Undergraduate Medical Program Research Articles

Defining a set of teaching EPAs tailored to an undergraduate medical curriculum using a modified Delphi approach

BackgroundThe concept of entrustable professional activities (EPAs) has recently been extended to operationalize professional tasks in teacher training and faculty development in health professions education. The aim of this study is to report on the process and results of defining a set of teaching EPAs (t-EPAs) tailored to the local characteristics of a particular undergraduate medical program.MethodsThe undergraduate medical program at the Charité – Universitätsmedizin Berlin is competency-based, integrates thematic modules and spans 6 years. A writing team identified teaching EPAs based on the program’s study regulations and drafted content descriptions with titles, specifications and knowledge, skills and attitudes. Content validation involved a modified Delphi procedure with a systematic, iterative interaction between a panel of content experts consisting of purposively selected educators and physicians from our faculty (n = 11) and the writing team. The threshold for a consensus was an agreement of 80% of the participants.ResultsAfter two Delphi rounds, a consensus was reached regarding the teaching activities to be included and their content descriptions. The response rate was 100% in both Delphi rounds. The Delphi results include the content descriptions of a total of 13 teaching EPAs, organized into the two overarching EPA domains of classroom-based (n = 10) and workplace-based (n = 3) activities. Tailoring the classroom EPAs to small group teaching and the workplace EPAs to supervising medical students led to several distinct EPAs. Another feature was the development of 2 teaching EPAs for interdisciplinary teaching.ConclusionsIn systematic, Delphi-based process, we defined a set of 13 distinct teaching EPAs tailored to a specific undergraduate medical program that cover the core teaching tasks for faculty in this program. Our report on the principles of the process and the results may guide other medical schools and educators in defining and tailoring teaching EPAs according to their contexts.

Development of a rural strategy for an urban-based medical program: a pragmatic reality.

Health disparities between rural and urban areas in Aotearoa New Zealand are exacerbated by rural workforce issues. Traditionally, undergraduate medical programs are urban-based, and reconfiguring the curriculum to meet the needs of rural communities is challenging. The aim of this project is explore how urban-located universities might develop and implement a rural strategy. Evaluation of a rural strategy may lead to the strategy's ongoing improvements designed to increase the rural workforce. This is a qualitative study involving semi-structured interviews with purposively selected key stakeholders. Enquiry included the systematic identification of processes required to develop a rural strategy, including possible facilitators and challenges to be addressed. Qualitative analysis of de-identified data was conducted using a thematic approach. Fourteen stakeholders were interviewed: four rural GPs, two rural hospital doctors, four administrators involved in placing students, and four senior medical academics with involvement in the regional and rural programs. Five overarching themes were identified: (1) developing rural pathways into medical school, (2) improving and expanding rural exposures, (3) developing rural GP pathways, (4) implementing interprofessional education and (5) having a social mission. These findings align with the literature relating to developing rural strategies for universities. However, this study also suggested that rural health interprofessional programs may have a role. A key finding was that the social mission of a university may not be visible to rural stakeholders. Reorientating an urban-located university to having a rural strategy requires moving past having policy around social accountability to operationalising it.

The impact of accreditation on continuous quality improvement process in undergraduate medical education programs: A scoping review

