Abstract

Introduction: Continuing medical education and continuing professional development activities (CME/CPD) improve the practice of medical practitioners and allowing them to deliver quality clinical care. However, the systems that oversee CME/CPD as well as the processes around design, delivery, and accreditation vary widely across countries. This study explores the state of CME/CPD in the East and South East Asian region from the perspective of medical practitioners, and makes recommendations for improvement.

Methods: A multi-centre study was conducted across five institutions in Hong Kong, Indonesia, Malaysia, Singapore and Taiwan. The study instrument was a 28-item (27 five-point Likert scale and 1 open-ended items) validated questionnaire that focused on perceptions of the current content, processes and gaps in CME/CPD and further contextualised by educational experts from each participating site. Descriptive analysis was undertaken for quantitative data while the data from open-ended item was categorised into similar categories.

Results: A total of 867 medical practitioners participated in the study. For perceptions on current CME/CPD programme, 75.34% to 88.00% of respondents agreed that CME/CPD increased their skills and competence in providing quality clinical care. For the domain on pharmaceutical industry-supported CME/CPD, the issue of commercial influence was apparent with only 30.24%-56.92% of respondents believing that the CME/CPD in their institution was free from commercial bias. Key areas for improvement for future CME/CPD included 1) content and mode of delivery, 2) independence and funding, 3) administration, 4) location and accessibility and 5) policy and collaboration.

Conclusion: Accessible, practice-relevant content using diverse learning modalities offered by unbiased content providers and subject to transparent and rigorous accreditation processes with minimal administrative hassle are the main considerations for CME/CPD participants.

Keywords:           Medical Education, Health Profession Education, Continuing Professional Development, Continuing Medical Education, Accreditation

Abstract

Introduction: There is a global call for transforming medical education to meet evolving healthcare needs. However, navigating the challenges of educational change in resource-limited contexts requires key stakeholders, from leaders to educators and students, to adopt innovative approaches. This paper presents practical examples of such innovations from the University of Health Sciences (UHS) in Cambodia’s experiences, followed by discussions on enabled and hindered factors of their initiation, implementation, and sustainability. This paper also aims to inspire future medical education innovations.

Methods: This paper relied on internal document reviews, including strategic plans, project proposals & planning, course syllabi, and evaluation reports, and the collective working experiences of co-authors in initiating, implementing, and leading these innovations.

Results: Three innovative projects at UHS illustrated how creative ideas are put into practice, including (1) The elective International Programme (IP) with a dual objective of training local trainers while preparing students for international mobility, (2) The Master of Health Professions Education (MHPE), a cost-effective faculty development programme delivered in-person at UHS campus by faculty of a university partner, and (3) Peer-assisted Learning (PAL), a student-led initiative to promote learning skills.

Conclusion: Medical education innovations are needed in resource-limited contexts. The success of these initiatives resulted from multi-factors, notably long-term strategic planning, supportive leadership, active partnerships, policy commitment, local champions, resourcefulness, and student engagement. The late adoption of technology-enhanced learning, the necessity for robust faculty development programmes, and early investment in student leaders, coupled with post-graduate retention planning, represent challenges that present strategic opportunities.

The practice of medicine and provision of healthcare is evolving rapidly, driven not just by advancements in new treatment modalities but also by the integration of modern technologies in providing precision care to our patients. It is important to understand and embrace, where appropriate, innovative technologies to respond effectively to the evolving needs of a modern society. What will be seen in this transformative wave is how Artificial Intelligence (AI) has the potential to revolutionise various sectors in medicine and healthcare (Yu et al., 2018).

Focusing on health professions education, AI emerges as a pivotal force in training the future healthcare practitioners and preparing them for the multifaceted challenges of the modern medical landscape (Paranjape et al., 2019). There are 3 distinct uses of AI in education which was reported by Baker et al. (2019): Learner-oriented AI, Instructor-oriented AI and Institution-oriented AI. Let’s focus on some of these areas:

Abstract

Introduction: In 2016, a new university opened in Egypt that sought to ‘challenge the ordinary’ in a country with a long and rich heritage of knowledge production. Newgiza University (NGU), located adjacent to the ancient pyramids of Giza outside Cairo, launched with a foundational focus on health sciences, through undergraduate courses in medicine, dentistry, and pharmacy. Each programme was co-developed through an academic collaboration with University College London (UCL), a high-ranking, research-intensive, UK university.

Methods: As the collaboration passes a key juncture of graduating the first cohorts of doctors, dentists, and pharmacists from these courses who embark on their professional careers, we examine and reflect on the journey to date. In particular, this article reviews the growing academic literature about international partnerships in medical education, describes how curricula, assessments, and management structures in the three NGU healthcare courses were adapted and finessed to fit the Egyptian context, and shares the lessons learnt by the academic leadership teams responsible for this challenging but stimulating collaboration project.

Results: The collaboration between NGU and UCL is an example of an international education partnership approach that seems to be growing in popularity globally. The overriding importance of building trust and respect between partners was clear in this collaboration, as was the need for clear communication channels to guide the necessarily complex decision-making that underpinned it.

Conclusion: Given inevitable power imbalances in such collaborations, critical examinations of their impacts on organisations, staff, and students are an important research priority in the future.

Abstract

Introduction: The mini-Clinical Evaluation Exercise (CEX) is meant to provide on the spot feedback to trainees. We hypothesised that an ultra-short assessment tool with just one global entrustment scale (micro-CEX) would encourage faculty to provide better feedback compared to the traditional multiple domain mini-CEX.

Methods: 59 pairs of faculty and trainees from internal medicine completed both the 7-item mini-CEX and a micro-CEX and were surveyed regarding their perceptions of the 2 forms. Wordcount and specificity of the feedback was assessed. Participants were subsequently interviewed to elicit their views on factors affecting the utility of the CEX.

Results: Quantity and quality of feedback increased with the micro-CEX compared to the mini-CEX. Wordcount increased from 9.5 to 17.5 words, and specificity increased from 1.6 to 2.3 on a 4-point scale, p < 0.05 in both cases. Faculty and residents both felt the micro-CEX provided better assessment and feedback. The micro-CEX, but not the mini-CEX, was able to discriminate between residents in different years of training. The mini-CEX showed a strong halo effect between different domains of scoring. In interviews, ease of administration, immediacy of assessment, clarity of purpose, structuring of desired feedback, assessor-trainee pairing and alignment with trainee learning goals were identified as important features to optimize utility of the (mini or micro or both) CEX.

Conclusions: Simplifying the assessment component of the CEX frees faculty to concentrate on feedback and this improves both quantity and quality of feedback. How the form is administered on the ground impacts its practical utility.

Keywords:           Workplace Based Assessment, Mini-CEX, Micro-CEX, Feedback, Assessment

Abstract

Introduction: Case write-ups and reflective journals have been used as assessment tools of learning in clinical rotations in Yong Loo Lin school of medicine. It is timely to review the current process of conducting these assessments and effectiveness as an assessment tool. This study aims to understand faculty outlook towards these assessments.

Methods: This is a study that involves a survey-based questionnaire with both closed and open-ended questions, sent out to faculty marking the students’ assignments. This survey was anonymous & voluntary and was disseminated by administrative assistants. The purpose of this survey was to collect the feedback from faculty about current process with intentions of improving the effectiveness of these assessments. The suggestions for improvement were incorporated in the survey and faculty was invited to comment over these suggestions and provide further suggestions if any.

Results: Fifty-two responses from faculty were collected and analysed. Ninety percent of respondents thinks that this is an effective tool to assess and promote self-directed learning. Qualitative feedback was received about need of improvement in a) alignment of the submissions timings with rotation postings b) marking rubric to incorporate factors such as case complexity and weightage to different components of case write-ups, c) timely feedback to students, and d) follow up on action plans.

