Medical Degree Program Research Articles

Measuring the educational environment in a Sri Lankan medical school following curricular revision

BackgroundIn 2007, the Faculty of Medical Sciences, University of Sri Jayewardenepura revised its medical curriculum from discipline-based to one that was student-centered and integrated. This study aimed to evaluate the perceptions of students regarding the educational environment and compare them to those prior to curricular revision.MethodsThe Dundee Ready Education Environment Measure (DREEM) questionnaire was administered to all volunteering students enrolled in the medical degree programme at the time of the study (n = 595). Results were compared to DREEM scores obtained prior to curricular revision.ResultsThe overall DREEM score and sub-scale scores were positive and showed improvement compared to previous scores. The score for Students’ Perceptions of Atmosphere showed progression from ‘there are many issues which need changing’ to the next highest category ‘a more positive attitude’. The mean scores in pre-clinical, para-clinical and clinical phases also showed an improvement. ‘The teachers are knowledgeable’ was the highest rated item overall and within each phase of learning. All sub-scales were rated highest by pre-clinical students and lowest by para-clinical students, in contrast to previous results where such patterns were not observed. Certain items, especially those related to teaching/learning, received exclusively low scores in particular student subsets.ConclusionsStudents’ perceptions towards the educational environment overall, have improved following curricular revision. However, certain negative areas warranting further evaluation were highlighted.

Learning Strategies and Innovations among Medical Students in the Philippines during the COVID-19 Pandemic

This paper highlights the experience of graduating medical students or clinical clerks in the Philippines during the COVID-19 pandemic. For instance, clinical clerks are supposed to be having their actual face-to-face patient encounters in the hospital setting. It is during the clinical clerkship, the final year of a four-year medical degree program, that a medical student applies his or her theoretical knowledge in practice. However, due to the pandemic, changes needed to be done in order to ensure continuous learning despite having to have little to no contact with actual patients. Hence, in this paper, various learning strategies and innovations have been presented to give examples of how Filipino medical students or clinical clerks tried to cope and adapt with the changes in the mode of learning in the medical field.

Physical activity learning by medical students: the current picture in Brazil

Abstract: Introduction: Physical activity is essential for preventing and treating many diseases. Although physicians are the most influential health professionals in advising their patients on the benefits of physical activity, most medical degree programs in Brazil do not seem to include physical activity topics in their curricula. Objective: This study aimed to investigate physical activity topics on active medical curricula in Brazil. Method: The research was conducted separately in April 2015 and February 2019 using a governmental resource, the e-MEC system, and search in internet databases. Data were split into categories according to the type of enrollment (mandatory or optional) of the courses that have subjects or thematic modules with topics on physical activity, type of activities (theoretical, practical, or theoretical-practical), and emphasis on the content (health, performance, or health and performance). Results: Of the 223 medical curricula compiled in 2015 and 286 in 2019, respectively, only 24 (10.8%) and 19 (6.7%) had at least one subject or thematic module concerning physical activity with emphasis on health. Conclusion: In Brazil, the number of undergraduate medical curricula covering physical activity topics is still small and suffered a reduction between 2015 and 2019, which should warn medical education institutions about the need to include physical activity longitudinally distributed contents, with theoretical and - if possible - practical approaches, and emphasis on health promotion and treatment of diseases, in mandatory curricular units.

Knowledge of Avulsion of Permanent Teeth Emergency Management Among Undergraduate in Brazilian Health Care Students

Objective: To assess the knowledge of undergraduate health care students, about avulsion of permanent teeth. Material and Methods: It is a cross-sectional study. The sample consisted of Brazilian undergraduate students of the nursing, medicine, and dentistry degree programs. A structured questionnaire developed by the researchers, containing 18 objective questions about avulsion of permanent teeth was used as the data collection. Data analysis included Pearson's Chi-square and Fisher's Exact. Results: A total of 82.7% dental students, 22.9% nursing students, and 23% medical students had previously received some information about dental trauma. Students in the second half of the dentistry program had a higher percentage of correct answers in all questions (p<0.05). Being in the first or second half of the nursing program had no relation to the percentage of correct answers by students for any questions (p>0.05). Students in the first half of the medical program had a higher percentage of correct answers for six of these questions (p<0.05). Dentistry students had the highest percentage of correct answers in all the questions (p<0.001). Conclusion: Although students from the dentistry degree program report having information on avulsion of permanent teeth, their practical experience was considered low. Upon comparing students from the dentistry, nursing, and medical degree programs regarding their learning about avulsion of permanent teeth, dentistry students had greater knowledge on the subject.

