Medical Education In Europe Research Articles

International collaboration in health professions education

This article explores the essential elements for achieving excellence in international collaborations within health professions education (HPE), drawing on the Association for Medical Education in Europe (AMEE) ASPIRE Award criteria for International Collaboration. The International Collaboration award transcends recognition of excellence through the award; it aims to foster excellence in international HPE collaborations more broadly, by establishing a framework for evaluation and development that functions cross-culturally. This framework is based on five key elements that contribute to successful collaborations: mutually agreed goals; shared responsibilities and leadership structures; processes that support collaboration; demonstrated long-term impact and sustainability, and evaluation and practice sharing. Recognizing the historical context of unequal power dynamics in international partnerships, this article promotes the development of ethical and equitable collaborations. We advocate for integrating cultural competence, epistemic plurality, and leadership skills into HPE curricula to prepare future healthcare professionals for effective international collaboration.

Anatomy education during COVID-19 era: Evaluation of an anatomy blended course for medical students.

The COVID-19 pandemic has prompted a need to change traditional teaching methods. This study was conducted to evaluate the educational quality of a blended anatomy course and measure student satisfaction and knowledge after completing the course. Tyler's model was used to develop a new blended curriculum. The study guide for this curriculum was also developed using Association for Medical Education in Europe guide no. 16. A quasi-experimental study compared educational quality, students' satisfaction, and students' satisfaction using Students' Evaluations of Educational Quality (SEEQ), Borim Nejad's satisfaction survey, and multiple choice questions, respectively. Independent t-tests and Chi-square were used to compare the groups. A total of 122 students participated in this study, 62 and 60 in the intervention and control groups, respectively. The satisfaction score was significantly higher in the intervention group than in the control group (40.6 versus 38.6, P value = 0.03). The score of SEEQ was not significantly different (91.9 versus 91.08, P value = 0.52), but the subscales of learning (17.23 versus 16.32, P = 0.01), group interaction (16.87 versus 18.1, P = 0.01), and breadth (17.73 versus 16.65, P = 0.02) were significant. The knowledge score was also significantly higher in the intervention group than in the control group (18.13 versus 16.68, P value < 0.001). Using blended learning approaches for anatomy courses can increase students' satisfaction, improve the learning and breadth of educational quality subscales, but worsen group interaction. Although this study shows improvement in medical students' knowledge, further studies are needed because of the limitations of this study.

REFORMING THE MANAGEMENT OF THE SYSTEM OF CONTINUOUS MEDICAL EDUCATION

The article examines the continuous professional development of specialists in the field of health care as a gradual, cyclical, long-term process of updating professional knowledge, improving the professional competencies of medical specialists, which requires reforming its management. It was revealed that the integration of Ukraine into the European and world scientific and educational space involves the internationalization of education, which is actively discussed in scientific circles. Directions, goals, tasks, strategies, mechanisms of postgraduate education are defined. The essence, purpose, content and main tasks of postgraduate education are defined. The importance of ensuring the availability of post-graduate education for all applicants, regardless of their socioeconomic status, is substantiated. Measures for the stable development of postgraduate education are considered, the success of which depends on the solution of a number of problems, in particular such as: regulatory and legal support of the postgraduate education system; updating the content, forms, methods, technologies of education; optimization of the informatization process of postgraduate education; creation of a mechanism for stimulating specialists to continuous professional improvement of their knowledge and skills throughout their lives. The best practical models of medical education in Europe are characterized in order to clarify the issues of developing a strategy for the development of postgraduate education in Ukraine. It is substantiated that a reasonable step for raising the quality of post-graduate training of health care specialists is: carrying out systemic changes in postgraduate education that will meet modern global and European recommendations; coordination of activities with the main directives of the European Union and the World Federation of Medical Education; modernization of the material and technical base of educational institutions and internship bases; improvement of university hospitals. It was concluded that the development of the system of continuous professional training is a priority direction of state policy and it is important to provide high-quality and affordable education for everyone, oriented to the needs of the labor market and society.

Validation of the newly developed Advanced Practice Nurse Task Questionnaire: A national survey.