Conclusion: Case write-ups and reflective journals are still effective learning and assessment tools. They promote self-directed learning and clinical analysis in students. Feedback and action plans are the backbone of these assessments and optimal utilisation of these is recommended.

Keywords:           Undergraduate Medical Education, Case Write-ups, Medical Assessments, Reflective Journals

Abstract

Objectives: To compare the cut scores and pass/fail rates achieved by arbitrary 60% method and Hofstee method in an undergraduate year 4 end semester objective structured clinical examination (OSCE) and check the possibility of using Hofstee method of standard setting in future exams.

Method: 102 medical students of year 4 underwent a 10 station OSCE exam conducted in a state of art simulation lab in 3 cycles. The cut scores were calculated using arbitrary method aiming at 60% of task achievement and by Hofstee method. The student’s obtained scores were compared for cut scores and pass rates for individual stations and the entire exam.

Results: The arbitrary and Hofstee methods of standard setting leads to different cut scores. For the individual stations it was 60% vs 65-70% and for the overall score it was 60% vs 70%. The percentage of students failing the exam is 13.7% based on arbitrary scores and is 29.4% when Hofstee cut score is applied.

Conclusions: The two methods lead to different cut scores and students’ failure rates. Overall, Hofstee method is more appropriate for assessing competencies in an OSCE exam in medical schools as it leads to calculation of cut scores based on the difficulty level of the station/exam and the examiners expected level of performance by the students.

Keywords:          Objective Structured Clinical Examination, Standard Setting, Hofstee Method, Arbitrary Method

Abstract

Introduction: The literature confirms the challenges of learning clinical reasoning experienced by junior doctors during their transition into the workplace. This study was conducted to explore junior doctors’ experiences of clinical reasoning development and recognise the necessary adjustments required to improve the development of clinical reasoning skills.

Methods: A hermeneutic phenomenological study was conducted using multiple methods of data collection, including semi-structured and narrative interviews (n=18) and post-consultation discussions (n=48). All interviews and post-consultation discussions were analysed to generate themes and identify patterns and associations to explain the dataset.

Results: During the transition, junior doctors’ approach to clinical reasoning changed from a ‘disease-oriented’ to a ‘practice-oriented’ approach, giving rise to the ‘Practice-oriented clinical skills development framework’ helpful in developing clinical reasoning skills. The freedom to reason within a supportive work environment, the trainees’ emotional commitment to patient care, and their early integration into the healthcare team were identified as particularly supportive. The service-oriented nature of the internship, the interrupted supervisory relationships, and early exposure to acute care settings posed challenges for learning clinical reasoning. These findings highlighted the clinical teachers’ role, possible teaching strategies, and the specific changes required at the system level to develop clinical reasoning skills among junior doctors. 

Conclusion: The ‘Practice-oriented clinical skills development framework’ is a valuable reference point for clinical teachers to facilitate the development of clinical reasoning skills among junior doctors. In addition, this research has provided insights into the responsibilities of clinical teachers, teaching strategies, and the system-related changes that may be necessary to facilitate this process.

Keywords:           Clinical Reasoning, Medical Decision Making, Medical Graduates, Junior Doctor Transition, Hermeneutic Phenomenology, Qualitative Research

Abstract

Introduction: The level of BLS achievement at the end of basic education is not clear, so to develop a BLS training program using QCPR Learner^Ⓡ and to verify its effectiveness.

Methods: A quantitative descriptive study design was used. The developed BLS program was implemented for 81 fourth-year students at the school of nursing. The program consisted of 2 minutes of training per student and real-time feedback by QCPR Learner^Ⓡ as well as feedback among students and from faculty members and was conducted twice for each student. Evaluation was conducted from three aspects: learner response and program evaluation both using questionnaires, learning achievement of QCPR score.

Results: The mean values of learners’ responses before and after the program were: attention, 4.32 before and 4.59 after; relevance, 4.48 before and 4.75 after; confidence, 2.32 before and 3.78 after; and satisfaction, 2.12 before and 3.41 after, which increased significantly after the program. The QCPR Learner^Ⓡ scores increased significantly from 74.08 for the first time to 86.76 for the second time. In the free response, some respondents stated that “visualisation of the procedure by the application improved my skills.”

Conclusion: The results of the evaluation from three aspects showed that this program was effective in improving students’ motivation to learn and skills.

Keywords:           Basic Life Support, Real-Time Feedback, Basic Nursing Education, Simulation Training, QCPR Learner

Abstract

Introduction: Oral health education is essential for adolescents, yet traditional methods face challenges in engaging this demographic. This study evaluates the effectiveness of a multimedia-based dental education program among high school students. This study was carried out to assess the impact of a comprehensive multimedia-based dental education program on oral health knowledge and practices among high school students.

Methods: A total of 228 students were recruited and randomly assigned to experimental (n=114) and control (n=114) groups. The experimental group received a four-week multimedia program, while the control group followed the standard curriculum. Outcome measures included oral health knowledge scores, brushing frequency, flossing habits, dietary choices, and observational assessments. Statistical analysis employed descriptive statistics, paired t-tests, and analysis of covariance (ANCOVA).

Results: The multimedia-based program led to a significant increase in oral health knowledge scores in the experimental group compared to the control group (Mean Change: 14.6, p < 0.001). Moreover, the experimental group demonstrated higher brushing frequency (p < 0.001), increased flossing habits (p < 0.001), and improved dietary choices (p < 0.05). Observational assessments showed higher adherence to oral hygiene practices in the experimental group (p < 0.001).

Conclusion: The multimedia-based dental education program effectively improved oral health knowledge and practices among high school students. This approach holds promise for scalable and engaging oral health education strategies.

Keywords:           Multimedia-based Education, Oral Health, Adolescents, Dental Education, Health Promotion, Preventive Dentistry

Abstract

Introduction: Maintenance of procedural skills is crucial for paediatric emergency medicine (PEM) physicians to provide high-quality care. A study by Lin-Martore et al. (2021) in the US identified key themes in conceptualising procedural skill maintenance (PSM), its motivations, and barriers to maintenance. However, the difference in culture brings into question the validity of their findings in other contexts. To determine its applicability specifically in an Asian context, this study aims to replicate the study at KK’s Women and Children Hospital (KKH), focusing on PEM physicians. While the findings are limited to a single hospital, they provide valuable insights into challenges encountered by PEM physicians.

Methods: A general qualitative approach was used through semi-structured interviews. Participants were recruited through email. Interviews were conducted via Zoom and subsequently de-identified and transcribed. The data was coded manually through thematic analysis, identifying key themes.

Results: Fifteen PEM physicians were interviewed. Participants conceptualised PSM through technical aspects and measured competence through objective and subjective measures. General motivation themes found the (1) desire to provide optimal patient care, (2) procedural competence as part of the identity of a PEM physician who teaches and performs procedures, and (3) desire for choice when alternatives are present. Barriers included limited time, support, and opportunities.

Conclusion: The study found that the themes from the original study are applicable in KKH, featuring SDT concepts prominently. Practical recommendations for KKH were proposed. Future research can focus on the challenges and gaps in maintaining procedural skills and develop strategies to improve PSM in PEM physicians.

Keywords:         Procedural Skill Maintenance, Singapore, Emergency Medicine, Qualitative, Paediatric Medicine

Abstract

Introduction: Developing a professional identity involves understanding what it means to be a professional in a certain sociocultural context. Hence, defining the characteristics and/or attributes of a professional (ideal) physician is an important step in developing educational strategies that support professional identity formation. To date, there are still limited studies that explore undergraduate medical students’ professional identity. This study aimed to define the characteristics and/or attributes of an ideal physician from five first-year and three fourth-year undergraduate medical students.

