Development Of Medical Education Research Articles

TRANSFORMATION OF HIGHER EDUCATION IN MODERN CONDITIONS

The replacing of world civilization and Ukrainian society in particular played a significant role in the evolution of medical education in Ukraine. The system of higher education simultaneously affects the development of the future generation of doctors and is a remarkable social institution. That is why, the role of the system of higher medical education in difficult periods of the state’s development and proposed ways to innovate and optimize the scientific potential of students of higher medical education was analyzed.
 The aim of the study. The aim of the study is to analyze the current trends of transformational changes in the field of medical education and to propose ways to optimize the scientific potential of students of higher medical education.
 Objects and methods of the study include the system of medical education at the Higher Secondary School of the PSMU in various periods of its formation and development.
 Results and discussion. During our research, an analysis of modern trends in the development of medical education in Ukraine by studying well-known literary data was performed. The basis of own research is: quantitative analysis and synthesis (for the study of the higher education system of Ukraine); comparative analysis (to highlight the peculiarities of the functioning of the system of higher medical education in the conditions of modern challenges).
 Studying the system of higher education of Ukraine, it pays attention to the fact that the entire period of its development was accompanied by certain tests that prompted the transfer of the educational process to online format. At the same time, it should be noted that students are most often concerned with the following problems: poor or no Internet 30.2% of respondents; complex emotional state and psychological problems of higher education applicants 25.9; absence or lack of gadgets for learning 12.1%; a higher education student does not accept distance learning 10% of respondents; 9.2% of respondents noted that they were able to join distance learning partially or only for a certain period. Most of the higher education seekers who pointed out this problem lived in the Donetsk, Dnipropetrovsk, Kharkiv and Luhansk regions before the war; absence or partial distance learning happened to 2.5% of respondents, who for a certain period, namely at the beginning of the war, should not have been able to join the training at all; 2.0% faced the problem of studying during their stay abroad.
 Analyzing the transformational changes that have occurred in our state, one can safely say that the social and medical conditions in which the society found itself have caused many problems in the field of medical education. There is an urgent need to solve the strategy, content, structure, methods of teaching, education and formation of views.

Competency-Based Medical Training in Anesthesiology: Has It Delivered on the Promise of Better Education?

Competency-Based Medical Training in Anesthesiology: Has It Delivered on the Promise of Better Education?

The Anesthesiology Milestones 2.0: An Improved Competency-Based Assessment for Residency Training.

The evolution of medical education, from a time-based to a competency-based platform, began nearly 30 years ago and continues to slowly take shape. The development of valid and reproducible assessment tools is the first step. Medical educators across specialties acknowledge the challenges and remain motivated to develop a relevant, generalizable, and measurable system. The Accreditation Council for Graduate Medical Education (ACGME) remains committed to its responsibility to the public by assuring that the process and outcome of graduate medical education in the nation's residency programs produce competent, safe, and compassionate doctors. The Milestones Project is the ACGME's current strategy in the evolution to a competency-based system, which allows each specialty to develop its own set of subcompetencies and 5-level progression, or milestones, along a continuum of novice to expert. The education community has now had nearly 5 years of experience with these rubrics. While not perfect, Milestones 1.0 provided important foundational information and insights. The first iteration of the Anesthesiology Milestones highlighted some mismatch between subcompetencies and current and future clinical practices. They have also highlighted challenges with assessment and evaluation of learners, and the need for faculty development tools. Committed to an iterative process, the ACGME assembled representatives from stakeholder groups within the Anesthesiology community to develop the second generation of Milestones. This special article describes the foundational data from Milestones 1.0 that was useful in the development process of Milestones 2.0, the rationale behind the important changes, and the additional tools made available with this iteration.