Nemzetközi hallgatói mobilitás a magyar felsőoktatásban

The study aims to review the processes of international student mobility towards Hungary, with particular attention to the time-series analysis of the number of international students studying in Hungary, the trends emerging from the data and the changes regarding the sending countries as well as their hypothetical causes in the period between 2001 and 2019. The study is based on the latest available statistical data for 2019/2020, which we used to analyse the distribution of international students by research field, level of training and the geographical distribution of the host universities in Hungary. Following the international trends, a significant increase can also be observed within Hungary, in the number of students coming from the East, more exactly from Asian countries including China, Iran, and Turkey. Many students from the neighbouring countries also choose Hungary as their place of study for historical and ethnic reasons. International students studying in Hungary participate in a remarkably high proportion (approximately 30%) in medical and healthcare degree programs. However, with the diversification of programs available in foreign languages the comprehensive universities in the countryside have come to the foreground and now they host the largest number of international students.

Digital Health meets Hamburg integrated medical degree program iMED: concept and introduction of the new interdisciplinary 2nd track Digital Health.

Digitalization in medicine is transforming the everyday work and the environment of current and future physicians – and thereby brings new competencies required by the medical profession. The necessity for a curricular integration of related digital medicine and, in more general, digital health topics is mostly undisputed; however, few specific concepts and experience reports are available. Therefore, the present article reports on the aims, the implementation, and the initial experiences of the integration of the topic Digital Health as a longitudinal elective course (2nd track) into the integrated medical degree program iMED in Hamburg.

Perceptions of medical college academics on intercalated MBBS/BSc dual degree program in Nigeria

Purpose: The purpose of this study was to determine the perceptions of academics on the acceptability of the intercalated medical degree program in an attempt to proffer solutions to breach the gaps in manpower shortages in the medical profession.Methodology: This is a descriptive cross sectional survey. Randomly selected 150 academic staff of various medical colleges spread across Nigeria, who attended an educational programme in Abuja Nigeria in September 2018 completed semi structured questionnaires after consenting to participate in the study. Data from the retrieved questionnaires were collated, entered into Microsoft excel and analyzed using descriptive statistics. Most of the analyzed data were represented in percentages for ease of comparison.Findings: Sixty five percent of the respondents were aware of the intercalated (dual) Bachelor of Medicine, Bachelor of Surgery (MBBS)/ Bachelor of Science (B.Sc.) degree programme, offer it in their institutions and believe it is worthwhile. The merits of the dual degree programme from this study were an additional degree, more experienced medical doctors in terms of research and exit strategy for some medical students who may change their minds half way into the medical programme. The disadvantages reported were prolonged study period and increased cost of study. Majority of the respondents, who were academic staff of medical colleges were aware of, and favoured the establishment of intercalated MBBS degree programme in more Nigerian medical colleges.Unique contribution to theory, practice and policy: There is scarcity of literature on the intercalated degree programme in Nigeria. This research may influence policy change that will improve medical education. From the results of the study, it is recommended that the stakeholders in medical education should consider giving accreditation to more medical colleges that have the capacity to commence intercalated medical degree programs in Nigerian Universities as an option to interested medical students with good potentials.