Methods: Qualitative case studies were conducted with eight undergraduate medical students from a private Catholic medical school in Jakarta, Indonesia. The study findings were generated from participants’ in-depth interviews using in vivo coding and thematic analysis. Findings were triangulated with supporting evidence obtained from classroom observations and faculty interviews.

Results: First-year participants modeled their professional identities based on their memorable prior interactions with one or more physicians. They mainly cited humanistic attributes as a part of their professional identity. Fourth-year participants emphasised clinical competence and excellence as a major part of their professional identities, while maintaining humanistic and social responsibilities as supporting attributes. Several characteristics unique to Indonesian’s physician identity were ‘Pengayom’ and ‘Jiwa Sosial’.

Conclusion: Study participants defined their professional identities based on Indonesian societal perceptions of physicians, prior interactions with healthcare, and interactions with medical educators during formal and informal learning activities.

Keywords:           Professional Identity Formation, Indonesia Undergraduate Medical Students, Physician Identity

Abstract

Introduction: This study was undertaken to investigate students’ perceptions of innovation-integrated learning, adopted as an alternative approach for special care dentistry (SCD) training.

Methods: Ninety final-year dental students from the 2021 cohort were divided into eight groups to complete an innovation project dedicated to eight categories of patients with special health care needs. Discussion and final presentations, involving related experts were conducted remotely via an online platform. Then, students were invited to answer a validated online feedback survey on their perceptions of the learning approach.

Results: The response rate for the feedback survey was 91.1% (n=82). Most students agreed that the activity was interesting, improved their knowledge and understanding of SCD, allowed engagement between peers, supported sharing of ideas and experiences, encouraged student–lecturer interactions, and enhanced knowledge integration and application. Students also expressed that the activity enhanced creativity and innovation, instilled an interest and positive attitude toward learning SCD, and encouraged teamwork. However, a few students noted facing some limitations in completing their projects (i.e., technological challenges and reduced physical access to purchase materials). Around half felt neutral about having an increased workload from this activity. Moreover, perceptions differed regarding time and financial commitments, as well as supervisors’ and patients’ involvement during the project development process.

Conclusion: Students perceived that the innovation-oriented learning activity, was beneficial in multiple aspects of SCD training.

Keywords:           Innovation, Learning, Dental Students, Perception

Abstract

Introduction: Mentoring is an essential component of post-graduate medical training programs worldwide, with potential benefits for both mentors and mentees. While factors associated with mentorship success have been described, studies have focused on intrapersonal characteristics and are largely based in Western academic programs. Mentorship occurs in a broader environmental milieu, and in an Asian context, cultural factors such as respect for authority, hierarchy and collectivism are likely to affect mentoring relationships. We aim to explore the lived experience of mentors within an Asian postgraduate medical training program, and thus identify challenges and develop best practices for effective mentoring.

Methods: 14 faculty mentors from a post-graduate paediatric residency program were interviewed between October 2021 to September 2022. Data was collected through semi-structured one-on-one interviews, with participants chosen via purposeful sampling. Qualitative analysis was done via a systematic process for phenomenological inquiry, with interviews thematically coded separately by 2 independent reviewers and checked for consistency.

Results: 4 main thematic concepts were identified: “professional, but also personal”, “respect and hierarchy”, “harmony and avoidance of open conflict” and the “importance of trust and establishing a familial relationship”. Mentors also highlighted the value of structure in Asian mentoring relationships.

Conclusion: Cultural factors, which are deeply rooted in social norms and values, play an important role in shaping mentoring relationships in an Asian context. Mentoring programs should be tailored to leverage on the unique cultural norms and values of the region in order to promote career growth and personal development of trainees and mentors.

Keywords:           Medical Education, Graduate Medical Education, Professional Development

Abstract

Introduction: From the late 1960s to the present, physicians’ dress codes have been actively studied in Western countries. Until the early 21st century, patients tended to prefer a conservative dress style, such as “shirt and tie or skirt” with white coats for physicians. However, as attitudes toward dress codes have changed, knowledge regarding this issue needs to be updated. A variety of colours of scrubs are currently commonly used by medical professionals, but it is not known whether all colours are acceptable to patients. The current study sought to investigate the acceptability of various dress codes for physicians from the patients’ perspective, to inform medical education.

Methods: Outpatients and their family members at a university hospital and a small-to-medium-sized hospital were surveyed. We inquired about which of the different styles of white coats and different colours of scrubs were most desirable for male and female physicians. We used Scheffe’s paired comparison method to determine rankings.

Results: Patients and their family members expected their physicians to wear white coats rather than scrubs. Furthermore, a more traditional and formal dress code was preferred. The least preferred colour of scrubs was yellow.

Conclusion: The current results indicated that patients’ preference for a traditional, conservative appearance has not changed over time. This finding does not match current perspectives on infection prevention. Both patient preferences and infection prevention are important for informing education and gaining patient trust.

Keywords:           White Coat, Scrub Colour, Physicians’ Appearance, Medical Education, Doctor-Patient Communication

Abstract

Introduction: Health Professions Education (HPE) leadership development is advocated for success at the individual, team, and institutional levels. Many leadership theories exist informed mainly by Western perspectives, however, Pacific HPE leadership has not been investigated. Therefore, this research aimed to understand Pacific HPE leaders’ perspectives to develop substantive theory to guide faculty development in this setting and add nuanced perspectives to the international HPE leadership discourse.

Methods: Using an interpretivist case-study methodology, seven HPE leaders were purposefully recruited. Data collection tools included Rich Pictures, Talanoa Zoom interviews, and reflective journals. Participants drew a picture on ‘Being an HPE leader’, subsequently explaining their depiction, and then reflected on leadership events in their journals over six months. Codes and themes were identified using Miles, Huberman and Saldaña’s approach.

Results: Metaphors were assigned to three HPE leadership styles identified: The ‘Bridge’- helping students from novice to competent; the ‘Coconut Tree’- multiple roles and sturdy in the storm; and the ‘Boat’ – navigating towards the vision.

Conclusions: Rich Pictures, interviews and reflective journals allowed HPE leaders to reflect on ‘Being an HPE Leader’ and revealed tacit perspectives. This study suggests there are different styles of leadership, pertinent to the Pacific context, depending on the aims, strategies, and attributes of different HPE leaders. Although grounded in the Pacific, certain aspects may resonate in similar contexts. Notwithstanding that many facets of leadership identified align with current leadership models, intrapersonal emotional intelligence and cultural aspects of HPE leadership should be considered when designing contextually embedded faculty development.

Keywords:           Medical Education, Health Professions Education, Leadership, Qualitative Research, Case Study, Pacific

Abstract

Introduction: The night float (NF) system has been instituted in some hospitals in Singapore to improve the working hours and wellbeing of junior doctors. There have been concerns of compromised learning and patient safety with NF. The objective of this study is to compare clinical competency outcomes, based on existing assessment framework, between post-graduate year 1 (PGY1) doctors working on NF versus traditional call (TC) systems. The secondary aim was to explore patient safety outcomes between these groups of PGY1s.

Methods: Data on the formal assessments of PGY1s using the Entrustable Professional Activities (EPAs) and medical errors were prospectively collected between May 2021 and April 2022 from two hospitals that employed different on-call systems. Data was analysed descriptively. Categorical data was analysed using the Chi-square test or Fisher’s exact test where appropriate.

Results: One hundred and ninety-three PGY1s consented to the study. There was no statistically significant difference in the clinical competency of PGY1s in both groups. The number of PGY1s who had ‘needs improvement’ scores in a detailed EPA was not significantly different (9.0% in the NF group versus vs 3.7% in the TC group (p = 0.14)). They nonetheless passed the overall core EPA and no PGY1 failed their postings. No serious reportable medical errors occurred in either group.

