Paradigm In Medical Education Research Articles

Evidence-based educational algorithm “Anki” for optimization of medical education

Anki is an open-sourced educational platform that utilizes a spaced repetition-based algorithm for information retention. This application has become increasingly popular among medical students and residents over recent years. The aim of this review was to describe this novel education technique, provide reasons for its adoption, and summarize the available literature regarding the efficacy of this method. With the recent COVID-19 pandemic, the medical education paradigm has undergone dynamic shifts. With self-learning independent of lectures on the rise prior to the pandemic, COVID-19 served as a catalyst to increase Anki popularity. The all-encompassing, free of charge, and open-sourced structure of Anki was an ideal fit during times of isolated study. This review will allow current residents and medical students to recognize advantages of this evidence-proven study techniques to increase learning efficacy. A systemic review of papers across all medical journals available on PubMed was conducted to identify studies published without time constraints. The search was for (Anki) and (spaced repetition residency). Available outcome data was summarized and discussed for residents and medical students independently. We found that Anki use has steadily increased among both medical students and residents. The application was regarded highly by users when surveyed. Many studies showed a statistically significant increase in exam performance associated with Anki use and high levels of satisfaction among residents and medical students. As burnout and time constrictions threaten educational workflow, Anki may serve as a powerful tool to improve the quality of learning. Further data needs to be collected and analyzed in residency specialties where Anki use may already exist but be underreported. Additionally, research is warranted to provide more high-quality evidence of Anki’s efficacy among medical students. Further research can be used to promote adoption of this technique among medical students and pre-meds early in their careers.

More Than Survival: Embracing a New Paradigm in Medical Education.

More Than Survival: Embracing a New Paradigm in Medical Education.

The Impact of the Covid-19 Pandemic on the Education of Medical Students

The full-time education only was the traditional basic condition for the development of professional competencies of future health professionals. The COVID-19 pandemic, the digitalization of the medical field, and the effective global experience of distance learning have demonstrated the need to reengineer the established paradigm of medical education. The aim of the study was to assess the effectiveness of distance learning of Ukrainian medical students during the COVID-19 pandemic. The study involved content analysis, Computer Audio-Recorded Interviewing (CARI), face-to-face interviews, in-depth interviews, qualitative and quantitative analysis of the results of empirical research. Universal and specific problems of distance education are identified. The model of two-stage diagnostics of the state of distance education in medical vocational colleges of Ukraine (2020 - 2021) is presented. The results of the linear experiment showed a positive trend in: the quality of the Internet and the workplace arrangement of medical students (from 40% to 90%), special training in distance education technologies (from 13% to 74%), the use of unified educational platforms (from 39% to 100%), reduced stress level in students (from 100% to 60%), increased assessment objectivity (from 37% to 55%). Stereotypes about distance education as forced and ineffective in the development of practical skills (from 98% to 76%) remained steady. Online technologies in medical education require qualified scientific and methodological support of teaching. It is appropriate to develop and implement a national strategy, proven technologies of distance education for medical vocational colleges. The focus of further research is the development of reference models, distance education technologies that can provide effective training of mid-level medical staff.

Social Determinants, Risk Factors, and Needs: A New Paradigm for Medical Education.

COVID-19 and the escalation of racism and bias that has come in its wake have had a devastating impact on health professions students. In addition to academic challenges and personal health risks, aspects of students’ lives that have often gone unnoticed or inadequately addressed have come to light. Financial constraints that impact access to housing and food, neighborhood safety in light of the spike in hate crimes, and the bias inherent in the continuum from premedical education to undergraduate and graduate medical education are some examples. The authors believe that to better understand students’ lived experiences and determine how to best support them, the social determinants of health framework should be applied. This framework, the social determinants of education, encompasses concepts such as social risk factors and social needs in an effort to focus more intentionally on what can be done at a policy, institutional, and individual level. In response to the pandemic, the authors expanded their appreciation of students’ risk factors and needs by advancing the scope and refining the definitions of 3 key determinants: from well-being to the power of individual and communal resilience, from equity to centering racial justice, and from student health to public health and infection prevention. The authors propose applying this same paradigm to the lived experiences of staff in medical education, whose needs are often neglected in favor of students and faculty, and who, in many cases, were the most negatively impacted by COVID-19 of all the constituents in an academic health center.