To describe psychometric validation of the newly developed Advanced Practice Nurse Task Questionnaire. Cross-sectional quantitative study. The development of the questionnaire followed an adapted version of the seven steps described in the guide by the Association for Medical Education in Europe. A nationwide online survey tested the construct and structural validity and internal consistency using an exploratory factor analysis, Cronbach's alpha coefficient and a Kruskal-Wallis test to compare the hypotheses. We received 222 questionnaires between January and September 2020. The factor analysis produced a seven-factor solution as suggested in Hamric's model. However, not all item loadings aligned with the framework's competencies. Cronbach's alpha of factors ranged between .795 and .879. The analysis confirmed the construct validity of the Advanced Practice Nurse Task Questionnaire. The tool was able to discriminate the competencies of guidance and coaching, direct clinical practice and leadership across the three advanced practice nurse roles clinical nurse specialist, nurse practitioner or blended role. A precise assessment of advanced practice nurse tasks is crucial in clinical practice and in research as it may be a basis for further refinement, implementation and evaluation of roles. The Advanced Practice Nurse Task Questionnaire is the first valid tool to assess tasks according to Hamric's model of competencies independently of the role or the setting. Additionally, it distinguishes the most common advanced practice nurse roles according to the degree of tasks in direct clinical practice and leadership. The tool may be applied in various countries, independent of the degree of implementation and understanding of advanced nursing practice. The STARD 2015 guideline was used to report the study. No patient or public contribution.

Under- and post-graduate training to manage the acutely unwell patient: a scoping review

BackgroundJunior doctors are often the first responders to acutely unwell patients and yet frequently report feeling under-prepared to do so. To understand whether this is consequential of how medical students and doctors are trained to manage acutely unwell patients, a scoping review was conducted using a systematic approach.MethodsThe review, informed by the Arksey and O’Malley and PRISMA-ScR guidelines, identified educational interventions targeting the management of acutely unwell adults. Seven major literature databases were searched for journal articles published in English from 2005 to 2022, in addition to the Association of Medical Education in Europe (AMEE) conference proceedings from 2014 to 2022.ResultsSeventy-three articles and abstracts were eligible for the review, the majority of which were from the UK or USA, and demonstrated that educational interventions were more commonly targeted at medical students than qualified doctors. The majority of studies used simulation, but very few integrated complexities of the clinical environment within scenarios such as multidisciplinary working, distraction-handling techniques and other non-technical skills. A wide range of learning objectives pertaining to acute patient management were stated across studies, but few explicitly cited educational theory underpinning their study.ConclusionsThe results of this review encourages future educational initiatives to consider enhancing authenticity within simulation to promote transfer of learning to clinical practice, and use educational theory to augment the sharing of educational approaches within the community of clinical education practice. Additionally, increasing the focus on post-graduate learning, building upon undergraduate educational foundations, is essential to promoting lifelong learning within the ever-changing healthcare environment.

A Changing Landscape for Lifelong Learning in Health Globally

ABSTRACTOn 25 July 2022, the Continuing Professional Development (CPD) Special Interest Group of the Association for Medical Education in Europe came together to open up discussions during a live webinar on ‘Exploring the Evolution of CPD’. The objective was to bring together global medical educators to consider perspectives of CPD from the role of global lifelong learners, the role of educators and the role of education providers and health regulators. The landscape of CPD is evolving, and the roles of each key player must include specific actions for facilitated change. Delivering competency outcomes-based learning, fit for purpose, to lifelong learners in health will require (1) learner agency, (2) leadership from educators and (3) providers of lifelong learning to come together to improve delivery of CPD that leads to meaningful change in practice care delivery.

A planetary health-organ system map to integrate climate change and health content into medical curricula.

A planetary health-organ system map to integrate climate change and health content into medical curricula.

What are the characteristics of excellent physicians and residents in the clinical workplace? A systematic review

ObjectivesIn order to recognise and facilitate the development of excellent medical doctors (physicians and residents), it is important to first identify the characteristics of excellence. Failure to recognising excellence causes...