Background Accreditation in medical education has existed for more than 100 years, yet the impact of accreditation remains inconclusive. Some studies have shown the effects of accreditation on student outcomes and educational processes at medical schools. However, evidence showing the impact of accreditation on continuous quality improvement of undergraduate medical education programs is still in its infancy. This scoping review explores the impact of accreditation on continuous quality improvement (CQI). Methods This scoping review followed the methodology of the Preferred Reporting Items of Systematic Reviews and the Meta-Analysis extension for scoping reviews (PRISMA-ScR) checklist outlined by Arksey and O'Malley (2005). Databases, including PubMed, Medline, ERIC, CINHAL, and Google Scholar, were searched to find articles from 2000 to 2022 related to the accreditation of undergraduate medical education programs and continuous quality improvement. Results A total of 35 full-text articles were reviewed, and ten articles met our inclusion criteria. The quality assurance approach is based on meeting the standards of accreditation. The quality improvement approach is based on striving for excellence. Literature suggests a requirement to move from student outcomes to CQI measures. CQI requires everyone in the organization to take responsibility and accountability, considering quality as the result of every single step or process and leaders supporting improvements in data collection and data analysis for quality improvement. Conclusions The literature on accreditation and CQI are limited in number. More research studies are required to enhance undergraduate medical education accreditation practices' value to medical students, educators, academic leaders, programs, and the public. It was recommended that medical schools embrace the culture and vision perpetuated by the CQI process.

Clinical supervisors’ experience of a first-time application of entrustable professional activities in clinical supervision of medical students: findings from a Swedish pilot study

BackgroundRecently, all medical universities in Sweden jointly developed a framework for Entrustable Professional Activities (EPAs) for work-based training and assessment. This framework is now being introduced nationally in the new 6-year undergraduate medical programme that directly lead to a licence to practise. When EPAs are introduced, it is of central importance to gain clinical supervisors’ acceptance to apply the framework in their supervision of students. The aim of this study was therefore to investigate how clinical supervisors, not familiar with EPAs, experience clinical supervision using the framework for EPAs.MethodsWe used a purposive sampling to recruit clinical supervisors. They were given written information on EPAs with a selection of suitable EPAs and the Swedish observation rating scale for assessment of autonomy, and they were offered to attend a 30-minute introductory web course. The participants were informed that EPAs were to be tested, and the students were asked to participate. After the study period the clinical supervisors participated in semi-structured interviews. Inductive qualitative content analysis was used to analyse the transcribed interviews.ResultsThree general themes emerged in the qualitative analysis: Promoting Feedback, Trusting Assessments and Engaging Stakeholders. The participants described benefits from using EPAs, but pointed out a need for preparation and adaptation to facilitate implementation. The structure was perceived to provide structured support for feedback, student involvement, entrustment decisions, enabling supervisors to allow the students to do more things independently, although some expressed caution to rely on others’ assessments. Another concern was whether assessments of EPAs would be perceived as a form of examination, steeling focus from formative feedback. To understand the concept of EPA, the short web-based course and written information was regarded as sufficient. However, concern was expressed whether EPA could be applied by all clinical supervisors. Involvement and adaption of the workplace was pointed out as important since more frequent observation and feedback, with documentation requirements, increase the time required for supervision.ConclusionsEPAs were accepted as beneficial, promoting structured feedback and assessments of the students’ autonomy. Preparation of supervisors and students as well as involvement and adaptation of the workplace was pointed out as important.

Sociocultural factors affecting first-year medical students' adjustment to a PBL program at an African medical school.

Besides regulatory learning skills, learning also requires students to relate to their social context and negotiate it as they transition and adjust to medical training. As such, there is a need to consider and explore the role of social and cultural aspects in student learning, particularly in problem-based learning, where the learning paradigm differs from what most students have previously experienced. In this article, we report on the findings of a study exploring first-year medical students' experiences during the first semester of an undergraduate problem-based learning medical program at an African medical school. We employed a qualitative case study approach using in-depth interviews with 23 first-year medical students. Participants ranged in age from 18 to 25 years. All students were bi/multilingual (some spoke three to five languages), with English as the learning language. We conducted an inductive thematic analysis to systematically identify and analyze patterns in the data using the Braun and Clarke framework. Before medical school, students worked hard to compete for admission to medical school, were primarily taught using a teacher-centered approach, and preferred working alone. At the beginning of medical school, students found it challenging to understand the problem-based learning process, the role of the case, speaking and working effectively in a group, managing a heavy workload, and taking increased responsibility for their learning. By the end of the first semester, most students were handling the workload better, were more comfortable with their peers and facilitators, and appreciated the value of the problem-based learning approach. Our study highlights the importance of interrogating contextual sociocultural factors that could cause tension when implementing problem-based learning in non-western medical schools. Adjustment to problem-based learning requires a conceptual and pedagogic shift towards learner-centered practice, particularly concerning self-direction, the role of the case, and collaborative learning. As such, there is a need to develop and implement research-informed learning development programs that enable students to reflect on their sociocultural beliefs and practices, and enhance their regulatory learning competence to optimize meaningful and early engagement with the problem-based learning process.