Improving Medical Education in Hematology and Transfusion Medicine in Canada: Standards and Limitations.

The paradigm of medical education is evolving with the introduction of competency-based medical education (CBME) and it is crucial that residency programs adapt. In this paper, we provide an overview of the current status of medical education in Hematology in Canada including models of training, assessment methods, anticipated challenges, and the effects of the COVID-19 pandemic. We will also discuss additional training that can be pursued after a Hematology residency, with a particular focus On Transfusion Medicine as it was one of the first programs to implement a competency-based curriculum. Finally, we explore the future directions of medical education in Hematology and Transfusion Medicine.

Postgraduate medical education during the COVID-19 pandemic: lessons learned and calls to action for medical education leaders

The COVID-19 pandemic has led to a rapid transformation in the delivery of postgraduate medical education, causing unexpected effects on the learning experiences of residents in training. Program directors, as educational leaders, are relied on to adapt an established curriculum and clinical experience into a virtual world while navigating the limitations imposed by the pandemic. In this article, we focus on the impact of the dramatic changes to medical education delivery on both learners and leaders and examine the challenges and successes of the new strategies employed. A reflection of the importance of leadership in medical education is discussed, along with a review of the strategies that have emerged as successful and worthy of integration into our new medical education paradigm.

Simulation technologies in the modern paradigm of medical education: from general principles to use in teaching osteopathy

The article discusses the possibility of applying and using simulation training technologies in teaching osteopathy in residency programs, professional retraining in medical universities, and the methodology for constructing classes using simulation technologies.

The Flipped Classroom - Changing the Traditions in Medical Education

Medical education around the world is rapidly evolving which warrants a need for new and improved teaching methods. Many new models are being tested around the world to check for their efficacy in comparison to traditional classroom teaching. One of the most researched teaching models in the recent past is the 'flipped classroom model'. It has been labelled as the new paradigm for medical education.

Gamification as a tool to rise motivation of studying immunology in a medical university

Modern realities make us think about future doctor's motivation raising to study labor-intensive progressively developing disciplines including immunology. Understanding the immune mechanisms and their role in normal and pathological conditions requires students to have deep fundamental knowledge, analytical thinking and spatial representation of the processes occurring at the immune response. Creating a motivated competent personality of a doctor who is able to navigate quickly in a dynamically developing and updating information space, solve medical problems based on acquired competencies, and integrate knowledge and skills from fundamental disciplines to clinical practice is currently a paradigm of medical education. Introducing modern educational technologies, such as gamification (using the game in the educational process) into the pedagogical process increases significantly its effectiveness by raising the student involvement. This article reveals the design of the interactive digital quiz «General Immunology» created base on «Kahoot» service for test and educational project development, and reflects the research results of the game effect on learning and engagement. 112 students of the Medical Faculty of Northern State Medical University (Arkhangelsk) took part in the quiz, 67 (59.8 %) valid questionnaires with «feedback» were received. Most students (86.5 %) reported that the game was useful to study immunology and raised interest in the discipline. Respondents had a positive game perception in terms of fixing terminology in immunology (86.6 %), and structuring the material (86.1 %). Thus, introducing gamification technology can increase the student's motivation to study fundamental and clinical immunology, helps to structure the material and fix complex terminology.

