Opportunities For Medical Students Research Articles

IDEAL: Maintaining PHC-focused training in a MBChB programme through a COVID-induced innovation.

Responding to the need for authentic clinical training for students in the context of coronavirus disease 2019 (COVID-19), the Stellenbosch University Faculty of Medicine and Health Sciences developed an innovative 12-week longitudinal, integrated rotation for pre-final-year medical students, the Integrated Distributed Engagement to Advance Learning (IDEAL) rotation. This saw 252 students being placed across 30 primary and secondary healthcare facilities in the Western and Northern Cape provinces. With a focus on service learning, the rotation was built on experiences and research of members of the planning team, as well as partnership relationships developed over an extended period. The focus of student learning was on clinical reasoning through being exposed to undifferentiated patient encounters and the development of practical clinical skills. Students on the distributed platform were supported by clinicians on site, alongside whom they worked, and by a set of online supports, in the form of resources placed on the learning management systems, learning facilitators to whom patient studies were submitted and wellness supporters. Important innovations of the rotation included extensive distribution of clinical training, responsiveness to health service need, co-creation of the module with students, the roles of learning facilitators and wellness supporters, the use of mobile apps and the integration of previously siloed learning outcomes. The IDEAL rotation was seen to be so beneficial as a learning experience that it has been incorporated into the medical degree on an ongoing basis.Contribution: Longitudinal exposure of students to undifferentiated patients in a primary health care context allows for integrated, self-regulated learning. This provides excellent opportunities for medical students, with support, to develop both clinical reasoning and practical skills.

Six ways to get a grip on patient and family centered care during the undergraduate medical years

Patient and family-centered care and patient engagement practices have strong evidence-based links with quality and safety for both patients and health care providers. Expectations for patient and family-centered care have advanced beyond hearing the patient perspective and taking patient wishes into account. A participatory approach including patients as partners in their care journey is expected, but attitudes toward patient and family-centered care remain barriers in practice. As health service organizations shift from a system-centered approach to a patient and family-centered care delivery model, black ice occurs. In this Black Ice article, we present some practical tips for medical educators to improve opportunities for medical students to develop knowledge, attitudes, and skills that support patient and family-centered care.

Growing Medical Educators from Medical Students by Supporting Self-directing Learning Opportunities Born Out of Cadaveric Dissection

AbstractThis study focuses on a subset of medical students who participated in an anatomy dissection program and undertook an additional self-directed learning (SDL) project investigating incidental findings of cadaveric pathology. The value of SDL activity is explored as a means of enhancing medical student education, particularly its student perceived value in preparing and developing them as future medical educators. It was assessed whether the project advanced student interest in medical education by analyzing their motivations for participation. The results of the study highlight the potential of SDL as an experiential learning opportunity for medical students and the role of anatomic pathology in connecting multiple domains of medical education.

Exploring the Allen Brain Atlas with medical students in an official program of scientific training in neuropsychiatric genetics

Objective: The objective of this study is to illustrate how we introduced medical students to scientific training through the utilization of the Allen Brain Atlas (ABA) and how this endeavor resulted in significant scientific contributions presented at academic conferences, congresses, and published articles from 2013 to 2021.Methods: In this brief communication, we describe and analyze the papers authored by medical students from the Federal University of Pernambuco that were published in peer-reviewed journals using the ABA from 2013 to 2021 Results: ten papers at various medical conferences and events. Conclusion: We acknowledge the value of this initiative, which relies on open data resources and bioinformatics analysis, and we encourage others to explore similar opportunities for medical students to engage in research training.

Dynamic Opportunities for Medical Students to Assume the Roles of “Medical Teacher”

Abstract The traditional undergraduate medical education curriculum focuses on bolstering knowledge for practice and building clinical skills. However, as future clinicians, medical students will be tasked with teaching throughout their careers, first as residents and then as attendings. Here, we describe teaching opportunities for students that foster their development as future teachers and potential clinician educators. These offerings are diverse in their focus and duration and are offered across various levels of the curriculum — including course-based learning, longitudinal electives, and extra-curricular opportunities for medical students who have a passion for teaching.