Leveraging medical education resources to enhance instruction in accounting education

The objective of this paper is to provide an introduction to high-quality, practical, and evidence-based instructional resources from medical educators that can be adapted and adopted by accounting educators. The American Accounting Association (AAA) Pathways Commission Final Report set a goal of accounting becoming a learned profession by 2036. An AAA Presidential Scholar has advised that the achievement of this goal will require collaboration with other academic areas inside and beyond the business school. Responding to this call, this paper identifies a subset of Association for Medical Education in Europe (AMEE) Medical Education Guides that are relevant to accounting educators interested in problem-based learning (PBL), team-based learning (TBL), peer assisted learning (PAL) and reflection. Other opportunities for application of the medical resources to faculty responsibilities in teaching, research and service are shared to encourage accounting educators to learn from a well-established learned profession.

Perception of Pharmacy Teachers About Their Roles and Current Practice at Governmental Universities in Sudan.

BackgroundPharmacy educator has a number of roles and responsibilities, an information provider, clinical trainer, role model on-the-job, formal teaching settings, course planner and resource material creator, student assessor, and curriculum evaluator.ObjectiveThis study aimed to assess the perception and commitment of pharmacy teachers in Sudanese governmental universities about their roles and educational responsibilities.Materials and MethodsDescriptive cross-sectional study was conducted at governmental pharmacy colleges in Sudan from November 2020 to July 2021. Data were collected using an online self-administered questionnaire adapted from the Association for Medical Education in Europe (AMEE) Guide No. 20. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 26 and Microsoft Excel version 16.ResultsOut of 125 participants, 61.6% were female and 65.6% were lecturers. Approximately half of them had less than five years’ experience. The most important role perceived and the highest committed one was a lecturer in the classroom setting. Only half of the participants had good perceptions and commitment regarding teachers’ roles. Age, designation, and continuous professional development were significantly associated with participants’ commitment. Also, a significant association was found between the perception and practice of the participants.ConclusionOnly half of pharmacy educators were found to have a good perception and good commitment regarding their role as teachers.

Strategies for developing pre-clinical medical students' clinical reasoning based on illness script formation: a systematic review.

Clinical reasoning training in the pre-clinical phase has recently been considered important; however, when it comes to specific instructional methods for pre-clinical students, much is unknown. Thus, the aim of this review is to explore learning and teaching methods for pre-clinical students’ clinical reasoning development based on illness script formation, their results, and strategies. A systematic review was conducted in accordance with the guidelines of the Association for Medical Education in Europe. The literature search was performed using the Cochrane Library, PubMed, EMBASE, Web of Science, and ERIC databases based on keywords, including “illness script*” AND (“medical student*” OR pre-clinical OR undergraduate). Then, 10 studies among the 91 studies were included in the final analysis. The quality of the selected studies was also appraised using the Medical Education Research Study Quality Instrument. Diverse teaching and learning methods were used to support the integration of biomedical and clinical knowledge working with patient cases, and their effects were assessed through diverse methods, including illness script richness and maturity, to learner responses. The effects of these interventions were effective in terms of the clinical reasoning development of pre-clinical students. Learning and teaching strategies were synthesized and described. This review found that explicit attempts to promote illness script formation with a structured program rather than informal training lead to positive results, and such formal clinical reasoning programs can provide smooth transition from pre-clinical to clinical experience.

What sparks a guide on the side? A qualitative study to explore motivations and approaches of mentors in health professions education