E-learning in COVID 19 period: first year students’ perspective: a web-based Google form descriptive study

Background: The current COVID-19 pandemic has drastically changed the paradigm of medical education. Face-to-face mode of teaching was the basis of traditional medical education. In this crisis situation, e-learning has become the only method of education for continuous learning. In this study, we attempt to find out the students’ perspective of various aspects of e-learning.Methods: For the purpose of the study, a questionnaire was prepared to understand student’s attitude towards e-learning, their likes and dislikes about e-learning and also suggestions from their end to improve the existing modes of e-learning. The set of questionnaire (Google forms) along with informed consent was shared via whatsapp group at the end of physiology theory teaching session.Results: 175 first year MBBS students gave their consent and participated in this study. The most preferred method of e-learning was power-point with recorded narration and the least preferred method was live classes. Poor connectivity issue is the major challenge faced by the students in our study.Conclusions: In this COVID-19 era, the future of medical education has changed forever. E-learning is the new normal method of teaching. In order to be effective, students require support from Government, faculties and parents.

Hidden Costs in Resident Training: Financial Cohort Analysis of First Assistants in Reduction Mammaplasty.

Background:Graduate medical education (GME) programs are vital to developing future plastic surgeons. However, their cost-efficiency has yet to be contextualized. This cohort quality improvement (QI) project aimed to measure the indirect costs an institution assumes in training surgical residents, by comparing the differences in operative time and procedural charges between a resident and a physician assistant (PA) first-assisting during adolescent reduction mammaplasty.Methods:From 2013 to 2019, adolescent bilateral reduction mammaplasty procedures first-assisted by either a resident or physician assistant were considered for analysis. Financial data, including all hospital and physician expenditures and operation duration, patient demographics, and outcomes data were retrospectively collected.Results:A total of 49 reduction mammaplasty cases were included for analysis. Residents had an average of 5.9 ± 1.5 years of post-graduate surgical training, whereas the PA had 2 years of surgical experience. Procedures first-assisted by a surgical resident took a mean/median of 34 minutes longer and were $3750 more expensive, respectively, than cases first-assisted by a PA (P < 0.01, both).Conclusions:Reduction mammaplasty procedures were longer and accrued higher charges when first-assisted by a surgical resident than by a PA. Although Graduate Medical Education programs are necessary to train the next generation of surgeons, they may result in unintended opportunity costs for teaching hospitals. Federal support to academic medical centers aims to cushion the cost of residential training, but is insufficient to compensate for resident inefficiency. Hospitals may consider incorporating PAs into the Graduate Medical Education paradigm to alleviate administrative burden, lower operational charges, and enhance resident training curricula.

Evidence-Based Practice in Teacher Education: The Mediating Role of Self-Efficacy Beliefs and Practical Knowledge

European educational reforms call for the implementation of evidence-based teaching (EBT) in universities. Based on the evidence-based research paradigm in medical education, this study investigates the relationship between teacher educators' research experience, practical knowledge, self-efficacy beliefs, and frequency of EBT implementation. We report on survey data from N = 243 teacher educators from Germany, Austria, Switzerland, and the United Kingdom. A set of mediation analyses were run to identify the mediating role of self-efficacy beliefs and practical knowledge in the interplay among teacher educators' research experience and frequency of research evidence implementation. The results indicate that self-efficacy beliefs are a strong predictor of how frequently teacher educators implement EBT. Implications about the role of self-efficacy beliefs in teacher educators' professional learning and development along with future steps that are necessary to increase the implementation of EBT practices in teacher education will be discussed.

La responsabilidad social de las facultades de Medicina. Una exigencia inaplazable para adaptarse a las necesidades de la población

Social responsibility (SR) is a philosophy which starts to permeate the medical schools and drives the need to revise their mission in society and how to better contribute to its development for equity, participation, collaboration and social welfare values. We speak of the fact that medical schools must become aware of their obligations to satisfy the needs of society, as expressed by the global consensus in SR. In some countries, especially in the Anglo-Saxon ones, USA, Australia and Canada SR where has already being implemented. In Europe its implementation is still limited, except for some very specific cases in France and Belgium due to the Francophone Network. For some authors we are facing a change in the medical education paradigm which may have similar impact as the Flexner report in 1910, when a radical change took place, both in the training of the doctor and in the professional practice, which led to specialization and detriment of general medicine.The aim of this article is to clarify the concept, background and implications of SR in health science schools, as well as to present the main models developed up to now, all of them oriented to Primary and Community Care, a weakness that the COVID-19 pandemic has highlighted.