Neurosonology Survey in Europe and Beyond.

Purpose To provide an overview on education, training, practice requirements, and fields of application of neurosonology in Europe and beyond. Materials and Methods National representatives and experts in neurosonology were surveyed regarding neurosonology requirements and practice in their countries. Descriptive statistics were used to report the data. Results Between February 1 and March 31, 2023, 42/46 (91.3%) national representatives responded to our questionnaire and the completion rate was 100%. Most countries (71.4%) offer a neurosonology training program during neurology residency, but it is part of the undergraduate medical program only in 30.9%. National certification is available in 47.6% of the countries surveyed and most countries (76.2%) require certification to practice. In 50% of the countries, candidates are assessed by a board examination, while in 26.2% they just need to document their practice. There is no formal accreditation of neurosonology centers in 78.6% of the countries surveyed. Only a few require certified personnel and appropriate equipment. Adequate teaching and research activities are only rarely necessary elements for laboratory accreditation. Conclusion Our results indicate that there is a substantial need for transnational harmonization of neurosonological standards to guarantee uniformity and quality of performance. This survey will also provide guidance to promote an international accrediting council and create a quality-controlled laboratory network for implementing neurosonology in clinical trials.

Examining the Efficacy of ChatGPT in Marking Short-Answer Assessments in an Undergraduate Medical Program

Traditional approaches to marking short-answer questions face limitations in timeliness, scalability, inter-rater reliability, and faculty time costs. Harnessing generative artificial intelligence (AI) to address some of these shortcomings is attractive. This study aims to validate the use of ChatGPT for evaluating short-answer assessments in an undergraduate medical program. Ten questions from the pre-clerkship medical curriculum were randomly chosen, and for each, six previously marked student answers were collected. These sixty answers were evaluated by ChatGPT in July 2023 under four conditions: with both a rubric and standard, with only a standard, with only a rubric, and with neither. ChatGPT displayed good Spearman correlations with a single human assessor (r = 0.6–0.7, p < 0.001) across all conditions, with the absence of a standard or rubric yielding the best correlation. Scoring differences were common (65–80%), but score adjustments of more than one point were less frequent (20–38%). Notably, the absence of a rubric resulted in systematically higher scores (p < 0.001, partial η2 = 0.33). Our findings demonstrate that ChatGPT is a viable, though imperfect, assistant to human assessment, performing comparably to a single expert assessor. This study serves as a foundation for future research on AI-based assessment techniques with potential for further optimization and increased reliability.

A Journey of Innovation: 40years of Pioneering Medical Education at the Aga Khan University Medical College in Karachi, Pakistan.

This article presents an overview of Aga Khan University's (AKU) pioneering medical education initiatives over the past 40years, exploring its impact on healthcare in the region and its commitment to advancing medical education and research in the developing world. Established in 1983 as the first private university in Pakistan, AKU has evolved into a global institution with a focus on improving healthcare standards and addressing healthcare needs in the developing world. The article also discusses the undergraduate and postgraduate medical education programs at AKU Medical College, Pakistan, highlighting their unique features and pioneering approaches to medical education. The institution's journey highlights its ability to adapt to the evolving healthcare landscape while maintaining a focus on quality and excellence, offering a model for other institutions striving to meet healthcare needs in low- and middle-income countries.