Introduction Despite abundant research emphasising the value of mentoring for healthcare professionals, little is known about what motivates mentors. This study aimed to explore what motivated a group of internationally renowned health professions educators to accept informal, international and mostly online mentoring roles, and their approaches to that mentoring. Methods Using a qualitative approach, we interviewed ten global educational leaders, who volunteered to serve as mentors in an initiative implemented by the Association for Medical Education in Europe in 2019, via Zoom. The hour-long interviews, conducted between May and October 2019, were audiotaped and transcribed on Zoom. De-identified transcripts were analysed for key themes. Results The key themes identified could be mapped to three categories, Motivations – Why; Approaches – How, and Global and virtual mentoring – What. Themes under motivations included: (1) Nurturing relationships focussed on mentees’ growth; (2) Pass on the benefit of one’s experience; (3) For one’s own continued growth. Themes under approaches included: (1) Provide a safe space; (2) Encourage mentees to take ownership of their professional development. Themes under global and virtual mentoring included: (1) Mentoring across geographical borders is still about relationships; (2) Virtual mentoring is not a barrier to relationship building. Discussion Though mentors also saw own growth and ongoing professional development as an important benefit of mentoring, altruism or the desire to benefit others, appeared to be a key motivating factor for them. Finding ways in which to identify mentors who are passionate about strengthening the field in this way – for example through reflective narratives and critical conversations – could be key when implementing mentoring initiatives.

European Medical Education Initiative on Noonan syndrome: A clinical practice survey assessing the diagnosis and clinical management of individuals with Noonan syndrome across Europe

IntroductionNoonan syndrome (NS) is a rare genetic disorder caused by mutations in genes encoding components of the RAS/mitogen-activated protein kinase (MAPK) signalling pathway. Patients with NS exhibit certain characteristic features, including cardiac defects, short stature, distinctive facial appearance, skeletal abnormalities, cognitive deficits, and predisposition to certain cancers. Here, a clinical practice survey was developed to learn more about differences in the diagnosis and management of this disease across Europe. The aim was to identify gaps in the knowledge and management of this rare disorder. Materials and methodsThe European Medical Education Initiative on NS, which comprised a group of 10 experts, developed a 60-question clinical practice survey to gather information from European physicians on the diagnosis and clinical management of patients with diseases in the NS phenotypic spectrum. Physicians from three specialities (clinical genetics, paediatric endocrinology, paediatric cardiology) were invited to complete the survey by several national and European societies. Differences in answers provided by respondents between specialities and countries were analysed using contingency tables and the Chi-Squared test for independence. The Friedman's test was used for related samples. ResultsData were analysed from 364 respondents from 20 European countries. Most respondents came from France (21%), Spain (18%), Germany (16%), Italy (15%), United Kingdom (8%) and the Czech Republic (6%). Respondents were distributed evenly across three specialities: clinical genetics (30%), paediatric endocrinology (40%) and paediatric cardiology (30%). Care practices were generally aligned across the countries participating in the survey. Delayed diagnosis did not emerge as a critical issue, but certain unmet needs were identified, including transition of young patients to adult medical services and awareness of family support groups. ConclusionData collected from this survey provide a comprehensive summary of the diagnosis and clinical management practices for patients with NS across different European countries.

AMEE Consensus Statement: Planetary health and education for sustainable healthcare

The purpose of this Consensus Statement is to provide a global, collaborative, representative and inclusive vision for educating an interprofessional healthcare workforce that can deliver sustainable healthcare and promote planetary health. It is intended to inform national and global accreditation standards, planning and action at the institutional level as well as highlight the role of individuals in transforming health professions education. Many countries have agreed to ‘rapid, far-reaching and unprecedented changes’ to reduce greenhouse gas emissions by 45% within 10 years and achieve carbon neutrality by 2050, including in healthcare. Currently, however, health professions graduates are not prepared for their roles in achieving these changes. Thus, to reduce emissions and meet the 2030 Sustainable Development Goals (SDGs), health professions education must equip undergraduates, and those already qualified, with the knowledge, skills, values, competence and confidence they need to sustainably promote the health, human rights and well-being of current and future generations, while protecting the health of the planet. The current imperative for action on environmental issues such as climate change requires health professionals to mobilize politically as they have before, becoming strong advocates for major environmental, social and economic change. A truly ethical relationship with people and the planet that we inhabit so precariously, and to guarantee a future for the generations which follow, demands nothing less of all health professionals. This Consensus Statement outlines the changes required in health professions education, approaches to achieve these changes and a timeline for action linked to the internationally agreed SDGs. It represents the collective vision of health professionals, educators and students from various health professions, geographic locations and cultures. ‘Consensus’ implies broad agreement amongst all individuals engaged in discussion on a specific issue, which in this instance, is agreement by all signatories of this Statement developed under the auspices of the Association for Medical Education in Europe (AMEE). To ensure a shared understanding and to accurately convey information, we outline key terms in a glossary which accompanies this Consensus Statement (Supplementary Appendix 1). We acknowledge, however, that terms evolve and that different terms resonate variably depending on factors such as setting and audience. We define education for sustainable healthcare as the process of equipping current and future health professionals with the knowledge, values, confidence and capacity to provide environmentally sustainable services through health professions education. We define a health professional as a person who has gained a professional qualification for work in the health system, whether in healthcare delivery, public health or a management or supporting role and education as ‘the system comprising structures, curricula, faculty and activities contributing to a learning process’. This Statement is relevant to the full continuum of training – from undergraduate to postgraduate and continuing professional development.