Conclusion: PGY1s who worked on NF are equally competent compared to those who worked on TC based on the EPA assessment matrix. Patient safety is not compromised by PGY1s working on NF.

Keywords:           Clinical competence, Float, Junior doctor, Patient safety, Wellbeing

Abstract

Introduction: Many societal changes threaten the sustainability of health systems. Entrepreneurs play a significant role in creating sustainable innovations necessary for development and structural change. This study aimed to evaluate how university students studying health sciences perceive individual entrepreneurship during the COVID-19 pandemic and to explore the impact of COVID-19-related hopelessness on their perception of entrepreneurship.

Methods: Six hundred eighty-one undergraduate students from the faculty of health sciences in Türkiye, participated in the study. The Individual Entrepreneurship Perception Scale and Beck Hopelessness Scale were used to collect data.

Results: The results revealed that the students’ perception of individual entrepreneurship was high, while their hopelessness levels were moderate. In addition, a moderate negative relationship was found between the students’ hopelessness levels and their perception of individual entrepreneurship. The regression analysis showed that the students’ hopelessness levels and sub-dimensions (hope, loss of motivation, and future expectation) accounted for 26.3% of the total variance in individual entrepreneurship perception. Increased hopelessness regarding the sub-dimensions of hope, loss of motivation, and expectations for the future decreased their individual entrepreneurship perceptions.

Conclusions: These findings suggest that individual entrepreneurship perception among health sciences students could be negatively impacted during extraordinary periods related to health crises like pandemics. Developing hope, motivation, and expectations for the future is crucial to enhancing individual entrepreneurship perception among health sciences students.

Keywords: Individual Entrepreneurship Perception, Hopelessness, Health Sciences, University Students, COVID-19 Pandemic

Abstract

Introduction: The Singapore Institute of Technology-University of Glasgow (SIT-UofG) Nursing Programme has traditionally taken a didactic teaching approach in the delivery of the Evidence-Based Practice (EBP) module.  A hybrid approach was introduced using Game-Based Learning (GBL) to encourage active learning through gameplay. 

Methods: A Randomised Controlled Trial (RCT) was undertaken encompassing a cohort of 100 Nursing students taking the EBP module in their first year at the Singapore Institute of Technology (SIT) in the 2021/22 academic year. The experimental group (n=27) worked through the online GBL intervention and the EBP module, while the control group (n=27) took the EBP module alone. The GBL included five Learning Quests and three case studies.

Results: High levels of satisfaction were reported by both the experimental group (n=22) and the control group (n=15) on the traditional content and delivery of the EBP module. High levels of engagement were reported by the experimental group on the GBL intervention; a one-sample statistics analysis confirming a significant level of engagement (p<0.001). A Mann-Whitney U Test, however, found no significant difference in the Continuous Assessment (CA) scores of the two groups (p=0.507 and 0.461). 

Conclusion: The introduction of GBL designed to deliver educational content directly associated with the learning outcomes increased the nursing student engagement in the EBP module. These findings and discoveries can be utilised to improve the GBL intervention to the EBP module to have a more positive impact the student CA scores and therefore on student learning.

Keywords:           Evidence-Based Teaching, Evidence-Based Practice (EBP), Nursing Education, Game-Based Learning (GBL), Teaching and Learning EBP, Nursing Students, Gamification

Abstract

Introduction: A good learning environment (LE) will affect the quality and standard of the learning process, student performance, and the outcome of the curriculum as well as predictor of the quality of health services. Our study aims to assess residents’ perception of the LE in Ophthalmology training programs for future improvement.

Methods: Mixed method with an explanatory sequential design was implemented in this study using the Post-graduate Hospital Educational Environment Measure (PHEEM) as a quantitative approach and open-ended questions collaborated with focus group discussion (FGD) as a qualitative measurement. A comparison of the quantitative data was made using parametric and non-parametric analyses. Thematic analyses were performed for qualitative data. Integration of quantitative and qualitative data was done by connecting both data.

Results: Fifty-three residents participated in this survey. The mean age was 30.96±2.18 years old, 64.15% were female and 77.36% are at the internship stage. The mean score of overall PHEEM was 123.40 ±12.35, indicated an excellent LE, while the mean score of perceptions of role autonomy, perceptions of teaching, and perceptions of social support were 42.57±4.62, 47.75±4.84 and 33.08±4.15, respectively. There is no significant difference between gender and study period with the perception of LE. Thematic analysis from qualitative data reveals six positive and five negative perception themes. All discovered themes confirmed concordance with the result of LE perception.

Conclusion: Learning environment perception in the ophthalmology residency program was excellent and essential for the student’s skills and performance quality. Some specific areas still need improvement strategies for institutional development.

Keywords:           Learning Environment, PHEEM, Ophthalmology, Residency, Mixed Method

Abstract

Introduction: People skills play a crucial role in the professional development of Biomedical Scientists. A laboratory management and professional practice module was offered as part of the people skills development for Biomedical Science first-year students.  This study aims to describe the use of role-play to teach stress and anger management skills to Biomedical Science students and reports on students’ opinions of role-play as a teaching-learning method.

Methods: Students were divided into groups with 10 or 11 students per group. Each group of students presented a role-play for 15 to 20 min. This was followed by reflections by the group, feedback from other groups, and the facilitators. At the end of the session, student feedback was taken by a questionnaire using both closed (using a 5‑point Likert scale) and open‑ended questions. Statistical evaluation of the collected data was carried out using SPSS version 28 for Windows.

Results: A total of 96 students from the 2021 and 2022 cohorts participated in the role-plays. The survey was completed by 48 students from the 2021 intake and 33 students from the 2022 intake. The overall response rate was 84.37%. Respondents perceived role-play to be enjoyable, useful, and helpful for developing stress and anger management skills. They wanted role-play to be used as a teaching-learning method in the future.

Conclusions: Role-play can be effective to teach stress and anger management skills to undergraduate Biomedical Science first-year students.

Keywords:           Role-Plays, Stress and Anger Management Skills, Biomedical Science, Professional, Questionnaire, Feedback; Undergraduate

Abstract

Introduction: Singapore Institute of Technology’s undergraduate (UG) occupational therapy (OT) and physiotherapy (PT) programs are one of the first implementors of Entrustable Professional Activities (EPAs) in the respective allied health professions training. The aim of the paper is to report the outcomes of the first year of EPAs implementation in clinical practice education (CPE) and share next steps refining implementation.

Methods: A quality improvement (QI) study using the Plan-Do-Check-Act (PDCA) cycle was conducted. UG OT Year 2 and Year 3 students, UG PT Year 3 students and their clinical educators (CEs) who experienced the use of EPAs for the first time were surveyed at the end of the clinical block.

Results: There was generally high agreement (>70% agreed or strongly agreed) among all groups in using EPAs to better understand the learning objectives of CPE and practice expectations as future entry-level practitioners at conditional-registration. More than 70% of OT respondents but less than 50% PT respondents found the EPA assessment forms easy to use. Less than 60% of both program CEs did not include colleagues for EPA assessments. 55% of both OT and PT CEs found the EPA training and resources adequate. Overall, PT respondents showed lower agreement than OT respondents in five survey items.

Conclusion: The first implementation cycle of EPA in the undergraduate OT and PT CPE had mixed acceptability to the EPA assessment tools. Three strategic changes were made for the second implementation cycle., i.e., redesign of EPA-based assessment forms, training focus and ‘just-in-time’ training with streamlined resources.

