Medical Education Process Research Articles

Integrated curriculum and the change process in undergraduate medical education

Introduction: This study is aimed at explaining the change process followed for the implementation of the new curriculum at Avalon University School of Medicine and its evaluation.Background: Self-evaluation at Avalon University School of Medicine identified the need for a change in the curriculum. The main reasons for the change are isolated disciplines and overcrowded curriculum leading to less self-study time for students. The new curriculum is aimed to have an integrated curriculum and to avoid redundancies. The new curriculum is designed, implemented, and evaluation of the same is in place.Evaluation methods and materials: After implementation, quantitative (results from exams) and semi-quantitative (self-administered questionnaire) evaluation methods are being used to evaluate the new curriculum. Feedback is also taken by having discussions with teachers and students to find out what they like and where modifications are needed. In this article, we are presenting the results of course evaluations (semi-quantitative methods) for two courses. The course evaluations were taken from the sample class size of 30 students.Results and discussion: The course evaluations demonstrated an improvement. The main reason for the improvement is due to collaborative efforts of the faculty members from different disciplines in teaching, assessments, and providing feedback to the students.Conclusions: The well-approached change process is required for the successful implementation of the new curriculum. The idea of ownership among all stakeholders is required for a well-managed change process.

Due Process in Medical Education: Legal Considerations

Throughout the medical education continuum, some students encounter difficulty in meeting academic or professional standards that leads to remediation or dismissal. Termination of a student without due process may lead to litigation by deprivation of a student’s property or liberty interest. This article outlines the concept of procedural and substantive due process as applied to litigated student dismissal cases in undergraduate and graduate medical education. Determination of the amount of due process owed is based on whether the dismissal is academic or nonacademic. The decision to dismiss a student where the entire student record has been reviewed, due process provided, and the institution complied with its own policies is usually upheld by the courts in litigation.

Формування професійної ідентичності майбутніх молодших спеціалістів сестринської справи на засадах деонтологічного підходу

The most important stage of the scientific analysis of professional training future junior specialists of nursing (JSN) with a purpose of formation the professional identity on the bases of deontological approach for them is pedagogical experiment, which is one of the most effective ways of objective verification of validity of the research hypothesis. The article deals with the course and results of experimental work directed on formation the professional identity of future JSN on the bases of deontological approach. The stages of the pedagogical experiment (analytical, ascertained, forming and final) are considered. The research-experimental work on verification of effectiveness of pedagogical conditions and structural-functional model of formation the professional identity of future JSN on the bases of deontological approach was conducted in the period since 2015 till 2018 years of study in Chortkiv State Medical College of Ternopil region, Arsen Richynskyi Kremenets Medical School, Rivne State Basic Medical College and Haisyn Medical College. The pedagogical monitoring of formation the professional identity of future junior specialists of nursing on the bases of deontological approach is implemented with a use of diagnostic methods complex, which gave the opportunity to study the process and results of phased development of all professional identity components and to observe its dynamic of formation among students. The integrity and efficacy of the criterion-diagnostic apparatus, which was used for verification of level of formation the professional identity, provided with the phased formation of its components according to their indicators, accumulates in itself separate indicators in the best way, including author’s ones, and makes possible the full reflection of the process of formation the professional identity of future JSN on the bases of deontological approach in medical college educational process. The level of formation the professional identity of future junior specialists of nursing was determined by value-semantic, cognitive-communicative, subjective-activity, emotional-reflexive criteria.