Student Characteristics Associated with Passing the Exam in Undergraduate Pharmacology Courses\u2014a Cross-sectional Study in Six University Degree Programs

Adequate knowledge in pharmacology is crucial in many professions but a non-negligible proportion of students fail the exams and knowledge of underlying factors is largely lacking. This study was performed to evaluate to what extent various factors are related to student performance in pharmacology-related courses in higher education, linking administrative data to attendance at non-mandatory teaching sessions and questionnaire replies. A total of 596 students (median age: 22 years; 70% female) were included from eight courses which are part of either the medical, pharmacy, dentistry, nursing, or biomedical analyst degree programs at the Sahlgrenska Academy, Gothenburg, Sweden. In all, 380 (64%) students passed the regular program- and course-specific exam. Multivariate logistic regression analysis revealed that a high participation rate in non-mandatory teaching sessions, as well as a perceived great interest in pharmacology, was associated with students’ passing of the exam; adjusted odds ratio (95% confidence interval): 1.30 (1.19 to 1.42; per 10 percentage unit increase in attendance) and 3.38 (1.86 to 6.12), respectively. Working for wages during the course weeks and pre-university grades used in the program application were significant factors in subgroups of students, negatively and positively associated with the exam results, respectively. Age, having Swedish as a second language, and time spent studying were only associated with the exam result in the univariate analyses. To conclude, both students and teachers can contribute significantly to successful education within pharmacology, students by participating in the teaching sessions and teachers by encouraging students to find the subject interesting.

Flipping e-Learning for Teaching Medical Terminology: A Study of Learners’ Online Experiences and Perceptions

Since e-Learning has become popular in recent years, research studies have been conducted about which instructional methods are the most effective in online learning environments. The purpose of this study is to apply the flipped classroom model to a Medical Terminology Course that was provided fully online as part of a Medical Documentation and Secretarial associate degree program in a vocational college, and to analyze learners’ experiences associated with this application. Based on this method, as asynchronous activities, learners were required to study interactive multimedia content and applications. For synchronous activities, mainly learner-centered approaches, collaborative learning, problem solving and discussion, led the learning process. In the context of this study, learners’ usage of the system, submissions to the study process questionnaire, and academic achievement were collected as quantitative data; whereas, learners’ opinions towards the flipped classroom model were obtained as qualitative data. Hence, the study was designed as a mixed methods research. According to the results, it was found that learners’ academic achievement significantly related to their perceptions of deep learning and their time spent on learning activities. Moreover, learners indicated problematic aspects to the flipped classroom as time expectancies, insufficiency of instructional materials, and lack of advice received from the instructor.

Development of aCanMEDS-based instrument for evaluating medical students' perceptions of the key competencies of asocially accountable healthcare practitioner.

IntroductionNumerous frameworks and tools have been developed to assist medical schools striving to achieve their social accountability mandate. The purpose of this study was to design an instrument to evaluate medical students’ perceptions of the key competencies of a ‘socially accountable’ healthcare practitioner using widely accepted frameworks which contain clear measurable outcomes.MethodsThe instrument was designed in three phases: selection of a competency-based framework, development of items, and validation of the instrument through exploratory factor analysis. Medical students in the 6‑year medical degree program at the University of Cape Town, South Africa were invited to participate in the study. Descriptive and inferential statistical analysis was performed using Stata/SE version 13.1.ResultsOf 619 students invited to participate in the study, 484 (78%) responded. The CanMEDS framework was selected for designing the instrument, which comprised 35 statements reflecting five competencies for each CanMEDS role. Exploratory factor analysis of the student responses yielded a 28-item instrument. There was a significant difference in overall Perceptions of Social Accountability Instrument (PSAI) scores between men and women (p = 0.002) but no significant difference between the overall PSAI scores for students in the respective years of study.DiscussionThis study describes the design of an instrument to evaluate medical students’ perceptions of the essential competencies of socially accountable healthcare practitioners. Used longitudinally, the data may provide evidence of the successes of our programs and identify areas where further improvements are required.Electronic supplementary materialThe online version of this article (10.1007/s40037-020-00564-6) contains supplementary material, which is available to authorized users.