Keywords:           Clinical Training, Entrustable Professional Activities, Occupational Therapy, Physiotherapy, Undergraduate, Workplace-based Assessment

Introduction: Globally, persons with disabilities (PWD) face structural and social barriers to inclusive healthcare. Medical schools, as crucibles of medical professional identity formation, have the responsibility to foster person-centredness toward all patients, including PWD, among her graduates. We co-designed with PWD a “Communications with Persons with Disabilities” workshop and evaluated its impact.

Methods: The workshop enlisted PWD as patient educators, occurred within the third-year undergraduate Family Medicine posting, and was designed to positively impact communications skills and attitudes toward PWD. Students (n=135) were surveyed pre- and post- workshop following a mixed-methods approach (demographic data, Attitude Towards Disabled Persons (ATDP)-O scale, feedback questions, and post-workshop free reflections). Descriptive analysis was used for demographic and feedback questions, and thematic analysis for reflections. Paired t-test was used to evaluate change in ATDP-O scores.

Results: There were 69 survey respondents (51.11%). Most students agreed that communications training with PWD could be strengthened in medical school, and that the workshop was relevant to their future medical career (n=68, 98.55%). Attitudes towards PWD significantly improved after the workshop (ATDP-O change: +9.29 points (12.7%), p <0.001). Student reflections included attitudes, such as the importance of seeing the person beyond the disability, and a call for action towards inclusivity and accessibility of care for PWD.

Conclusion: Students’ attitudes were positively affected by involving PWD in the curriculum. Further research is needed for assessing the impact of how a longitudinal PWD curriculum could affect medical trainees and improve social inclusiveness in healthcare practice.

Keywords:           Medical Education, Communication, Persons with Disabilities, Disability, Social Inclusiveness, Student Attitudes, Person Centred Care, Active Learning

Abstract

Introduction: We frequently associate microbes with infection, rarely expounding on their usefulness and importance to healthy development. For humanity to leverage these microbial “super powers”, learners from all backgrounds need to appreciate their utility and consider how microbes could help solve some of the most critical problems we face. However, learners are frequently uninterested or intimidated by microbiology. The card game “No Guts No Glory” was created to engage students by piquing curiosity and encouraging informal learning to change perceptions and advocate the value of microbes to good health.

Methods: Undergraduates from various faculties in the National University of Singapore were invited to play and give feedback on accessibility, engagement and self-reported learning gains.

Results: The game was well-received across disciplinary backgrounds with positive feedback (5-point scale) on game mechanics being fun (4.17±0.63), attractive artwork (3.83±1.00) and scientific snippets (3.79±1.04), positive re-playability (3.46±0.84), player engagement for those without foundational knowledge in microbiology (3.63±1.04), and usefulness of knowledge taught (3.54±1.10). Areas for improvement evidenced from feedback included unclear instructions (2.74±0.98), limited content taught (2.76±0.93), not generating interest to attend formal microbiome classes (2.88±1.17) and not prompting lifestyle changes (1.98±1.11).

Conclusion: This pilot study provided valuable insights from the target demographic, with concrete ideas on how to improve the educational potential of “No Guts No Glory”. Findings further lay the groundwork for the design of future instruments to objectively quantify learning gains from gameplay.

Keywords:           Game-based Learning, Microbiome, Microbiology, Card Game, No Guts No Glory

Abstract

Introduction: Nurses’ professional identity is important for their career orientation and clinical practice. This study explored Singaporean nurses’ perceptions of professional identity. The results provide an understanding of how guided learning and reflection could help nurses in their professional identity formation and development.

Methods: Using an exploratory descriptive qualitative research study and purposive sampling by researchers teaching in the programme, 64 Registered Nurses with a diploma qualification pursuing a Bachelor of Science degree with Honours in Nursing programme in Singapore were invited to participate. They responded to open ended survey questions online, which were analysed using a thematic analysis. Ethical approval was obtained.

Results: All 64 first year students were invited to participate at the start of the module and upon the completion. The response rates were 94% and 81% respectively. Two overarching themes – “nurses as professionals with knowledge and moral character” and “the construction of professional identity” – emerged from the data.

Conclusion: The nurses perceived their professional nursing identity as a construct comprised of knowledge and moral characteristics, which is consistent with international literature. A professional nursing identity, relationships with other healthcare professionals, patients and confidence in practice were all interrelated. Guided reflection and discussion on clinical experiences and social interactions helped students become aware of their professional identity and responsibilities. Such purposive educational effort needs to be started early and supported through the students’ educational journey into clinical practice.  

Keywords:           Professional Identity of Nursing, Singapore Nurses, Image of Nursing, Social Perception of Nursing in Singapore, Nurse Education

Abstract

Introduction: Several nations around the world had to close schools, colleges, universities, and other educational institutions as they were badly affected by the spread of COVID-19. The purpose of this study was to measure the effectiveness of online vs physical teaching during the COVID-19 pandemic, at the Faculty of Allied Health Sciences (FAHS), University of Ruhuna (UoR) Sri Lanka.

Method: A cross-sectional study was conducted among 200 undergraduates. The data were collected through displayed/approved results sheets of the students of selected batches in the Department of Nursing, Department of Pharmacy, and Medical Laboratory Science (MLS). Paired sample T-test was used to compare the results of undergraduates.

Results: The examination results of 47-54 undergraduates in nursing, 28 in pharmacy, and 22 in MLS were analysed. Significant differences in Psychiatry in Nursing and Nursing Clinical Attachment were identified in the Department of Nursing (p=0.001). In the Department of Pharmacy, only Pharmaceutical Chemistry I (p=0.012) reported a significant difference. The undergraduates of MLS who underwent online theory sessions had scored more in Microbiology and Immunology (p=0.022) and Basic Genetics and Molecular Biology (p=0.000) whereas in Research Methodology and Epidemiology, the undergraduates who participated in physical lectures had scored more marks (p=0.001).

Conclusion: Practical/interactive session-based course units and clinical appointments had a higher impact on the mode of teaching than many theoretical course units. The results might serve as a primer for the creation of an action plan to support the academics and clinical/practical components of undergraduates.

Keywords:           Undergraduates, Online Teaching, Physical Teaching, Examination Results, COVID-19

Abstract

Introduction: A valid, longitudinal approach is critical for service planning in healthcare and to understand career choice in medical graduates.

Methods: We quantitatively analysed self-reported influences underlying career choice in a national cohort of medical graduates over the first five years of their careers. Participants rated career influences on importance across 26 items using a 5-point Likert scale (1=not at all, 5=a great deal).

Results: We included 659 New Zealand medical graduates (mean 25.4 years old, 376 F, 283 M) from the University of Auckland and the University of Otago, graduating in 2012 and 2013 (85% response rate). Responses were linked longitudinally over their post-graduate years 1, 3 and 5, and underwent principal component analyses. At graduation the factor rated as the most important in career choice had a mean (SD) item score of 3.9 (0.7) and comprised: Medical School Experiences; Specialty Experience; Mentors; and Self-Appraisal – consistent with graduates securing initial employment. Factors which explained the most variance in career choice over the five years after graduation indicated that the costs of medical school and further training were consistently rated as the least important in career choices, while flexibility in working hours were consistently rated as the most important. Factors remained relatively stable over time, showing variation in scores of only a median of 0.5 Likert points, indicating further opportunities for career choice research.

Conclusion: Our results regarding costs of medical training are reassuring, and suggest that greater flexibility in working hours may attract graduates to underserved specialties.