STUDENTS’ PERSPECTIVE OF A COMPETENT MEDICAL TEACHER: A QUALITATIVE STUDY

Background: Current experience shows that at the end of the medical education process, there is relative lack of knowledge, skills, communication, and attitude which are necessary for an effective young doctor. It is the gap in medical teaching. Competency of medical teacher plays an important role in transforming the young medical student into an efficient young doctor to meet this gap. Objectives: To formulate the students’ perspective of a competent medical teacher. Materials and Methods: Qualitative descriptive study was conducted using focus group discussions. The study participants were consented medical students. Results: The transcribed text data were subjected to conventional content analysis and identified 278 meaning units. These codes were categorized and eight themes were generated regarding the students’ perspective of a competent medical teacher. They are good communication skill, adequate knowledge, attitude to demonstrate, concern for students, teaching skill, professional development, personal qualities, and interpersonal skill. Conclusion: The findings of this study can be discussed in teachers training activities under medical education units which may help to bring out attitudinal change and skill development among the medical teachers.

ACCIOLOGICAL ASPECTS OF IMPROVING MORAL-ETHICAL QUALITIES OF THE FUTURE DOCTOR

The author analyzes the problem of upbringing the moral and ethical qualities of the future doctor through the prism of the value perception of professional requirements, reveals the tasks of educational influence on the student in the educational process, ensures the formation of a humanistic, professionally verified system of values as a basis for perfect moral choice in professional activity. With the purpose of research, the criteria (motivational-value, cognitive, procedural-analytical) and levels (elementary, low, medium, high) education of the moral and ethical qualities of the future doctor, which can be achieved in the educational process of medical education, are described and described. requirements for professional activities in the field of medicine. The means of the confirmatory experiment noted how stable the pattern of positive dynamics of education of moral and ethical qualities of future physicians from the first to the graduation course, which was achieved by the traditional means of organizing the educational process in higher education, which allows us to conclude that the orientation of professional training for the education of each student as highly moral, conscious regarding his professional duty of the individual. As a direction of further research, a hypothesis was formulated in relation to the growth of the established dynamics, provided that the future system of exercises that include the axiological aspect of the education of moral and ethical qualities is included in the humanitarian training of future physicians.

Exploring the experience of postgraduate students in their transition from a health science to an educational scholarship in an African university setting

Calls have emerged to improve the medical education process through scholarly teaching and education research. Little is known about the development as health professions educators of students enrolled in postgraduate Master’s-level programmes in an African context. This study explored the first-year experiences of students enrolled in the MPhil in Health Professions Education (HPE) at the University of Stellenbosch. The study confirms that Scholarship for Teaching and Learning (SOTL) for postgraduate students entering the health profession education paradigm from a health science background is challenging and provides pointers to advance SOTL in the South.
 
 How to cite this article:
 SMIT, Liezl; MEYER, Rhoda; CRAFFORD, Ilse; PARRIS, Dianne. Exploring the experience of postgraduate students in their transition from a health science to an educational scholarship in an African university setting. Scholarship of Teaching and Learning in the South, [S.l.], v. 1, n. 1, p. 78-90, sep. 2017. Available at: <http://sotl-south-journal.net/?journal=sotls&page=article&op=view&path%5B%5D=14>. Date accessed: 12 sep. 2017.
 
 This work is licensed under the Creative Commons Attribution 4.0 International License.To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

Investigation of strategy for improving clinical practice teaching quality in the department of gastrointestinal surgery

As the key phase for medical students to be doctors, clinical internship plays a vital role in the whole medical education process. Interns in the department of gastrointestinal surgery face series of difficulties, such as wide variety of diseases and emergence of new technology and new concepts. In addi-tion, because of the uneven levels of teachers and low enthusiasm of interns, the result of clinical practice teaching is not satisfactory. Based on the above-mentioned problems, measures have been introduced during the process of clinical practice teaching, including selection of typical diseases and surgical procedures, construction of clinical practice teaching team, adoption of pluralistic teaching methods, reinforcement of participation of interns during the clinical practice. Finally, the quality of teaching in our department has been improved significantly. Key words: Department of gastrointestinal surgery; Clinical practice; Teaching

医師・看護師養成プロセスにおけるメンタルヘルス調査 : 自殺予防プログラムの構築を目的として

医師・看護師養成プロセスにおけるメンタルヘルス調査 : 自殺予防プログラムの構築を目的として

Comparison of Electronic Learning Versus Lecture-based Learning in Improving Emergency Medicine Residents' Knowledge About Mild Induced Hypothermia After Cardiac Arrest.