Assessing the knowledge, skills and effectiveness of e-learning among medical graduates amongst the COVID pandemic

Background: Introduction of e-learning as a new paradigm in medical education is gaining in the era of COVID pandemic as an alternative to traditional teaching where students and faculty skills are widely required in information and communication technology. Objectives were to assess the knowledge and attitude of medical students in application of e-learning in medical education. The level of satisfaction attained in gaining knowledge and availability of e resources were also assessed.Methods: A cross sectional online study was conducted for two months at Narayana medical college, Nellore among the medical graduates with a pre designed structured questionnaire after ethical committee approval. The questionnaire was designed to assess the Knowledge and attitude and was closed ended type. The questionnaire regarding level of satisfaction were assessed using 5-point Likert scale. The data was analysed by using SPSS version 17 and p valve&lt;0.05 was considered significant.Results: Total 200 medical students with 50 in each phase were selected with 42% males and 58% females. Smart phone was the commonest device used (54%). 68.5% were familiar with e-learning in medical education, 55% accessed regularly, 47% were using for assessment with majority in phase 4 students. 81% agreed e-learning definitely improves their overall academic performance and 83% their self-assessment.Conclusions: Students had positive attitude towards e-learning and accepted supplementation of e-learning in regular traditional teaching method. Majority were satisfied with clinical material provided, knowledge gained in practical and theoretical aspects by online lectures in various formats and professional assistance provided.

Incorporating a virtual curriculum into ophthalmology education in the coronavirus disease-2019 era

The purpose of this review is to describe the transition of ophthalmology education to a virtual curriculum during the COVID-19 pandemic. We highlight innovative solutions ophthalmic educators implemented for medical students, residents, and fellows. Clinical and surgical ophthalmology volume abruptly decreased in March 2020 as a result of the COVID-19 public health crisis. All didactics, grand rounds, and journal clubs shifted to an online format. Ophthalmic educators collaborated with other institutions in the United States and abroad on shared virtual curricula and seminars, and simulation-based training tools were better emphasized for surgical skill acquisition. We share the latest literature written by ophthalmic educators on successful adaptation of these new instructional strategies. The COVID-19 pandemic transformed ophthalmology education overnight and accelerated the adoption of innovative e-virtual learning resources for trainees. These changes will undoubtedly remain part of the new paradigm of medical education in the post-COVID era.

Formación científica en el pregrado de medicina en Chile: ¿dónde estamos? y ¿hacia dónde vamos?

For more than a century the training of medical professionals has been organized according to the Flexnerian model, which comprises three cycles: basic, clinical and clerkship. On the other hand, the accelerated development of biomedical sciences modified the competences of the first cycle. Additionally, new skills required for medical practice, such as teamwork and innovation as a tool to solve health problems, challenged in recent years the classic paradigm of medical education. Therefore, the medical schools have developed multiple strategies to deal with it, such as curricular integration using competency-based education models, incorporating basic and clinical sciences in parallel during the curriculum, ensuring a relevant and applicable scientific knowledge throughout the training process. Although in Chile the Flexner prototype is still followed, the basic sciences are taught as single or integrated courses or using a systems approach. In this article we report a diagnosis about the local integration of fundamental sciences in medical training. We also compare our schools with those of Canada, Europe and Latin America. Recommendations aimed at modernizing medical school curricula are made.

Behavior Change Theories: a New Medical Education Paradigm?