Evolution of medical education in India: some miles travelled, many miles to go

Evolution of medical education in India: some miles travelled, many miles to go

Katerinoslav provincial zemstvo and development of medical education of the province in the early twentieth century

The article considers the role of Katerinoslav provincial and county zemstvos in the development ofmedical education of the province in the early twentieth century. It is emphasized that in the conditions ofreforming local self-government, the analysis of the experience of the zemstvos activity, in particular theactivities of the Katerynoslav provincial zemstvo in the training of medical staff, the improvement of themedical service of the population of the Katerynoslav province is of great importance. Thus, the role of theprovincial zemstvo in the organization of the activities of the provincial zemstvo felcher school, its financialsupport and the role of the provincial congresses of the zemstvo doctors and representatives of the zemstvoinstitutions in the improvement of medical education in the country are highlighted. The contribution of theprovincial zemstvo Medical School to the training of medical staff of secondary qualification in the regionis considered. The new Charter of the school, approved by the Ministry of Internal Affairs on October 10,1907, is analyzed, in particular, the purpose of the school establishment, its management system is described,the content of the school curricula according to the "Normal Statute of Zemstvo Feldsher School" 1897 isconsidered, changes in the requirements for educational qualification of graduates are revealed. Particularattention is paid to the analysis of the dynamics of training of felchers in school at the beginning of thetwentieth century, the activity of the zemstvo on organization of training for women as medical workersis shown. Significant attention is paid to the role of the provincial zemstvo in the creation of the systemof training of lower medical staff - schools of nursing and servants at the provincial zemstvo hospitalsand similar special schools at county zemstvo hospitals, as well as the system of advanced training offeldshers of the province in the form of so-called "repetition courses." The contribution to the developmentof medical education in Katerynoslav region of private medical schools is also described.

A Scoping Review of Medical Education Research in Neurosurgery

Little is known about the state of medical education (ME) research in neurosurgery. As ME started to develop in neurosurgery in recent years, it is important to understand the current status and develop the theory for advancement in neurosurgery. The aim of this study was to undertake a scoping review of neurosurgery literature on ME research. MEDLINE, SCOPUS, and PubMed databases were searched. Inclusion criteria were full-text articles in English published from January 2006 to December 2017. Research aspects included country of publication, annual number of publications, journal types, type of participants, frequently researched topics, and research design. Search terms included neurosurgery, medical education, teaching, training, learning, and curriculum. A total of 9863 references were found across 3 databases. After duplicate removal and further screening, 533 references remained for coding analysis. ME research activity in neurosurgery is increasing and commonly observed in Western countries. Identified articles were mostly quantitative, with curriculum, assessment (especially simulation), and teaching and learning being the most dominant research themes. This study highlights the need for enhanced quantity and quality of ME research in neurosurgery. It identifies areas of highest priority and aspects to be improved and provides us with a rationale for future development in ME in neurosurgery. These findings reveal future education research direction and programmatic research areas, while also establishing a benchmark to assess changes in educational scholarship over time.

A Study of the Evolution of Medical Education in Ancient India

A Study of the Evolution of Medical Education in Ancient India

The evolution of medical education and what scares us about it

In the early Middle Ages, future doctors were not students; they were apprentices. Teaching consisted of knowledge about herbs and surgical skills, “taught” by older, experienced peers. In monasteries, monks occupied themselves copying classic texts in the scriptorium. These sources, however, were not consulted by apprentices at the time. In convents and nurseries, manuals of medical botany, especially the ones about herbs of their local orchards, were preferable reading. The first record on medical training in literature is attributed to Charaka, a Hindu physician who in 500 BC referred to the distinctive idea of a “master” from whom one could learn the art and medical practice. In the tenth century, in a somewhat pre-academic teaching style developed in Salerno and later in the Alexandrian model, Mentors were respected celebrities, authorized and of great powers. Shortly afterwards, Constantin came to Monte Cassino to translate Arabic medical writings into Greek (internationalizing medicine) and the University of Bologna was founded on September 18, 1088, by and for students.

Evolution of medical education in the Department of Medicine of the Complutense University of Madrid in the last decade

Objectives: This paper aims to show changes in Medical Education in the Department of Medicine at the Complutense University of Madrid in the last 10–15 years.Results: Medical education in the Department of Medicine at the Complutense University of Madrid has undergone significant changes in the last 10–15 years. An attempt to summarize these shows that radical change in the teaching of medicine for both teachers and students has taken place in three areas: 1. Progressive development of Patient-centered medical education. 2. Development of a competency-based training concerned with the mastering of knowledge and skills and their evaluation through objective and structured clinical assessment tests. 3. Introducing simulation techniques and virtual reality in the teaching of clinical practice aimed at improving our students' training and enhancing patient safety.Conclusions: We believe that the changes applied have pleased students as well as teachers and even patients and are helping to improve the training of our students.