BackgroundThe process of medical education depends on several issues such as training materials, students, professors, educational fields, and the applied technologies. The current study aimed at comparing the impacts of e-learning and lecture-based learning of mild induced hypothermia (MIH) after cardiac arrest on the increase of knowledge among emergency medicine residents.MethodsIn a pre- and post-intervention study, MIH after cardiac arrest was taught to 44 emergency medicine residents. Residents were randomly divided into 2 groups. The first group included 21 participants (lecture-based learning) and the second had 23 participants (e-learning). A 19-item questionnaire with approved validity and reliability was employed as the pretest and posttest. Then, data were analyzed with SPSS software version 17.0.ResultsThere was no statistically significant difference in terms of the learning method between the test scores of the 2 groups (P = 0.977).ConclusionsE-learning and lecture-based learning methods was effective in augmentation of residents of emergency medicine knowledge about MIH after cardiac arrest; nevertheless, there was no significant difference between these mentioned methods.

ВПРОВАДЖЕННЯ ДИСТАНЦІЙНОЇ ОСВІТИ НА КАФЕДРІ СІМЕЙНОЇ МЕДИЦИНИ І ТЕРАПІЇ

Мета дослідження – аналіз педагогічної ефективності курсів передатестаційного циклу для лікарів з фаху “Загальна практика – сімейна медицина”, що проводилися на базі кафедри сімейної медицини і терапії навчально-наукового інституту післядипломної освіти та на філії кафедри у м. Кременчук.Матеріали та методи дослідження. Оцінка ефективності використаних педагогічних технологій проводилася наприкінці циклу шляхом проведення тестування за допомогою ліцензованої комп’ютерної програми “Elex” (пропонувалося 150 питань 2-3 рівня складності з відповідного фаху) і шляхом перевірки опанування практичних навичок згідно зі стандартизованими картами практичних навичок та підведення підсумків з анонімним анкетуванням. Важливою особливістю навчального процесу в галузі післядипломної медичної освіти також є тісне поєднання теоретичної та практичної підготовки фахівців, тому велике значення має саме комплексність навчання: використання дистанційних форм на етапі теоретичної підготовки та відпрацювання практичних навичок на клінічних базах стажування. Це є переконливим поясненням наявності заочної частини навчання та пояснює перевагу дистанційної освіти, коли слухачі віддалені від бази навчального закладу. Дистанційні форми освіти не можуть існувати самостійно та використовуються у поєднанні з класичними формами навчання.Результати й обговорення. Показана ефективність використання дистанційних форм навчання за даними результатів тестування та опанування практичних навичок.Висновки. Дистанційна освіта на післядипломному етапі навчання лікарів-інтернів та лікарів-курсантів є самостійна цілеспрямована робота з використанням сучасних інформаційних технологій, ефективність якої залежить від методологічно структурованого викладачем процесу та інформаційно-комунікаційних можливостей вищого навчального закладу. Надані рекомендації щодо впровадження елементів дистанційного навчання в практику роботи Навчально-наукового інституту післядипломної освіти.

Effect of Virtual Social Networks on Nursing Students’ English Learning

Introduction Development of new virtual technologies has evolved teaching-learning process. As for the technologies, it can be refered to the use of virtual social networks in education. The current study aimed at exploring the effect of using virtual social networks on nursing students’ English learning. Methods The current study employed pretest-posttest plan with control group. The research population consisted of all nursing students of Malayer nursing school, Malayer, Iran, in 2015-2016, among which 30 students were selected by available sampling method, and then, randomly assigned to the control and experimental groups. Instruments used in the research consisted of learning tests (pretest with 0.87 reliability and posttest with 0.89 via test-retest and confirmation of formal validity by English teachers as experts). Paired t test was employed to analyze data by SPSS version 18. Results The research findings showed that the learning level of students who learned English via virtual social networks was more than that of students who learned it traditionally (t = 14.30 and plusmn; 2.48, P = 0.001). Conclusions Given the effect of virtual social networks on nursing students’ English learning, it is recommended to use this teaching technique in the teaching-learning process of medical education.