Performance assessment: Consensus statement and recommendations from the 2020 Ottawa Conference

Introduction In 2011 the Consensus Statement on Performance Assessment was published in Medical Teacher. That paper was commissioned by AMEE (Association for Medical Education in Europe) as part of the series of Consensus Statements following the 2010 Ottawa Conference. In 2019, it was recommended that a working group be reconvened to review and consider developments in performance assessment since the 2011 publication. Methods Following review of the original recommendations in the 2011 paper and shifts in the field across the past 10 years, the group identified areas of consensus and yet to be resolved issues for performance assessment. Results and discussion This paper addresses developments in performance assessment since 2011, reiterates relevant aspects of the 2011 paper, and summarises contemporary best practice recommendations for OSCEs and WBAs, fit-for-purpose methods for performance assessment in the health professions.

Twelve tips for facilitating and implementing clinical debriefing programmes

Contemporary clinical practice places a high demand on healthcare workforces due to complexity and rapid evolution of guidelines. We need embedded workplace practices such as clinical debriefing (CD) to support everyday learning and patient care. Debriefing, defined as a ‘guided reflective learning conversation’, is most often undertaken in small groups following simulation-based experiences. However, emerging evidence suggests that debriefing may also enhance learning in clinical environments where facilitators need to simultaneously balance psychological safety, learning goals and emotional well-being. This twelve tips article summarises international experience collated at the recent Association for Medical Education in Europe (AMEE) debriefing symposium. These tips encompass the benefits of CD, as well as suggested approach to facilitation. Successful CD programmes are frequently team focussed, interdisciplinary, implemented in stages and use a clear structure.

Florida International University Herbert Wertheim College of Medicine.

Florida International University Herbert Wertheim College of Medicine.

Test Items Validation in the Context of Education Export

It is necessary to develop special assessment tools for international students, which will comply with the principles of evidence-based education. This is especially important in the context of Russian higher education export. Multiple choice questions (MCQs) are an essential part of the assessment and are suited for assessing the knowledge level of international students. The “Organic chemistry” is a basic course for pharmaceutical students, which is necessary for the understanding of principal subjects. The study objective was to develop a normative-oriented model of the “Organic chemistry” MCQs based examination for international students (the specialty 33.05.01 “Pharmacy”) in accordance with the recommendations of the Association for Medical Education in Europe (AMEE). The previously developed interactive “Organic Chemistry Test Simulator”, created at the Sechenov University, was used as the basis for the examination MSQs bank. It was analyzed by five independent experts, who work as teachers of organic chemistry. The average timing and the cut score were determined by the Angoff method, 90 sec and 64%, respectively. Among analyzed MCQs the 3% were found irrelevant, 22% were recommended for revision and modernization. Valid MSCs (600 items) served as the basis for the creation of extended examination MSQs bank. An algorithm for modeling the “Organic chemistry” MCQs based examination was proposed. The standardized examination test has 30 MSQs of different types. The standardized normative-oriented model of the “Organic chemistry” MCQs based examination for international students (the specialty 33.05.01 “Pharmacy”) was validated in terms of relevance and representativeness, optimized in time and cut score.

Helping medical educators worldwide to pivot curricula online: pivotmeded.com.