Teaching, reflecting, and learning: The value of an intercalated medical education programme

Objectives: Teaching programmes within medicine focus primarily on pathways of a shorter length with little regard to teaching lasting longer than a month. This study is different from other studies as it examines the benefits of a nine month-long medical education degree programme and its impact beyond graduation. This study set out to explore the impact of a medical education intercalated degree programme for its graduates and their careers.Methods: A small scale, exploratory qualitative case study was conducted with 10 graduates of an intercalated degree programme.Results: The findings highlight the longer term value of an intercalated degree programme with particular emphasis on academic and personal skills; research and teaching skills; independence and confidence; its impact on future practice and the notion that ‘student as teacher’ programmes are a valuable asset to medical education as a whole. Participants advocated more teaching opportunities as a core longitudinal teaching component in preparation for the teaching responsibilities in their working lives.Conclusions: The programme enables the development of a range of academic and personal skills, with particular emphasis on research and teaching skills, independence and confidence.

Emergency Medicine Education Research Since the 2012 Consensus Conference: How Far Have We Come and What's Next?

In 2012, the Society for Academic Emergency Medicine convened a consensus conference on the state of medical education research with goals of defining and advancing a future research agenda. Since that time, emergency medicine (EM) education research has grown significantly. A task force of EM education experts was assembled and sought to understand the current state of EM education research and future directions. Among the advances are increases in medical education fellowships, advanced degree and certification programs, faculty development programs, publication venues, and funding. These findings are discussed in light of the prior objectives from the 2012 consensus conference, and recommendations for future directions are provided.

The Hamburg integrated medical degree program iMED.

The integrated medical degree program (iMED) was established in winter semester 2012/2013 at the Faculty of Medicine of Universität Hamburg with the aim of improving medical education. The main features of the iMED medical degree program include the close integration of theoretical knowledge and practical skills, scientific orientation and the teaching of psychosocial and communication skills. All these features are commonly found in the modular compulsory core curriculum and elective courses (“2nd Tracks”): The compulsory core curriculum comprises 19 modules which are arranged thematically in seven module groups and cover three stages of a “learning spiral”. By comprehensively coordinating the teaching content and the learning objectives of the participating theoretical and clinical subjects, theoretical content is taught on the basis of real patient’s medical histories from the first stage of the learning spiral. The elective courses enable students to learn and apply scientific work in a structured curriculum according to their own interests. Relevant practical skills for students future professional routines are taught in the longitudinal training course “Clinical Examination Methods plus Communication” (KUMplusKOM), which runs through the entire curriculum up to the final practical year. Accompanying, extra-curricular projects such as crash courses in the natural sciences or using the iMED Textbook as an online learning platform increase the attractiveness of the iMED degree program. Results of the evaluation show that the introduction and the accompanying optimization of iMED were very successful.

The modular curriculum of medicine at the Charité Berlin - a project report based on an across-semester student evaluation.

Aim: The introduction of a reform clause into the German licensing laws for medical doctors has enabled German faculties to pilot alternative designs for medical degree programmes. The aim of this project report is to outline the curricular features of the modular curriculum of medicine (MCM) at the Charité and to assess the results of its implementation based on a student evaluation across semesters.Project outline: The MCM was planned and implemented in a competency- and outcome-based manner from 2010-2016 in a faculty-wide process. The curriculum is characterised by a modular structure, longitudinal teaching formats and the integration of basic and clinical science. In the winter semester 2017, evaluations by students in semesters 1-10 were carried out. The results were analysed descriptively, and the coverage of overarching learning outcomes was compared to the results of a survey carried out amongst students on the traditional regular curriculum of medicine track in 2016.Results: A total of 1,047 students participated in the across-semester evaluation (return rate 35%). A high percentage of the respondents positively rated the achieved curricular integration and longitudinal teaching formats. The majority of the respondents agreed with the relevance of the overarching learning outcomes. Students’ evaluations of the coverage of learning outcomes showed a differentiated picture for the MCM. Compared to the regular curriculum track, the coverage in the MCM programme showed substantial improvements in all aspects. Students found themselves to be better prepared for the M2 state examination and the practical year. The students’ overall satisfaction with their decisions to study in the MCM was high.Conclusions: The results of the student evaluation show that a significant improvement in medical education has been achieved at the Charité with the new integrated, outcome-oriented design and the implementation of the MCM. At the same time, ongoing weaknesses have been revealed that serve as a basis for the continued development of the curriculum. This report aims to contribute to the discussion of the future of undergraduate medical education in Germany.