Bridging the Health Data Divide.

Fundamental quality, safety, and cost problems have not been resolved by the increasing digitization of health care. This digitization has progressed alongside the presence of a persistent divide between clinicians, the domain experts, and the technical experts, such as data scientists. The disconnect between clinicians and data scientists translates into a waste of research and health care resources, slow uptake of innovations, and poorer outcomes than are desirable and achievable. The divide can be narrowed by creating a culture of collaboration between these two disciplines, exemplified by events such as datathons. However, in order to more fully and meaningfully bridge the divide, the infrastructure of medical education, publication, and funding processes must evolve to support and enhance a learning health care system.

ПРО ОНОВЛЕННЯ “ІНФОРМАЦІЙНОЇ СИСТЕМИ ПЕРЕВІРКИ ЗНАНЬ У МЕДИЧНІЙ ОСВІТІ”

Розглянуто деякі аспекти інформатизації галузі медичної освіти. Показано необхідність оновлення програмного забезпечення ІСПЗМО при внесенні змін у методику проведення семестрового іспиту. Розроблено методику оновлення ПЗ ІСПЗМО, що полягає в створенні окремої підсистеми обробки результатів оцінювання тестових робіт студентів та усної співбесіди. Наведено приклад реалізації вказаної підсистеми у складі ІСПЗМО, як веб-додатка – ІС CSE. Показано практичну методику реалізації вказаного веб-додатка на мові програмування PHP з використанням відкритого веб-фреймворку Laravel.

Funding of Graduate Medical Education in a Market-Based Healthcare System

The graduate medical education (GME) process in the United States is considered the most respected model for high-quality education of graduate physicians in the world. With substantial funding through government and private insurers and through structured educational accreditation standards, the American Board of Medical Specialists–certified physicians are recognized for their expertise in delivering high-quality medical care. However, under fiscal constraints and changing social expectations, questions are continually posed about the process of funding and whether the “physician outcomes” are sufficient to continue with the investment. This article reviews the history of postgraduate physician education, the multiple funding pathways, disruptions to a placid educational system and changing social expectations. The ultimate issues involve the core goals of GME and how much GME should shoulder responsibility for changing the healthcare system.

Analysis of educational research at a medical faculty in Germany and suggestions for strategic development - a case study.

Background: Evidence-based medical education is playing an increasingly important role in the choice of didactic methods and the development of medical curricula and assessments. In Germany, a growing number of educational research projects has accompanied an ongoing change in the medical education process. The aim of this project was to assess medical education research activities at one medical faculty to develop procedural recommendations for the support and development of best evidence medical education.Methods: Using a newly developed online questionnaire, the 65 institutes and departments of the medical faculty of Hamburg University at Hamburg University Medical-Center (UKE) were asked to report their medical education research and service projects, medical education publications, medical education theses, financial support for educational projects, and supportive structures that they would consider helpful in the future. The data were grouped, and a SWOT analysis was performed.Results: In total, 60 scientists who were involved in 112 medical education research publications between 1998 and 2014 were identified at the UKE. Twenty-five of them had published at least one manuscript as first or last author. Thirty-three UKE institutions were involved in educational service or research projects at the time of the study, and 75.8% of them received internal or external funding. Regular educational research meetings and the acquisition of co-operation partners were mentioned most frequently as beneficial supportive structures for the future.Conclusion: An analysis to define the status quo of medical education research at a medical faculty seems to be a helpful first step for the development of a strategy and structure to further support researchers in medical education.