Inadequacies in Undergraduate Musculoskeletal Education - A Survey of Nationally Accredited Allopathic Medical Programs in Canada.

To document the current state of MSK medicine education across nationally accredited undergraduate medical programs. A cross-sectional survey design was used to gather curricular data on three MSK themes: 1) anatomy education; 2) preclinical education; and 3) clerkship education. The survey had a 100% response rate with all 14 english language medical schools in Canada responding. The mean time spent teaching MSK anatomy was 29.8 hours (SD ± 13.7, range 12 - 60), with all but one program using some form of cadaveric-based instruction. MSK preclinical curricula averaged 58.0 hours (SD ± 53.4, range 6 - 204), with didactic lectures, case-based learning, and small group tutorials being the most common modes of instruction. Curricular content varied greatly, with only 25% of "core or must-know" MSK topics being covered in detail by all programs. MSK training in clerkship was required by only 50% of programs, most commonly being two-weeks in duration. Results document the large variability and curricular inadequacies that exist in MSK education across nationally accredited allopathic programs and highlight the need for the identification and implementation of more consistent MSK curricular content and educational standards by all nationally accredited medical programs.

Obsessive-Compulsive Disorder: A Medical School Curriculum and Textbook Review.

We conducted a curriculum review of Canadian undergraduate medical programs to identify why aggressive obsessions (among those with obsessive-compulsive disorder [OCD]) are so often misidentified by primary care physicians and professional students. This study involved standardized interviews with representatives from Canadian medical schools regarding the content, time, and teaching styles used to deliver curricula related to OCD. Further, we utilized a set of standardized criteria to assess the OCD content of recommended textbooks from these schools. Canadian medical curricula failed to provide a comprehensive picture of OCD. One-third of medical programs did not provide an example of aggressive obsessions to students, with textbook case examples centered heavily (70%) on contamination or symmetry. Only 25% of programs (and 60% of textbooks) discussed the composition of the Unacceptable Thought Domain to include aggressive, sexual, and religious obsessions. Finally, over half of medical programs failed to indicate that aggressive obsessions are ego-dystonic and do not lead people to harm themselves or others. A series of recommendations are provided for medical schools intended to improve the comprehensiveness of OCD-related training.

Chronotype, Eating Habits, and Body Mass Index in First-Year Undergraduate Medical Program Students

This cross-sectional study aimed to identify the correlation between chronotype and body mass index (BMI) in medical students, mediated by energy intake, and to explore eating habits. There were 46 participants who completed Morningness-Eveningness Questionnaire and Chrononutrition-Profile Questionnaire in the Indonesia version and a 3 days of 24-hour food record. Participants’ weight and height were measured by microtoise and digital body weight scale. Additionally, univariate and correlation analyses were conducted to identify the correlation of the variables. The study found no significant difference in the correlation between chronotype preference and BMI, chronotype preference and energy intake, and BMI and energy intake. Medical students had a habit of eating breakfast, even skipping breakfast, having dinner later, consuming the highest energy at lunchtime, and consuming high-calorie, high-fat, and high-sugar foods at night. The study revealed no significant correlation between chronotype, eating habits, and BMI. However, the eveningness medical students have bad eating habits.

Exploration of Clinical Clerkship Remediation in Undergraduate Medical Programme during the COVID-19 Pandemic

Medical students in their clinical phase face various academic and non-academic challenges affecting their achievement of expected competencies. Medical students who fail competency assessments are encouraged to enrol in a remediation programme. Due to COVID-19, remediation learning activities have been altered to distance learning. Unfortunately, studies on clinical remediation programmes are scarce. This study aims to explore the clinical clerkship remediation process during the COVID-19 pandemic to provide a reference for developing appropriate remediation programmes. This is a qualitative study with a phenomenological design. The remediation process was explored through focus group discussions (FGDs) and in-depth interviews. Five FGDs with regular students, five FGDs with remedial students, five in-depth interviews with clinical lecturers and five in-depth interviews with education coordinators were completed. Four themes were identified from the gathered data: academic and non-academic factors influencing the need for remediation, planning, learning activities and assessment, and evaluation of learning processes and outcomes. Remediation during the clinical phase comprises several critical steps, and following the remediation process, students demonstrated improved performance. To improve the quality of the remediation process, the factors underlying the need for remediation should be determined.