Abstract: A critical perspective on the importance of evidence-based behavior change theories for medical education is presented. Numerous theoretical models have been proposed to explain behavior changes, with two theories currently emerging as a new paradigm, namely the Behaviour Change Wheel (BCW) and the Prime Theory of Motivation. Behind this is the fact that these theories were proposed based on comprehensive literature review about explanatory models of behavioral changes, in addition to consensus among experts. The basic principle is that any change in behavior necessarily involves three interrelated aspects: capability, opportunity, and motivation. In the present essay, these theories were addressed with a view to problems involving behaviors in medical education, and emphasis on the problem of obsolete teaching practices in the training of health professionals. Assuming that good teachers have a global view of the teaching profession, and not merely of their specialty, interventions to change outdated teaching performances among health educators should start by understanding their motivation to change. It is also necessary to investigate their knowledge and skills about innovative teaching-learning methods (capability), as well as whether the environment supports methodological diversification and innovation (opportunity). In summary, evidence-based behavior change theories may represent a new paradigm for medical education when the goal involves overcoming behavioral problems.

Early Clinical Exposure in Physiology

In India, the medical council of India (MCI) has taken steps to implement competency-based undergraduate curriculum from 2019 throughout the country. In this new curriculum, MCI has recommended for introduction of Early Clinical Exposure (ECE), as part of training of 1st MBBS students.[1] ECE is a method adopted by medical educationists to foster exposure of medical students early in their first year in medical college to patients through genuine human contact, not through simulations. It is the new paradigm of medical education and training. It sounds easier to integrate basic science subjects for clinical years student as they can easily revert back to basic science subjects and further improve their competency levels. However, it is more challenging to introduce clinical years subjects into preclinical years which is the formative years for an undergraduate student to learn the basics and therefore overburdening with clinical disciplines has to be carefully avoided. ECE is an appropriate solution for this challenge. Life of a medical student in the very first year is both challenging and yet interesting. There is a demand of a comprehensive and integrated approach for solving the issues pertaining to practical skill-based knowledge in medicine. Therefore, the sooner the students are exposed to the reality of their profession, the better they will appreciate the role of first MBBS topics as the building blocks in their MBBS career.

Evidence-based medicine and problem based learning a critical re-evaluation.

Evidence-based medicine (EBM) has been the subject of controversy since it was introduced in 1992. However, it has yet to be critically examined as an alternative paradigm for medical education, which is how it was proposed. This commentary examines EBM on the terms on which it was originally advanced and within the context that gave rise to it, the problem-based learning (PBL) environment at McMaster University in the 1970s and 80s. The EBM educational prescription is revealed to be aligned with the information processing psychology (IPP) model of learning through acquisition of general problem solving skills that characterized the early McMaster version of PBL. The IPP model has been identified in the literature as discordant with an alternative, constructivist, model that emerged at Maastricht University in the Netherlands over the subsequent period. Strengths and weaknesses of EBM are identified from the standpoint of the underlying cognitive theories. Principles are proposed with which to guide an educationally viable approach to learning and teaching the valuable skills included within the original EBM formula.

How e-learning creates new opportunities in hospital settings? Innovations in a low resource setting

Background: E-learning and telemedicine have become common methods in changing and developing medical education and clinical processes. The purpose of this study was to describe the innovations of blending e-Learning into the educational and medical processes of hospital services Methods: The process of action research included plan, act, observation and reflection was followed. Implementation, which took 18 months, included purchasing and installing the required software and administration of new educational and medical processes. The result reflected in regional and national innovation councils among universities of medical sciences and minister of health and in Iran. Results: Incorporation of eLearning into medical and educational processes resulted in practical innovations. The first was setting up an e-clinic, which was formed based on virtual and online communication between the hospital's clinic and distant rural health centers. It prevented from unnecessary referrals and created an accountable paradigm of medical education based on a triple consultation between family physicians (GPs), specialists and patients in rural and urban communities. Another innovations were the development of a joint clinic of diabetes and ophthalmology specialists, running online medical classes, online morning reports meetings and holding OSCE using virtual reality technology. Moreover, with the establishment of virtual reality technology, novel productions in medical education also emerged. Conclusion: the result reveled eLearning and telemedicine create novel opportunities in health systems toward accountable education and improving both equity and efficiency in health service provision.