A scoping review of the ethical impacts of international medical electives on local students and patient care

BackgroundInternational electives are often considered a valuable learning opportunity for medical students. Yet, as travelling to lower and middle income countries (LMICs) becomes more common, ethical considerations of such practices emerge. We conducted a scoping review to assess the extent to which five ethical themes were addressed in existing literature about electives, with the aim of investigating the ethical impacts of medical student electives on local resources, patients and clinicians in LMICs.MethodsWe systematically searched PubMed, Global Health and Embase databases using the search terms “(ethics) AND (medical electives)”. Thematic content analysis was undertaken using a combination of deductive and inductive themes. The deductive themes included: exceeding clinical competence, use of limited local resources, respect for patients and local culture, collaboration with local community/colleagues, and one-sided benefits in partnership. In addition, we also allowed for emerging themes within the data, and conducted a narrative synthesis of the results.ResultsA total of 37 papers discussed ethical issues relating to medical student international electives to LMICs. More publications were written from the medical student perspective (n = 14), than by the host-institution (n = 5), with nearly half written from third-party perspectives (n = 18). Negative impacts on local host students and impact upon patient care were identified as additional ethical considerations.ConclusionsOur review demonstrated that while there is a degree of awareness in the existing literature of the potential negative impacts of medical electives to local LMIC students’ access to medical education and patient care, continued work is needed to ensure equitable partnerships. We recommend that these ethical themes should be further explored in pre-departure elective teaching courses and post-elective debriefs to increase medical students’ awareness of the impact of their presence on host communities.

Peer-assisted Virtual Learning in Basic Surgical Skills for Medical Students in Malaysia during the COVID-19 Pandemic

Abstract Introduction: During the coronavirus disease 2019 pandemic, all in-person teachings were suspended. This includes opportunities to learn surgical skills among undergraduate medical students in Malaysia. Virtual learning became the prime modality of medical education for all Malaysian universities. InciSioN Malaysia designed and conducted an online suturing workshop to increase medical students’ exposure to surgical skills. This workshop aimed to evaluate the feasibility and the reception of such workshops for undergraduate medical students in Malaysia. Methods: All participants received a preworkshop handbook covering the basic techniques of knotting and suturing. The online workshop was 2 h and peer-led. We conducted the suturing workshop through Zoom and using a unique set-up to provide real-time skills sharing with immediate feedback. This involved connecting on Zoom with two devices from both the tutor and the participant. A smartphone to show the suturing and knotting skills and a laptop to provide tutor-to-participant feedback. Participants were divided into small peer-to-peer (PTP) teaching groups where tutors demonstrated the basic surgical skills according to the handbook. Results: All tutors’ reported challenges in orientating their equipment set-up to ensuring that their technique was visible to the participants. Few participants faced difficulties understanding the tutor’s instruction on the knotting technique. Variations in the participants’ and tutors’ camera angles and Internet connectivity issues hindered effective real-time feedback. All participants were satisfied with the knotting and suturing skills session and 80% of participants rated a score of higher than 4/5 on the overall workshop and the quality of the lecture. In the perspective of long-term outcome, participants were motivated to practice more on the knotting and suturing technique which was taught on the event day. Discussion: Online PTP surgical skills workshops can reduce the time, travel, and costs to deliver and receive surgical skills teachings. This increases the learning opportunities for medical students, especially within social distancing limitations. This can provide workshops to upskill health-care providers in remote areas. However, Internet connectivity, technical issues with meeting platforms, and camera angles limited the effectiveness of online suturing workshops. These issues can be tackled by prior testing of the orientation of the phone and checking for the speed of Internet connectivity. Participants enjoyed the small group PTP teaching as it provided a comfortable environment for immediate questions and feedback. Conclusion: Virtual skills workshop has the potential to continue surgical education and can develop an interest in surgery. More importantly, this model has the potential to reach remote areas where workshops like this are usually conducted in the cities.

Ethical Issues in the Planning and the Conduct of Escape Rooms in Medical Education.

Escape rooms in medical education are relatively a novel approach to facilitate critical thinking and decision-making in simulated realistic clinical scenarios among the medical students. The success of escape rooms in the attainment of specified competencies depends on several factors that must be given due consideration for optimizing the overall outcome. Further, there might be multiple ethical concerns that must be given due attention before, during, and after the conduct of such sessions. There is an immense need to integrate ethical considerations while designing and implementing escape rooms in medical schools, as it will aid in the creation of a respectful and encouraging learning atmosphere for the students. In conclusion, escape rooms provide a great learning opportunity for medical students to critically think, engage in teamwork, and learn the art of adaptation depending on the given clinical scenario. However, the successful conduct of such sessions is determined by a wide range of factors, including ethical considerations, and all of them need to be systematically analyzed and measures should be taken to reduce their impact on students.

