COVID pandemic created worldwide disruptions to all services and had profound impact on training of health professionals, posing serious challenges to maintaining essential healthcare services. During the height of the pandemic, most of the undergraduate learners were prevented from clinical training sites, restricted intra, inter-institutional and overseas learning opportunities and in many institutions, there were termination of onsite learner-educator engagements (Ng et al., 2021; Renaud et al., 2021; Samarasekera et al., 2020). Less face to face, peer and faculty interactions and restricted mobility of learners led to some of them facing poor mental wellbeing and health issues.  The learning activities were mostly restricted to online platforms during the pandemic for students following health professional programs. During the latter part of the pandemic, however, there were changes when better preventive measures and immunisation were developed. The students were also allowed to provide limited care services to assist the practitioners who were providing critical services (Lau et al., 2021).

Abstract

Introduction: The pandemic caused by the novel coronavirus (COVID-19) has produced dramatic changes in the learning environment for clinical practice in medical education, and the impact on medical students has been significant. However, few program evaluation studies involving professional identity, now emphasised in medical education, have compared current with pre-COVID-19 programs. Here, we compared the professional identity recognised by medical students in the years before and during COVID-19.

Methods: Medical students who participated in clinical practice were evaluated using the Japanese version of the Professional Self-Identity Questionnaire (PSIQ), a 9-item inventory rated using 7-point Likert scales. They answered on the first day of a 4-week clinical practice module within a community-based medical education (CBME) program and at graduation in 2018-2019 (pre-COVID-19 pandemic) and in 2019-2020 (during-COVID-19 pandemic). We compared the mean difference in total PSIQ score of the 2019-2020 students to those of the 2018-2019 students as a historical cohort using an unpaired t-test.

Results: Participants were 104 medical students in the 2018-2019 academic year and 92 in the 2019-2020 academic year. PSIQ was increased at graduation. Mean difference in total PSIQ score was statistically higher for the 2019-2020 students (13.5 ± 9.4) than for the 2018-2019 students (10.3 ± 8.1) (t =2.6, df =195, p = 0.01).

Conclusion: Although clinical practice was restricted by COVID-19, this had some positive impact on the strengthening of professional identity recognised by medical students. This finding may have been influenced by the imprinting of professional norms and changes in society.

Keywords:           Novel Coronavirus Infection, Professional Identity, Clinical Practice, Questionnaire Survey, Program Evaluation

Abstract

Introduction: Workplace contexts, including political and sociocultural systems influence health professions’ perception and experience of ethical issues. Although established health ethics principles are relevant guiding values, they may be experienced and interpreted differently within different health contexts. How should ethics education account for this? This paper presents ethical dilemmas and concerns encountered by physiotherapists practicing in Singapore and discusses the implications for ethics education.

Methods: Qualitative methods informed by interpretivism and phenomenology were employed. In-depth interviews with 42 physiotherapists from different workplace settings in Singapore were conducted. Participants described everyday ethical challenges they encountered. Inductive content analysis was used to analyse the interview transcript data.

Results: Ethical issues occurred within and across three spheres of ethics:  micro, meso and macro. Ethical issues at the micro sphere centered around physiotherapist-patient relationships, interactions with colleagues, and therapists’ feelings of moral distress. In the meso sphere, ethical challenges related to influences arising from the organizational resources or systems. In the macro sphere, ethical challenges developed or were influenced by sociocultural, religious, economic, and political factors.

Conclusion: The findings reflect current literature indicating that context can influence ethical situations, as experienced and perceived by physiotherapists in their unique settings. Such empirical data might inform the development of ethics curricula to ensure that universal ethical principles are situated within the realities of clinical practice. Locally relevant and realistic ethical case studies will better enable students to recognise and address these situations.

Keywords:           Ethics, Physiotherapy, Health Professions Education, Ethics Education, Asian Context, Singapore, Healthcare Principles, Health Ethics Principles

Abstract

Introduction: This study was performed to understand how fixed clinical teams affected informal learning in Emergency Medicine Residents. Better understanding the effects of team dynamics on informal learning may help to optimise learning and improve performance.

Methods: From 8^th February 2020 till 27^th September 2020, the Singapore General Hospital Emergency Department adopted a fixed team system. Zoom interviews were carried out amongst Emergency Medicine Residents who worked in the fixed team system using a semi-structured iterative interview guide. A qualitative content analysis was used for this exploratory study. The interviews were transcribed verbatim, anonymised and coding via template analysis performed. Data collection and analysis were performed until data sufficiency.

Results: The themes identified centred around relationship dynamics, team composition and motivation for learning. The first was how improved relationships led to improved trust, communications and camaraderie among team members. This improved peer learning and clinical supervision and provided a more personalised learning experience. A balanced team composition allowed learners to be exposed to experts in various subspecialties. Finally, there was an initial increase in motivation, followed by a decrease with time.

Conclusion: In postgraduate medical education, working in a fixed team system with balanced members had positive effects on informal learning by strengthening relationships and communications.

Keywords:           Informal Learning, Workplace Learning, Fixed Teams, Medical Education, Postgraduate

Abstract

Introduction: Perceptions towards the working and learning environment as well as coping mechanisms have been studied across different healthcare sectors. They have shown to reduce stress and burnout. However, perceptions of the work environment in the Emergency Department (ED) setting have not been studied in depth. The literature surrounding coping mechanisms also mostly focuses on their impacts rather than the mechanisms utilised. In addition, these were often investigated using surveys. This study aimed to use a phenomenological approach to explore the perceptions and coping strategies of junior doctors working in a paediatric ED.

Methods: Sixteen junior doctors working in the Paediatric ED were recruited. Semi-structured interviews were conducted after conducting literature reviews. Data was collected until saturation point. All interviews were recorded and transcribed verbatim manually and subsequently analysed.