An app to enhance resident education in otolaryngology.

Technological change is leading to an evolution in medical education. The objective of our study was to assess the impact of a medical knowledge app, called PulseQD, on resident education within our otolaryngology-head and neck surgery department at Montefiore Medical Center, Albert Einstein College of Medicine (Bronx, NY). A prospective cohort study was conducted within the Department of Otolaryngology-Head and Neck Surgery from July 2016 to June 2017. All faculty attendings and residents were asked to participate in the study and were included. A Web and mobile-based app, PulseQD, that allowed for collaborative learning was implemented. Questionnaires were given at the beginning and end of the academic year. Otolaryngology Training Exam (OTE) scores were collected RESULTS: A total of 20 residents and 13 faculty members participated in the study. Residents used online sources of medical information significantly more often than faculty (90% and 54%, respectively, P = 0.0179). Residents and faculty felt that PulseQD offered a valuable perspective on clinically relevant medical information (P = 0.0003), was a great way to test clinical and medical knowledge (P = 0.0001), and improved the sharing and discussing of medical knowledge (P < 0.0001). There was a statistically significant 5.8% improvement in OTE scores (P = 0.0008) at the end of the academic year. The implementation of a novel mobile app, PulseQD, was well received by residents and faculty in the Department of Otolaryngology-Head and Neck Surgery. Preliminary data suggest that app-based learning may lead to improved performance on knowledge-based assessments. NA. Laryngoscope, 128:1340-1345, 2018.

The Rise of Hospitalists: An Opportunity for Clinical Ethics

Translating ethical theories into clinical practice presents a perennial challenge to educators. While many suggestions have been put forth to bridge the theory-practice gap, none have sufficiently remedied the problem. We believe the ascendance of hospital medicine, as a dominant new force in medical education and patient care, presents a unique opportunity that could redefine the way clinical ethics is taught. The field of hospital medicine in the United States is comprised of more than 50,000 hospitalists-specialists in inpatient medicine-representing the fastest growing subspecialty in the history of medicine, and its members have emerged as a dominant new force around which medical education and patient care pivot. This evolution in medical education presents a unique opportunity for the clinical ethics community. Through their proximity to patients and trainees, hospitalists have the potential to teach medical ethics in real time on the wards, but most hospitalists have not received formal training in clinical ethics. We believe it is time to strengthen the ties between hospital medicine and medical ethics, and in this article we outline how clinical ethicists might collaborate with hospitalists to identify routine issues that do not rise to the level of an "ethics consult," but nonetheless require an intellectual grounding in normative reasoning. We use a clinical vignette to explore how this approach might enhance and broaden the scope of medical education that occurs in the inpatient setting: A patient with an intra-abdominal abscess is admitted to the academic hospitalist teaching service for drainage of the fluid, hemodynamic support, and antimicrobial therapy. During the initial encounter with the hospitalist and his team of medical students and residents, the patient reports night sweats and asks if this symptom could be due to the abscess. How should the hospitalist approach this question?

Evolution of medical education in India: The impact of colonialism.

The cross-cultural exchanges between the people of India and their colonial rulers provides a fascinating insight into how these encounters shaped medicine and medical education in India. This article traces the history of how Indian medicine was transformed in the backdrop of colonialism and hegemony. It goes on to show how six decades after independence, we have have still been unable to convincingly shrug off the colonial yoke. India needs to work out a national medical curriculum which caters to our country's needs. A symbiotic relationship needs to be developed between the indigenous and allopathic systems of medicine.