Strengthening Workplace Learning in Medical and Health Profession Education: Medical Educators’ Perspective

Abstract The profession of medicine is a challenging one considering the pace with which medical knowledge continues to expand on a daily basis. The purpose of the current review was to explore the significance of workplace learning from the perspective of different stakeholders. An extensive search of all materials related to the topic was carried out on the PubMed and Google Scholar search engines, and a total of 26 articles were selected based on their suitability with the current review objectives. Keywords used in the search include workplace learning and medical education in the title alone only. The workplace offers an opportunity for medical students to apply their acquired knowledge and participate in the process of patient care. Workplace learning gives a platform for medical students to not only participate in patient care but also gradually move forward on the path to becoming an effective member of the health workforce. We must realize that it is not only the students who derive benefits from workplace learning but also the teachers who can optimize their teaching and facilitation skills. To conclude, acknowledging the scope and merits attributed to workplace learning for different stakeholders, there is a definitive need to strengthen the overall process. Medical teachers have a crucial role to play in the strengthening and reinforcement of workplace learning in different contexts, and thus, they should be supported in their task to eventually improve the quality of medical doctors that we are producing.

Investigation of the Effect of Virtual Microscopy on Pathology Education in a Medical Faculty

Aim: Virtual microscopy technology has been widely used in histopathological diagnosis and pathology education, replacing the traditional light microscope, which is considered an important visual tool in pathology education. Slides scanned and stored online for use in virtual microscopy were first described in 1985 and have experienced significant developments since 2000. In this study. The aim of this study was to determine how virtual microscopy affected medical school students' pathology education. Methods: The study included the 3rd year students of Izmir Democracy University Faculty of Medicine. The study was conducted prior to the end-of-year pathology practice exam. As a result of the scanning performed by company received support, 102 slides were selected from the training archive and virtualized. Among them, forty slides representing lesions and organs from ten different systems, were chosen. The students were divided into two groups (group 1 and 2.) and the selected slides were used as educational material. Each student was given the opportunity to study both 20 virtual and 20 microscope slides. The students in the first group (G1) examined 20 slides (M1) of the ten systems with the light microscope and the other 20 slides on the virtual microscope (S1). On the other hand, the students in the second group (G2) examined with a light microscope (M2) the slides which shown to the first group in the virtual microscope (V1); and they examined with the virtual microscope (V2) the slides which shown to the first group in the light microscope (M1). This training course was completed in approximately eight hours. For the end-of-year pathology practice exam held the next day, the students were randomly divided into 4 groups and each group was asked questions about 10 slides from 10 different systems. These questions were about the descriptive characteristics of the organs and lesions that are examined. All slides were shown to the examinees one day later. Results: Eighty-nine students in total [n:52 (58.4%) men, n:37 (41.6%) women] took part in the survey. The study found no significant difference in overall exam scores between students using traditional light microscopy and those using virtual microscopy, with average scores being 17.2±7 on a scale of 5 to 40 points. Students who examined slides using light microscopy had an average score of 8.7±4.6, while those who used virtual microscopy had an average score of 8.6±4.1. It was found that the success rates were similar regardless of whether the students used traditional microscopy or virtual reality. Yet when the results were grouped by gender, female students had higher overall (p=0.05) and light microscopy scores (p=0.001). When the groups were investigated separately, the exam scores attained were comparable in terms of from the exam content related to major system disorders did not differ between the groups. based on learning method without any statistical significance between groups. However, while group 1 students who participated in studying with light microscopy training before the exam had higher exam scores in the exam content related to bone and soft tissue pathology compared to group 2 students studying with virtual microscopy (in bone and soft tissue pathology had a mean score of 3±1.5 vs 1.2±1.7) points, virtual learners had a mean score of 1.2±1.7 points, with a statistically significant intergroup difference according to the Mann- Whitney U test (p=0.027). Conclusions: Virtual microscopy is a crucial component of medical students' pathology training in undergraduate medical education in terms of providing opportunities for medical students to see the rare cases and standardization of the training in different institutions. Particularly in undergraduate education, it is crucial for the understanding of rare cases and standardization of the pathology education. But as our study's findings on the pathology of bone and soft tissues showed, conventional light microscopy is still essential for understanding the pathology of some systems. Moreover, one's gender may affect student's capacity for virtual learning. Understanding the distinction between genders in terms of learning capacity may aid in providing students a better education.

Certified Nurse-Midwives as Teachers: Expanding Interprofessional Collaboration Learning Opportunities for Medical Students on the Obstetrics and Gynecology Clerkship.