Development of Core Entrustable Professional Activities for Indonesian Undergraduate Medical Education: The Experience of Universitas Muhammadiyah Jakarta

Indonesia has implemented Competency-Based Education (CBE) since 2006 based on a national standard for physician competencies. This study aimed to develop Core Entrustable Professional Activities (EPAs) for Indonesian undergraduate medical programs to remedy the challenge of translating competencies into professional activities in CBE. Two rounds of modified Delphi were employed in October-November 2022. The research subjects selected were (i) experts in medicine such as internal medicine, surgery, medical education, etc., and (ii) medical teachers in the preclinical/clinical stage for two years or more. Fifteen experts were involved in both Delphi rounds. The first Delphi instrument referring to literature frameworks included 34 professional activities for individual healthcare tasks and 17 for family-community medicine/public health. The second Delphi instruments used were based on the first-round results. After the first Delphi, 31 individual healthcare tasks and all family-community medicine/public health tasks reached a consensus. One expert suggested two additional family-community medicine/public health activities. The second Delphi instrument listed the percentage of agreement for individual healthcare tasks and family-community medicine/public health tasks, including the two additional activities. After the second-round of Delphi, two individual healthcare tasks and one family-community medicine/public health task had not reached a consensus However, 94.7% of activities were still acceptable as Core EPAs in family-community medicine and public health services. In conclusion, developing EPAs for undergraduate medical programs using two rounds of the Delphi method resulted in 32 individual medical service activities and 18 family medicine-community/public health tasks. These core EPAs were expected to facilitate the translation of competencies into professional activities.

The evolution of the medicine course at the Institute of Health and Biotechnology of the Federal University of Amazonas in the municipality of Coari/AM, and its current implementation status

The implementation of the medicine course in Coari-AM is a recent achievement for the city and the entire Middle Solimões region, crucial to addressing the shortage of doctors in the Northern Region, which has an average of about 1.4 doctors per thousand inhabitants across all its states, representing some of the worst indicators in Brazil. Thus, aiming to understand the history of the implementation of the medicine course at the Institute of Health and Biotechnology (ISB) in Coari at the Federal University of Amazonas (UFAM) and the current state of implementation, the objective of this work was to report the historical facts about the implementation of this course based on a substantiated analysis of the current work reality offered to the medical faculty involved. For this purpose, the perspectives of the faculty who worked on the implementation of the course were investigated, the causes leading to the attrition of medical professionals from the ISB were diagnosed, and measures were proposed to retain these professionals in this Institute. This work is justified because conducting a historical survey of the implementation of the medicine course at the ISB in Coari is necessary to obtain an accurate diagnosis of the current causes of attrition among faculty in this medical undergraduate program. As a result, it was found that for the purpose of implementing the course, only one building was constructed, but it was not equipped. There was institutional failure in developing a job profile for the hiring of faculty for this course, so only twelve professors with a medical background were hired. The same happened with administrative staff, so there are only two permanent employees specifically supporting this course.