A ordem dos fatores altera o produto. Reflexões sobre educação médica e cuidados paliativos

«Curar algumas vezes, aliviar com frequência, confortar sempre». Essa clássica afirmação, que resume a função do médico, apresenta‐se numa ordem que encerra um equívoco educacional importante. O que se pode esperar quando a ordem recomendada para a atuação do médico é curar, aliviar e, em último caso, confortar? O lógico é pensar que se avança do mais importante para o detalhe. Quando não se consegue curar é preciso aliviar; e quando o alívio não é possível, resta providenciar conforto. Proceder nessa sequência fatalmente apresenta o alívio e o conforto como um prêmio de consolação para o médico que se deparou com uma doença incurável, dolorosa, terminal. O produto resultante desse processo equívoco – o médico – apresenta deficiências importantes. O autor faz uma extensa reflexão sobre a formação humana e técnica do médico. Inicia‐se com as advertências que chegam do paciente, aborda o tema do erro médico, para adentrar‐se no terreno necessário do sofrimento e da morte, cenários que o médico deve palmilhar na sua formação porque farão parte da sua atuação profissional. Adverte, a seguir, como assumir a postura correta nesse cenário requer uma antropologia médica de caráter prático, impregnada de valores filosóficos e perpassada pela ética. A reflexão desemboca sobre a medicina como ciência e arte que, também, facilita a prática dos cuidados paliativos com a competência requerida. A modo de conclusão, o autor propõe um giro hipocrático‐copernicano na educação médica, para evitar esse equívoco que rende importantes deficiências formativas. Enquanto confortar é algo que deve ser feito sempre, pela altíssima prevalência, o curar apresenta uma prevalência muito menor. O processo da educação médica deve contemplar essa proporção para produzir melhores médicos. Médicos que sempre sabem confortar e que, segundo os casos e as moléstias com as que se deparam, também sabem curar quando é possível. Quer dizer, a ordem dos fatores altera o produto. A introdução dos cuidados paliativos de modo formal no curriculum médico facilitará alterar a ordem desses fatores. “To heal sometimes, to relieve frequently, to comfort always.” This classic statement, summarising the doctor's role, is presented in a sequence that leads to an important educational error. What can be expected when the recommended order for the doctor's role is to cure, relieve and, ultimately, comfort? The logic is to think that we move from the main issue to the lesser one, to the details. When healing is not possible it can at least be relieved, and if it cannot be relieved, providing comfort still remains. To proceed in this sequence inevitably presents relief and comfort as a consolation prize to the doctor who was faced with an incurable, painful, and terminal disease. The resulting product of this process misconception ‐the physician‐ has important deficiencies. The author makes an extensive reflection on human and technical aspects of medical education. The reflection starts with the warnings coming from the patient, the doctor's mistakes, and enters into the necessary land of suffering and death, those scenarios that doctors should learn in their training, as they will be part of their professional activities. To assume the correct posture in this scenario requires a practical medical anthropology, imbued with philosophical values, and permeated by ethics. The reflection then leads to medicine as a science and art that also leads to the practice of palliative care with the required competence. As a conclusion the author proposes a Hippocratic‐Copernican shift in medical education, to avoid this misconception that yields important training deficiencies. While comfort is something that should always be given due to its high prevalence, the cure has a much lower prevalence. The medical education process should include this ratio to produce better doctors. Doctors must always know how to comfort and, depending on the circumstances and the diseases with which they encounter, they also should heal when cure is possible. That means, the order of the factors changes the product. The introduction of Palliative Care in the medical curriculum could facilitate change in the order of these factors.