Keywords:           Medical Education, Career Choice, Career Influences, Cost, Debt, Measurement, Medical Graduates, National Longitudinal Study, Working Hours, Work Culture

I. INTRODUCTION

Risk management is a skillset that is embedded within clinical practice. Clinicians use protective equipment to safeguard themselves from pathogens carried by patients, learn de-escalation techniques to manage violent patients, and learn to ask for help. Patients of course are also at risk, because they present with illness or injury that may get worse despite our best efforts, and because there’s always a chance of iatrogenic injury or disease. Healthcare providers dedicate themselves to healing injury and illness, and to not causing further harm. In contrast, risk management is rarely considered with regards to teaching and learning, as they are not commonly understood to involve risk. When a teaching or learning experience feels risky, but we don’t think it should, then we don’t talk about it, and this can create cognitive dissonance and discourage us from engaging in teaching and learning.

I. INTRODUCTION

Neonatology is considered a ‘niche’ paediatric subspecialty. Most junior doctors posted to the department have limited prior exposure to the neonatal population, and require quick and effective training to help them function safely on the clinical floor. In recent years, postgraduate medical teaching has found the use of blended learning to be effective (Liu et al., 2016). Blended learning is defined as a combination of classroom face-time with online teaching approaches, and there is currently paucity of literature on its efficacy in ‘up-skilling’ relatively inexperienced healthcare professionals in a subspecialty setting. Hence, the aim of this study was to design and evaluate the efficacy of a blended-learning orientation programme in improving neonatal clinical knowledge and procedural skills amongst junior doctors.

Abstract

Introduction: Objective structured clinical examinations have traditionally been used to assess clinical skills. However, these face-to-face clinical assessments were hindered by physical and social restrictions imposed during COVID-19. This created a need to develop novel approaches for reliable assessment of clinical skills. We explored and evaluated a virtual exercise teleconsultation assessment (VETA) to replicate a teleconsultation setting where physiotherapy students were assessed on exercise prescription and coaching skills.

Methods: We conducted a cross-sectional mixed-methods study using convenience sampling. A VETA was implemented for 172 physiotherapy students via Zoom to allow synchronous interaction with standardised patients (SPs). 67 students and 9 SPs completed two separate post evaluation surveys on themes relating to administration, support, authenticity, effectiveness, and value of the VETA. Likert-type responses were categorised as positive, neutral, or negative while coded qualitative responses were consolidated into themes by inductive content analysis.

Results: 76% of students agreed that the assessment was authentic while 93% felt that the SPs were realistic and believable. Responders also highlighted important challenges including the limited camera viewing angle, time and space constraint, adequacy of equipment and reliability of connectivity. Exploratory factor analysis of responses revealed three latent constructs: (1) clarity of assessment, (2) clinical relevance, and (3) value of assessment.

Conclusion: Despite the technical challenges, VETA demonstrated clarity and value as an alternative assessment and showed relevance to future telehealth practice, which is increasingly pervasive in clinical settings. This paper demonstrates a feasible approach for the virtual assessment of clinical competencies.

Keywords:           Health Sciences Education, Virtual Assessment, Clinical Skills, OSCE, Physiotherapy, Exercise Prescription

Abstract

Introduction: The purpose of this study is to carry out a comparative analysis of the job satisfaction of nurses working in India based on the different types of the hospital they are working with. The study tests the null hypothesis that the job satisfaction of nurses from India across different types of hospitals is the same.

Methods: Four hundred nurses divided into 100 each for four popular types of hospitals – (1) Educational; (2) Government; (3) Charitable Trust; and (4) Private, from all over India were surveyed. Two ANOVA tests were performed. The first one was performed, taking overall job satisfaction as the dependent variable. The second ANOVA was performed by taking the monetary and compensation factors, work environment and management support, and job-related factors as the dependent variables.

Results: The overall mean of job satisfaction was -0.73 (SD 0.60). Overall, 65 percent of the variability of the dependent variable, job satisfaction, is explained by the type of hospital and is statistically significant (p<0.0001).

Conclusion: Monetary and compensation factors, work environment and management support, and job-related factors impact nurses’ job satisfaction. These factors vary with the type of hospital, and hence it can be concluded that due to variation in these factors depending on the type of hospital, the job satisfaction of nurses varies. Implications of our study are for the educational, government, and charitable trust hospitals to improve their work culture, management, and work environment so that nurses will have higher job satisfaction.

Keywords:           Nurses, Job Satisfaction, India, Hospitals, Government, Private, Charitable Trust, Educational 

Abstract

Introduction: Clinical practice education is an important curriculum in developing physiotherapy students to professionals. This curriculum is largely dependent on clinical educators. Although traits of effective clinical educators had been studied in Western population, it was unclear if the Asian population would yield similar traits. Hence, we studied perspectives of students and academic educators to identify top five core traits of an effective clinical educator. The findings will then help guide policy development for clinical educator training and development.

Methods: A survey was circulated to physiotherapy students and academic educators through convenience sampling. We studied 16 traits – enthusiasm, availability, clarity, clinical competence / knowledge, feedback skills, organisational skills, professionalism, well prepared, scholarly activity, non-judgemental, respect students’ autonomy / independence, sincerity, listening skills, evidence-based practice, role model, and awareness of students’ learning needs.

Results: The top five traits identified by students and academic educators were similar in four traits – clinical competency / knowledge, clarity, feedback skills, and enthusiasm, and differed in the choice of “non-judgemental” by students and “awareness of students’ learning needs” by academic educators. Interestingly, when the top six traits were considered instead of five, students and academic educators identified the same traits but in different ranked orders.

Conclusion: The study found six common core traits of an effective clinical educator from the perspectives of students and academic educators. Continuing education development for clinical educators should focus on these six traits prior to other 10 sub-traits.

Keywords:           Training, Development, Education, Allied Health, Entrustable Professional Activities, Mentoring

I. INTRODUCTION

The COVID-19 epidemic has prompted the spread of ICT-based education, with many university classes being conducted remotely. Some education systems use asynchronous tools such as learning management systems (LMSs); others use synchronous tools such as web conference systems. This trend has affected not only lectures but also exercises among students and clinical practice. Game-based education is no exception, and classes that require direct face-to-face interaction have become difficult to implement. Escape rooms (ERs) are one example of game-based education.

Abstract

Introduction: An online survey was conducted on 16 National Institute of Technical Education Certificate (NITEC) Dental Surgery Assistant (DSA) trainees in National Dental Centre Singapore to find out their perceptions and understanding of mental well-being.

Methods: The 43-item survey included (i) Psychological General Well-being Index (PGWB) with 22 items based on 6 domains (anxiety, depression, positive well-being, self-control, general health, and vitality); (ii) 5 items on mental health knowledge; (iii) 4 items on lifestyle; and (iv) 12 items on perceptions of mental well-being and working in the dental clinic. Responses were collated for descriptive analysis and Cronbach’s alpha analysis was done for internal consistency for Likert scale items.

Results: The average PGWB score was 61.5 (range 18-89). Fourteen trainees (75%) indicated they were feeling depressed and 31.2% of trainees felt under stress in the past month. The majority (81.3%) of trainees recognised the role of exercise in maintaining mental health and 75% of trainees were able to differentiate between sadness and depression. However, 56.3% and 87.5% of the trainees incorrectly answered that mental and psychological disorders are not preventable conditions and mental disorders are caused by a wrong way of thinking respectively. The Cronbach’s alpha on PGWB (a = 0.87) and trainees’ perception of working in the clinic (a = 0.76) revealed good internal consistency.

Conclusion: The PGWB scores and survey analysis indicate there is a knowledge gap about mental health and the need to improve mental well-being in this cohort of NITEC DSA trainees.