No knowledge gap in human physiology after remote teaching for second year medical students throughout the Covid-19 pandemic

The COVID-19 pandemic had a disruptive effect on higher education. A critical question is whether these changes affected students’ learning outcomes. Knowledge gaps have consequences for future learning and may—in health professionals' education—also pose a threat to patient safety. Current research has shortcomings and does not allow for clear-cut interpretation. Our context is instruction in human physiology in an undergraduate medical program from high stakes end of term examinations. The sequence of imposed measures to slow the COVID-19 pandemic created a natural experiment, allowing for comparisons in performance during in-person versus remote instruction.In a two-factorial design, mode of instruction (in-person vs. remote) and mode of assessment (in-person vs. remote) were analyzed using both basic (non-parametric statistics, T-tests) and advanced statistical methods (linear mixed-effects model; resampling techniques). Test results from a total of N = 1095 s-year medical students were included in the study.We did not find empirical evidence of knowledge gaps; rather, students received comparable or higher scores during remote teaching. We interpret these findings as empirical evidence that both students and teachers adapted to pandemic disruption in a way that did not lead to knowledge gaps.We conclude that highly motivated students had no reduction in academic achievement. Moreover, we have developed an accessible digital exam system for secure, fair, and effective assessments which is sufficiently defensible for making pass/fail decisions.

An evidence-based approach to artificial intelligence education for medical students: A systematic review.

The exponential growth of artificial intelligence (AI) in the last two decades has been recognized by many as an opportunity to improve the quality of patient care. However, medical education systems have been slow to adapt to the age of AI, resulting in a paucity of AI-specific education in medical schools. The purpose of this systematic review is to evaluate the current evidence-based recommendations for the inclusion of an AI education curriculum in undergraduate medicine. Six databases were searched from inception to April 23, 2022 for cross sectional and cohort studies of fair quality or higher on the Newcastle-Ottawa scale, systematic, scoping, and integrative reviews, randomized controlled trials, and Delphi studies about AI education in undergraduate medical programs. The search yielded 991 results, of which 27 met all the criteria and seven more were included using reference mining. Despite the limitations of a high degree of heterogeneity among the study types and a lack of follow-up studies evaluating the impacts of current AI strategies, a thematic analysis of the key AI principles identified six themes needed for a successful implementation of AI in medical school curricula. These themes include ethics, theory and application, communication, collaboration, quality improvement, and perception and attitude. The themes of ethics, theory and application, and communication were further divided into subthemes, including patient-centric and data-centric ethics; knowledge for practice and knowledge for communication; and communication for clinical decision-making, communication for implementation, and communication for knowledge dissemination. Based on the survey studies, medical professionals and students, who generally have a low baseline knowledge of AI, have been strong supporters of adding formal AI education into medical curricula, suggesting more research needs to be done to push this agenda forward.

Implementing virtual interprofessional education (VIPE) in an undergraduate medical programme: a feasibility study

Introduction: Virtual interprofessional education (VIPE) presents an opportunity to develop interprofessional competencies in undergraduate medical students. This paper describes the feasibility of implementing VIPE in an undergraduate medical programme.
 Methods: A multiple-methods research design incorporating quantitative and qualitative elements was used to describe undergraduate medical students' experiences of an international VIPE intervention. Eleven universities and students in 14 different health professions participated in synchronous and asynchronous sessions. Forty-one medical students completed an online post-assessment survey, of which six volunteered to participate in a focus group discussion related to their VIPE experience. Descriptive statistics were used to evaluate the post-assessment survey, while inductive thematic analysis was applied for qualitative data.
 Results: The quantitative responses indicated an awareness of IPE competencies, such as role clarification, team functioning, interprofessional communication, person-centeredness and values and ethics. The focus group discussions supported the quantitative outcomes where the themes reflected the significance and influence of the educational programme, clarifying engagement and recommendations for the future of VIPE.
 Discussion: The findings of this study demonstrate the feasibility and value of VIPE as a reasonable alternative to face-to-face IPE. VIPE may have additional benefits such as cross-institutional and international engagement. This evaluation also provided valuable lessons for the more widespread implementation of VIPE.