Selecting the Best and Brightest: A Structured Approach to Orthopedic Resident Selection

Resident selection is integral to the graduate medical educational process and the future of our profession. There is no consensus among residency directors as to how to systematically and consistently screen and select applicants who would perform well as residents. The purpose of this study was to introduce and assess a high volume application screening tool and semistructured interview process. This study took place in an academic orthopedic surgery department over 2 years (2013-2014). Overall, 1382 applications were screened in 7 categories, with a maximum score of 100. A total of 14 faculty reviewed applications; 218 interviews were offered; 165 applicants accepted the interview. Overall, 4 interview domains (cognitive, affective, activities, and theme), and an impression score were ranked from 1 (Exceptional) to 6 (Concern). Each room had an assigned "theme" (ethics, affective, cognitive, research, and "fit") with standardized questions. A summary score was generated of all scores to determine the preliminary rank list; the final rank list was determined after group discussion. Correlation between preliminary rank, final rank, and screening scores were assessed. The average screening score was 62.5 (range: 0-100, median = 64). The average interview score was 69.5 (range: 32.24-95.0). Final rank lists correlated most highly with initial rank (0.912, p < 0.001), impression (0.847, p < 0.001), and affective domain (0.834, p < 0.001). Cognitive domain (0.628, p < 0.001) and screening scores (0.264, p < 0.001) less highly correlated with final rank position. A systematic approach was used to screen and evaluate a large number of orthopedic surgery applicants. Our system demonstrated excellent feasibility, reliability, and predictability for the final rank list.

Some aspects need to focus on in humanistic quality education of undergraduate clinical medical students

The humanistic quality education of undergraduate clinical medical students is a system of education throughout the whole process of medical education. Some aspects include new career planning education, medical humanities quality courses, social practice, professional courses, clinical practice and evaluation of humanistic quality education need to design and control, which are necessary to achieve a good education results. Key words: Clinical medicine; Undergraduates; Humanistic quality education; Aspect

Medical Oaths and Their Educational Impact

Current health system put different tasks on physicians. Alongside with this change, medical education also becomes more sophisticated and the humanistic features of medicine undermined. However, it should be pointed out that the professional commitment of a physician and his/her primary duty is caring for the patients. Although changes in the health care system have affected the physician’s roles, this primal commitment mentioned as the primary task of the medicine as a profession. Besides, nowadays, physicians, patients, and members of the society have come to believe that medicine and especially its physician-patient relationship component is under threat, and virtually all have concluded that any action to address the issue must include a major educational initiative. (R L. Cruess, S R. Cruess &Yvonne Steinert eds. Teaching Medical Professionalism. 2009, Cambridge University Press) On the other hand, usually duties and responsibilities show themselves in the form of national and international codes and statements. Therefore a professional code could be seen as a set of ethical rules, values and standards that specify the jurisdiction and responsibilities of the members of that profession. That is why the professional code is also called rules governing the professional responsibilities. In the medical history since about four centuriesBC, emphasis on the obligations of a physician and his essential competencies was importantand has been discussed in philosophical and medical literature. For example, taking an oath based on the textof the Hippocratic Oath or the like, with its stresses on professional commitment and ethical responsibilitiesis still accepted as a part of the medical education or graduation process all over the world. Over the years, these ethical codes have been reviewed and revised and in each period have specified standards of the medical profession.

ОРГАНІЗАЦІЯ НАВЧАЛЬНОГО ПРОЦЕСУ У ВИЩИХ НАВЧАЛЬНИХ ЗАКЛАДАХ МІНІСТЕРСТВА ОХОРОНИ ЗДОРОВ’Я УКРАЇНИ В УМОВАХ ВПРОВАДЖЕННЯ ЗАКОНУ УКРАЇНИ “ПРО ВИЩУ ОСВІТУ” (ЗА ПІДСУМКАМИ МОНІТОРИНГУ В 2016 р.)

&lt;p class="1reziume"&gt;У статті наведено результати моніторингу стану організації навчального процесу у вищих медичних та фармацевтичних навчальних закладах і закладах післядипломної освіти, підпорядкованих МОЗ України, в 2016 р. &lt;/p&gt;