Results: The greatest fears of junior doctors starting their paediatric emergency posting were lack of knowledge due to inexperience in the subspecialty; fear of the work environment due to unfamiliarity as well as workload and the intrinsic high-stress environment. The main coping strategies were ensuring clinical safety, obtaining psychosocial support from loved ones and colleagues, and placing focus on spirituality and wellbeing.

Conclusion: In this study, the perceptions and coping strategies of the junior doctors in the Paediatric ED were explored. The findings from this study will help to structure and improve the support given to future junior doctors who rotate to the department as well as better orientate them to allay their pre-conceived notions.

Keywords:          Coping Behaviours, Perceptions, Paediatric Emergency Department, Stressors, Interviews

Abstract

Introduction: A series of workshops was held early in our MD curriculum redesign with two aims: gaining stakeholder input to curriculum direction and design; engaging colleagues in the curriculum development process.

Methods: Workshops format included rationale for change and small-group discussions on three questions: (1) Future challenges in healthcare? (2) our current strengths? (3) Future graduate attributes? Small-group discussions were audio-recorded, transcribed and fieldnotes kept and thematically analysed. We conducted a literature review looking at best practice and exemplar medical programs globally.

Results: Forty-seven workshops were held across 17 sites with more than 1000 people participating and 100 written submissions received. Analysis showed alignment between data from workshops, written submissions and the literature review.

The commitment of our medical community to the education of future doctors and to healthcare was universally evident.

Six roles of a well-rounded doctor emerged from the data: (1) Safe and effective clinicians – clinically capable, person-centered with sound clinical judgement; (2) Critical thinkers, scientists and scholars with a thorough understanding of the social and scientific basis of medicine, to support clinical decision making; (3) Kind and compassionate professionals – sensitive, responsive, communicate clearly and act with integrity; (4) Partners and team players who collaborate effectively and show leadership in clinical care, education and research; (5) Dynamic learners and educators – adaptable and committed to lifelong learning; and (6) Advocates for health improvement – able to positively and responsibly impact the health of individuals, communities and populations

Conclusion: Deliberate stakeholder engagement implemented from the start of a major medical curriculum renewal is helpful in facilitating change management.

Keywords:            Medical Education, Medical Curriculum, Stakeholder Engagement, Collaboration

Abstract

Introduction: During the era of COVID-19 pandemic, online learning has become more prevalent as it was the most available option for higher education training which has been a challenging experience for the students and the lecturers especially in the medical and health sciences training.  The study was conducted to determine the perceptions of clinical year medical students on online learning environments during the COVID-19 pandemic.

Methods: A cross sectional study was conducted to clinical year medical students at University Tunku Abdul Rahman. The validated Online Learning Environment Survey (OLES) was used as a tool to conduct the study.

Results: Total 84 clinical year students participated in the study. Among four domains of OLES questionnaire, the domain; “Support of online learning” had the highest mean perception scores, 4.15 (0.55), followed by “Usability of online learning tools” 3.89 (0.82), and “Quality of Learning; 3.80 (0.68) and the domain “Enjoyment” was the lowest mean perception scores 3.48 (1.08). Most of the students (52.4%) rated the overall satisfaction of online teaching experiences “Very good” while (13.1) % rated “Excellent”.

Conclusion: In conclusion, the perceptions of clinical year medical students on online learning environments during the COVID-19 pandemic were satisfactory although there were challenging online learning experiences during the pandemic. It was recommended to include qualitative method in future studies to provide more useful in-depth information regarding online learning environment.

Keywords:            Online Learning Environment, Perceptions, Medical Students, Malaysia, COVID-19

I. INTRODUCTION

The world will never be the same after the COVID-19 pandemic. Education has had to evolve. Evaluation of cognitive skills is still achieved by written examinations administered through learning management systems. However, an integral part of evaluation, the Objective Structured Clinical Examination (OSCE), which assesses the students’ ability to obtain, communicate information, perform physical examination, diagnose, and solve problems, could not be given due to COVID-19 restrictions.

I. INTRODUCTION

Increasing attention has been given to the role of medical humanities in both clinical care as well as in medical education. Medical humanities is defined as an “interdisciplinary perspective that draws on both creative and intellectual methodological aspects of disciplines such as anthropology, art, bioethics, drama and film, history, literature, music, philosophy, psychology, and sociology” (Hoang et al., 2022). 

I. INTRODUCTION

Airway management is critical for any anaesthetist. The Coronavirus Disease 2019 (COVID-19) pandemic has brought such skills to the forefront over the last three years. Yet, the outbreak has also disrupted traditional methods of airway skills training and limited the chances of in-person workshops and conferences due to social distancing requirements and demanding manpower needs. To lower the incidence of airway-related morbidity (Joffe et al., 2019), regular and effective instructional methods are needed to maintain airway providers’ skills.

I. INTRODUCTION

Anatomy is considered as one of the key components of undergraduate medical education. Hence, it is important to have a sound knowledge in anatomy to proceed into clinical medicine. Didactic lectures, textbooks, prosected specimens, and cadaveric dissection are the most frequently used anatomy teaching methods. However, with the emergence of COVID-19 pandemic, conventional teaching and learning were challenged. Technology integration for medical education has been increased during COVID-19 in many countries. With the integration of new technologies to the anatomy teaching, the traditional ‘directed self-learning’ started to move towards ‘self-directed learning’. This transformation however, was not without various challenges, especially in low-resource settings such as Sri Lanka (Karunathilake et al., 2020). Augmented reality (AR), Virtual reality (VR), and principles of gamification play an important role in motivation and engagement in medical teaching and learning by enhancing interactivity (Moro et al., 2021). Such technologies also found to have positive impact on students’ spatial understanding and 3D comprehension of anatomical structures.