Interprofessional experiences provide critical exposure to collaborative health care teams, yet medical students often lack this experience during clinical clerkships. We created a labor and delivery triage rotation exclusively staffed by certified nurse-midwives in the obstetrics and gynecology clerkship to address this gap. We sought to evaluate the clinical learning experiences of medical students rotating on this midwife-supervised collaborative team. Between 2018 and 2020, we electronically sent all medical students an evaluation after each required clerkship. Our primary outcome was the quality of teaching score, as defined by level of agreement on a 5-point Likert scale with a statement regarding teaching quality. A secondary outcome evaluated scores from the National Board of Medical Examiners (NBME) Obstetrics and Gynecology subject examination taken by all students at the end of the rotation. Evaluations and assessments were compared between students rotating on labor and delivery triage and those who did not. Evaluation comments from students rotating on labor and delivery triage were collated to identify common themes. Of 374 students, 370 (98.9%) completed the end-of-clerkship course evaluation and 312 (83.4%) completed teaching evaluations. Sixty-seven students (17.9%) rotated in labor and delivery triage; of these, 52 (77.6%) completed both the course and triage rotation evaluations. There were no differences in the mean quality of teaching scores (3.9 ± 1.2 versus 3.8 ± 1.2, p = 0.54) or in NBME Obstetrics and Gynecology subject examination scores between students rotating in labor and delivery triage compared to all other rotations (79.9% ± 7.2% vs 80.2% ± 7.8%, P = 0.436). Comments from teaching evaluations highlighted student exposure to the midwifery philosophy of care model. This work demonstrates the feasibility and benefits of this midwife-led authentic interprofessional collaborative experience for medical students. This model can serve as an example of how to implement and evaluate interprofessional collaboration experiences in the clinical setting.

Medical students’ perception of learning from patient encounters in primary health care; a qualitative interview study

BackgroundClinical practice gives medical students opportunities to develop clinical skills and to gain insight into their future profession as a physician. Students in the medical programme at Karolinska Institutet in Sweden had clinical practice in primary health care in nine of their 11 semesters. The aim of this study was to explore medical students’ perceptions of learning from patient encounters in a primary health care context.MethodsThe study was a qualitative inductive interview study. The 21 participating medical students were from their 3rd, 4th and 5th (final year) year of the study programme. A semi-structured interview guide was used. The data analysis was performed with qualitative content analysis.ResultsThe overarching theme of the study was: The individual patient encounters are the key to learning in primary health care. The patient encounters presented both useful opportunities and challenges that could contribute to the students’ professional development. The following four categories were found: 1. Patient encounters in are instructive, rewarding and challenging. Practising in primary health care provided experience in meeting and communicating with a wide variety of patients. Students described it being challenging to trust in their own clinical competence and feeling a responsibility towards the patients. 2. Encounters with patients in primary health care provide opportunities for gradual professional development. Students had the opportunity of increasing independence based on their level of clinical competence. They experienced a progression in their professional development after each period in primary health care. 3. A committed supervisor plays a significant role in learning. Committed supervisors who set aside time for supervision, offered support, and encouraged the student, played an important role in the student’s learning. 4. Learning in primary health care and learning in hospitals complement one another. It could be difficult for the students to sort out exactly where they learnt different things as they perceived that learning in primary health care and in hospitals complemented one another.ConclusionsThe students’ encounters with authentic patients in primary health care gave them recurring opportunities to develop communication skills and to be trusted to work on their own under supervision, giving them guidance on their way to becoming future physicians.

Investigation of Views and Experiences of Medical Interns on the Facilitating and Inhibiting Factors Affecting the Quality of Education in the Clinical Education System

Introduction: Clinical education is the most important part of medical education that provides a golden opportunity for medical students to combine their theoretical mix with the clinical environment, and this is important in the countries of the style of the arena of medicine Special attention is paid. Therefore, this study was conducted to examine the views and experiences of medical students as facilitators and inhibitors of clinical education quality.
 Methods: This is qualitative research and a phenomenological approach was used. The study population consisted of medical students of Kerman University of Medical Sciences. Target-based sampling was performed on 40 medical students. The method for collecting information was a deep interview with the participants. The data were analyzed by the Colaizzi method.
 Results: Two initial codes were extracted in the form of two main themes (facilitating and inhibiting factors) and 10 sub-themes including providing motivational patterns and creating interest in interns, the high scientific and educational level of attending professors, use of technology, authorizing more responsibility, inappropriate treatment, inappropriate educational planning, inappropriate evaluation method, low-quality mornings, lack of facilities, and overwhelming of some wards were classified.
 Conclusion: Considering these factors, it is possible to raise the quality of clinical education to the highest possible level and educate responsible and responsible physicians for generations.