Keywords:            Mental Well-being, Dental Surgery Assistant Trainee, Psychological General Well-being Index

I. GLOBALISATION IN EAST ASIA

Globalisation, a complex and multifaceted phenomenon, encompasses not merely an increasing people’s mobility and economical trades, but sometimes, their political and ideological struggles, and cultural identity formation issues, too. While North American and European countries have had a long history of accepting a large number of immigrants, while Asia experienced 74% growth of hosting international migrants from 2000 to 2020, which was most remarkable (McAuliffe & Triandafyllidou, 2021). For example, Japan’s proportion of immigrant population increased from 1.3% in 2000 to 2.2% in 2021, with Chinese migrants constituting the largest group, followed by Vietnamese, Koreans, Filipinos, and Brazilians. Similarly, in 2021, immigrants accounted for 3.4% of Korea’s total population in 2021, compared to 0.5% in 2000. These immigrants came from China, Vietnam, Thailand, Uzbekistan and other countries (McAuliffe & Triandafyllidou, 2021).

Abstract

Introduction: This study compares online and in-person delivery of a weekly clinical reasoning seminar for fourth-year medical students at a Malaysian medical school. During the easing of COVID-19 pandemic restrictions, the initial eight seminars took place online, followed by eleven in-person seminars. This study looks at student preference for online or in-person delivery and how these reasons differ due to gender.

Methods: An online questionnaire was sent to fourth-year medical students after returning to in-person seminars. The response rate was 60/128 (46.88%) and the data was analysed using SPSS software.

Results: 65% of students preferred in-person seminars and a larger proportion of female students (71.43%) preferred in-person sessions compared to male students (50.00%), although this was not statistically significant (p=0.11). A significantly larger proportion of female students preferred in-person seminars for the following reasons compared to male students: enjoyment (p=0.041), developing history-taking skills (55.56%) and for formulating differential diagnoses (p=0.046). Students were asked whether online or in-person seminars were most appropriate for eighteen reasons, they felt in-person seminars were most appropriate for 16/18 of these reasons.

Conclusions: More students preferred in-person clinical reasoning seminars and a higher proportion of these students were female. A significantly larger proportion of female students felt in-person seminars were better for; enjoyment and for developing history-taking skills and formulating differential diagnoses, compared to male students. The students preferred online seminars for home comforts and ease of travel, but they preferred in-person seminars for the other 16/18 reasons listed including all reasons linked to learning skills and interreacting with others.

Keywords:            Online Teaching, In-person Teaching, Gender, Clinical Reasoning, Medical Students

I. INTRODUCTION

In preclinical years, histology, which is the study of the microscopic structures of tissue and organs, aids students in understanding the normal morphology of cell and tissue organisation in organs and differentiating their pathological changes (Hussein & Raad, 2015). The study of histology is important as it provides the fundamental basis of anatomical knowledge. Students have adapted to a new learning environment, particularly after the COVID-19 outbreak, by utilising autonomous learning strategies, including online and digital learning, as histology requires visual interpretation that is developed by continuous practice (Yohannan et al., 2019). Given this, we have created a virtual histology platform using our existing tool: the National University of Singapore – Human Anatomy Learning resOurce (NUS-HALO). NUS- HALO is an online platform with digital images and videos and has emerged as a novel tool in transforming anatomy teaching and learning. By integrating cutting-edge, high-definition histology images and relevant learning materials, the histology component of NUS-HALO offers a platform that aids students to excel in histology (Darici et al., 2021).

Abstract

Introduction: The study aimed to ascertain how the faculty at the Faculty of Medicine, Hasanuddin University perceived their role as a tutor during a problem-based learning activity during the academic phase of medical education, based on the length of time they acted as a tutor.

Methods: This was prospective observational research with an explanatory sequential mixed-method design, which was performed at the Undergraduate Medical Study Program, Faculty of Medicine, Hasanuddin University, from January 2023 until May 2023. Research subjects were divided into two groups: a) the Novice group and b) the Expert group. Quantitative data were collected by giving a questionnaire containing six categories with 35 questions and distributed by Google form. An independent t-test was used to compare the faculty’s perception, with a p-value <.05 significant. Followed by Focus Group Discussion (FGD) for qualitative data, which then were analysed by thematic analysis. The last stage is integrating quantitative and qualitative data.

Results: There were statistically significant differences in seven issues between the two groups. Most of the tutors in both groups had favorable opinions, except for the expert group’s disagreement with the passive role of the tutor in the tutorial group. Eight positive and twelve negative perceptions were found in the FGD.

Conclusion: Most tutors positively perceived their role in PBL, with the expert group having more dependable opinions and well-reasoned suggestions.

Keywords:           Problem-Based Learning, Undergraduate Medical Education, Focus Group Discussion

I. INTRODUCTION

Antimicrobial resistance has been considered a “silent” global pandemic of magnitudes similar to climate change. However, just as climate change, awareness and understanding of the public on this needs to be increased. Recent work from Sri Lanka indicates the same (Gunasekera et al., 2022). World Health Organisation (WHO) also recommends that awareness should be increased among those involved in antibiotic prescription as well as consumers and that this should be made part of the core curriculum in professional training (World Health Organisation, 2023). Those studying in health-science related streams and other biology related streams tend to take knowledge on concepts like “microorganisms”, “infectious diseases” and “antibiotics” as granted. As they are taught these concepts, or they revise what they learnt in school once again in the university, they assume that the others may also have an acceptable level of understanding on these key concepts. This leads to a communication gap between the two groups of people, the ones who have formal education on concepts like “microorganisms”, “infectious diseases” and “antibiotics” and the ones who do not have such education. Therefore, we find that health education materials are not targeted to the level of simplicity that is required by the general public.

I. INTRODUCTION

“Teach them this art, if they want to learn it, without fee or indenture; to impart precept, oral instruction, and all other instruction”- Hippocratic Oath

Since time memorial, the very act of teaching has been intertwined with that of being a physician. In so far that this tradition is found inscribed in the Hippocratic Corpus dating to the 5^th century BC. Beyond a calling and a duty, the sharing of experience and expertise is also a rewarding aspect of our roles of doctors. In a climate of ever-increasing demands of knowledge and clinical load, it is imperative we hold on to this aspect closely, and simultaneously look to and embrace new mediums to assist medical educators to meet the current challenges. In this article, we share our experience on how we can incorporate X, formerly known as Twitter, as an extra tool to facilitate teaching on the go during ward rounds and promote self-reflection after.

I. INTRODUCTION

The landscape of health profession education, particularly dental education, is evolving to equip students with essential contemporary knowledge and skills for competent dental practice. Within this context, dental materials science plays a pivotal role in undergraduate dental programs, providing the foundation for understanding the materials used in clinical dentistry. However, traditional teaching approaches relies on didactic lectures, often rendering this multidisciplinary subject seem dry and challenging (Soni et al., 2021). Students also face difficulties in grasping the practical applications of materials science in clinical dentistry within the confines of passive didactic lectures.

I. INTRODUCTION

Learning spaces can be physical, virtual, or hybrid spaces where students engage with the learning material and interact with peers and facilitators. Traditionally, learning spaces used to be classrooms, lecture halls, laboratories, and libraries and would include a teacher and students working inside a fixed space using a blackboard/whiteboard, PowerPoint projector, boards, and flexible/fixed seating arrangements.  With the advancement in educational methodologies and incorporation of technology and newer applications, learning spaces now include simulated laboratories, online learning platforms, and virtual and augmented reality-based platforms. Using virtual spaces students can interact and learn from wherever they are living/staying.

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.

I. ON PROFESSIONAL IDENTITY FORMATION

Professionalism in medicine can be considered as attributes, behaviours, and identity of the professionals who put the needs of their patients and the community they serve above their individual needs. The concept of professionalism is dynamic and might be perceived differently over time, in different contexts, and by different fields, although some ground values like excellence, competence, and altruism might persist. 

