani binti Abd Razak
No 126, Jalan Jalil Perkasa 19
Bukit Jalil, 47000
Kuala Lumpur, Malaysia
+6019-4429985
Email: sitisuriani@imu.edu.my

Submitted: 14 March 2023
Accepted: 31 March 2023
Published online: 3 October, TAPS 2023, 8(4), 57-58
https://doi.org/10.29060/TAPS.2023-8-4/LE3021

Tomoko Miyoshi1, Mikiko Iwatani2 & Fumio Otsuka1

1Department of General Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan; 2Department of Nursing, Okayama University Hospital, Japan

It was found that the excess mortality rate for U.S. physicians was considerably lower during the COVID-19 pandemic than in the general population, but more physicians died than expected when compared to pre-pandemic levels. These results suggest that appropriate infection control measures can reduce mortality; however, additional measures are needed.

During the COVID-19 pandemic, there have been many reports of burnout among healthcare professionals (HCPs). Although no causal relationship has been established, it is acknowledged that it would be difficult to pay attention to mental health issues and the creation of a healthy work environment during a pandemic.

Globally, the COVID-19 pandemic has subsided, but what have we learned from this COVID-19 pandemic?

We conducted six online significant event analyses (SEAs) in collaboration with facilities providing administrative support, nursing care, and medical care for COVID-19-infected individuals in March 2022. The participants were limited to HCPs and healthcare students. The presentations were based on actual cases of COVID-19-infected patients, focusing on the struggles of their positions and efforts to overcome them. Seventy-three people participated, and 38 responded to the post-event survey (52.1% response rate). Twenty respondents (52.6%) were satisfied, and 16 (42.1%) were very satisfied with this initiative, with gratitude for having the reflection.

SEA, a method of reflection, is a learning process in which recognition of one’s feelings is important (Henderson et al., 2002). HCPs are always considered to be engaged in reflective practices. However, during the COVID-19 pandemic, there were issues that were insufficient to transfer previous experiences. However, in the case of the COVID-19 pandemic, “reflection in action” was not sufficient to overcome the challenges, and the SEA may have served as a place for “reflection on action” to prepare for the next stage of the COVID-19 pandemic.

Furthermore, this SEA provided an opportunity to recognise the existence of “common humanity,” which is one of the three elements of self-compassion (the ability to understand that people other than oneself are also suffering). It is believed that, through the SEA, the HCPs were able to become aware of the feelings of other HCPs. It has been reported that increased self-compassion increases compassion for others (Neff & Germer, 2013), and the increased self-compassion of HCPs may increase their compassion for other HCPs and patients.

In the COVID-19 pandemic, reflection among healthcare providers beyond the facility may enhance self-compassion and compassion for others in preparation for the next pandemic, which may lead to HCPs’ well-being.

Notes on Contributors

T Miyoshi conceptualised and wrote the manuscript and approved the final version.

M Iwatani conceptualised and approved the manuscript.

F Otsuka supervised and edited the manuscript.

Funding

There is no funding provided.

Declaration of Interest

There is no conflict of interest, including financial, consultant, institutional or otherwise for the author.

References

Henderson, E., Berlin, A., Freeman, G., & Fuller, J. (2002). Twelve tips for promoting significant event analysis to enhance reflection in undergraduate medical students. Medical Teacher, 24(2),121–124. https://doi.org/10.1080/01421590220125240 

Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of Clinical Psychology. 69(1), 28–44. https://doi.org/10.1002/jclp.21923

*Tomoko Miyoshi
2-5-1 Shikata-cho, Kita-ku
Okayama, 700-8558, Japan
+81-86-235-7342
Email: tmiyoshi@md.okayama-u.ac.jp

Submitted: 16 December 2022
Accepted: 3 January 2023
Published online: 4 July, TAPS 2023, 8(3), 68-69
https://doi.org/10.29060/TAPS.2023-8-3/LE2930

David Mathew

Department of Anaesthesia, Khoo Teck Puat Hospital, Singapore

Dear Editor,

I read with great interest the article entitled “The associates of Emotional Intelligence in medical students: A systematic review” (Edussuriya et al., 2022) in your journal published in October 2022. The association of Emotional Intelligence (EI) with wellbeing cannot be underestimated, especially with the plethora of positive effects it has on mental health and academic performance. In fact, I think this can be extended beyond students, to all healthcare professionals.

In my opinion, humanities in medicine provide a potentially novel way of improving emotional intelligence. The writer of a piece acknowledges the scientific experience that has moved him/her, and subsequently reflects on the entire experience through the arts and writing. The process of writing can be cathartic as it presents an avenue for the writer to release emotions that might have been pent-up or hidden as we provide a brave front to our patients. Once written, the piece can be shared, and reach out to other healthcare professionals who might have encountered similar experiences. Some may find comfort in reading such pieces, as they realise they are not alone in experiencing the roller-coaster of emotions in their daily lives.

I have appended a piece I wrote regarding my experience with an obstetrics patient and how sometimes the lesser said, the more it means. The process of writing and sharing this piece helped me better understand and appreciate what I went through and I hope it can do the same for fellow readers.