Final-year medical students' reflections on types of significant events in primary care.

Adverse events are considered a universal challenge and a burden in the provision of healthcare. For that reason, significant event analysis (SEA) is a critical undertaking in primary health care (PHC), particularly in South Africa where 84% of the population relies on the public health system for their care. The study aimed to describe the types of perceived significant events medical students experienced during an integrated primary care block placement. Eighteen PHC settings included clinics, community health centres and district hospitals across three provinces in Gauteng, Mpumalanga and the North West. Using a qualitative descriptive design with purposeful sampling and maximum variation, structured reflection reports were retrieved from logbooks of final-year medical students studying at a South African university in 2014. Conventional content analysis was used to record the relevant facets of secondary data from 124 logbooks that contained a recording of a significant event using MAXQDA software version 2020.4. An iterative process revealed three major themes of significant events that were prevalent in PHC settings. These comprised medication and prescription errors, diagnostic errors and suboptimal patient management. Significant event analysis became a critical quality improvement reflective learning tool. Logbooks offered an opportunity for medical students to explore significant events as a strategic way towards addressing quality and safe practices in PHC settings.Contribution:This study demonstrated medical students' ability to identify incidents in the care of patients using the SEA approach and their role in assessing patient safety issues in PHC settings.

A Case Study of Curriculum Co-creation During a Seminar-Style Course for Senior Medical Students.

Opportunities to learn about education theory underpinning medical education are limited in both undergraduate and graduate medical education and predominantly focus on "student as teacher." Key components of education theory relevant to medical education, including learning theory, curricular design, and assessment design, are rarely included in student-as-teacher training. Opportunities for medical students to co-create curricula with faculty are scarce. We present the case study of a month-long, seminar-style course titled, Applications and Foundations of Education in Medical Education. We describe the course, report student feedback, and identify the value of curriculum co-creation expressed in student reflections. The course was designed by a faculty member with formal medical education training; students co-created their own learning outcomes through self-selected articles and personal reflections on the topics: How do people learn; what is the best way to teach; what is a curriculum; and how should students be assessed? Forty-seven post-clinical students completed the course; 28 completed course evaluations. They strongly agreed that the class met its stated goals (4.89/5) and that faculty teaching (4.93/5) and supervision (4.93/5) were appropriate. Themes from student reflections expressed that the co-creation process was insightful about the profession itself, from the perspective of their own participation in learning how to become a member of the profession. This course offered a unique opportunity for medical students to learn medical education beyond the skill of teaching. The course allowed deep immersion into current literature and offered the chance to plan and execute one's own learning.

Medical Students as Educators: Addressing Teaching Skills Through a Pre-clerkship Development Group.

In medicine, effective teaching is requisite for both successful patient care and trainee development. However, opportunities for medical students to gain exposure to pedagogical principles and hone teaching skills are currently limited. Our initiative provides avenues for medical students to intentionally develop their teaching skill set from an early stage.

1170 An Experience of Arranging the UK’s First Free Robotic Surgery Workshop for Medical Students and Doctors Early in Their Careers

Abstract Aim Training opportunities for Robotic Surgery training are very competitive and expensive in the era of parallel training with consultants also in a learning phase. We share our experience of providing a free Robotic Surgery workshop to medical students and junior doctors under the umbrella of Association of Surgeons in training (ASiT). Method The course was organised as a collaboration between ASiT and Intuitive Surgical at Leicester General Hospital Educational centre. Dedicated opportunities were designed for device training, theory, and DaVinci XI console and simulator stations. Training was provided by a Robotic Surgery Fellow and Technical team from Intuitive on voluntary basis. No fees were charged for the course. Results 48 Delegates applied for registration. 23 were shortlisted into four groups. 13 medical students and 10 doctors were in attendance. Each Delegate was provided a dedicated time of at least 20 minutes on each station. Delegates had an opportunity to use the Console and Simulator for training exercises. Feedback from the course was resoundingly positive. To our knowledge this was the 1st free Robotic Surgery course in UK providing hands on experience to medical students and junior doctors. Conclusions Our experience of organizing a “Free Robotic Surgery Workshop” may be utilised nationally to increase training opportunities for medical students and junior doctors.