Identity formation is an inseparable part of professionalism as it underlines the importance of “being” in addition to the essence of “behaving”. Professional identity formation (PIF) in medical education is both an active psychological process conducted by individuals in internalising their values and others’ expectations. It is also a dynamic socialisation process allowing an individual to be part of the professional community with increasing roles and recognitions. This applies for both medical students who grow to become medical professionals and for medical teachers who probably juggle their different identities as clinicians/researchers to be able to enact their roles as teachers (Cruess et al., 2014).

There is no “one-size-fits-all” rule as to how their PIF should be navigated, as PIF is a journey unique to each individual. The students need to be supported to form their identity from the stage where they just follow the rules to become individuals who can internalise values and expectations from their professional community as an integral part of themselves. The medical teachers, on the other hand, still have to develop their professional identities as teachers and educators in addition to their other identities.

There is growing awareness of the need to include humanities in educating dental students at the undergraduate/pre-doctoral level (Marti et al., 2019). However, there appears to be no literature discussing or advocating the inclusion of humanities for the training of dental specialists. Dental Public Health (DPH) is one such dental specialty where its trainees and practitioners would benefit from an inclusion of humanities in its pedagogy.

This author opines that exposure to humanities (which includes, but is not limited to, literature – both fiction and non-fiction, art, history, narrative dentistry/medicine, philosophy, ethics, and medical anthropology) that touch on dental themes can make a DPH trainee/practitioner more rounded; able to empathise better with the individuals that his/her policies and programs would affect; become even more persuasive in health promotion efforts; and more articulate in their advocacy efforts with stakeholders and policy makers.

I. INTRODUCTION

Concept maps serve as teaching and learning tools that appear to assist medical students in cultivating critical thinking skills. This is attributed to the adaptability of the tool, acting as a facilitator for knowledge integration and a method for both learning and teaching. The extensive array of contexts, purposes, and approaches in utilising Concept maps and tools to evaluate critical thinking enhances our confidence in the consistent positive effects (Fonseca et al., 2023).

In the realm of medical education, employing concept maps as a learning strategy can prove to be beneficial (Torre et al., 2023). Concept maps, visual representations of learners’ understanding of a set of concepts, have proven to be valuable tools in medical education (Novak & Cañas, 2008). The integration of concept maps as a teaching strategy allows for the depiction and exploration of the relationships among various medical concepts (Ruiz-Primo & Shavelson, 1996). In our instructional approach, instructors employ concept maps during lectures (Appendix 1), emphasising the interconnectedness of key concepts. Students actively participate in creating their own concept maps, facilitating collaborative learning. This flexible approach accommodates diverse learning styles, with students using both concept map notes and textbooks. The final evaluation includes an assessment of students based on their application of concepts outlined in the concept maps, contributing to a well-rounded and adaptable learning experience in medical education.

In this study, we aimed to assess the impact of utilising the concept map teaching technique in conjunction with concept map notes on the academic performance of students.

I. INTRODUCTION

Residents are vital to the medical workforce, especially for overnight call duties. Transitioning from junior roles to handling overnight calls as senior residents (SRs) can be anxiety-inducing, leading to decline in cognitive performance and fatigue (Weiss et al., 2016). These pose concerns for patient safety and quality of supervision, as SRs often serve as the most senior staff on-site overnight. However, calls offer valuable training opportunities, fostering autonomy, decision-making skills, and preparation for future consultant roles. The challenge is to ensure that overnight calls are safe for both patients and physicians while being conducive to learning.

During the COVID-19 pandemic, the health system’s reallocation of manpower substantially increased the workload. While there remains conflicting evidence on the optimal on-call arrangement, the Accreditation Council for Graduate Medical Education stipulates a maximum of 24 consecutive hours of direct patient care to safeguard against negative effects of chronic sleep deprivation (Nasca et al., 2010). In our tertiary hospital, two medical SRs performed stay-in overnight calls ranging from 15 to 21 hours (1700-0800h on weekdays and 1100-0800h on weekends). Before each call, SRs started work at 0700h. One SR was in-charge of the intensive care unit (ICU) and the other was on the general medicine floor. During each call, the ICU SR was responsible for supervising 2 stay-in junior residents, 2-5 new patient admissions and 20 existing ICU patients; the general medicine SR was responsible for supervising a team of four stay-in junior residents, 30-50 new patient admissions, and 100-150 existing inpatients. After each call, SRs would continue with the morning ward rounds before ending work. SRs could seek help by calling the duty consultant, who stayed out of hospital.

With limited data on SRs’ call experiences during the pandemic, understanding their perceptions and attitudes would be essential for system improvement and preparation for future challenges. Therefore, we aimed to explore the perceptions, attitudes, and practices of SRs with regards to overnight stay-in calls during the COVID-19 pandemic, as well as avenues for improvements in the call system.

I. INTRODUCTION

Over the past 25 years, the Asia Pacific region has seen striking growth in the scholarship of health professions education, and it is poised to continue its development. A window into the past and a glimpse of the future can be found in the meetings of the Asia Pacific Medical Education Conference (APMEC), which recently celebrated its 25th anniversary. To frame my personal observations, a word cloud was created using the titles of the plenaries, keynotes, and symposia of the 2003, 2004, and 2006 conferences and another was created using the titles from 2021, 2022, and 2023. When comparing these two clouds (an exercise akin to interpreting inkblots), three themes emerged: interprofessional education and practice (IPEP), the scholarship of teaching and learning (SoTL), and the growing role of technology.

I. INTRODUCTION

Portfolios, as structured collections of documentation, not only showcase a student’s learning progress and achievements but also foster a self-directed approach to assessing their own performance and setting future goal (Birgin & Adnan, 2007). Existing literature predominantly addresses the broader usage of portfolios across various disciplines, underscoring their role in enhancing reflective practice and competency-based assessments (David et al., 2001). Although portfolios in paediatrics department provide advantages, their implementation encounters substantial obstacles. These include the substantial time and effort required to maintain them, the need for clear guidelines from faculty, and a varying degree of acceptance among students and faculty, who may prefer traditional assessment methods. This study specifically aims to address these challenges by exploring the perceptions of postgraduate students on the use of portfolios in the paediatrics department at the Defence Services Medical Academy.

I. INTRODUCTION

Despite agreement on the importance of Interprofessional education (IPE) for health professional education (HPE), best practice in developing and implementing IPE remains ambiguous. Students are important stakeholders and can be allies in IPE, but much of their potential in the development of curricula remains untapped.

In 2022, the University of Notre Dame, Australia (UNDA) partnered with the University of Tasmania (UTAS) to engage students in the co-design, implementation, and delivery of a program to support the development of interprofessional practice for preclinical medical students from the Doctor of Medicine (MD) and final year paramedicine students. The COVID-19 pandemic was a catalyst to re-imagine different ways of learning and teaching in this area. This paper aims to describe the process of and opportunities for involving students as partners (SaP).

I. INTRODUCTION

Recommended strategies for the development of eLearning resources have largely focused on teachers rather than students. Co-creating eLearning resources with students has received increasing attention driven by learner-centric design and dialogical learning models (Gros & López, 2016). Engaging students as co-creators is beneficial, leading to better engagement and academic performance as students take ownership of the learning experience (McDonald et al., 2021). However, challenges to engaging students as creators include the lack of clear processes, the lack of content expertise among students, students feeling threatened or uncomfortable with an unfamiliar role, power relations between learners and teachers, and teachers feeling insecure about giving up control of curricular elements.

Hackathons began as computer programming competitions which aimed to solve problems through intensive collaboration over a short time. In healthcare, they have been used to spur innovation in mHealth and surgery. In this paper, we report an innovative approach to engaging students as co-creators in eLearning resource development by using a virtual hackathon as well as the evaluation outcomes of this approach.

Dear Editor,

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.