The model medical degree programme "human medicine" in Oldenburg - the European Medical School Oldenburg-Groningen.

In the summer of 2012 the School of Medicine and Health Sciences at the Carl von Ossietzky University of Oldenburg became the first new medical faculty to be founded in Germany in more than 20 years. The faculty was established within the framework of the European Medical School Oldenburg Groningen, a cooperation project between the University of Oldenburg and the University of Groningen. In addition to the University of Groningen and its faculty of medical sciences (Universitair Medisch Centrum Groningen – UMCG), four hospitals in Oldenburg are involved in the programme as cooperation partners, as well as a network of general practitioner practices that provide training and academic teaching hospitals across northwest Germany. The programme itself is a model medical degree programme with a modular structure, a highly integrative approach and an early and consistent focus on practical skills and patient-centredness. In addition to the early introduction to outpatient care in the first years of study, longitudinal pathways and a strong focus on research with early integration of scientific activities into medical studies are the defining characteristics of this programme. The two faculties in Oldenburg and Groningen coordinated their respective curriculums during the founding phase and recognise each other's study modules as equivalent to their own. This has created the preconditions for students from Oldenburg to obtain Dutch qualifications (Bachelor of Human Life Sciences and/or Master of Science in Medicine) in addition to the German "Staatsexamen" (the state examination in medicine) under certain circumstances. Irrespective of whether they intend to obtain these qualifications, all students from Oldenburg must spend at least a year studying at the partner university in Groningen. In exchange, up to 40 students from Groningen have the option to complete part of their studies in Oldenburg.

Involvement, self-reported knowledge and ways in which clinicians learn about assessment in the clinical years of a medical curriculum

Background. Medical students in their clinical years are assessed by clinician educators (CEs) with different levels of involvement and responsibilities in the assessment process. Objective. To obtain a better understanding from CEs of their involvement in assessment activities in the clinical years of a medical degree programme, their self-reported knowledge of assessment and methods of learning about assessment. This study also explored the potential association between involvement in assessment activities, self-reported knowledge of assessment and employment profile. Methods. An online cross-sectional survey was conducted among CEs involved in assessment of an undergraduate medical programme (years 4 - 6) at a South African university. Results. Fifty-four CEs were contacted and 30 responses (56%) were received. Assessment responsibilities included design of assessment instruments, participation in assessment activities and quality assurance of assessments. The top five assessment activities that CEs were involved in were conducting objective structured practical examinations (OSPEs)/objective structured clinical examinations (OSCEs), designing multiple-choice questions, being a clinical examiner, conducting portfolio-based oral examinations and marking written assessments. CEs (≥80%) reported having some knowledge of formative and summative assessment, and of validity and reliability. Fewer CEs reported knowledge of constructive alignment, standard setting, item analysis and blueprinting. CEs acquired knowledge of assessment predominantly through informal methods such as practical experience and informal discussion rather than through formal education processes such as attending courses. Conclusions. CEs participated extensively in assessment, but their knowledge with regard to assessment concepts varied.

Science, Technology, and Human Health: The Value of STS in Medical and Health Humanities Pedagogy.

As the number of medical and health humanities degree programs in the United States rapidly increases (Berry, Lamb and Jones 2016, 2017), it is especially timely to consider the range of specific disciplinary (and multidisciplinary) perspectives that might benefit students enrolled in these programs. This paper discusses the inclusion of one such perspective from the field of Science and Technology Studies (STS.) The author asserts that STS benefits students in the medical and health humanities in four particular ways, by: (1) challenging the "progress narrative" around the advancement of biomedicine as scientific practice, (2) evaluating the meaning of technology, especially in how technology orients us towards sickness and how health technology is in turn shaped by social and cultural values, (3) assessing the plurality of biomedical epistemologies, rather than assuming biomedicine is one, cohesive body of knowledge that does not differ across contexts, and (4) critiquing bias in biomedical practice and science, especially in the marginalization of women's voices and in the racial and postcolonial trajectories of contemporary biomedicine. The paper discusses the theoretical importance of these four trajectories to the medical and health humanities, as well as the venues for inclusion of STS within coursework and programming at Case Western Reserve University. The paper also comments on how programming at other institutions might be adapted to incorporate STS scholarship. By drawing on numerous examples of research in the anthropology, sociology, history, and the philosophy of science, this article seeks to open a conversation about the value of science and technology studies to health humanities pedagogy.