Queen of the professions: the rise and decline of medical prestige and power in America

Acknowledgments and Preface Introduction: What Makes a Profession a Profession? Part I: From Healing Art to Scientific Profession: Medicine 500 B.C.E. to 1850 C.E. 1: Swearing by Apollo 2: The Levant: Saving Grace of the Middle Ages 3: Physicians, Barbers and Old Wives 4: Hospitals or Hospices? 5: Gifts from the Sister Sciences Part II:The Making of a Doctor: The Evolution of Medical Education 6: Acolytes and Apprentices 7: Starting with Salerno: Europe's First Medical Schools 8: From Sacrilege to Science: Dissection and Observation 9: Three Paths Leading to Modern Medical Education 10: Money Talks: Abraham Flexner's Reforms 11: High Tech, Low Touch? Part III: Changing Concepts of Medical Ethics: When Values Collide 12: A Sacred Trust: Roots of MedicalEthics 13: First, Do No Harm: The Introduction of Humanistic Values 14: The Physician as Gentle-man 15: Balancing Individual and Public Benefit: Experimental Abuses 16: Gods No More: The Rise of Patients' Rights 17: Collisions of Cultures Part IV: The Future of Medicine as a Profession: From Hippocrates to Dr. House 18: Cures, at Last! 19: The Conundrum of Insurance: Raising Income, Threatening Autonomy 20: Expanding Access to the Physician's Role 21: What It All Means Bibliography Index

“Revolution and Evolution in Medical Education”: An IAMSE Webcast Audio Seminar Series Fall Series, September 11–October 16, 2014

“Revolution and Evolution in Medical Education”: An IAMSE Webcast Audio Seminar Series Fall Series, September 11–October 16, 2014

Evolution of the anatomical theatre in Padova

The anatomical theatre played a pivotal role in the evolution of medical education, allowing students to directly observe and participate in the process of dissection. Due to the increase of training programs in clinical anatomy, the Institute of Human Anatomy at the University of Padova has renovated its dissecting room. The main guidelines in planning a new anatomical theatre included: (1), the placement of the teacher and students on the same level in a horizontal anatomical theatre where it is possible to see (theatre) and to perform (dissecting room); (2), in the past, dissection activities were concentrated at the center of the theatre, while in the new anatomical theatre, such activities have been moved to the periphery through projection on surrounding screens-thus, students occupy the center of the theatre between the demonstration table, where the dissection can be seen in real time, and the wall screens, where particular aspects are magnified; (3), three groups of tables are placed with one in front with two lateral flanking tables in regards to the demonstration table, in a semicircular arrangement, and not attached to the floor, which makes the room multifunctional for surgical education, medical students and physician's continued professional development courses; (4), a learning station to introduce the students to the subject of the laboratory; (5), cooperation between anatomists and architects in order to combine the practical needs of a dissection laboratory with new technologies; (6), involvement of the students, representing the clients' needs; and (7), creation of a dissecting room of wide measurements with large windows, since a well-illuminated space could reduce the potentially negative psychological impact of the dissection laboratory on student morale.

Universities, medical education and women: Birmingham in the late nineteenth and early twentieth centuries

Examining the evolution of medical education for women in a major city, this paper details the combination of private and public initiative, and the role of nonconformist denominational networks in Birmingham, one of the largest industrial and commercial centres of the British Empire. From the 1880s women gradually gained access to both higher education and professional training in medicine. This was necessarily underpinned by the growth of school science for girls. In this, the role of the new endowed and proprietary schools for girls was very significant in Birmingham but that of the School Board and LEA was also important, not least in demonstrating class and gendered attitudes in education and medicine. In theory from the 1880s and 1890s it was possible even for girls from elementary schools to proceed by way of scholarship both to secondary school and to university. Such educational opportunities expanded in early twentieth-century Birmingham yet always remained slimmer for girls. From 1900 the new university ostensibly gave equal rights to women in medical education as in all other studies. The university itself had grown out of local interests and patronage and saw itself as serving the local community. Birmingham’s liberal leaders believed in scientific education and social reform, including greater equality between the sexes, although contemporary cultural and social currents could militate against such high aspirations. Nevertheless, the university did take a lead in opening up medicine to women, allowing participation in professional life, for some at the highest levels, and serving the local city and regional community.