Cry

The day I saw her cry

was when her baby’s heart

slowed.

She needed the Caesarean

quickly.

 

Her eyes conceived tears

crawling down her cheeks

shaping into an anxious cry.

I counted the tears

and spoke more words

comforting, reassuring.

 

I saw her cry

one week later,

this time her littlest bundle

the greatest joy.

 

Tears of happiness

dancing muted screams of relief

I counted the tears

but spoke nothing

comforting, reassuring.

 

Tears

instead of words,

won wars of emotions.

And staying silent

might be the most reassuring cry

of comfort.

Note on Contributor

DM came up with the concept of the manuscript, and wrote the entirety of its contents.

Funding

There was no funding for this paper.

Declaration of Interest

There is no conflict of interest declared.

References

Edussuriya, D., Perera, S., Marambe, K., Wijesiriwardena, Y., & Ekanayake, K. (2022). The associates of Emotional Intelligence in medical students: A systematic review. The Asia Pacific Scholar, 7(4), 59–70. https://doi.org/10.29060/taps.2022-7-4/oa2714

*David Mathew
Khoo Teck Puat Hospital,
90 Yishun Central, Singapore
Email: davidmathew3142@gmail.com

Submitted: 27 December 2022
Accepted: 13 March 2023
Published online: 4 July, TAPS 2023, 8(3), 70-71
https://doi.org/10.29060/TAPS.2023-8-3/LE2938

Hirofumi Kanazawa1 & Ikuo Shimizu2,3

1Shinshu University School of Medicine, Matsumoto, Japan; 2Safety Management Office, Shinshu University Hospital, Matsumoto, Japan; 3Department of Medical Education, Chiba University Graduate School of Medicine, Chiba, Japan

Medication errors are one of the most serious problems in healthcare, and their occurrence is due to a wide variety of causes. While almost all drug-related medical errors are potentially avoidable, the main obstacles are primarily health system vulnerabilities and human error. To remove those obstacles, the World Health Organization (WHO) suggested providing more education (World Health Organization, 2017), specifically by participating in medical care. Graduation competencies in many countries, which include activities about medication and patient safety, are consistent with the statement. In addition, it is known that more prescribing errors occur in the first postgraduate year. Learning about prescriptions during medical studentships must be enhanced.

Nevertheless, we are concerned that medication safety education is still insufficient in the current undergraduate curriculum because of license-based regulation. It is considered difficult for clinical students to incorporate prescribing and ordering medication as part of medical studentship. Such license-based regulation is typical in Asia, where authoritarian attitudes are strong. We would like to point out that invasive clinical procedures are handled differently from prescriptions, despite the fact that such procedures are also medical practices that can involve risk. While medical students have the opportunity to conduct invasive medical procedures in the workplace, they scarcely prescribe medication before graduation.

It is time for medical educators to take the WHO statement seriously and organise more opportunities to learn how to prescribe medications safely. We can transfer learning strategies from invasive clinical procedures, even in the context of strict regulations. For example, we can implement more simulation practices. Although the WHO Curriculum Guide for Patient Safety does not yet include scenario simulation, research suggests that education with appropriate feedback can be very effective (Motola et al., 2013). Simulation-based prescription practice, especially in situations where medication errors are likely to occur, would allow for focused practice in a zero-risk environment. Another concern is that there have been relatively few published studies on the effectiveness of medication safety in undergraduate education, including simulation. High-fidelity simulators are available in many medical schools, but the usability is still limited because they do not cover a wide variety of situations to use medications. A possible breakthrough can be the implementation of virtual or mixed reality environment. Enhancing the reality of prescribing and administrating medications through these educational strategies could be a very useful tool to apply not only in Asia but also in other contexts.

Notes on Contributors

Hirofumi Kanazawa conceptualised and wrote the manuscript.

Ikuo Shimizu wrote and supervised the manuscript.

All authors discussed and contributed to the final manuscript.

Funding

This work was supported by JSPS KAKENHI Grant Number 21H03161.

Declaration of Interest

There is no conflict of interest.

The main idea of this article was presented at The 17th Annual Congress of Japanese Society for Quality and Safety in Healthcare on November 27, 2022.

References

Motola, I., Devine, L. A., Hyun, S. C., Sullivan, J. E., & Issenberg, S. B. (2013). Simulation in healthcare education: A best evidence practical guide. AMEE Guide No. 82. Medical Teacher, 35(10), e1511-e1530. https://doi.org/10.3109/0142159X.2013.818632

World Health Organization. (2017, May 15). Medication Without Harm – Global Patient Safety Challenge on Medication Safety. https://www.who.int/publications/i/item/WHO-HIS-SDS-2017.6

*Ikuo Shimizu
Safety Management Office,
Shinshu University Hospital,
Matsumoto, Japan
3-1-1, Asahi, Matsumoto City,
Nagano, Japan, 390-8621
+81 263 37 3359
Email: qingshuiyufu@gmail.com

Announcements