Lecturers’ Beliefs and Perceptions on Formative Assessment and Their Practice in Training Medical Students in a Malaysian University

Introduction: Formative assessment refers to frequent evaluation of student attainment to identify learning needs. It is crucial for the development of soft skills and improvement in learning progress in the classroom. However, the practice is still lacking and undervalued in medical education. This study aims to determine the level of beliefs and perceived practices of formative assessment among lecturers teaching undergraduate medical programme in a Malaysian university. Methods: A self-administered 27-item questionnaire was distributed to 62 lecturers in a medical school in Selangor, Malaysia. They were required to indicate their agreement and frequency on each item that describes their beliefs on the importance and practice of formative assessment in the medical programme. All data was analysed using IBM SPSS Statistics software version 26. Results: Majority of the respondents indicated that the assessment was conducted frequently during small group sessions (64.5%), through written examination (59.7%) and during practical classes (53.2%). The respondents rated positively on the importance and practice of formative assessment. The score of formative assessment practice through scaffolding was significantly higher than monitoring (Z = 944.5, p < 0.001). There was no significant correlation between beliefs and practice of formative assessment (r(62) = 0.213, p = 0.097). Additionally, the duration of service had no significant association with their perception and practice of formative assessment (p < 0.05). Conclusion: The results of this study suggested that regardless of their level of experience, lecturers exhibited a positive perception of and engagement with formative assessment in training medical students. A substantial improvement of peer and self-assessment practices is warranted to foster student autonomy and accountability on their learning.

“But This Is the New Reality, and I Will Adapt”: Understanding Lecturers’ Experiences of COVID-19 Lockdown Online Learning and Teaching

Following the 2020 COVID-19 pandemic national lockdown in South Africa, the University of the Free State launched various support initiatives for academic staff and students. Teaching and learning activities and assessments were adapted for emergency remote teaching. Students and academic staff members experienced disruption due to the migration to the online environment. This study aimed to investigate the experiences of academic staff members in an undergraduate medical programme using a mixed-methods approach in the form of a sequential exploratory design in two phases. Quantitative data were obtained through an online questionnaire survey that were triangulated and complemented with qualitative data obtained from responses to open questions in the questionnaire survey and online reflective essays. Quantitative data revealed that although most academic staff members had received training in and used mostly administrative functions in the learning management system (Blackboard) prior to lockdown, its uses almost doubled during the lockdown. Qualitative data analysis gave an in-depth understanding of academic staff members’ experiences identified in the themes Teaching and Learning, Assessment, Technology, Communication, and Personal Experience. Concerns were expressed regarding students’ access to technology and adaptation to online learning, and training needs and challenges were identified. The lessons learnt through the resilient, transformative responses to this global disruptor can guide future strategies for medical education.

Blended learning in human anatomy education in undergraduate medical programmes: A review

Objective: This review aims to evaluate the trends, teaching-learning practices, strengths, limitations, and outcomes of the blended-learning approach in Anatomy education in undergraduate programmes in Medicine.Methods: An electronic search for literature was done in the MEDLINE database. Original research articles on blended learning in Anatomy, in undergraduate medical programmes, published in English, and available in full text were included, and narrative description and synthesis were done.Results: Seventeen articles were reviewed, and the majority were published in 2021 and 2022. Blended learning was used in all components of Anatomy courses with different combinations of face-to-face and online teaching-learning methods. Commonly cited benefits of blended learning were higher knowledge acquisition and consolidation, improved self-directed learning, flexibility in time, place and pace of learning, increased motivation, higher level of engagement, and more opportunities to review. The main problems were related to connectivity and interactivity during online instruction. Blended learning courses have generally improved the course outcomes in terms of students’ cognitive gain, especially at the knowledge and comprehension level.Conclusion: Several recommendations were derived from this review. These include proper needs analysis and planning, increasing awareness and provision of training to students and teachers, developing support systems for students and teachers, and continuous monitoring and review of the courses. The need for collaborative planning and development of learning material and teaching-learning activities, with appropriate quality and quantity of the content, systematic and timely delivery and regular evaluation and review were recognized. These recommendations will be useful in planning and successful implementation of blended learning in Human Anatomy courses in medical undergraduate programmes.