Et system for studentevaluering av forelesninger ved medisinstudiet i Oslo

Students and education authorities are expressing an increasing demand for educational quality and student involvement in higher education. We present a descriptive observational study of a student-initiated system for evaluation of lectures in the medical degree programme at the University of Oslo. Criteria-based student evaluations of 445lectures in the first and second year of the medical degree programme were conducted in spring and autumn 2017 and spring 2018; after each lecture, three students completed a questionnaire about the lecture. The responses were sent by email to the lecturer on the same day. We performed an analysis of the evaluations, a group interview with the cohort's elected representatives, and a questionnaire survey among the lecturers who received an evaluation. The lecturers received generally good feedback, but the student evaluations also indicated a clear potential for improvement: 21% of the lectures were not adapted to the volume of information, 32% did not point out the association with the learning outcomes, 31% failed to activate the students and 40% did not provide a summary at the end of the lecture. The cohort's elected representatives had a positive attitude to the evaluation scheme, but requested a simpler technical solution. Almost all the lecturers welcomed the student evaluation, and more than half had used the evaluations to improve their lectures. This quality development project shows how students, teachers, administration and management can collaborate to improve the teaching.

Exploring Creativity in Medical Students: Themes and Media in a Compulsory Humanities Student Selected Component

Background: Humanities/arts modules are employed in medical education programmes with the aim of promoting reflection and creativity. The aim of this study was to examine media and themes chosen by students in a novel, compulsory, humanities Student Selected Component (SSC) with the aim of better understanding what influences students’ project choice at this point in their training. Methods: We studied 430 SSC projects (weighting equivalent to 2.5 ECTS credits) undertaken by students who had completed the first two years of a 4 year graduate entry medical degree program. Students’ work was qualitatively analysed, focusing on a number of themes and subthemes. Students have the option of a critique or producing an original work.Results: 99% of students produced original works (of which 85% were visual media, 10% written, 5% performing arts) while 1% were critiques. Descriptive analysis of the reflections identified six overarching themes as to why students chose particular projects: Biological (25.6%), Mental Health (11.9%), Life of the Student(14.4%), Life of the Doctor (15.8%), the Patient Experience/Perspective (12.6%) and Culture and Society(19.8%). There was a significant association between gender and choice of theme (p < 0.001) with female students more likely to choose the Patient Experience/Perspective and Culture and Society as a basis for their project than male students. Conclusion: The study demonstrates that students chose creative expression over critiques in self-selected media and themes related to medicine when motivated by a compulsory credited module. Gender rather than educational background influences themes chosen.

Opção sexual ou orientação sexual? A compreensão de professores de um curso de Medicina sobre sexualidade

Este artigo apresenta parte de resultados de um estudo que investigou a compreensão de docentes de um curso de Medicina sobre a dimensão humana da sexualidade para desvelar processos de educação sexual vividos numa proposta de currículo inovador. A pesquisa foi norteada pelo paradigma do materialismo histórico dialético que utiliza o método dialético para análise da realidade. Os instrumentos de coleta compreenderam questionários e entrevistas. A análise de conteúdo desvelou contradições na prática pedagógica, que representa vivências ancoradas na vertente médico-biológica somada ao paradigma da medicina científica. Como resultado, registrou-se o uso ainda constante das palavras “opção sexual”, “escolha sexual” e “homossexualismo”, o que sugere a compreensão da diversidade por abordagens biológicas, patologizantes e reducionistas. O fortalecimento da formação continuada e permanente dos docentes torna-se urgente e necessária. Contudo, as contradições também apontam para um curso vivo, dinâmico e em transição paradigmática, onde há possibilidades de se vivenciar com plenitude pedagógica processos de educação sexual numa abordagem emancipatória.&#x0D; Palavras-chave: Graduação em Medicina; Currículo integrado; Formação médica; Educação sexual emancipatória; Formação de professores