The coronavirus disease 2019 (COVID-19) pandemic has resulted in the implementation of restrictions on group gatherings and educational events in many countries, creating imperatives for medical educators to move curricula online at short notice. Within medical schools and health sciences programmes, this urgency was compounded by competing priorities of health care delivery as many medical educators are also clinicians. To support medical educators, faculty development leaders in Canadian medical schools (FacDevCanada) collaborated to curate medical education resources in three categories: guidance on pivoting to online curriculum (classroom and clinical) delivery; discipline-specific learning resources, and general resources (including basic science, Indigenous health, patient safety and leadership development resources). The FacDevCanada developed PIVOTMeded (Partners in Virtual and Online Teaching in Medical Education), found at pivotmeded.com. Members of FacDevCanada crowdsourced resources in the three categories described above. Resource nominations were reviewed according to the following criteria: open accessibility; lack of evident bias; lack of (or minimal) personal information gathering, and relevance to the likely needs of learners and medical educators. A Google Site platform (Google LLC, Mountain View, CA, USA) was utilised in view of: (a) the platform's relative programming ease; (b) user navigation ease; (c) the platform's facilitation of responsive and dynamic displays compatible with computers, tablets and mobile devices, and (d) the curators' familiarity with the platform. Initially, one person reviewed nominations from contributors and sought materials for inclusion. Two additional medical educators with adeptness in curating resources and configuring the website became co-editors. Two administrative staff supported resource posting and website maintenance. Each resource's post includes a link and a customised annotation. PIVOTMeded launched on 17 March 2020. By 28 April (at the time of writing), the site had 2007 unique users. This indicates a high rate of utilisation; in comparison, a well-established open-access resource for family medicine educators, ‘learnfm.ca,’1 had 1265 unique users in the same 6 weeks. To date, we have curated 84 open-access resources, which support medical educators to pivot curricula online. Content comes from a variety of authors and multiple countries. Users come from 74 countries; the largest cohorts are from Canada (48%) and the USA (24%), followed by Portugal, the United Kingdom and Mexico (3% each). Half of website users visited directly (eg, by typing ‘pivotmeded.com’ into a browser), which suggests awareness of this website by name. One-third of users came through social media links and posts by individuals and organisations including the Association for Medical Education in Europe, the Royal College of Physicians and Surgeons of Canada, the College of Family Physicians of Canada, the Harvard Macy Institute, and faculty development units (all utilisation data from Google Analytics [Google LLC, Mountain View, CA, USA]). Key lessons learned refer to: (a) the value of an easily memorable name and URL (uniform resource locator) for this kind of project; (b) the importance of curating site content selectively rather than providing links to a large number of resources (as evidenced by spontaneous feedback and tweets about our project); (c) the need to have multiple people collaborate on this type of project (to ensure high-quality curation within a tight time frame), and (d) the value of tweets, posts and emails from established individuals and organisations in building awareness. Beyond COVID-19, pivotmeded.com will continue to curate open-access materials supporting online medical education.

E-Learning and E-Assessement: Two Big Challenges of Medical Education Management in Romania

Background – digitalization in eastern European medical education is a stringent need of teaching and assessment processes, which must be updated to challenges continuously launched by medical students. In this context, our university implemented an e-learning and e-assessment system in histology, a preclinical education subject. Aim – to evaluate the impact of replacing a classic learning and assessment methods with a completely digitized one. Methodology – the new system impact on students’ skills and teacher’s performance, was evaluated by using an opinion pool questionnaire including as assessment criteria system compliance, student-teacher interaction, online access improvement and new facilities regarding e-assessment and time management was performed. Results – “computer gaming” was delightful for students. Management of information’s given to students was improved by a higher standardization and this, helped them to pass evaluations easier. Better stress management of examination induced the increase of attendance to first presentation. Graduation percentage and students’ confidence in the accuracy of the exam results were improved. Time for evaluation was significantly reduced giving to teachers the opportunity for a better management of their time dedicated to research or academic development. Teaching and exam module software was periodically updated, being adapted to our curriculum. Conclusions – e-learning and e-assessment had a quick positive impact on students and teacher’s despite of controversial issues which commonly come with any change