Hybridizing video-based learning with simulation for flipping the clinical skills learning at a university hospital in Pakistan

BackgroundWhile learning and practicing on actual patients is a major mode of teaching clinical skills, concerns about patient safety, unavailability, and lack of standardization have led to the development of simulation for medical education. Simulation-based teaching is affected by challenges such as lack of protected time for faculty, inexperienced learners, and the number of students per group. These have led to the integration of various eLearning formats in the curriculum. The hybridized format changes the traditional clinical skills teaching into the flipped classroom. This study aims to measure the effectiveness of hybridizing video-based learning with simulation for flipping the clinical skills teaching of fourth-year medical students at the Department of Paediatrics and Child Health at Aga Khan University, Pakistan.MethodsThe study employed a mixed-methods design. Fourth-year medical students of the batch 2020-21 (n = 100) consented to participate in the study. The quantitative component focuses on identifying the effect of the intervention on the perceived self-efficacy of medical students (batch 2020-21) relevant to the clinical skill. Along with this, the performance of the intervention batch of 2020-21 on the end of clerkship objective structured clinical exam (OSCE) was compared with the previous batch of 2019-20, taught using simulation alone. Focused group discussions (FGDs) were used to explore the experiences of medical students (batch 2020-21) about the intervention. Quantitative data underwent descriptive and inferential analysis using Stata v16 while qualitative data underwent content analysis using NVivo software.ResultsHybridization of video-based learning with simulation significantly improved self-efficacy scores for all examinations (cardiovascular, respiratory, neurological, and abdomen) with p-value < 0.05. OSCE scores of the intervention group were significantly higher on the neurological and abdominal stations as compared to the previous batch (p-value < 0.05). In addition, the overall structure of the intervention was appreciated by all the students, who stated it allowed reinforcement of basic concepts, retention, and further insight into clinical applications.ConclusionThe hybridization of video-based learning with simulation facilitated in creation of better opportunities for medical students to revive their prior knowledge, apply core concepts for the problem and engage in clinical reasoning.

Examining the Growing Demand for Surgical Care in Rural Communities and Novel Approaches to Achieving a Sustainable Surgical Workforce: A Narrative Review.

Surgery continues to be an increasingly vital component of public health and aspect of patient care in rural communities. An anticipated shortage of surgeons within the next decade in the United States prompts a growing concern for increasing the delivery of essential surgical care to these populations. When considering the existing barriers to surgical healthcare in rural communities, there is a sense of urgency to identify innovative approaches that will promote a sustainable surgeon workforce.A narrative review was conducted to investigate the current state of access to essential surgical care in rural communities. Qualitative and quantitative data were collected to better understand the key issues in rural healthcare and to provide statistical data related to the status of the surgical workforce. With the anticipated shortage of surgeons in both rural and urban areas, this review highlights the importance of enacting immediate measures to address the concern. This review has accomplished the initial objectives of gaining a better understanding of the current state of access to surgical care in rural communities and utilizing this knowledge to provide recommendations to readily attain a sustainable number of rural surgeons. With each approach addressing ways to address the contributory issues to the surgeon shortage, this review reveals a new avenue of integrating valuable aspects from each approach, rather than relying on a single approach. In particular, enhancing the overall pipeline of medical training to attending status may prove to be more beneficial for achieving this goal. Ultimately, this may be accomplished by introducing additional rural surgical mentorship opportunities for medical students, developing a rural surgery fellowship, and incorporating a market-based response that will correspond to attractive incentives that help to retain a sustainable number of surgeons working in rural areas.

Reflective writing in social sciences: challenges and opportunities for medical students

ABSTRACT An application of Bologna Process parameters in the classroom setting requires new skills on the part of students. One of these significant skills is the ability to reflect upon one’s learning path, which provides an opportunity for students to enhance their knowledge, and, moreover, make pivotal changes in their professional field. Thus, students would benefit greatly from reflective learning skills being harnessed at the early stage of their learning. Aim. This study aims to explore students’ reflections and interpretations of their learning through writing essays. Methodology and research methods. This study employed a survey design with open-ended questions in which 14 out of 23 students participated. In addition, two individual inter-views were conducted, and 345 weekly essays and 23 final student reflections were analyzed. Results. Research results found that over 50% of respondents indicated that they had ac-quired reflective skills as they reflected on their content learning and writing and reading skills. Indeed, 96% of respondents demonstrated a positive understanding of the structure of the essay; however, their reflections remained at the descriptive level, in contrast to an expected change in their learning approach.