The basic role of basic science

As the celebrations of the hundredth anniversary of the Flexner Report become a distantmemory, it may be a good time to review the legacy of Flexner one last time. Unfortu-nately a few page editorial will not do justice to the topic; many others have made moreextensive comments on the impact of the report (Duffy 2011; Markel 2010) and MedicalEducation devoted an entire issue to discussion of the impact of Flexner and the evolutionof medical education since his time.At the risk of gross oversimplification, the essence of Flexner’s report was to stronglyencourage the linkage between the medical school and the university—to establish thefundamental role of basic medical sciences in the medical curriculum. His ‘‘gold standard’’was the curriculum at Johns Hopkins, which itself emulated the German medical schools ofa few decades earlier (Duffy 2011). The immediate impact of the report was the closing ofabout 1/3 of American and Canadian medical schools that did not meet the standards usedin the report, as well as the provision of large sums of Carnegie and Rockefeller money toenhance the remaining schools (Barr 2011).Arguably, the real impact of the Flexner report occurred half a century later, when,following World War 2, the National Institutes of Health established a grant program(National Institutes of Health 2012) that dramatically increased funding for basic scienceresearch in medical schools (from $8 million in 1947 to $1 billion in 1966!). Manypositions were created for basic scientists, and the Hopkins curriculum, with 2 years ofbasic science followed by 2 years of clinical became the norm.Basic science dominated the medical school, whose raison d’eˆtre was the production ofmedical scientific knowledge (Duffy 2011). Few academics (but sadly far more lay per-sons, including some notables like Prince Charles) would challenge the critical role ofbasic biological science as a catalyst for the stunning advances we have observed in qualityand quantity of life in the past century as a consequence of medical progress. But while themarriage of basic science and clinical medicine directed at advances in knowledge is ahappy one, it is less clear why the undergraduate medical curriculum should be dominatedby biological science. Indeed, while the articles in the special issue of Medical Educations

A Social and Academic Enrichment Program Promotes Medical School Matriculation and Graduation for Disadvantaged Students

This study assessed the impact of a pre-medical pipeline program on successful completion of medical school and the capacity of this program to address achievement gaps experienced by disadvantaged students. The University of North Carolina (USA) Medical Education Development (MED) program provides intensive academic and test skills preparation for admission to medical, dental, and other allied health professions schools. This retrospective study evaluated the academic progress of a longitudinal sample of 1738 disadvantaged college students who completed MED between 1974 and 2001. Data sources included MED participant data, medical school admissions data for the host school, aggregate data from the Association of American Medical Colleges (AAMC), and individual MED participant data from AAMC. Methods of analysis utilized Chi-square, independent samples t test, and logistic regression to examine associations between factors. Of the 935 students in MED from 1974 to 2001, who had indicated an interest in medical school, 887 (94.9%) successfully matriculated and 801 (85.7%) successfully earned the MD degree. Using logistic regression, factors that were significantly correlated with earning the medical degree included the student's race, college undergraduate total and science grade point averages, with Hispanic, African American, and Native American participants earning the medical degree at rates comparable to Caucasian participants. MED students successfully earned the MD degree despite having significantly lower Medical College Admissions Test (MCAT) scores and undergraduate grade point averages compared to all United States medical school applicants: MCAT scores had little relationship with student's success. These findings suggest that an intensive, nine-week, pre-medical academic enrichment program that incorporates confidence-building and small-group tutoring and peer support activities can build a foundation on which disadvantaged students can successfully earn matriculation to and graduation from medical school.

Considerações sobre o ensino médico no Brasil: consequências afetivo-emocionais nos estudantes

Faz-se uma revisão não exaustiva da evolução do ensino médico no Brasil desde sua origem, passando pelas inúmeras reformas praticadas, que buscam melhorar a formação técnica dos estudantes. Chama-se a atenção para o fato de nessas reformas nunca terem sido referidas questões como o bem-estar e a saúde mental dos alunos. O curso de Medicina sempre foi considerado estressante, mas a preocupação com esse aspecto é recente na história. Alguns estudos tentam identificar a fase do curso mais estressante, e a maioria indica a primeira série do ciclo clínico. Outros tentam apontar os fatores mais responsáveis pelo estresse, buscando-os nas características dos alunos e do curso. São apontados os diagnósticos mais frequentes citados na literatura e sugestões para minimizar esse processo no âmbito das escolas médicas.

Evolution of medical education in ancient Greece

he study of ancient Greece is essential for the proper understanding of the evolution of modern Western medicine. An important innovation of classical Greek medicine was the development of a body of medical theory associated with natural philosophy, i.e. a strong secular tradition of free enquiry, or what would now be called “science” (Eπιστήμη). Medical education rests upon the ancient Greek foundations and its history remains a fascinating topic for modern physicians and medical teachers.